Serum paraoxonase 1 and 3 activities in benign and malignant diseases of the prostate and changes in levels following robotic-assisted laparoscopic radical prostatectomy

Background/aim: This study aimed to examine serum paraoxonase 1 and 3 (PON1 and PON3) activities in benign and malignant diseases of the prostate, to determine lipid profile and malondialdehyde (MDA) levels, and to investigate changes in levels following robotic-assisted laparoscopic radical prostatectomy (RALRP). Materials and methods: A total of 137 patients, including a control group, were enrolled in the study and assigned into four groups. Group 1 (n = 33) consisted of patients previously undergoing RALRP with no recurrence, group 2 (n = 36) consisted of patients diagnosed with prostate cancer (PCa) and undergoing RALRP, and group 3 (n = 34) consisted of patients diagnosed with benign prostatic hyperplasia. The control group (n = 34) consisted of healthy individuals. Serum low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride, cholesterol, prostate-specific antigen (PSA), PON1, PON3, and MDA values were measured. In addition, group 2 MDA, PON1, PON3, and PON1/HDL levels were investigated preoperatively and at the first month postoperatively. Results: Significant changes were found in PON1, PON3, and MDA levels. PON1 and PON3 levels decreased significantly in patients with PCa, while MDA levels increased. PON1 and PON3 increased postoperatively in the PCa group, while MDA decreased. BPH group PON1, PON3, and MDA levels were higher than those of the control group. Conclusion: An increase in free oxygen radicals in the body or a decrease in endogenous antioxidant enzyme levels can result in malignant and benign diseases of the prostate. Surgical excision of malignant tissue in PCa causes a decrease in oxidative stress.

The combination of AroCell TK 210 ELISA with Prostate Health Index or prostate-specific antigen density can improve the ability to differentiate prostate cancer from noncancerous conditions.

BACKGROUND: Prostate-specific antigen (PSA) is an established tumour marker for prostate cancer (PCa). Serum thymidine kinase 1 is a possible new marker for the detection of PCa. The aim of the study was to investigate the diagnostic value of the AroCell TK 210 enzyme-linked immunosorbent assay (ELISA) together with free PSA, [-2]proPSA, and Prostate Health Index (PHI) in differentiating PCa from benign urological conditions. METHODS: Serum samples from 140 patients with PSA values in the range between 2 and 10 µg/L were collected at the Ljubljana University Medical Centre and the Maribor University Medical Centre. Thymidine kinase (TK1) protein levels were determined using the AroCell TK 210 ELISA and PSA-related parameters analysed with commercial assays. RESULTS: Serum TK1 protein, total and free PSA, proPSA, PSA density (PSAD), and PHI levels in patients with confirmed PCa were significantly higher than in patients with benign urological conditions (P < 0.05). Overall, the AroCell TK 210 ELISA results showed a significant correlation with PHI ( r = 0.25, P = 0.0031). Receiver-operating characteristic curve analyses were used to compare the area under the curve (AUC) of TK 210 ELISA, PHI, and PSA density. For PHI, the AUC was 0.73, comparable to those of TK 210 ELISA (0.67) and PSAD (0.66), with no significant differences in pairwise comparisons (PHI vs TK 210 ELISA P = 0.32, PHI vs PSAD P = 0.24, and TK 210 ELISA vs PSAD P = 0.95). The AUC for the combination of TK1 plus PSAD was significantly higher than those for the individual PSA-related biomarkers and marginally PHI, while the AUC for the combination of TK1 plus PHI was significantly higher than those for the individual PSA-related biomarkers except for PHI and marginally for PSAD. Total PSA concentration was the only marker, that was significantly higher in patients with an increasing Gleason grade. CONCLUSIONS: These results suggest that TK1 protein determinations together with PHI or PSAD could be a valuable additional tool in PCa management.

Is There A Relation Between Serum Uric Acid Values and Prostatic Calculi Presence?

