Correlation of Hematological Parameters with Specific Antigen Concentration and Prostate Volume in Benign Prostatic Hyperplasia: A Retrospective-Analytical Study

Prostate-specific antigen (PSA) is an androgen-dependent glycoprotein protease (M.W. 33 kDa) and a member of kallikrein super-family of serine protease, and has chymotrypsin-like enzymatic activity. It is synthesized by the prostate epithelial cells and found in the prostate gland and seminal plasma as a major protein. It is widely used as a clinical marker for diagnosis, screening, monitoring and prognosis of prostate cancer. In normal male adults, the concentration of PSA in the blood is below 4 ng/ml and this value increases in patients with the prostate cancer or the benign prostatic hyperplasia (BPH) due to its leakage into the circulatory system. As such, systematic monitoring of the PSA level in the blood can provide critical information about the progress of the prostatic disease. We have developed a compact integral system that can quantitatively measure the concentration of total PSA in human blood. This system utilizes the fluorescence emitted from the dye molecules attached to PSA molecules after appropriate immunoassay-based processing. Developed for the purpose of providing an affordable means of fast point-of-care testing of the prostate cancer, this system proved to be able to detect the presence of the PSA at the level of 0.18 ng/ ml in less than 12 minutes, with the actual measurement taking less than 2 minutes. The design concept for this system is presented together with the result for a few representative samples.

INTEREXAMINER RELIABILITY OF TRANSRECTAL ULTRASOUND FOR ESTIMATING PROSTATE VOLUME

High grade prostatic intraepithelial neoplasia (HGPIN), a premalignant lesion of the prostate gland, is more common in black men than in white men. The influence of HGPIN on the serum prostate specific antigen (PSA) concentration is controversial, and correlations between HGPIN and PSA in black men and white men have not been investigated. Between January 1992 and December 1998, 411 black men and 639 white men with suspected prostate carcinoma underwent an initial benign prostate biopsy at a single medical center. The presence or absence of HGPIN in the biopsy specimens was determined by one uropathologist. HGPIN was identified in 8.9% of the specimens. When stratified by PSA concentration (< 4.0 ng/mL, 4.0-9.9 ng/mL, and > or = 10.0 ng/mL), HGPIN was associated with an increased PSA concentration only among men with PSA concentrations < 4.0 ng/mL (P = 0.01). The prevalence of HGPIN in the black and white patients was 13.4% and 5.9%, respectively (P < 0.0001), and was significantly greater in black men than in white men with PSA concentrations < 4.0 ng/mL (P = 0.002). Among the patients with PSA concentrations < 4.0 ng/mL, black race was an independent predictor of an increased PSA concentration when adjusted for patient age, prostate volume, and the presence or absence of HGPIN (P = 0.03). HGPIN is more common in black men than in white men and may produce an increase in the PSA concentration. However, racial differences in the prevalence of HGPIN may not contribute to racial differences in PSA concentrations among men with no clinical or histologic evidence of carcinoma.

BackgroundRed cell distribution width (RDW), one of many routinely examined parameters, shows the heterogeneity in erythrocyte size. We investigated the association of RDW levels with clinical parameters and prognosis of lung cancer patients.MethodsClinical and laboratory data from 332 patients with lung cancer in a single institution were retrospectively studied by univariate analysis. Kaplan-Meier survival analysis and Cox proportional hazard models were used to examine the effect of RDW on survival.ResultsThe RDW levels were divided into two groups: high RDW (>=15%), n=73 vs. low RDW, n=259 (<15%). Univariate analysis showed that there were significant associations of high RDW values with cancer stage, performance status, presence of other disease, white blood cell count, hemoglobin, mean corpuscular volume, platelet count, albumin level, C-reactive protein level, and cytokeratin 19 fragment level. Kruskal-Wallis tests revealed an association of RDW values with cancer stage in patients irrespective of comorbidity (patient with/without comorbidity: p<0.0001, patient without comorbidity: p<0.0001). Stages I-IV lung cancer patients with higher RDW values had poorer prognoses than those with lower RDW values (Wilcoxon test: p=0.002). In particular, the survival rates of stage I and II patients (n=141) were lower in the high RDW group (n=19) than in the low RDW group (n=122) (Wilcoxon test: p<0.001). Moreover, multivariate analysis showed higher RDW is a significant prognostic factor (p=0.040).ConclusionRDW is associated with several factors that reflect inflammation and malnutrition in lung cancer patients. Moreover, high levels of RDW are associated with poor survival. RDW might be used as a new and convenient marker to determine a patient’s general condition and to predict the mortality risk of lung cancer patients.

