Abstract
BackgroundEarly prostate cancer antigen (EPCA) has been shown a prostate cancer (PCa)-associated nuclear matrix protein, however, its serum status and prognostic power in PCa are unknown. The goals of this study are to measure serum EPCA levels in a cohort of patients with PCa prior to the treatment, and to evaluate the clinical value of serum EPCA.MethodsPretreatment serum EPCA levels were determined with an ELISA in 77 patients with clinically localized PCa who underwent radical prostatectomy and 51 patients with locally advanced or metastatic disease who received primary androgen deprivation therapy, and were correlated with clinicopathological variables and disease progression. Serum EPCA levels were also examined in 40 healthy controls.ResultsPretreatment mean serum EPCA levels were significantly higher in PCa patients than in controls (16.84±7.60 ng/ml vs. 4.12±2.05 ng/ml, P<0.001). Patients with locally advanced and metastatic PCa had significantly higher serum EPCA level than those with clinically localized PCa (22.93±5.28 ng/ml and 29.41±8.47 ng/ml vs. 15.17±6.03 ng/ml, P = 0.014 and P<0.001, respectively). Significantly elevated EPCA level was also found in metastatic PCa compared with locally advanced disease (P<0.001). Increased serum EPCA levels were significantly and positively correlated with Gleason score and clinical stage, but not with PSA levels and age. On multivariate analysis, pretreatment serum EPCA level held the most significantly predictive value for the biochemical recurrence and androgen-independent progression among pretreatment variables (HR = 4.860, P<0.001 and HR = 5.418, P<0.001, respectively).ConclusionsSerum EPCA level is markedly elevated in PCa. Pretreatment serum EPCA level correlates significantly with the poor prognosis, showing prediction potential for PCa progression.
Highlights
Prostate cancer (PCa) has emerged as the most commonly diagnosed malignancy and the second leading cause of cancerrelated death among men in the great majority of Western countries [1]
The majority of patients diagnosed with prostate cancer (PCa) are currently found to have clinically localized disease [4], and local therapies with curative intent such as radical prostatectomy (RP) and radiotherapy can provide effective and durable disease control, approximately one third of those patients eventually experience biochemical recurrence [5,6], which is often due to the early dissemination of microscopic metastatic disease that remains undetected by currently conventional pretreatment staging modalities such as radionuclide bone scan, computerized tomography (CT) scan, and magnetic resonance imaging
We found that elevated serum levels of Early prostate cancer antigen (EPCA) were significantly correlated with increased risk of the subsequent PCa onset in high-grade prostatic intraepithelial neoplasia (HGPIN) during a period of $5 years follow-up and the incidental PCa presence on TURP specimens analysis
Summary
Prostate cancer (PCa) has emerged as the most commonly diagnosed malignancy and the second leading cause of cancerrelated death among men in the great majority of Western countries [1]. For locally advanced and metastatic PCa, androgen deprivation therapy (ADT) remains the most important and the primary treatment [7], which can lead to symptomatic improvement and a reduction in serum prostate specific antigen (PSA) levels in most patients. Almost all these patients progress to hormone independence, which remains the main obstacle to improving survival and quality of life in these patients [8,9]. The goals of this study are to measure serum EPCA levels in a cohort of patients with PCa prior to the treatment, and to evaluate the clinical value of serum EPCA
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