Low Prostate-specific Antigen Group Research Articles

Interaction between drinking and dietary inflammatory index affects prostate specific antigen: a cross-sectional study

BackgroundNumerous studies have shown that the dietary inflammatory index (DII) is associated with adverse health effects. However, the relationship between DII and prostate cancer (PCa) remains controversial. Although alcohol is included in DII as a dietary factor, the various adverse health effects of alcohol consumption are not only related to inflammation. On the other hand, it has been a long-standing debate whether alcohol consumption is linked to the risk of PCa. Therefore, to clarify whether drinking affects the relationship between DII and PCa, we evaluated the correlation between DII and prostate-specific antigen (PSA) based on the National Health and Nutrition Examination Survey (NHANES) database.MethodsWe used data from the NHANES spanning from 2005 to 2010 to analyze the relationship between PCa and DII. Out of the 31,034 NHANES participants, we enrolled 4,120 individuals in our study, utilizing dietary intake data from a twenty-four-hour period to determine DII scores. Demographic data, physical and laboratory test results were collected to compare between low PSA and high PSA groups, and to calculate the odds ratio between both groups, we employed a logistic regression analysis.ResultsIn this cross-sectional investigation of PCa, drinkers and non-drinkers had different relationships between DII and PSA levels (OR: 1.2, 95% Cl: 1-1.44 vs. OR: 0.98, 95% Cl: 0.9–1.07), and DII and abstaining from alcohol were effective in reducing the incidence of PSA (p-value for significant interaction = 0.037).ConclusionThe results of our study suggest that drinking may influence the relationship between DII and PSA levels. DII is likely to be a reliable indicator for estimating PSA levels among non-drinkers, who may limit their intake of pro-inflammatory ingredients to lower the incidence and death of PCa.

Absolute Prostate Specific Antigen after 6 Months of Androgen Deprivation Therapy Is a Predictor of Overall and Cancer-Specific Mortality in Men with Hormone-Sensitive Prostate Cancer.

We sought to determine if absolute prostate specific antigen (PSA) value after 6 months of androgen deprivation therapy (ADT) is predictive of subsequent survival in patients with prostate adenocarcinoma. We performed a retrospective review of men receiving care within the Veterans Health Administration who initiated ADT for prostate adenocarcinoma. We used low- (≤0.2 ng/ml), intermediate- (>0.2 to 4 ng/ml) and high-risk (>4 ng/ml) absolute PSA values after 6-9 months of ADT, previously described in Southwest Oncology Group trial 9346. The primary endpoints were all-cause mortality and prostate cancer-specific mortality (PCSM). Kaplan-Meier survival curves for each PSA category were estimated and log-rank test was conducted. We employed Cox regression analysis adjusted for covariates and inverse propensity score weights associated with PSA categories to estimate the PSA category association with PCSM and all-cause mortality. We identified 9,170 patients in our cohort. Following ADT induction, 3,508 patients had low, 3,419 had intermediate and 2,243 had high PSA values. Two- and 5-year survival rates for low, intermediate and high PSA groups were 93.9% and 85.2% vs 88.6% and 71.2% vs 63.6% and 38.6%, respectively (p <0.0001). Patients in the high and intermediate PSA categories had a 15-fold and 3-fold higher risk of PCSM compared to those with PSA <0.2 ng/ml (p <0.0001). Absolute PSA in hormone-sensitive prostate cancer after 6-9 months of ADT is a predictor of overall mortality and PCSM. This measure can rapidly assess the efficacy of new interventions in phase 2 clinical trials.

Survival Analysis and Prognostic Factors in Prostate Cancer Patients: A Single Center Experience in Eastern Anatolia

