Higher Prostate-specific Antigen Research Articles

Ultrasensitive prostate cancer marker PCA3 detection with impedimetric biosensor based on specific label-free aptamers

Prostate cancer (PCa) appears among the most frequently diagnosed types of malignancies in males. Because of the high demand and increasing detection rate of early PCa, alongside the specificity limitations of the gold standard clinical tools available for the diagnosis and prognosis of prostate cancer, there is an urgent need for more reliable PCa markers and highly sensitive diagnostic tools to avoid under-treatment and over-diagnosis. PCA3, or prostate cancer antigen 3, is a potential prostate cancer biomarker that is more specific and useful for preventing unnecessary repeat biopsies, particularly in men with persistently high prostate-specific antigen indices after a negative biopsy. Additionally, an electrochemically based biosensor would prove to be a powerful diagnostic tool for PCA3 detection in urine because of its simplicity, sensitivity, and cost-effectiveness, in contrast to the more traditional PCa diagnostics that depend on blood testing. This paper aimed to design a novel and simple electrochemical impedimetric biosensor based on a label-free RNA-aptamer (CG3-PCA3) as the molecular recognition element for detecting PCA3. The proposed aptasensor for the detection of PCA3 has been developed using a screen-printed carbon electrode (SPCE) modified by gold nanoparticles (AuNPs), further improving sensitivity and allowing the immobilisation of thiolate aptamers on its surface. The findings presented here demonstrated a high sensitivity to PCA3, with a detection limit of 20 fM in artificial urine and 1 fM in buffer. These results indicate that the PCA3 aptasensor could be a promising tool for routine PCa diagnosis due to its high sensitivity and cost-effectiveness.

Clinical and histopathological parameters in transrectal ultrasound-guided biopsies associated with tumor upgrading after radical prostatectomy: A comparative analysis of risk groups.

Thanks to technological advances, prostate cancer (PCa) can be diagnosed at a younger age. It is known that most of these patients are in the low-intermediate risk group, and the histological grade of the tumor increases in half of those undergoing radical prostatectomy (Rp) compared to their diagnostic biopsies. This is especially important in terms of active surveillance (AS) and/or the timely evaluation of curative treatment options in patients diagnosed at an early age. Our aim was to investigate clinical and histopathological parameters that may be associated with an increase in the histological grade of the tumor in patients with acinar adenocarcinoma who were diagnosed by transrectal ultrasound-guided biopsy (TRUS-Bx) and underwent Rp. A total of 205 patients with classical acinar adenocarcinoma diagnosed by TRUS-Bx without metastasis and who underwent Rp were grouped according to the D'Amico risk classification. Age at diagnosis, serum prostate-specific antigen (PSA), PSA density, prostate volume, Prostate Imaging Reporting and Data System (PI-RADS) score, clinical stage, Gleason Grade Group (GGG), high-grade intraepithelial neoplasia in tumor-free cores (HGPIN) (single and ≥2 cores), perineural invasion (PNI), and lymphovascular invasion (LVI) was obtained. Additionally, GGG, pathological stage, lymph node metastasis, surgical margin positivity, and tumor volume obtained from Rp were evaluated. Comparisons were made between the case groups in which the tumor grade increased and remained the same, in terms of age, serum PSA, PSA density, HGPIN in tumor-free cores (single and ≥2 cores), PNI, and LVI in all biopsies (with or without tumors), as well as risk groups. In addition, the relationships of HGPIN in tumor-free cores (single and ≥2 cores), PNI, and LVI on TRUS-Bx with age, serum PSA and PSA density, tumor volume, surgical margin positivity, pathological stage, lymph node metastasis, and risk groups were examined separately. Of the patients, 72 (35.1%) were in the low-risk group, 95 (46.3%) in the intermediate-risk group, and 38 (18.5%) in the high-risk group. Most of the patients with an increased histological grade (n = 38, 48.1%) were in the low-risk group (p < 0.05) and had an advanced median age. HGPIN in single and ≥2 tumor-free cores and PNI were more common in these patients (p < 0.01, p < 0.001, and p < 0.05, respectively). According to the multivariable analysis, advanced age (odds ratio [OR]: 1.087, 95% confidence interval [CI]: 1.029-1.148, p < 0.05), high serum PSA (OR: 1.047, 95% CI: 1.006-1.090, p < 0.05), HGPIN in ≥2 tumor-free cores (OR: 6.346, 95% CI: 3.136-12.912, p < 0.001), and PNI (OR: 3.138, 95% CI: 1.179-8.356, p < 0.05) were independent risk factors for a tumor upgrade. Furthermore, being in the low-risk group was an independent risk factor when compared to the intermediate- and high-risk groups (OR: 0.187, 95% CI: 0.080-0.437, p < 0.001 and OR: 0.054, 95% CI: 0.013-0.230, p < 0.001, respectively). The HGPIN diagnosis was more common in the low- and intermediate-risk groups. Advanced age at diagnosis, high serum PSA and PSA density values were associated with PNI on TRUS-Bx. High serum PSA and PSA density values were associated with LVI on TRUS-Bx. Surgical margin positivity was higher in cases with PNI and LVI detected by TRUS-Bx. HGPIN in ≥2 tumor-free cores, PNI, and LVI on TRUS-Bx were associated with a higher rate of lymph node metastases. In patients diagnosed with acinar adenocarcinoma, the presence of HGPIN even in a single tumor-free core on TRUS-Bx was found to be significant in terms of showing an increase in the histological tumor grade in Rp. The diagnosis of HGPIN in ≥2 tumor-free cores on TRUS-Bx was determined as an independent risk factor for an increased Gleason score after Rp. Furthermore, an advanced age, a high serum PSA value, being in the low-risk group, and the presence of PNI were associated with a tumor upgrade. HGPIN in ≥2 tumor-free cores, PNI, and LVI were also associated with lymph node metastasis. Therefore, the diagnosis of HGPIN should be signed out on pathological reports.

