Prostate-specific Antigen In Patients Research Articles

First-Strike Rapid Predictive Dosimetry and Dose Response for 177Lu-PSMA Therapy in Metastatic Castration-Resistant Prostate Cancer.

We devised and clinically validated a schema of rapid personalized predictive dosimetry for 177Lu-PSMA-I&T in metastatic castration-resistant prostate cancer. It supersedes traditional empiric prescription by providing clinically meaningful predicted absorbed doses for first-strike optimization. Methods: Prostate-specific membrane antigen PET was conceptualized as a simulation study that captures the complex dosimetric interplay between tumor, marrow, and kidneys at a single time point. Radiation principles of fractionation, heterogeneity, normal-organ constraints (marrow, kidney), absorbed dose, and dose rate were introduced. We created a predictive calculator in the form of a free, open-source, and user-friendly spreadsheet that can be completed within minutes. Our schema achieves speed and accuracy by sampling tissue radioconcentrations (kBq/cm3) to be analyzed in conjunction with clinical input from the user that reflect dosimetric preconditions. The marrow-absorbed dose constraint was 0.217 Gy (dose rate, ≤0.0147 Gy/h) per fraction with an interfraction interval of at least 6 wk. Results: Our first 10 patients were analyzed. The first-strike mean tumor-absorbed dose threshold for any prostate-specific antigen (PSA) response was more than 10 Gy (dose rate, >0.1 Gy/h). The metastasis with the lowest first-strike tumor-absorbed dose correlated the best with the percentage decrease of PSA; its threshold to achieve hypothetical zero PSA was 20 Gy or more. Each patient's PSA doubling time can be used to personalize their unique absorbed dose-response threshold. The predicted mean first-strike prescription constrained by marrow-absorbed dose rate per fraction was 11.0 ± 4.0 GBq. Highly favorable conditions (tumor sink effect) were dosimetrically expressed as the combination of tumor-to-normal-organ ratios of more than 150 for marrow and more than 4 for kidney. Our schema obviates the traditional role of the SUV as a predictive parameter. Conclusion: Our rapid schema is feasible to implement in any busy real-world theranostics unit and exceeds today's best practice standards. Our dosimetric thresholds and predictive parameters can radiobiologically rationalize each patient's first-strike prescription down to a single becquerel. Favorable tumor-to-normal-organ ratios can be prospectively exploited by predictive dosimetry to optimize the first-strike prescription. The scientific framework of our schema may be applied to other systemic radionuclide therapies.

Is It a Necessity to Revise Normal Level of Prostate-Specific Antigen in Patients with Chronic Kidney Disease?

Is It a Necessity to Revise Normal Level of Prostate-Specific Antigen in Patients with Chronic Kidney Disease?

Independent association between prostate-specific antigen nadir and PSA progression-free survival in first-line abiraterone acetate treatment in castration-resistant prostate cancer patients: a pilot study.

There is limited evidence regarding the correlation between prostate-specific antigen (PSA) kinetics and clinical outcomes. Therefore, after regulating other covariates, we studied patients with castration-resistant prostate cancer who received abiraterone acetate as the first-line treatment. In this study, we investigated whether time to PSA nadir was independently associated with PSA progression-free survival (PFS). As a retrospective cohort study, this study contained a total of 77 castration-resistant prostate cancer patients who received abiraterone acetate from October 2015 to April 2021 in a Chinese hospital. The dependent variable was PSA-PFS. The objective independent variable was time to PSA nadir (TTPN). Covariates involved in this study included age, duration of androgen deprivation therapy (ADT), PSA level at baseline, time of 50% PSA decline, time of PSA decline to nadir, Gleason score, bone metastasis, previous treatment, PSA decline <50% in 3 months, PSA to nadir in 3 months, PSA decline <90%, PSA decline <0.2 ng/mL, and PSA flare. For the 77 subjects, their mean age was 72.70 ± 8.08 years. Fully calibrated linear regression findings indicated that PSA decline and kinetics were positively associated with PFS (months) after adjusting confounders (β = 0.77, 95% CI: 0.11-1.44). A non-linear relationship was not detected between PSA decline or PSA kinetics and progression-free survival. According to the data of this study, there was a correlation between early PSA changes and patients treated with abiraterone acetate.