Objective: Prostate cancer (PC), one of the most common malignancies of the urogenital tract, is more common in older men and shows significant prognostic differences among individuals. In recent years, new grade groups and American Joint Committee on Cancer (AJCC) stage groups have been used to predict prognosis. However, there is limited information on the prognostic significance of this new system in PC patients in Turkey. In this study, we aimed to evaluate the follow-up results of patients with diagnosis of PC, and the clinical significance of the new prognostic staging system in this patient population in Eastern Anatolia Region.&#x0D; Methods: Retrospectively, 141 PC patients being followed up in Erzurum Ataturk University of Medical Oncology Department were included in this study. The relationships between overall survival (OS) and progression free survival (PFS) and clinical-pathological parameters were analysed using Kaplan-Meier curves and compared with the log-rank test. Univariate and multivariate analysis were used to determine the prognostic significance of clinical and pathologic variables for PFS and OS.&#x0D; Results: The median age of patients was 69 and the majority of them were stage IV patients (79.4%). The median value of prostate specific antigen (PSA) was 39 ng/mL and the median Gleason score was 8. The majority of the patients had PSA value of ≥ 20 ng / ml (61.7%) and Gleason grade group 5 (35.5%). The median PFS and OS values were 29 and 33 months, respectively. The 5-year survival rates were 50% for local-locoregional disease and 20% for metastatic disease. PFS and OS were longer in patients with good Eastern Cooperative Oncology Group (ECOG) performance status (0-1), early stage (I-II), undergone to surgery, having low PSA (&lt; 10 ng / ml) and low Gleason group (1-2). According to the multivariate analysis; stage, PSA and Gleason grade group were independent prognostic factors for both PFS and OS.&#x0D; Conclusion: The new grading system, PSA and AJCC staging system are independent prognostic factors in patients with PC. Considering that patients in our region have shorter life spans compared to the world, these prognostic factors should be used more effectively in daily practice in determination of treatment strategy.

Prebiopsy biparametric MRI: differences of PI-RADS version 2 in patients with different PSA levels

To validate the diagnostic accuracy of Prostate Imaging-Reporting and Data System (PI-RADS) version 2 in detecting clinically significant prostate cancer (csPCa, Gleason score ≥7) on prebiopsy biparametric MRI (bpMRI) in patients with different prostate-specific antigen (PSA) levels. This retrospective study included 184 patients who underwent prebiopsy bpMRI followed by transrectal ultrasonography-guided biopsy between June 2015 and February 2017. Reader 1 performed a combination of systematic and targeted biopsy with cognitive fusion after reviewing bpMRI and reader 2 reviewed the bpMRIs retrospectively. PI-RADS categories 4 and 5 were considered positive, and the results of the biopsy were considered the reference standard. Diagnostic performance of PI-RADS of bpMRI was evaluated in two PSA groups with a PSA cut-off level of 10ng/ml and compared to PSA and the PSA density using receiver operating characteristics (ROC) curve analysis. csPCa was diagnosed in 24 of 123 patients (19.5%) and 26 of 61 patients (42.6%) in the low and high PSA groups, respectively. A PI-RADS v2 category by either readers 1 or 2 had a significantly better performance to detect csPCa than PSA in both PSA groups. In the high PSA group, only one csPCa was missed by reader 2, but none by reader 1. In the low PSA group, readers 1 and 2 were unable to detect seven and five of the 24 csPCas, respectively. Prebiopsy bpMRI has good performance for detecting csPCa in the high PSA group but may miss small-volume csPCa in the low PSA group.

Pathological Outcome following Radical Prostatectomy in Men with Prostate Specific Antigen Greater than 10 ng/ml and Histologically Favorable Risk Prostate Cancer

Active surveillance is now the treatment of choice in men with low risk prostate cancer. Although there is no consensus on which patients are eligible foractive surveillance, prostate specific antigen above 10 ng/ml is generally excluded. In an attempt to determine the validity of using a prostate specific antigen cutoff of 10 ng/ml to counsel men considering active surveillance we analyzed a multi-institution database to determine the pathological outcome in men with prostate specific antigen greater than 10 ng/ml but histologically favorable risk prostate cancer. We queried a prospectively maintained database of men with histologically favorable risk prostate cancer who underwent radical prostatectomy between 2003 and 2015. The cohort was categorized into 3 groups based on prostate specific antigen level, including low-less than 10 ng/ml, intermediate-10 or greater to less than 20 and high-20 or greater. Associations of prostate specific antigen group with adverse pathological and oncologic outcomes were analyzed. Of 2,125 patients 1,327 were categorized with histologically favorable risk disease. However on multivariate analyses the rates of up staging and upgrading were similar between the intermediate and low prostate specific antigen groups. In contrast compared to the intermediate prostate specific antigen group the high group had higher incidences of up staging (p = 0.02) and upgrading to 4 + 3 or greater disease (p = 0.046). Biochemical recurrence-free survival rates revealed no pairwise intergroup differences except between the low and high groups. Patients with preoperatively elevated prostate specific antigen between 10 and less than 20ng/ml who otherwise had histologically favorable risk prostate cancer were not at higher risk for adverse pathological outcomes than men with prostate specific antigen less than 10 ng/ml.