OBJECTIVE: We planned to examine the connection between serum uric acid (UA) values and prostatic calculi (PCal) presence and to evaluate the relation between PCal and other etiological factors. METHODS: Patients between 20 and 60 years of age who were referred to the clinic with any reason and had non-contrast abdominal tomography (NCACT) for PCal were included in the study. While the patients were separated into 2 groups based on their serum UA level as ≥7 mg/dL (Group 1) and < 7 mg/dL (Group 2), NCACT was also divided into 2 groups as PCal presence (PCal+) and lack (PCal-) serum UA, calcium, phosphorus, sodium, prostate-specific antigen levels and urinary analysis results of the patients were evaluated and compared. RESULTS: PCal were detected in 38 of 169 patients (22%). PCal presence was detected to be significantly high in Group 1 (p = 0.015). While Type A localization PCal were present both in Groups 1 and 2. Based on PCal presence, UA level was detected to be significantly high in PCal+ patients (p = 0.01). No significant difference was detected among the groups in biochemical parameters and urine-related parameters other than UA. CONCLUSION: A significant relation was found between high UA value and PCal in this study. These results may show that UA plays an active role in PCal etiology.

[Clinical value of contrast-enhanced ultrasonography in the diagnosis of prostate cancer in patients with different PSA concentrations].

OBJECTIVE: To investigate the clinical value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of prostate cancer in patients with different concentrations of prostate-specific antigen (PSA). METHODS: Based on the PSA concentration, 186 patients were divided into three groups (PSA 4－10 µg/L, 11－20 µg/L, and >20 µg/L) and underwent transrectal CEUS and biopsy. We compared the pathological results with the CEUS features in different groups of patients and performed a statistical analysis on the characteristics of the CEUS manifestations of prostate cancer and benign prostatic lesions. RESULTS: Of the 186 patients, 118 (63.4%) were diagnosed by biopsy with prostate cancer and the other 68 (36.6%) with benign prostatic lesions. The positive rate of CEUS in the diagnosis of prostate cancer was above 95% in all the three groups, significantly higher than that of conventional ultrasound in the PSA 4－10 and >10－20 µg/L groups (P <0.01). CONCLUSIONS: Contrast-enhanced ultrasonography can achieve a high detection rate in the diagnosis of prostate cancer, especially for the patients with a low PSA concentration, and therefore can be used as one of the most valuable diagnostic techniques for this purpose.

Association between age-related reductions in testosterone and risk of prostate cancer-An analysis of patients' data with prostatic diseases.

The relationship between serum total testosterone and prostate cancer (PCa) risk is controversial. The hypothesis that faster age-related reduction in testosterone is linked with increased PCa risk remains untested. We conducted our study at a tertiary-level hospital in southeast of the USA, and derived data from the Medical Registry Database of individuals that were diagnosed of any prostate-related disease from 2001 to 2015. Cases were those diagnosed of PCa and had one or more measurements of testosterone prior to PCa diagnosis. Controls were those without PCa and had one or more testosterone measurements. Multivariable logistic regression models for PCa risk of absolute levels (one-time measure and 5-year average) and annual change in testosterone were respectively constructed. Among a total of 1,559 patients, 217 were PCa cases, and neither one-time measure nor 5-year average of testosterone was found to be significantly associated with PCa risk. Among the 379 patients with two or more testosterone measurements, 27 were PCa cases. For every 10 ng/dL increment in annual reduction of testosterone, the risk of PCa would increase by 14% [adjusted odds ratio, 1.14; 95% confidence interval (CI), 1.03-1.25]. Compared to patients with a relatively stable testosterone, patients with an annual testosterone reduction of more than 30 ng/dL had 5.03 [95% CI: 1.53, 16.55] fold increase in PCa risk. This implies a faster age-related reduction in, but not absolute level of serum total testosterone as a risk factor for PCa. Further longitudinal studies are needed to confirm this finding.

[Evaliating men's health survey results within the framework of "men's health school"].