Index tumor location affected early biochemical recurrence after radical prostatectomy in patients with negative surgical margin: a retrospective study

BackgroundIndex tumors are the most aggressive tumors of the prostate. However, their clinical significance remains unclear. This study aimed to assess the incidence of index tumor location according to the zonal origin and whether these locations affect the prognosis after radical prostatectomy in patients with negative surgical margins.MethodsThis single-centered, retrospective study evaluated 1,109 consecutive patients who underwent radical prostatectomies. An index tumor was defined as the largest tumor in the prostate gland. We detected these locations based on McNeal's zonal origin using whole-mount sections. Biochemical recurrence (BCR) free survival curves were generated using the Kaplan–Meier method. Univariate and multivariate analyses using the Cox proportional hazards model were performed to determine the predictive factors for early BCR (within 1-year).ResultsA total of 621 patients with negative surgical margins who did not receive adjuvant therapy were included in this study. The index tumor were located in the transitional zone in 191 patients (30.8%), the peripheral zone in 399 patients (64.3%), and the central zone in 31 patients (5.0%). In total, 22 of 621 patients (3.5%) experienced early BCR and 70 patients (11.2%) experienced overall BCR at a median follow-up of 61.7 months. According to the index tumor location, the early BCR-free rates were 99.5%, 95.7 %, and 83.3% in the transitional, peripheral, and central zones, respectively. On multivariate analysis, the index tumor in the central zone was an independent predictor of early BCR with negative surgical margins following radical prostatectomy, followed by prostatectomy pathological grade, index tumor in the peripheral zone, and high prostate-specific antigen level.ConclusionsWe assessed the significance of index tumor location in patients with negative surgical margins following radical prostatectomy. Index tumors located in the central zone, although infrequent, were the strongest predictive factors for early BCR. Our results may allow urologists and patients to reconsider the therapeutic strategies for prostate cancer.

A population-based propensity score matching analysis of risk factors and the impact on survival associated with refusal of cancer-directed surgery in patients with prostate cancer

Cancer-directed surgeries (CDS) play a crucial role in prostate cancer (PCa) management along with possible survival and therapeutic benefits. However, barriers such as socioeconomic factors may affect patients’ decision of refusing recommended CDS. This study aimed to uncover risk factors and the impact on survival associated with CDS refusal. We retrospectively reviewed the Surveillance, Epidemiology, and End Results database for patients diagnosed with PCa between 2000 and 2019. Multiple sociodemographic and clinical characteristics were extracted to assess predictors for physicians’ surgical recommendations and patients’ surgical refusal, respectively. Propensity score matching was performed to balance the covariates. The impact of surgical refusal on mortality risk was also investigated. A total of 185,540 patients were included. The physician’s recommendation of CDS was significantly influenced by the patient’s age, race, income, home location, diagnosis year, Gleason score, prostate-specific antigen (PSA), and TNM stage. About 5.6% PCa patients refused CDS, most of whom were older, non-White race, lack of partners, living outside of metropolitan areas, with higher PSA or lower clinical TNM stage. Patients who refused CDS had an increased risk of cancer-specific mortality and overall mortality than those who performed CDS. Physicians may weigh a host of sociodemographic and clinical factors prior to making a CDS recommendation. Patients’ refusal of recommended CDS affected survival and was potentially modifiable by certain sociodemographic factors. Physicians should fully consider the hindrances behind patients’ CDS refusal to improve patient-doctor shared decision-making, guide patients toward the best alternative and achieve better outcomes.

Serum Levels of Prostate Specific Antigen and Specific Reproductive Hormones Among Male Subjects with Benign Prostate Hyperplasia in Port Harcourt, Nigeria

Benign prostate hyperplasia (BPH) is a medical condition in elderly men in which there is proliferation and enlargement of the prostate gland. This study evaluated the levels of male reproductive hormones among subjects with BPH. The study involved 150 subjects aged 40 years and above, comprising 80 BPH subjects attending the urology clinic and 70 control subjects. Five millilitres (5ml) of venous blood were collected from each subject into plain bottles for the determination of prostate-specific antigen (PSA), testosterone, prolactin, and estradiol, using the ELISA technique. The mean values of PSA (16.68±10.96 ng/ml), estradiol (71.03±18.56 pg/ml) and for the BPH subjects and prolactin (9.38±4.51 ng/ml) were significantly higher compared to the mean values of PSA (0.48±0.25ng/ml), estradiol (51.33±7.13npg/ml) and prolactin (6.92±1.93ng/ml) of the control subjects. However, the mean testosterone value of the BPH subjects (5.02±1.93 ng/ml) was significantly lower than the mean value for the control (6.57±3.48ng/ml). The BPH who used to consume alcohol had higher PSA (24.26±8.33ng/ml) and testosterone (7.68±3.41ng/ml) compared to the PSA (16.34±3.22ng/ml) and testosterone (4.95±3.62ng/ml) of those who never consumed alcohol. The BPH had significantly altered hormone parameters as well as raised PSA levels. Including hormonal parameters in diagnosing and managing BPH could be an important consideration in our population.