MP63-17 EARLY DETECTION OF CLINICALLY SIGNIFICANT PROSTATE CANCER: LOW FREE PROSTATE-SPECIFIC ANTIGEN LEVELS AS A CRITERION FOR PROSTATE BIOPSY IN PATIENTS WITH LOW TOTAL PROSTATE-SPECIFIC ANTIGEN LEVELS

INTRODUCTION AND OBJECTIVES: The present study investigated whether applying %fPSA as a criterion for prostate biopsy in patients with low PSA ( 4.0 ng/mL) could facilitate early diagnosis of clinically significant prostate cancer. METHODS: Free prostate-specific antigen (fPSA) levels have been measured in addition to total prostate-specific antigen (PSA) in all patients undergoing prostate cancer screening at Tohoku University and the Miyagi Cancer Society since July 2001. Subjects comprised 9,522 patients who underwent screening for prostate cancer between July 2001 and June 2011. Patients with %fPSA 12% and PSA 2.0 10.0 ng/mL with no gaps in prostate biopsy histopathological diagnosis (n 1⁄4 260) were divided into the following two PSA groups: low (PSA: 2.0 4.0 ng/mL) and mildly elevated (PSA: 4.1 10.0 ng/mL). Malignancy was evaluated based on Gleason scores of biopsy specimens. Statistical significance was assessed using Pearsons c test. RESULTS: Median age, PSA, and %fPSA were 66 years, 4.5 ng/mL, and 9.9%, respectively. A total of 129 patients (49.6%) were diagnosed with prostate cancer based on biopsy of all patients in the low PSA (n 1⁄4 114, 43.8%) and mildly elevated PSA (n 1⁄4 146, 56.2%) groups. No significant differences were observed between the low PSA group and the mildly elevated PSA group (p 1⁄4 0.1010) in prostate cancer detection rate. Patients were then further classified as low, medium, or high risk (Gleason scores 6, 7 and 8 , respectively) based on biopsy histopathological diagnosis. However, no significant differences were observed between the low and mildly elevated PSA groups (p1⁄40.9974) in malignancy. Overall detection rate in the mediumand high-risk patients was 76%, and highlyiimalignant prostate cancer was efficiently detected. CONCLUSIONS: If %fPSA is low, clinically significant prostate cancer is likely to be diagnosed, even in patients with low total PSA. A high detection rate of 76% was achieved in mediumand high-risk patients, demonstrating that highly malignant prostate cancer was efficiently detected. Including %fPSA as a criterion for prostate biopsy could facilitate early diagnosis of clinically significant prostate cancer, even in patients with low total PSA.

Abstract 3186: Increased number of mast cells infiltrating in non-malignant biopsy is associated with detection of prostate cancer