Within the framework of "Men's Health School" 571 men were examined in 2014. The mean age of the surveyed men was 49.66+/-14.5 years. 86% (227) of the surveyed men had PSA levels from 0 to 4 ng/ml. Prostate ultrasound scan showed prostate enlargement in 37.2%+/-6.0 of men. The disturbances of libido or sexual life were registered in 45.5% (221) of the surveyed men. 58% of patients reported insufficient penile rigidity for sexual intercourse, 50% reported a sharp decrease in the amount of ejaculate, and 10% - pain during erection. Detailed medical history showed that in many patients the disease was provoked by family discord. The study findings revealed the poor condition of the male reproductive system in Kazakhstan. Resolving this problem requires considerable logistical costs, and an integrated approach to the early detection of diseases of the male reproductive system. The reproductive health of men was found to be affected by somatic, psychological and sexual health factors. At present we can say about the need for such "Men's Health School" in all regions on a regular basis, especially with the training of the primary care physicians.

Association between systemic inflammatory markers and serum prostate-specific antigen in men without prostatic disease - the 2001-2008 National Health and Nutrition Examination Survey.

BACKGROUND: Serum prostate specific antigen (PSA) may be elevated in otherwise healthy men; systemic inflammation has been associated with cancer. The study of systemic inflammatory markers in men without clinical prostate disease, but with elevated PSA may characterize the subgroup of men at higher risk for subsequent prostate cancer. METHODS: We investigated the associations between systemic inflammatory markers and serum PSA in 3,164 healthy men without prostatic disease, aged >40 years, from the 2001 to 2008 U.S. National Health and Nutrition Examination Survey (NHANES). Serum total PSA levels and concentrations of serum C-reactive protein (CRP) and plasma fibrinogen, neutrophil count, lymphocyte count, and platelet count were recorded. Neutrophil-lymphocyte ratio (NLR) ratio and platelet-lymphocyte (PLR) ratio were calculated. PSA elevation was defined as levels equal or greater than 4 ng/ml. RESULTS: Elevated serum PSA (194 men, 6.1% of the total), was significantly associated with plasma fibrinogen (ORmultiv = 1.88; 95% CI, 1.09-3.25), and NLR (ORmultiv = 1.14; 95% CI, 1.03-1.26), after adjustment for age, smoking, body mass index, education, race, co-morbidities, and use of medications. CONCLUSIONS: Markers of systemic inflammation were associated with elevated PSA in men without known prostatic disease. Future studies are needed to examine these markers' relationship with prostate cancer occurrence and progression.

Physical exercise on the rat ventral prostate: steroid hormone receptors, apoptosis and cell proliferation.

Studies have investigated the effect of exercise on prostate cancer risk. However, there are still doubts regarding the correlation between physical activity and the steroid hormones with respect to the reduction of the risk for prostatic lesions. We evaluated the levels of corticosterone, dihydrotestosterone (DHT), testosterone, estradiol, and steroid hormone receptors, and investigated the relationship between apoptosis and cell proliferation in the rat ventral prostate after training. Two groups were included in this study: control and trained. The trained group was submitted to training for 13 weeks (1 week of adaptation). Two days after the last training session, all animals were euthanized, and the intermediate and distal regions of the ventral prostate were collected and processed for immunohistochemistry, Western blotting and hormonal analyses. Physical exercise increased the corticosterone plasma, DHT and testosterone. In addition, androgen receptor expression was lower and estrogen receptor (ER) α and ER ß expression were higher in the trained group. However, the trained group showed disruption of the ratio of apoptotic to proliferating cells, indicating a predominance of apoptosis. We conclude that physical exercise alters the sex hormones and their receptors and is associated with the disruption of the balance between apoptosis and cell proliferation in the rat ventral prostate.

[Relations between red cell structure, function and immune homeostasis in prostatic diseases].

Patients with chronic prostatitis alone and in combination with prostatic adenoma have changes in the activity of the complement system, neutrophil function and content of pro- and anti-inflammatory cytokines. Abnormal representation of the proteins of the red cell membrane in patients with prostatic diseases affects structural and functional activity of erythrocytes in these patients. Dynamic changes in immune status of patients with chronic prostatitis and prostatic adenoma correlate with changes in functional red cell activity. This fact helps better understanding of pathogenesis of chronic prostatitis and prostatic adenoma.