The role of multiparametric magnetic resonance ımaging in the diagnosis of granulomatous prostatitis mimicking prostate cancer.

Aimed to investigate the role of multiparametric magnetic resonance imaging (mp-MRI) in the diagnosis of granulomatous prostatitis caused by intravesical Bacillus Calmette-Guérin (BCG). In this prospective, single-center study, 10 male patients who were given intravesical BCG due to intermediate- and high-risk bladder cancer were included. Before transurethral resection of bladder tumors (TURB), all patients were evaluated by mp-MRI, serum prostate-specific antigen (PSA), and digital rectal examination (DRE). Serum PSA levels and DRE findings were evaluated before and after intravesical BCG treatment. Prostate mp-MRI was performed for patients with elevated levels of serum PSA and/or with abnormal DRE findings. Then, MRI fusion + systematic prostate biopsy was performed. Demographic data of the patients before and after intravesical BCG were compared. The average age of the patients was 66.9years (55-87years). While PSA was 1.7ng/ml before intravesical BCG treatment, it was 4.3ng/ml after intravesical BCG treatment (p = 0.005). PSA density (PSAD) was 0.04 and 0.10 before and after the treatment, respectively (p = 0.012). DRE findings of all patients were normal before the treatment. However, abnormal findings were detected in 80% of them after the treatment (p = 0.008). PI-RADS ≥ 3 lesions were found to be significantly higher in all patients after intravesical BCG (p = 0.004). Granulomatous prostatitis is a rare complication of intravesical BCG. High PSA, abnormal DRE, and PI-RADS ≥ 3 lesions detected after intravesical BCG should suggest granulomatous prostatitis and unnecessary biopsies may be avoided.

Exposure to environmental pollutants and genetic variants related to oxidative stress and xenobiotic metabolism—Association with prostate cancer

This study assessed whether genetic variants coding for certain enzymes involved in xenobiotic detoxification, antioxidant defences and DNA repair, along with exposure to environmental chemicals, were associated with an increased prostate cancer (PCa) risk. The study population consisted of 300 men (150 PCa cases and 150 controls) which underwent prostate biopsy as their serum prostate specific antigen (PSA) levels were greater than 4 ng/ml. Genetic variants in GSTM1, GSTP1, SOD2, CAT, GPX1, XRCC1 were determined and data for chemical exposures was obtained through a structured questionnaire and by biomonitoring in a subsample of cases and controls. High serum PSA levels were associated with a greater risk of PCa, while physical exercise appears to exert a protective effect against its development. In addition, elevated urinary levels of certain organic pollutants, such as benzo(a)pyrene (BaP), bisphenol A (BPA), and ethyl-paraben (EPB), were associated with an increased risk of PCa.

Impact of Circulating Tumor Cell-Expressed Prostate-Specific Membrane Antigen and Prostate-Specific Antigen Transcripts in Different Stages of Prostate Cancer.

Prostate-specific membrane antigen (PSMA)-based images, which visually quantify PSMA expression, are used to determine prostate cancer micrometastases. This study evaluated whether a circulating tumor cell (CTC)-based transcript platform, including PSMA mRNA, could help identify potential prognostic markers in prostate cancer. We prospectively enrolled 21 healthy individuals and 247 patients with prostate cancer [localized prostate cancer (LPCa), n = 94; metastatic hormone-sensitive prostate cancer (mHSPC), n = 44; and metastatic castration-resistant prostate cancer (mCRPC), n = 109]. The mRNA expression of six transcripts [PSMA, prostate-specific antigen (PSA), AR, AR-V7, EpCAM, and KRT 19] from CTCs was measured, and their relationship with biochemical recurrence (BCR) in LPCa and mCRPC progression-free survival (PFS) rate in mHSPC was assessed. PSA-PFS and radiological-PFS were also calculated to identify potential biomarkers for predicting androgen receptor signaling inhibitor (ARSI) and taxane-based chemotherapy resistance in mCRPC. CTC detection rates were 75.5%, 95.3%, and 98.0% for LPCa, mHSPC, and mCRPC, respectively. In LPCa, PSMA [hazard ratio (HR), 3.35; P = 0.028) and PSA mRNA (HR, 1.42; P = 0.047] expressions were associated with BCR. Patients with mHSPC with high PSMA (HR, 4.26; P = 0.020) and PSA mRNA (HR, 3.52; P = 0.042) expressions showed significantly worse mCRPC-PFS rates than those with low expression. Increased PSA and PSMA mRNA expressions were significantly associated with shorter PSA-PFS and radiological PFS in mCPRC, indicating an association with drug resistance. PSMA and PSA mRNA expressions are associated with BCR in LPCa. In advanced prostate cancer, PSMA and PSA mRNA can also predict rapid progression from mHSPC to mCRPC and ARSI or taxane-based chemotherapy resistance.

