Abstract
BackgroundThis study aimed to explore the diagnostic value of alpha-l-fucosidase (AFU) in prostate cancer (PCa) patients with “gray-zone PSA” and to investigate the correlation between AFU expression and clinicopathological characteristics of PCa patients.MethodsThe level of AFU and other necessary clinicopathological variables of patients were retrieved from electronic medical records. The transcriptome profiling and clinical information of PCa patients were obtained from The Cancer Genome Atlas (TCGA) database. The protein level of AFU in tissue was assessed by immunohistochemistry (IHC). All the data were processed by appropriate analysis methods. The p-value of <0.05 was considered statistically significant.ResultsAFU showed ideal diagnostic value for PCa with prostate-specific antigen (PSA) levels ranging from 4 to 10 ng/ml, and its optimal cutoffs were 19.5 U/L. Beyond this, low AFU expression was associated with high pathological grade, T stage and N stage, more postoperative residual tumors, and poor primary therapy outcome, as well as shorter progression-free interval. The Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis illustrated that FUCA1/FUCA2 exerted tumor-suppressive function by regulating the glycosylation.ConclusionsAFU (<19.5 U/L) could effectively distinguish the PCa from the patients with “gray-zone PSA”, and low expression of AFU was an independent unfavorable predictor for the clinicopathological characteristics of PCa patients.
Highlights
Prostate cancer (PCa) is an epithelial malignancy with a high incidence that occurs in the male genitourinary system [1]
It was meaningful that we found that the free/ total (F/T) prostate-specific antigen (PSA) and AFU levels in the benign prostatic hyperplasia (BPH) patients were higher than in the PCa patients (F/T PSA: 0.22 ± 0.24 vs. 0.18 ± 0.19, p = 0.008; AFU: 20.16 ± 6.17 U/L vs. 18.21 ± 6.66 U/L, p = 0.049) (Table 1 and Figures 1A, B), but there was no line correlation between them (Figure 1E)
The receiver operating characteristic (ROC) analysis indicated that AFU had a better value for PCa diagnosis than F/T PSA especially in specificity (the area under the ROC curve (AUC): 0.630 vs. 0.612)
Summary
Prostate cancer (PCa) is an epithelial malignancy with a high incidence that occurs in the male genitourinary system [1]. Based on the last data, the morbidity of PCa ranks no. The treatment options of PCa vary based on cancer grade and stage. Early and accurate diagnosis is crucial for the treatment of PCa patients. The prostate-specific antigen (PSA) screening has made great contributions to the early diagnosis of PCa, some limitations are readily apparent. A prostate biopsy can provide an accurate diagnosis, but it is a time-consuming and expensive method that requires an experienced urologist and causes great suffering for patients. The identification of effective and practical biomarkers for early and accurate diagnosis of PCa (especially men with a PSA of 4–10 ng/ml) is urgent and important. This study aimed to explore the diagnostic value of alpha-l-fucosidase (AFU) in prostate cancer (PCa) patients with “gray-zone PSA” and to investigate the correlation between AFU expression and clinicopathological characteristics of PCa patients
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