Exploration of the Value of Combined UA, IL-6, and fPSA/tPSA in the Diagnosis of Prostate Cancer.

Objective: To investigate the differences in uric acid (UA), interleukin-6 (IL-6), and free prostatic-specific antigen (fPSA)/total prostatic-specific antigen (tPSA) (F/T) between patients with and without prostate cancer (PCa) in order to discover the value of the three indicators in improving PCa diagnostic accuracy. Methods: Patients with pathologically diagnosed PCa (PCa group, n = 25), patients with other benign prostate diseases (benign group, n = 25), and men who underwent normal physical examination (control group, n = 25) at the First Affiliated Hospital of Guangzhou University of Chinese Medicine between October 2020 and January 2021 were included. The serum UA, IL-6, and F/T levels of participants in the three groups were measured, and the measured data were statistically analyzed. Results: There were statistically significant differences in IL-6 and F/T among the three groups (all P < 0.05), but there were no statistically significant differences in UA (P > 0.05). The area under the receiver operating characteristic (ROC) curve (AUC) for the three indicators was, respectively, as follows: PCa group-benign group 0.5416, 0.6776, and 0.6832; PCa group-control group 0.5432, 0.9536, and 0.9887; and benign group-control group 0.5000, 0.8784, and 0.9456. Logistic regression analysis indicated that IL-6 and F/T were independent predictors of PCa, with AUCs of 0.6776 and 0.6832, respectively, and a combined accuracy of 72.0%. Conclusion: These results suggest that IL-6 and F/T have a good detection effect for PCa screening. Compared with the detection of F/T alone, the combined detection of IL-6 and F/T can improve the diagnosis rate of PCa to a certain extent, providing effective guidance for the clinical diagnosis and treatment of patients. The value of UA needs to be further studied, and its feasibility in the diagnosis of PCa needs to be further explored.

Prostate specific antigen.

This article forms part of our 'Tests and results' series for 2011 which aims to provide information about common tests that general practitioners order regularly. It considers areas such as indications, what to tell the patient, what the test can and cannot tell you, and interpretation of results.

Prostate diseases in Lagos, Nigeria: a histologic study with tPSA correlation.

OBJECTIVE: To present a 10year retrospective histologic study of prostate diseases in Lagos, Nigeria. The aim is to document the prevalence, histologic pattern, age distribution and PSA values of prostatic diseases. MATERIALS AND METHODS: The materials consisted of slides, paraffin embedded tissue blocks, patients case files and histology request forms of all prostatic biopsies received at the Morbid Anatomy department of Lagos University Teaching Hospital Idi-Araba, Lagos from 1999 to 2008. Each sample represents a different patient. RESULTS: Prostatic biopsies comprised 3.6 % of all biopsies in LUTH. BPH was the commonest prostatic lesion and accounted for 70.9% of all cases. The age range was 40 to 94 years with a mean of 67 years and a peak age group at 60-69 years. Stromoglandular pattern was the most common histological type of BPH accounting for 72.2 %( 393) of the cases. Malignant tumours constituted 28.9% of all prostatic biopsies. Most (93.7%) of these malignancies were seen in trucut biopsies. Adenocarcinoma accounted for 99.1% of the total 222 malignant tumours. It showed an age range of 40 to 98 years, a mean age of 66 years and peak prevalence in the 60-69 year age group. Gleason score nine was the most frequent (16.8%) in occurrence. Most adenocarcinomas were poorly differentiated (40%). Incidental carcinoma was seen in 4.2% of prostatectomy samples. High grade PIN was seen in 19.1% of adenocarcinoma cases. The most common inflammatory lesion was chronic non-specific prostatitis accounting for 76.4% of all inflammatory lesions. Malignant and benign lesions were accountable for PSA levels of 1 to 49.9ng/ml while values of 50ng/ml and above were seen exclusively in malignant lesions. CONCLUSION: Prostatic lesions constitute a significant source of morbidity among adult males in Lagos. Adenocarcinoma is the commonest histologic subtype of prostatic cancer and most are of poorly differentiated variety. Elevated levels of tPSA in Nigerian males may be as a result prostate cancer, BPH or BPH with prostatitis. PSA should in our opinion be used as a component of a strategy integrating multiple diagnostic approaches for prostate cancer screening and not to be used alone in our environment.