Enhancing the anticancer effect of androgen deprivation therapy by monocarboxylate transporter 1 inhibitor in prostate cancer cells.

Tumor initiation and progression necessitate a metabolic shift in cancer cells. Consequently, the progression of prostate cancer (PCa), a leading cause of cancer-related deaths in males globally, involves a shift from lipogenic to glycolytic metabolism. Androgen deprivation therapy (ADT) serves as the standard treatment for advanced-stage PCa. However, despite initial patient responses, castrate resistance emerges ultimately, necessitating novel therapeutic approaches. Therefore, in this study, we aimed to investigate the role of monocarboxylate transporters (MCTs) in PCa post-ADT and evaluate their potential as therapeutic targets. PCa cells (LNCaP and C4-2 cell line), which has high prostate-specific membrane antigen (PSMA) and androgen receptor (AR) expression among PCa cell lines, was used in this study. We assessed the expression of MCT1 in PCa cells subjected to ADT using charcoal-stripped bovine serum (CSS)-containing medium or enzalutamide (ENZ). Furthermore, we evaluated the synergistic anticancer effects of combined treatment with ENZ and SR13800, an MCT1 inhibitor. Short-term ADT led to a significant upregulation in folate hydrolase 1 (FOLH1) and solute carrier family 16 member 1 (SLC16A1) gene levels, with elevated PSMA and MCT1 protein levels. Long-term ADT induced notable changes in cell morphology with further upregulation of FOLH1/PSMA and SLC16A1/MCT1 levels. Treatment with ENZ, a nonsteroidal anti-androgen, also increased PSMA and MCT1 expression. However, combined therapy with ENZ and SR13800 led to reduced PSMA level, decreased cell viability, and suppressed expression of cancer stem cell markers and migration indicators. Additionally, analysis of human PCa tissues revealed a positive correlation between PSMA and MCT1 expression in tumor regions. Our results demonstrate that ADT led to a significant upregulation in MCT1 levels. However, the combination of ENZ and SR13800 demonstrated a promising synergistic anticancer effect, highlighting a potential therapeutic significance for patients with PCa undergoing ADT.

Serum Prostat-Spesifik Antijen Düzeyi 2,5-10 Ng/Ml Arasındaki Erkeklerde İki Kadeh Testinin Prostat Biyopsisi ve Asemptomatik Prostat İnflamasyonu Varlığı ve Derecesiyle İlişkisinin Araştırılması

Objective: Prostate-specific antigen (PSA) is a marker used to detect prostate cancer. When high PSA values are detected, a prostate biopsy is performed considering the possibility of prostate cancer. PSA elevation is not specific to prostate cancer, but may also be caused by conditions such as benign prostatic hyperplasia (BPH), urinary tract infection, and chronic prostatitis. Prostate cancer is not detected in approximately 66% of patients undergoing a biopsy, and patients are exposed to unnecessary biopsy and biopsy complications. Chronic prostatitis is detected in approximately 40% of these biopsies. The two-glass test is based on examining urine before and after rectal examination, which is used in diagnosing chronic prostatitis. In this study, we aimed to reveal the two-glass test’s effectiveness in predicting the incidence of prostatitis and inflammation in patients with a PSA value of 2.5-10 ng/ml and who underwent prostate needle biopsy.&#x0D; &#x0D; Methods: Fifty-two male patients, aged between 50 and 78 years, with PSA values between 2.5 and 10 ng/ml, who applied to our clinic were included in the study. EPS-two-glass test and prostate biopsy were applied to all patients. EPS; is a sample obtained by removing the fluid from the urethra after a prostate massage; VB-3; shows the urine produced by taking about 10 ml of urine voided after massage. EPS and VB3 detect prostate infection. Under the microscope, ≥10 leukocytes were considered significant for prostate inflammation. According to the pathology results, the patients were divided into 3 groups; prostate cancer, BPH, and chronic prostatitis. The chronic prostatitis group was classified according to the histopathological calcification described by Nickel.&#x0D; &#x0D; Results: In this study, the ratio of chronic prostatitis was found to be 38%. VB3 positivity was found to be statistically significant in the chronic prostatitis group compared to the other groups (p = 0.028). Although there was no statistically significant difference between the prevalence of inflammation and PSA elevation, PSA was found to be higher in the multifocal inflammation subgroup than in the focal inflammation patient group.&#x0D; &#x0D; Conclusion: The relationship between chronic prostatitis and PSA elevation remains a mystery. Although no statistical relationship was found between inflammation and PSA elevation in this study, the significant correlation between chronic prostatitis and VB3 positivity reinforces the possibility of this relationship. We believe that our results will form the basis for further studies to avoid unnecessary biopsies.