Evaluation of the relationship between prostate volume and prostate specific antigen in patients diagnosed with benign prostatic hyperplasia

Aims: The aim of this study was to investigate the relationship between prostate volume and prostate specific antigen (PSA) levels in patients diagnosed with benign prostatic hyperplasia (BPH). In addition, it is aimed to show that BPH may be one of the causes of PSA elevation in patients without prostate cancer. Methods: Prostate volume was calculated in 60 BPH patients who underwent prostate magnetic resonance imaging (MRI) imaging in radiology department between December 1, 2023 and March 1, 2024 due to elevated PSA. The relationship between prostate volume and the tpsa and fpsa values of the patients in the last month was evaluated. Results: There was a positive correlation between age and total prostate specific antigen (tpsa) and free prostate specific antigen (fpsa) in patients with benign prostatic hyperplasia. However, the correlation between age and fpsa was stronger. Similarly, a positive correlation was found between prostate volume and tpsa and fpsa. The correlation between increased prostate volume and increased fpsa was also stronger. Conclusion: In our study, a positive correlation was found between prostate volume and tpsa and fpsa in patients diagnosed with BPH. It was determined that one of the reasons for the increase in PSA values may be the increase in prostate volume.

Prostate-Specific Antigen as an Ultrasensitive Biomarker for Patients with Early Recurrent Prostate Cancer: How Low Shall We Go? A Systematic Review.

Serum prostate-specific antigen (PSA) needs to be monitored with ultrasensitive PSA assays (uPSAs) for oncologists to be able to start salvage radiotherapy (SRT) while PSA is <0.5 µg/L for patients with prostate cancer (PCa) relapsing after a radical prostatectomy (RP). Our systematic review (SR) aimed to summarize uPSAs for patients with localized PCa. The SR was registered as InPLASY2023110084. We searched for studies on Google Scholar, PUBMED and reference lists of reviews and studies. We only included studies on uPSAs published in English and excluded studies of women, animals, sarcoidosis and reviews. Of the 115 included studies, 39 reported PSA assay methods and 76 reported clinical findings. Of 67,479 patients, 14,965 developed PSA recurrence (PSAR) and 2663 died. Extremely low PSA nadir and early developments of PSA separated PSAR-prone from non-PSAR-prone patients (cumulative p value 3.7 × 1012). RP patients with the lowest post-surgery PSA nadir and patients who had the lowest PSA at SRT had the fewest deaths. In conclusion, PSA for patients with localized PCa in the pre-PSAR phase of PCa is strongly associated with later PSAR and survival. A rising but still exceedingly low PSA at SRT predicts a good 5-year overall survival.

Plain language summary: Does the amount of time it takes for prostate-specific antigen to double affect how long men with nonmetastatic castration-resistant prostate cancer live and their healthcare costs?

This is a plain language summary of a research article originally published in Clinical Genitourinary Cancer. The original article described the effect of rapidly rising prostate-specific antigen (PSA) levels on how long men with a type of advanced prostate cancer live and their healthcare costs. The prostate is a part of the male body that helps make semen. PSA is a protein produced by the prostate that can show how advanced prostate cancer has become. One measure of prostate cancer growth is assessing how quickly a patient's PSA level doubles. This is known as the PSA doubling time (PSADT). People with a shorter PSADT usually have faster-growing prostate cancer compared with people who have a longer PSADT of more than 12months (long PSADT). Researchers wanted to know if PSADT can predict cancer spread (known as metastasis) or death for people with a type of advanced prostate cancer called non-metastatic castration-resistant prostate cancer (nmCRPC). Researchers also wanted to know if PSADT can predict healthcare costs. This could help doctors choose the right treatment for their patients with nmCRPC. This was a real-world study, not a clinical trial. This means that researchers looked at what happened when men received the treatments prescribed by their own doctor as part of their usual healthcare treatment. In this study, researchers used insurance claim information. Researchers looked at information for 2800men with nmCRPC. Six out of every 10men (60%) had a long PSADT of more than 12months. Researchers found that it took longer for the cancer to spread to other parts of the body in men with a longer PSADT than men with PSADT of 12months or less. Researchers also found that men with a longer PSADT lived longer than men with PSADT of 12months or less. The long PSADT group had fewer healthcare visits overall than men with PSADT of 10months or less. Over time, it cost less to treat men with a long PSADT than men with PSADT of 10months or less. Generally, if PSADT was shorter, patients tended to do worse. In this real-world study, researchers found that men with nmCRPC lived longer and had lower healthcare costs if they had a long PSADT of more than 12months compared with men who had a shorter PSADT. Men with nmCRPC and a shorter PSADT may benefit from approved treatments that slow cancer spread and help them live longer. However, these treatments may have side effects and cost more than standard treatment. Doctors take all these things into account when choosing treatments for their patients. Most men in this study had a long PSADT of more than 12months. Standard treatment may be the right choice for them because they are more likely to have better outcomes than men with a shorter PSADT.