Background:Bacteria and their products involved in periodontitis evoke an immunoinflammatory response in the host tissue. Inflammatory diseases, such as periodontitis, are often not just a local event, but may have systemic ramifications, including elevations in the numbers of circulating leukocytes, acute-phase proteins and oxidative stress markers. It is now emerging that also erythrocytes are affected by chronic inflammatory diseases. This phenomenon, named “anemia of inflammation,” is not caused by marrow deficiencies or other diseases. The present study aimed to assess whether there was any relation between chronic periodontitis and hematological parameters.Materials and Methods:A total of 80 patients were included in the study and were divided into the healthy and periodontitis groups. Blood sample was obtained from each participant for hematological analysis of leukocytes, erythrocytes, platelets, red blood cell (RBC) distribution width (RDW), mean corpuscular volume (MCV), platelet count and neutrophil–leukocyte ratio (NLR). Further, the values were gathered and subjected to statistical analysis. Unpaired t-test was performed to assess the statistical significance between the groups and P < 0.05 and < 0.001 were considered to be statistically significant.Results:Results show statistically significant difference seen in leukocytes, lymphocytes, RDW, MCV, platelet count and NLR which was higher in patients with periodontitis, all other parameters are nonsignificant.Conclusion:Thus, within limitations, it can be concluded that increased levels of leukocytes, lymphocytes, RDW, MCV, platelet count and NLR depict the inflammatory state and destructive nature of periodontitis.

Effect of Central Obesity on Prostate Specific Antigen Measured by Computerized Tomography: Related Markers and Prostate Volume

PurposeProstate cancer is rare in men younger than 50 years. Digital rectal examination (DRE) and measurement of prostate-specific antigen (PSA) concentrations are standard screening methods for detecting prostate cancer. We retrospectively investigated the risks and benefits of repeated transrectal ultrasonography-guided prostate needle biopsies in relation to the follow-up status of men younger than 50 years with a consistently high PSA concentration (>3.0 ng/mL).Materials and MethodsDuring the period from January 2000 through February 2013, we reviewed patient's ages, dates of procedures, DRE results, frequencies of biopsies, results of the biopsies, periods of follow-up, PSA concentrations, and prostate volumes in Chonbuk National University Hospital records. We conducted telephone interviews in patients who did not undergo regular follow-up.ResultsThe mean age of the patients was 44.7 years, and the mean PSA concentration was 8.59 ng/mL (range, 3.04-131 ng/mL) before biopsy. The PSA concentration was significantly different (p<0.001) between the patients with prostate cancer and those with benign prostatic hyperplasia (BPH). Nineteen patients underwent repeated prostate biopsy; however, in only one patient did the pathologic findings indicate a change from BPH to prostate cancer. We identified several complications after transrectal biopsy through an evaluation of follow-up data.ConclusionsAll patients with benign prostatic disease based on their first biopsy were shown to have benign disease based on all repeated biopsies (15.83%), except for one patient; however, several complications were noted after biopsy. Therefore, the risks and benefits of repeated biopsy in young patients should be considered because of the low rate of change from benign to malignant disease despite continuously high PSA concentrations (>3.0 ng/mL).

Multiplicative Interaction Between Mean Corpuscular Volume and Red Cell Distribution Width in Predicting Mortality of Elderly Patients with and without Anemia

Serum prostate-specific antigen as a predictor of prostate volume in men with benign prostatic hyperplasia

Prostate-specific antigen (PSA) is a tissue-specific serine protease which forms complexes with protease inhibitors such as f 1 -antichymotrypsin and f 2 - macroglobulin. We have studied the interaction between PSA and f 1 -protease inhibitor (API) in vitro and found that 15% of the added PSA binds to API while the majority of API is cleaved between Met358 and Ser359 when PSA is incubated with a 5-fold excess of API at 37 C for 7 days. The complex between PSA and API (PSA- API) formed in vitro displays the same chromatographic behavior, molecular size and immunoreactivity as endogenous PSA- API occurring in serum, indicating that they are identical. PSA- API can be detected in serum by a time-resolved immunofluorometric assay (IFMA), in which a monoclonal antibody to PSA is used as a catcher and a polyclonal antibody to API labeled with a Eu-chelate is used as a tracer. Purified PSA- API formed in vitro is used as a calibrator. PSA- API in serum represents 1.0- 7.9% (median 2.4%) of total PSA (tPSA) in prostate cancer (PCa, n= 82) and 1.3- 12.2% (median 3.6%, p<0.01) in patients with benign prostatic hyperplasia (BPH, n= 66). The IFMA for PSA- API in serum is hampered by a variable background, which is caused by non-specific adsorption of the huge excess of API in serum to the solid phase. The background can be determined by an assay using the same tracer as in the IFMA for PSA- API but PSA-unrelated antibody on the solid phase. The background signal is subtracted from the PSA- API signal. The clinical utility of PSA- API in serum has been evaluated in PSA-positive subjects from the Finnish PCa screening trial. After subtraction of the background, the proportion of PSA- API in relation to tPSA is lower in PCa than in controls, 0.9% vs. 1.6%, respectively (p<0.001). Logistic regression analysis showed that the concentration of PSA- API was independent of the proportion of free PSA as a diagnostic variable among subjects with a tPSA of 4- 10 w g/l (p= 0.009). The probability of PCa calculated by logistic regression using the concentration of PSA- API and the proportion of free PSA in serum significantly improved cancer specificity at high sensitivity levels (85 - 95%) as compared to the proportion of free PSA alone.