Association between patient ethnicity and prostate cancer diagnosis following a prostate-specific antigen test: a cohort study of 730,000 men in primary care in the UK

BackgroundBlack men have higher prostate-specific antigen (PSA) levels and higher prostate cancer incidence and mortality than White men, while Asian men tend to have lower prostate cancer incidence and mortality than White men. Much of the evidence comes from the USA, and information from UK populations is limited.MethodsThis retrospective cohort study used data on patients registered at general practices in England contributing to the Clinical Practice Research Datalink (CPRD) Aurum dataset. Those eligible were men aged 40 and over with a record of ethnicity and a PSA test result recorded between 2010 and 2017 with no prior cancer diagnosis.The aim was to assess the incidence of prostate cancer following a raised PSA test result in men from different ethnic groups. Additionally, incidence of advanced prostate cancer was investigated. Cancer incidence was estimated from multi-level logistic regression models adjusting for potential confounding factors.Results730,515 men with a PSA test were included (88.9% White). Black men and men with mixed ethnicity had higher PSA values, particularly for those aged above 60 years. In the year following a raised PSA result (using age-specific thresholds), Black men had the highest prostate cancer incidence at 24.7% (95% CI 23.3%, 26.2%); Asian men had the lowest at 13.4% (12.2%, 14.7%); incidence for White men was 19.8% (19.4%, 20.2%). The peak incidence of prostate cancer for all groups was in men aged 70–79. Incidence of prostate cancer diagnosed at an advanced stage was similar between Black and White men.ConclusionsMore prostate cancer was diagnosed in Black men with a raised PSA result, but rates of advanced prostate cancer were not higher in this group. In this large primary care-based cohort, the incidence of prostate cancer in men with elevated PSA levels increases with increasing age, even when using age-adjusted thresholds, with Black men significantly more likely to be diagnosed compared to White or Asian men. The incidence of advanced stage prostate cancer at diagnosis was similar for Black and White men with a raised PSA result, but lower for Asian men.

Role of 18F-FCH PET/CT in Detecting Recurrences of Prostate Cancer After Curative Treatments.

To evaluate the role of 18F-fluorocholine (18F-FCH) positron emission tomography/computed tomography (PET/CT) in prostate cancer (PC) patients with biochemical recurrence who were submitted to different curative treatments. Seventy-five patients with PC who underwent 18F-FCH PET/CT for biochemical recurrence were retrospectively analyzed to distinguish patients who were submitted only to prostatectomy (PR group), only to radiotherapy (RT) on prostate with curative intent (RT group), and to both (PR + RT group). Correlations between 18F-FCH PET/CT and outcome and between prostate-specific antigen (PSA) values and sites and the number of metastases were analyzed. The performance of 18F-FCH PET/CT in relation to the PSA value and of maximum standardized uptake value (SUVmax) value in relation to patient outcome were assessed by receiver operating characteristic (ROC) curves. 18F-FCH PET/CT relapses mostly involved lymph nodes, bones, and prostate bed. K-cohen test showed moderate agreement with the outcome in the whole population and in the PR group, whereas in the RT group it was perfect and in PR + RT fair. A statistically significant difference in PSA values was observed in the presence of lymph node metastases and with multiple metastases. ROC curves showed PSA cut-off values of 1.96 ng/dL, 1.95, 1.81, and 2.96, respectively, in the whole population, PR, RT and PR + RT group. SUVmax cut-off values of 3.75, 3.45, and 4.7 were described in the whole population, PR group, and PR + RT group. The study confirms that 18F-FCH PET/CT is still valid in PC patients with suspected biochemical recurrence. Therefore, we can affirm that it still makes sense to perform it both with high PSA values and with lower values when prostate-specific membrane antigen tracers are not available.

Prevalence of Helicobacter pylori, Mycobacterium tuberculosis, Malaria Infections, and High Serum Prostate Specific Antigen Levels among Individuals at the Rivers State University, Nigeria: Findings of a Free Medical Outreach

Background: Co-morbidity of infections and non-infectious diseases is increasing in developing societies with little effort in identifying these trends. The study aimed to estimate the prevalence of Helicobacter pylori, Mycobacterium tuberculosis, malaria infections, and high serum prostate-specific antigen levels among individuals and residents at Rivers State University, Port Harcourt, Nigeria.&#x0D; Experimental Design: The study is a cross-sectional descriptive study, which consisted of 501 participants in a free medical outreach organized by the Association of Medical Laboratory Scientists of Nigeria, Rivers State University Chapter, Rivers State, Nigeria, in commemoration of the 2022 International Biomedical Day. The test subjects consisted of males and females, who were students, staff, and residents at the Rivers State University, Port Harcourt, Nigeria. The age range of the test subjects was 18-64 years.&#x0D; Methods: The cross-sectional descriptive study encompassed 501 adults (males and females) who gave consent for their blood screening during our free medical outreach. As a procedure, venous blood specimens were collected at the antecubital fossa from the attendees by venipuncture technique and were screened forH. Pylori antibody, Mycobacterium tuberculosis, malaria parasite, and prostate-specific antigen with the use of Accu-Tell rapid diagnostic test kits. Each test was read within 10 minutes. Red lines on the test zone and control zones of the test kits were read and recorded as positive cases, while a red line on the control zone and the absence of a red line on the test zone of the test kit were read, and recorded as negative case, in line with the rapid diagnostic manufacturer’s instructions.&#x0D; Results: Out of a total of 501 participants, the prevalence of H. pylori, M. tuberculosis, Plasmodium falciparum, and prostate-specific antigen were 9 (1.79 %), 3 (0.6 %), 12 (2.40 %), 6 (4.65 %%) respectively. The sex-based comparison showed that males have the same prevalence for all infectious diseases (H. pylori, M. tuberculosis, and P. falciparum) of 3 (2.32 %), and 6 (4.65 %) for a prostate-specific antigen. For the females, the prevalence of H. pylori, M. tuberculosis and P. falciparum were 6 (2.20 %), 0 (0.00 %), and 9 (2.42 %) respectively.&#x0D; Conclusion: M. tuberculosis prevalence was observed to be greater in the males than in the females of the studied population while that of H. pylori was observed to be higher in the females than the male participants. So continuous screening of the public to monitor and prepare them against the insurgence of these diseases which are of public health concern is important.