Abstract INTRODUCTION AND OBJECTIVE: Prostate cancer (PCA) is one of the most common malignancies. Prostate-specific antigen (PSA) is currently the most useful serum tumor marker for detecting PCA. However, because of the low specificity of PSA, many patients undergo unnecessary needle biopsies of the prostate. The discovery of new predictors is essential to establish appropriate repeat biopsies. Tumor cells are surrounded by inflammatory cells such as macrophages, lymphocytes, neutrophils and mast cells(MCs). Inflammatory cell infiltrates may contribute to tumor progression by producing angiogenic factors. MCs are potent stimulators of angiogenesis, and condition cancer growth and development of the metastasis. In the present study, infiltration of MCs in non-malignant biopsy specimens was evaluated as a possible predictive value for PCA. METHODS: These reviews were evaluated for 125 patients ranging from 51 to 82 years (median, 69 years), who received repeat needle biopsies of the prostate and were diagnosed as non-malignant during first biopsy. Of these, 40 (32.0%) were positive for cancer during second or third biopsy. MCs was immunohistochemically labeled using a mast cell tryptase monoclonal antibody. For systematic counting, 6 ocular measuring fields were randomly chosen under a microscope at a power of×400 within first negative biopsy specimens. RESULTS: Serum PSA levels measured by the immunoenzymatic assay from 1.70 to 43.18 ng/ml (median, 8.30 ng/ml) at first biopsy. Of these, 30 (32.0%) were positive for cancer during second, third or fourth biopsy. Serum PSA levels ranged from 1.90 to 52.68 ng/ml (median, 10.01 ng/ml) at the time of biopsy of detection of PCA. The period between the date of first biopsy and diagnosis of PCA ranged from 4.1 to 70.1 months (mean, 25.7 months).There were no significant differences in PSA at first biopsy, age and interval of previous and subsequent biopsies, between negative and positive cases for cancer. However, in PSA at first and repeat biopsy, there were significant differences between patients with or without cancer (P = 0.014, 0.002). MCs were observed in all specimens tested. Median count of MCs in each case was 11. MCs count in patients with cancer was higher than in those without cancer (P &amp;lt; 0.001). Frequency of PCA in high MCs group (≥ 11) (54.5%) was much higher than that in low MCs group (&amp;lt; 11) (12.5%) (P &amp;lt; 0.001). Frequency of PCA in high PSA group (≥ 9.0) (43.8%) was much higher than that in low PSA group (&amp;lt;9.0) (20.5%) (P = 0.015). CONCLUSION: Increased number of Mast cells infiltrating in non-malignant biopsy Is Associated with Detection of PCA. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3186. doi:10.1158/1538-7445.AM2011-3186

T1c prostate cancer detection rate and pathologic characteristics: Comparison between patients with serum prostate-specific antigen range of 3.0 to 4.0 ng/mL and 4.1 to 10.0 ng/mL in Korean population

Objectives To prospectively evaluate the Stage T1c prostate cancer detection rate and pathologic characteristics of patients with a serum prostate-specific antigen (PSA) level of 3.0 to 4.0 ng/mL and compare this with the rate of patients who had a PSA level of 4.1 to 10.0 ng/mL. Methods We analyzed the data of patients who had PSA levels of 3.0 to 10.0 ng/mL, benign findings on digital rectal examination, and no specific lesion identified on transrectal ultrasonography. The clinical characteristics, cancer detection rate, and pathologic findings of the biopsy and prostatectomy specimen were compared between the low (3.0 to 4.0 ng/mL) and intermediate (4.1 to 10.0 ng/mL) PSA groups. Results A total of 450 patients met our criteria. Of these 450 patients, 85 and 365 had a low or an intermediate PSA level, respectively. Prostate cancer was diagnosed in 26% of the low and 19% of the intermediate PSA group. No significant difference was found between the two groups in the pathologic biopsy findings, including the mean Gleason score and percentage of patients with a Gleason score of 7 or more. The pathologic findings of the prostatectomy specimens also showed no significant differences between the two groups, including the mean Gleason score, pathologic stage, and percentage of insignificant prostate cancer. Conclusions No statistically significant difference was found in the incidence of Stage T1c prostate cancer or pathologic characteristics in comparison between the low and intermediate PSA groups. These results suggest that a lower PSA cutoff should be considered as an indication for prostate biopsy in the Korean population.

Detection of Prostate Cancer at Low and Intermediate Serum Prostate-Specific Antigen Levels in a Country with a Low Incidence of Prostate Cancer

The objective of this study was to evaluate the cancer detection rate and the pathologic findings of biopsy in men at low and intermediate prostate-specific antigen (PSA) levels in an Asian population. Patients between 40 and 79 years were entered into a study and 755 patients with serum PSA level of 2.0-10.0 ng/ml underwent trus-guided systematic biopsy. Patients were divided to low (PSA 2.0-4.0 ng/ml, n = 144) and intermediate (PSA 4.1-10.0 ng/ml, n = 611) PSA groups. Patients in the low PSA group had significantly smaller prostates (P = 0.003) and lower PSA density (P < 0.001). The rate of cancer detection was 16.7% (24 of 144) in the low PSA group and 23.7% (145 of 611) in the intermediate PSA group (P = 0.067). In men with normal digital rectal examination (DRE), prostate cancer was diagnosed in 14 (13.3%) of the 105 men in the low PSA group and 99 (19.5%) of the 508 men in the intermediate PSA group (P = 0.139). In all patients and patients with normal DRE, no statistically significant differences were found in the pathologic findings of biopsy between the two groups. Our findings provide a rationale to recommend prostate biopsy at lower PSA threshold in this population. At present, however, it is not clear that men who are treated when their cancers are detected at lower PSA levels have better outcomes than those who are treated when the PSA is higher than 4.0 ng/ml.

