NEW BIOCHEMICAL MARKERS OF RECURRENCE OF PROSTATE CANCER AFTER HIS TREATMENT

Abstract

We studied the condition of the blood proteolytic systems (activity of kallikrein (К) and level of prekallikrein (PK), the total proteolytic activity of serine proteinases and elastase-like activity, the leukocytic elastase (LE) activity, the angiotensin-converting enzyme (ACE) activity, and the inhibitor activity of the α1-proteinase inhibitor (α1-PI) and α2-macroglobulin (α2-MG) in 36 patients after radical prostatectomy (RPE). Group I was composed of 28 patients without biochemical recurrence (BR) after RPE. In this group, 18 patients had locally limited cancer, and 10 patients had рТ3. Group II included 8 patients after RPE with development of BR. The prostate cancer stage in Group II was as follows: рT3 in 7 patients, and pT4 in one patient. The average age of the patients in the groups was 61.44±1.39 years. The median PSA before RPE was 8.05 ng/ml (LQ=5.01; UQ=12). The average prostate volume in the groups was 52±2.74 cm3 . The median of observations was 18 months. The control group consisted of 20 healthy males. In Group II patients at 1 month after the RPE, the ACE activity was 136.5% (p1<0.001) higher, and the LE activity was 29.0% (p1<0.05) lower than the corresponding indicators in Group I. The median PSA in Group I at that time was 0.02±0.01 ng/ml, and in Group II it was 0.2±0.04 ng/ml. Thus, increased activity of ACE against the background of the reduced antiproteolytic potential of the blood in patients after RPE is the metabolic basis for development of biochemical recurrence, and can be a marker of its progression. Increased activity of ACE and reduced activity of EA are predictors of BR development as early as at 1 month after RPE, when the PSA level is not yet elevated.