The epidemiology of male lower urinary tract symptoms associated with benign prostatic hyperplasia: Results of 20 years of Korean community care and surveys.

To investigate the prevalence of lower urinary tract symptoms/benign prostatic hyperplasia in a Korean population. The Korean Prostate &amp; Voiding Health Association provided free prostate-related community health care and conducted surveys in all regions of Korea from 2001 to 2022 with the cooperation of local government public health centers. A total of 72,068 males older than 50 were surveyed and analyzed. History taking, International Prostate Symptom Score (IPSS), transrectal ultrasonography, prostate-specific antigen (PSA) testing, uroflowmetry, and urine volume testing were performed. The mean prostate volumes in males in their 50s, 60s, 70s, and 80s or above were 24.7 g, 27.7 g, 31 g, and 33.7 g, respectively. The proportion of males with high PSA greater than 3 ng/mL was 3.8% among males in their 50s, 7.7% among males in their 60s, 13.1% among males in their 70s, and 17.9% among males 80 years of age or older. The mean IPSS total scores in males in their 50s, 60s, 70s, and 80s or above were 10.7, 12.7, 14.5, and 16, respectively. Severe symptoms were reported by 27.3% of males, whereas 51.7% reported moderate symptoms. The mean Qmax in males in their 50s, 60s, 70s, and 80s or above were 20 mL/s, 17.4 mL/s, 15.4 mL/s, and 13.8 mL/s, respectively. In this population-based study, mean prostate volume, IPSS, PSA, and Qmax were 30.6±15.1 g, 14.8±8.2, 1.9±4.7 ng/mL, and 15.6±6.5 mL/s, respectively. Aging was significantly associated with increased prostate volume, PSA levels, and IPSS scores, and with decreased Qmax and urine volume.

Biochemical progression free and overall survival among Black men with stage IV prostate cancer in South Africa: Results from a prospective cohort study.

Men of African descent are disproportionately affected by prostate cancer (PCa), and many have metastatic disease at presentation. In South Africa (SA), androgen deprivation therapy (ADT) is the first-line treatment for stage IV PCa. To identify predictors of overall survival (OS) in Black South African men with stage IV PCa treated with ADT. Men diagnosed with prostate cancer (3/22/2016-10/30/2020) at Chris Hani Baragwanath Academic Hospital in Soweto, Johannesburg, were recruited for the Men of African Descent with Cancer of the Prostate study. We included men with newly diagnosed stage IV PCa treated with ADT who had a prostate-specific antigen (PSA) level drawn prior to initiation of ADT and had ≥1 PSA drawn ≥12 weeks after ADT start. We used Kaplan-Meier statistics to estimate OS and Cox regression models to identify predictors of OS. Of the 1097 men diagnosed with prostate cancer, we included 153 men with stage IV PCa who received ADT and met PSA requirements. The median age was 68.0 years (interquartile range 64-73 years). Median OS from time of ADT initiation was 3.39 years (95% confidence interval (CI): 3.14%-noncalculable), while biochemical progression-free survival was 2.36 years (95% CI: 2.03%-3.73%). Biochemical progression (HR 3.52, 95% CI: 1.85%-6.70%), PSA nadir level >4 ng/mL (HR 3.77, 95% CI: 1.86%-7.62%), alkaline phosphatase level at diagnosis >150 IU/dL (HR 3.09, 95% CI: 1.64%-5.83%), and hemoglobin at diagnosis <13.5 g/dL (HR 2.90, 95% CI: 1.28%-6.56%) were associated with worse OS. In this study, we identified factors associated with poor OS among Black South African men with stage IV PCa treated with ADT. These factors may be useful in identifying patients for upfront treatment escalation, including the use of docetaxel chemotherapy or escalation of therapy at the time of biochemical progression. In this study, we found that high alkaline phosphatase level, anemia at diagnosis, and high PSA nadir after initiation of androgen deprivation therapy are associated with worse overall survival among Black South African men treated with androgen deprivation therapy for metastatic prostate cancer.