Prostate-specific antigen reduction after capecitabine plus oxaliplatin chemotherapy: A case report

Prostate cancer (PC) is currently the most common malignant tumor of the genitourinary system in men. Radical prostatectomy (RP) is recommended for the treatment of patients with localized PC. Adjuvant hormonal therapy (AHT) can be administered postoperatively in patients with high-risk or locally advanced PC. Chemotherapy is a vital remedy for castration-resistant prostate cancer (CRPC), and may also benefit patients with PC who have not progressed to CRPC. A 68-year-old male was admitted to our hospital because of urinary irritation and dysuria with increased prostate-specific antigen (PSA) levels. After detailed examination, he was diagnosed with PC and treated with laparoscopic RP on August 3, 2020. AHT using androgen deprivation therapy (ADT) was performed postoperatively because of the positive surgical margin, extracapsular extension, and neural invasion but lasted only 6 mo. Unfortunately, he was diagnosed with rectal cancer about half a year after self-cessation of AHT, and was then treated with laparoscopic radical rectal resection and adjuvant chemotherapy using the capecitabine plus oxaliplatin (CapeOx) regimen. During the entire treatment process, the patient's PSA level first declined significantly after treatment of PC with laparoscopic RP and ADT, then rebounded because of self-cessation of ADT, and finally decreased again after CapeOx chemotherapy. CapeOx chemotherapy can reduce PSA levels in patients with high-risk locally advanced PC, indicating that CapeOx may be an alternative chemotherapy regimen for PC.

177Lu-PSMA SPECT Quantitation at 6 Weeks (Dose 2) Predicts Short Progression-Free Survival for Patients Undergoing 177Lu-PSMA-I&T Therapy.

177Lu-PSMA is an effective treatment in metastatic castration-resistant prostate cancer (mCRPC). Our ability to assess response rates and adjust treatment may be improved using predictive tools. This study aimed to evaluate change in 177Lu-PSMA SPECT quantitative parameters to monitor treatment response. Methods: One hundred twenty-seven men with progressive mCRPC previously treated with androgen-signaling inhibition (99%) and chemotherapy (71%) received a median of 3 (interquartile range [IQR], 2-5) 8-GBq (IQR, 8-8.5 GBq) doses of 177Lu-PSMA-I&T. Imaging included 68Ga-PSMA-11 PET/CT (SUVmax > 15 at a single site and > 10 at all sites > 2 cm), diagnostic CT, and 177Lu SPECT/CT from vertex to mid thigh (24 h after treatment). 177Lu SPECT/CT quantitative analysis was undertaken at cycles 1 (baseline) and 2 (week 6) of treatment. Clinical and biochemical results were assessed to evaluate prostate-specific antigen (PSA) progression-free survival (PFS) and overall survival (OS). Results: A PSA reduction of more than 50% was seen in 58% (74/127). The median PSA PFS was 6.1 mo (95% CI, 5.5-6.7), and OS was 16.8 mo (95% CI, 13.5-20.1). At the time of analysis, 41% (52/127) were deceased. At baseline and week 6, 76% (96/127) had analyzable serial 177Lu SPECT/CT imaging. SPECT total tumor volume (TTV) was reduced between baseline and week 6 in 74% (71/96; median, -193; IQR, -486 to -41). Any increase in SPECT TTV between baseline and week 6 was associated with significantly shorter PSA PFS (hazard ratio, 2.5; 95% CI, 1.5-4.2; P = 0.0008) but not OS. Median PSA PFS in those with an increase in SPECT TTV was 3.7 mo (95% CI, 2.8-6.8), compared with 6.7 mo (95% CI, 5.8-10.6) in those with no increase in SPECT TTV. An increase in SPECT TTV greater than 20% was also associated with PSA PFS (hazard ratio, 1.9; 95% CI, 1.2-3.0; P = 0.008) but less significantly than any change in SPECT TTV. There was a significant difference in PSA PFS between patients with both increased PSA and SPECT TTV and patients with reduced SPECT TTV and PSA (median, 2.8 vs. 9.0 mo; P < 0.0001). Conclusion: Increasing PSMA SPECT TTV on quantitative 177Lu SPECT/CT predicts short progression-free survival and may play a future role as an imaging response biomarker, identifying when to cease or intensify 177Lu-PSMA therapy.