Eight Days of Water-Only Fasting Promotes Favorable Changes in the Functioning of the Urogenital System of Middle-Aged Healthy Men.

The aim of this study was to determine whether, after 8 days of water-only fasting, there are changes in the efficiency of the lower urinary tract, the concentration of sex hormones, and the symptoms of prostate diseases in a group of middle-aged men (n = 14). For this purpose, before and after 8 days of water-only fasting (subjects drank ad libitum moderately mineralized water), and the following somatic and blood concentration measurements were made: total prostate specific antigen (PSA-T), free prostate specific antigen (PSA-F), follicle stimulating hormone (FSH), luteotropic hormone (LH), prolactin (Pr), total testosterone (T-T), free testosterone (T-F), dehydroepiandrosterone (DHEA), sex hormone globulin binding (SHGB), total cholesterol (Ch-T), ß-hydroxybutyrate (ß-HB). In addition, prostate volume (PV), volume of each testis (TV), total volume of both testes (TTV), maximal urinary flow rate (Qmax), and International Prostate Symptom Score (IPSS) values were determined. The results showed that after 8 days of water-only fasting, Qmax and IPSS improved but PV and TTV decreased significantly. There was also a decrease in blood levels of PSA-T, FSH, P, T-T, T-F, and DHEA, but SHGB concentration increased significantly. These results indicate that 8 days of water-only fasting improved lower urinary tract functions without negative health effects.

Transrectal Ultrasound Guided Prostatic Biopsy and its Complications: A Descriptive Cross-sectional Study.

INTRODUCTION: Transrectal ultrasound of prostate provides better visual for biopsy. Transrectal ultrasound guided prostate biopsy is usually performed in men with an abnormal digital rectal examination, and elevated prostate specific antigen (>4ng/ml) or prostate specific antigen velocity (rate of prostate specific antigen change) i.e., >0.4-0.75ng/ml/year. The aim of the study is to find out the complications of transrectal ultrasound guided prostatic biopsies. METHODS: This descriptive cross-sectional study was done among 50 patients who transrectal ultrasound guided prostatic biopsies in a tertiary care hospital, from July 2017 to July 2019 after receiving ethical approval from the Institutional Review Committee of Kathmandu Medical College and teaching hospital. Convenient sampling was done. All patients were informed about the potential benefits and risks of the transrectal ultrasound guided prostate biopsy and patients signed an informed written consent form. Statistical analysis was done by using Statistical Package for Social Sciences version 16. RESULTS: Mean prostate specific antigen was 34.571 and mean weight of prostate was 44.6gm. Moderate to severe pain was experienced by 15 (30%), 2 (4%) had hematuria with fever accounting for 3 (6%) patients. All were managed conservatively with no mortality related to the procedure and complication. Three patients was positive for malignancy on re-biopsy. CONCLUSIONS: Transrectal ultrasound guided biopsy of prostate is a pioneer experience in Nepal. It has proved to be an useful tool of diagnosis of suspected carcinoma of Prostate. Use of neurovascular block may reduce the pain during the procedure.

Serum active hepatocyte growth factor (AHGF) in benign prostatic disease and prostate cancer.

BACKGROUND: Hepatocyte growth factor (HGF) is secreted as an inactive single-chain precursor called pro-HGF. Pro-HGF is converted to an active two-chain form by HGF activator and matriptase. We attempted to clarify whether serum levels of active HGF (AHGF) could be used as a marker of prostate cancer. METHODS: Serum levels of AHGF and total HGF (THGF; pro-HGF + AHGF) were measured by enzyme-linked immunosorbent assay in 38 patients with benign prostatic disease and 160 patients with prostate cancer. RESULTS: Serum levels of AHGF in patients with untreated prostate cancer (0.37 +/- 0.12 ng/ml) were significantly higher than those in patients with benign prostatic disease (0.28 +/- 0.08 ng/ml) (P = 0.0001). Serum AHGF levels were increased in patients with stage D or D3 compared with stage B. In addition, there were significant differences in serum AHGF levels between patients with well-differentiated and poorly differentiated adenocarcinoma. Furthermore, the mean serum AHGF/THGF ratio in patients with stage D3 prostate cancer was significantly higher than that in patients with stage B. CONCLUSIONS: AHGF may be a potential tumor marker for prostate cancer. Further studies in large groups of patients are needed to define the clinical value of AHGF.