Comparison of the Rate of Detecting Prostate Cancer and the Pathologic Characteristics of the Patients with a Serum PSA Level in the Range of 3.0 to 4.0ng/ml and the Patients with a Serum PSA Level in the Range 4.1 to 10.0ng/ml

Purpose: We prospectively evaluated the prostate cancer detection rate and pathologic characteristics of patients with a serum prostate-specific antigen (PSA) level of 3.0 to 4.0ng/ml and we compared this with the patients who had a PSA level in the range of 4.1 to 10.0ng/ml. Materials and Methods: We analyzed the data of patients who had PSA levels of 3.0 to 10.0ng/ml, benign findings on digital rectal examination (DRE) and no specific lesion identified on transrectal ultrasound. The clinical characteristics, cancer detection rate and pathologic findings of the biopsy and prostatectomy specimen were compared between the low (3.0 to 4.0ng/ml) and intermediate (4.1 to 10.0ng/ml) PSA groups. Results: A total of 370 patients met our criteria and so they were included in the study. Sixty five and 305 patients had low or intermediate PSA levels, respectively. The mean age and the number of prostate biopsy cores were not different between the two groups. Prostate cancer was diagnosed in 26% of the low PSA group and in 20% of the intermediate PSA group. No significant difference was found between the two groups on the pathologic findings of the biopsy and on the pathology findings of the prostatectomy specimens, including the mean Gleason score, the percentage of patients with a Gleason score 7 or higher, the pathologic stage and the percentage of insignificant prostate cancer. Conclusions: No statistically significant difference was found in the incidence of prostate cancer or pathological characteristics on comparison between the low and intermediate PSA groups. These results suggest that a lower PSA cutoff should be considered as an indication for a prostate biopsy in the Korean population. (Korean J Urol 2006;47:358-361) ꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏꠏ

Detection of prostate cancer in men with prostate-specific antigen levels of 2.0 to 4.0 ng/mL equivalent to that in men with 4.1 to 10.0 ng/mL in a Japanese population

Objectives To analyze prospectively whether prostate cancer (CaP) incidence differs between Japanese men with a prostate-specific antigen (PSA) level of 2.0 to 4.0 ng/mL and those with a PSA level of 4.1 to 10.0 ng/mL. Methods Men 79 years old or younger who were referred to our clinic were screened for CaP. Individuals with PSA levels of 2.0 ng/mL or greater were recommended for transrectal prostate biopsy. The prebiopsy clinical characteristics, cancer detection rate, and pathologic findings from the needle biopsy and prostatectomy specimen were compared between the low (2.0 to 4.0 ng/mL) and intermediate (4.1 to 10.0 ng/mL) PSA groups. Results Of 858 patients screened for CaP, 440 with benign findings on digital rectal examination met the criteria, and 274 (62.3%) underwent biopsy. Of those undergoing biopsy, 110 and 123 patients had a low or an intermediate PSA level, respectively. Men in the low PSA group had a higher free/total PSA ratio, smaller prostate volume, and lower PSA density compared with those in the intermediate PSA group. CaP was diagnosed in 26 (23.6%) of 110 in the low and 29 (23.6%) of 123 in the intermediate PSA group. No statistically significant difference was found between the two groups in the pathologic findings of needle biopsy, including Gleason score, number of cores per biopsy, percentage of positive cores, and cancer length in the positive cores. Conclusions No statistically significant difference was found in the incidence of CaP (23.6%) between men with low and intermediate PSA levels in a Japanese population. The diagnostic yield was comparable to that reported for both white and black men.