BACKGROUND/OBJECTIVESThis study was conducted to investigate the effect of a corn silk extract on improving benign prostatic hyperplasia (BPH).MATERIALS/METHODSThe experimental animals, 6-week-old male Wistar rats, were divided into sham-operated control (Sham) and experimental groups. The experimental group, which underwent orchiectomy and received subcutaneous injection of 10 mg/kg of testosterone propionate to induce BPH, was divided into a Testo Only group that received only testosterone, a Testo+Fina group that received testosterone and 5 mg/kg finasteride, a Testo+CSE10 group that received testosterone and 10 mg/kg of corn silk extract, and a Testo+CSE100 group that received testosterone and 100 mg/kg of corn silk extract. Prostate weight and concentrations of dihydrotestosterone (DHT), 5α-reductase 2 (5α-R2), and prostate specific antigen (PSA) in serum or prostate tissue were determined. The mRNA expressions of 5α-R2 and proliferating cell nuclear antigen (PCNA) in prostate tissue were also measured.RESULTSCompared to the Sham group, prostate weight was significantly higher in the Testo Only group and decreased significantly in the Testo+Fina, Testo+CSE10, and Testo+CSE100 groups (P < 0.05), results that were consistent with those for serum DHT concentrations. The concentrations of 5α-R2 in serum and prostate as well as the mRNA expression of 5α-R2 in prostate were significantly lower in the Testo+Fina, Testo+CSE10, and Testo+CSE100 groups than that in the Testo Only group (P < 0.05). Similarly, the concentrations of PSA in serum and prostate were significantly lower in the Testo+Fina, Testo+CSE10, and Testo+CSE100 groups (P < 0.05) than in the Testo Only group. The mRNA expression of PCNA in prostate dose-independently decreased in the Testo+CSE-treated groups (P < 0.05).CONCLUSIONSBPH was induced through injection of testosterone, and corn silk extract treatment improved BPH symptoms by inhibiting the mRNA expression of 5α-R2 and decreasing the amount of 5α-R2, DHT, and PSA in serum and prostate tissue.

Comparison of Prostate Specific Antigen Concentration Versus Prostate Specific Antigen Density in the Early Detection of Prostate Cancer: Receiver Operating Characteristic Curves

To evaluate relation between red cell distribution width (RDW) and benign prostatic hyperplasia (BPH). The overall study population consisted of 942 men with lower urinary tract symptoms (LUTS), ranging in age from 60 to 85 years old. Patients with disorder or medication that can influence lower urinary tract or erythrocytes were excluded from the study. The relationship between RDW, white blood cell (WBC), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and prostate volume, International Prostate Symptom Score (IPSS) were assessed with multivariate linear regression model. Patients were analyzed in four groups stratified according to the quartiles of prostate volume. The one-way analysis of variance (anova) was used to compare RDW, WBC CRP, and ESR between different quartiles of prostate volume. A graded and independent association of RDW with the prostate volume was identified (P = 0.001). RDW was significantly associated with prostate volume in multivariate linear regression model that was adjusted for age and hemoglobin. IPSS was significantly correlated with RDW, CRP and ESR. However significance was lost after adjustment for age and prostate volume. The RDW was significantly associated with the surgical treatment in the multivariate linear regression model that was adjusted for age and prostate volume. A correlation between an increased RDW and prostate volume was suggested by the new data from this study. This relation may be a consequence of inflammatory stress arising from BPH. The significant association between the easy, inexpensive RDW may provide a rational basis to include the RDW in algorithms for surgery risk prediction.

Benefit-harm ratio of the diagnostic workup in patients with prostate cancer of Gleason score from 9 to 10.

With retrograde ejaculation, the ejaculation mechanism changes: the expulsion of the seed fluid occurs in the proximal direction into the bladder.The aim of the research. Identification of the value of determining the concentration of prostate specific antigen (PSA) in post-orgasmic urine (POM) for the diagnosis of retrograde ejaculation.Materials and methods. 59 men (age 34,1 ± 8,9 years) were examined. The main group (n=27) consisted of men suffering from retrograde ejaculation. The comparison group (n=32) included men whose ejaculation was physiologically antegrade and who had no coitus during the previous 2 days. The concentration of total PSA in blood serum and urine was determined by solid-phase enzyme immunoassay (ELISA) using the test system "total PSA-ELISA-BEST" (T-8458) (Vector–Best LLC, Russia).Results. The median concentration of total PSA in urine in the comparison group was 9,52 times higher than the same indicator in blood serum. When comparing the content of total PSA in the main group of patients in the morning urine, in the 1st (at the beginning of the act of urination) and 2nd (at the end of the act of urination) portions of POM, we found comparable indicators of the concentration of total PSA, no significant differences were found (the Kraskel–Wallis criterion H=0,4914, p=0,9208, with a pairwise comparison between all the studied groups of urine samples, p = 1,000000).Conclusion. The level of PSA in the urine of men of fertile age is almost 10 times higher than that in blood serum. The presence of PSA in high concentration in the bladder urine may indicate various ways of getting this substance into the urine: retrograde casting of sperm during ejaculation and free filtration of this protein in the glomeruli of the kidney. The PSA total urine test is not suitable for laboratory diagnosis of retrograde ejaculation.