Vulnerabilities of Prostate Glandular Concretions Considered as Artefacts: A Cross-sectional Biopsy Slide Study.

There is no clear consensus regarding the contour of prostatic glandular intraluminal concretions. This study enlightens the rational approach toward deciphering the true nature of these concretions and evaluates their role in normal routine histology of the prostate gland. Fifty hematoxylin and eosin slides that were prepared from procured transrectal biopsy specimens of normal prostate glands from asymptomatic patients suspected of having a prostatic disease but later found to be normal were retrospectively observed for the staining, contour, and positioning of the aggregated masses or concretions within their prostatic lumina and were then compared with the blood prostate specific antigen (PSA) levels. Although significant associations highlighting the utility of these masses in presumed pathological states of the gland were drawn by comparing their staining parameters and contours to those of their respective PSA levels, their interluminal contour variations and vivid staining appearances did not necessarily rule out the possibility of some of them being artefacts, provided they were assessed in totality with the surrounding acini. Intensely eosinophilic concretions were found in patients with a high mean age and those with high PSA levels. Prostatic intraluminal masses that were rounded tended to indicate pathological shifts within the gland; however, the possibility of them changing to artefacts during slide preparations could not be ruled out.

Correlations Between Preoperative Indicators and Postoperative Histopathological Outcomes in Prostate Cancer Patients

Objective: Prostate cancer continues to pose a significant health challenge, with diverse prognoses influenced by preoperative and postoperative assessments. This study aims to elucidate the correlation between preoperative clinical indicators and postoperative histopathological outcomes to enhance prognostic models. The primary objective of this study is to investigate the predictive value of preoperative factors, such as age, Prostate-Specific Antigen (PSA) level, prostate volume (PV), and tumor volume (TV), on postoperative outcomes, specifically focusing on extracapsular invasion (ECI), seminal vesicle invasion (SVI), and positive surgical margins (PSM). Materials and Methods: We retrospectively analyzed the data of 63 patients with prostate cancer who underwent radical prostatectomy. Preoperative clinical data, including age, PSA level, PV, and TV, were collected. Postoperative histopathological data were gathered for ECI, SVI, and PSM. Statistical analyses, including correlation coefficients and median comparisons, were employed to identify significant predictors of postoperative outcomes. Results: The cohort had a mean age of 64.1 years, with PSA levels ranging from 3.65 to 112 ng/ml. Patients with ECI had a median PSA of 14.9 ng/ml, whereas those without had 8.2 ng/ml (p=0.001). Median PV and TV were significantly higher in patients with ECI (PV: 55 cc, TV: 8.07 cc) than in those without ECI (PV: 49 cc, TV: 4.25 cc, p=0.001). Similar significant differences were noted for SVI and PSM, with higher PSA, PV, and TV values in patients with these features (p≤0.042). Age did not significantly affect the outcomes. Conclusion: Preoperative PSA level, prostate volume, and tumor volume were significant predictors of adverse postoperative histopathological features in patients with prostate cancer. These findings highlight the need for a multifactorial approach in preoperative evaluation and advocate the development of enhanced predictive models for improved clinical decision-making and patient management.

Interaction between smoking status and dietary selenium intake affects PSA: A cross-sectional study

BackgroundConflicting results regarding the impact of selenium on reducing prostate cancer have been reported. The current analysis aimed to understand whether there are potential factors affecting the relationship between selenium and prostate cancer. ObjectiveTo clarify the relationship between dietary selenium intake and prostate cancer, we evaluated the correlation between dietary selenium intake and prostate-specific antigen (PSA) based on the National Health and Nutrition Examination Survey (NHANES) database. MethodsAfter screening the NHANES survey data from 2005 to 2010, data for 3,614 of 31,034 participants were considered suitable to include in our study. Dietary selenium intake was the independent variable of our study, while PSA was the dependent variable. We stratified participants into current, former, and never smokers and performed an interaction test on the relationship between selenium intake and PSA using multivariable logistic regression for each smoking-status subgroup. ResultsFor our subgroup analysis, we grouped participants based on smoking status and investigated the association between dietary selenium intake and PSA levels. Among the 242 participants with a PSA level of 4 or higher, the mean age was 58.5 years (±12.1). After adjusting for covariates, we did not find a significant association between dietary selenium and the odds of having a high PSA level. However, we observed a significant interaction between smoking status and dietary selenium in relation to PSA levels (P = .007). Specifically, smokers had lower odds of having high PSA levels, while nonsmokers had higher odds. This suggests that smoking status may modify the effect of dietary selenium on PSA levels. ConclusionOur findings suggest that smoking status affects the relationship between dietary selenium intake and PSA and that smokers are at lower odds of having a high PSA level.