Prostate specific antigen detection using microgapped electrode array immunosensor with enzymatic silver deposition.

BACKGROUND: Analysis of trace proteins plays an essential role in the fields of biomedical research and clinical diagnosis. Development of methods for the detection of proteins at very low concentrations has historically been a challenge in immunochemistry. We have developed an electrical immunosensor for the detection of prostate specific antigen (PSA). METHODS: The electrical immunosensor uses a microgapped interdigitated electrode array (MGIDEA) based on enzymatic silver deposition reaction. The deposition of silver was dispersed over the microgaps and allows the microgapped interdigitated electrodes to be electrically connected, resulting in an increase in electrical conductance of MGIDEA that is used to quantify the analyte concentration. We used this electrical immunosensor to measure PSA in human serum samples from patients with prostate diseases. RESULTS: This electrical immunosensor exhibited a linear response with PSA concentrations over a 6-decade range from 1.0 pg/L to 1.0 microg/L, with detection limit of 0.9 pg/L. PSA concentrations using this immunosensor agreed within 10% of those obtained using a commercial chemiluminescent immunoassay. CONCLUSIONS: The MGIDEA method has characteristics (analyte specific, low background, low limit of detection) that provide potential for molecular detection in various biomedical areas.

Selenium Supplementation and Prostate Health in a New Zealand Cohort.

BACKGROUND: There is variable reporting on the benefits of a 200 µg/d selenium supplementation towards reducing prostate cancer impacts. The current analysis is to understand whether stratified groups receive supplementation benefits on prostate health. METHODS: 572 men were supplemented with 200 µg/d selenium as selinized yeast for six months, and 481 completed the protocol. Selenium and prostate-specific antigen (PSA) levels were measured in serum at pre- and post-supplementation. Changes in selenium and PSA levels subsequent to supplementation were assessed with and without demographic, lifestyle, genetic and dietary stratifications. RESULTS: The post-supplementation selenium (p = 0.002) and the gain in selenium (p < 0.0001) by supplementation were significantly dependent on the baseline selenium level. Overall, there was no significant correlation between changes in PSA and changes in selenium levels by supplementation. However, stratified analyses showed a significant inverse correlation between changes in PSA and changes in selenium in men below the median age (p = 0.048), never-smokers (p = 0.031), men carrying the GPX1 rs1050450 T allele (CT, p = 0.022 and TT, p = 0.011), dietary intakes above the recommended daily intake (RDI) for zinc (p < 0.05), and below the RDI for vitamin B12 (p < 0.001). CONCLUSIONS: The current analysis shows the influence of life factors on prostate health benefits of supplemental selenium.

Dihydrotestosterone and testosterone throughout the life span of Czech men.

OBJECTIVE: The dihydrotestosterone:testosterone ratio seems to be an important factor in the expression of androgenic activity, especially in the prostate and pilosebaceous unit. Whereas the decline of testosterone (T) in aging men is well known, controversial data can be found in literature concerning the age dependence of dihydrotestosterone (DHT) levels. Data from the database of the Institute of Endocrinology served as the basis for the definition of the life span curve for the ratio dihydrotestosterone : testosterone. METHODS: The results of testosterone and dihydrotestosterone obtained immunoassays from 10 251 male patients were used in the construction of the curve. RESULTS: The data show that after a peak of DHT:T in infancy and a subsequent decrease in puberty, the ratio of both androgens remains practically without change from approx. 20 years of age till old age. CONCLUSION: High DHT:T ratio in infancy decreases at puberty and throughout the entire reproductive period of life this ration remains practically constant.