Massive pre-prostatic nodal metastasis from localized aggressive prostate cancer removed during robotic-assisted radical prostatectomy with extended pelvic lymph node dissection: a case report with brief literature review

BackgroundDuring robotic-assisted radical prostatectomy (RARP) for prostate cancer (PCa), few attention is given to pre-prostatic fat tissue (PPT) even during pelvic lymph node dissection (PLND). However, the rare potential involvement of PPT lymph nodes (LN) by PCa metastasis has already been reported by several authors and may influence therapeutic strategy in intermediate and high-risk patients. We present the case of a 69-year-old man who underwent RARP with extended PLND (ePLND) for aggressive PCa with massive pre-prostatic nodal metastasis, sampled during prostate biopsies. We sought to report this case for the particular preoperative images and reinforce benefits of resecting PPT during PLND for PCa.Please confirm if the author names are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author 1 Given name: [Moncef] Last name [Al Barajraji].OkCase presentationA 69-year-old man consulted our department for high serum prostate specific antigen level (57 ng/mL). He had familial history of PCa only at first degree. On digital rectal evaluation, induration of left prostatic lobe was felt. Transrectal ultrasonography showed hypoechogenic lesion in left prostatic lobe with supra-centimetric nodule in PPT. Pelvic magnetic resonance revealed two lesions in the peripheral zone with a 19-mm nodule on right paramedian side of PPT (see Fig. 1). Transrectal ultrasound-guided prostate biopsies were performed, including the nodule. On left side, 2 biopsies out 6 showed Gleason 10 prostate cancer. On right side, all biopsies showed Gleason 9 prostate cancer. The PPT nodule showed Gleason 9 prostate cancer. Prostate specific membrane antigen (PSMA) positron emission tomography computed tomography scan showed hypermetabolic expression from left prostate lesions and PPT nodule. Transperitoneal RARP with ePLND was performed including PPT. Histopathological study revealed advanced prostate cancer with lymphovascular invasion and ECE (see Fig. 2). Evaluation of ePLND material showed metastasis in on pelvic LN and 23 mm nodal metastasis in PPT (see Fig. 2). Therefore, adjuvant therapy was initiated.Please check the edit made in the article title.OPkConclusionsPPT resection is not part of routine RARP with ePLND for PCa. However, this tissue might contain LN harbouring metastasis independently from pelvic LN, indicating adjuvant therapy in case of upstaging. Considering the low morbidity of resecting PPT and its facility, it should always been resected and sent for analysis in intermediate and high-risk PCa.

Administering [177Lu]Lu-PSMA-617 Prior to Radical Prostatectomy in Men with High-risk Localised Prostate Cancer (LuTectomy): A Single-centre, Single-arm, Phase 1/2 Study

BackgroundHigh-risk localised prostate cancer (HRCaP) has high rates of biochemical recurrence; [177Lu]Lu-PSMA-617 is effective in men with advanced prostate cancer. ObjectiveTo investigate the dosimetry, safety, and efficacy of upfront [177Lu]Lu-PSMA-617 in men with HRCaP prior to robotic radical prostatectomy (RP). Design, setting, and participantsIn this single-arm, phase I/II trial, we recruited men with HRCaP (any of prostate-specific antigen [PSA] >20 ng/ml, International Society of Urological Pathology (ISUP) grade group [GG] 3–5, and ≥cT2c), with high tumour uptake on [68Ga]Ga-PSMA-11 positron emission tomography/computed tomography (PSMA PET/CT), and scheduled for RP. InterventionCohort A (n = 10) received one cycle and cohort B (n = 10) received two cycles of [177Lu]Lu-PSMA-617 (5 GBq) followed by surgery 6 weeks later. Outcome measurements and statistical analysisThe primary endpoint was tumour radiation absorbed dose. Adverse events (AEs; Common Terminology Criteria for Adverse Events (CTCAE) version 5.0), surgical safety (Clavien-Dindo), imaging, and biochemical responses were evaluated (ClinicalTrials.gov: NCT04430192). Results and limitationsBetween May 29, 2020 and April 28, 2022, 20 patients were enrolled. The median PSA was 18 ng/ml (interquartile range [IQR] 11–35), Eighteen (90%) had GG ≥3, and six (30%) had N1 disease. The median (IQR) highest tumour radiation absorbed dose after cycle 1 for all lesions was 35.5 Gy (19.5–50.1), with 19.6 Gy (11.3–48.4) delivered to the prostate. Five patients received radiation to lymph nodes. Nine (45%) patients achieved >50% PSA decline. The most common AEs related to [177Lu]Lu-PSMA-617 were grade 1 fatigue in eight (40%), nausea in seven (35%), dry mouth in six (30%), and thrombocytopenia in four (20%) patients. No grade 3/4 toxicities or Clavien 3–5 complications occurred. Limitations include small a sample size. ConclusionsIn men with HRCaP and high prostate-specific membrane antigen (PSMA) expression, [177Lu]Lu-PSMA-617 delivered high levels of targeted radiation doses with few toxicities and without compromising surgical safety. Further studies of [177Lu]Lu-PSMA-617 in this population are worthwhile to determine whether meaningful long-term oncological benefits can be demonstrated. Patient summaryIn this study, we demonstrate that up to two cycles of [177Lu]Lu-PSMA-617 given prior to radical prostatectomy in patients with high-risk localised prostate cancer are safe and deliver targeted doses of radiation to tumour-affected tissues. It is tolerated well with minimal treatment-related adverse events, and surgery is safe with a low rate of complications. Activity measured through PSA reduction, repeat PSMA PET/CT, and histological response is promising.