Segmented linear correlations between bone scan index and prostate cancer biomarkers, alkaline phosphatase, and prostate specific antigen in patients with a Gleason score ≥7.

Technetium-99m methyl diphosphonate bone scintigraphy is relatively easily accessible for detecting bone metastases in prostate cancer patients. However, it is subjective and can be challenging to compare images taken at different time points. The bone scan index (BSI) is a more objective evaluation and allows for better comparison of images. Its correlation with other biomarkers of prostate cancer metastases such as prostate specific antigen (PSA) and alkaline phosphatase (ALP) is not clearly understood. This study thus aimed to compare the BSI correlation to PSA against that of BSI to ALP levels in patients with a Gleason score ≥7.A retrospective analysis of the medical records of 50 prostate cancer patients with a Gleason score of ≥7 referred for a bone scan between January 1, 2015 and December 31, 2018 was undertaken. Bone scans were interpreted visually, and using a semi-automated computer programme to quantify the BSI and its relation to PSA and ALP measurements.For the metastasis positive measurements, there was a statistically significant moderate positive overall linear correlation between BSI and PSA. For ALP and BSI, there were 2 segmented strong positive linear relationships between them. The first segment consisted of ALP < 375 IU/L and BSI >10%, where ALP and BSI were strongly and positively correlated. The other segment tended to have generally low BSI measurements (<10%) and also had a strong and positive correlation.The BSI was found to be better linearly correlated with ALP than PSA.

Association of Plasma Zinc and Prostate-Specific Antigen in Patients with Prostatic Cancer in Khartoum

Background: Prostate cancer is the most common visceral cancer in males, ranking as the second most common cause of cancer-related deaths in men older than 50 years of age, after carcinoma of the lung. It is predominantly a disease of older males, with a peak incidence between the ages of 65 and 75 years. This study aimed to estimate the plasma zinc level and plasma prostate-specific antigen (PSA) level in patients suffer from prostate cancer. Materials and Methods: A case–control study was conducted in Khartoum on 100 males aged more than 50 years old which were divided into 50 apparently healthy as control and 50 with prostate cancer as case. A 5 ml of blood specimens was collected in lithium heparin anticoagulants for the estimation of plasma zinc level using Buck model 210 VGP Atomic Absorption Spectrophotometer (East Norwalk, CT 06855) made in the USA and the plasma total PSA that was measured by immunoassay Sandwich principle HITACHI ROCHE COBAS E 411 (serial number 04641655190 V 13.0). Results: The mean level of plasma zinc was 0.35 mg/L ± standard deviation [SD] 0.14 in case and in control was 0.68mg/L ± SD 0.13, so the P value was 0.002 and PSA was 43.08 ng/ml ± SD 20.08 in case and 3.53 ng/ml ± SD 3.90 in control, so the P value was 0.000, the correlation between the level of plasma PSA with plasma zinc in patients with prostate cancer give R was 0.01 and R 2 was 0.001. Conclusion: This study concluded that PSA is significantly increased in patients with prostate cancer and plasma zinc level is significantly decreased in patients with prostate cancer. However, it is statistically significant.

Prostate Biopsies and its Correlation with Prostate Specific Antigen in Patients Attending Birat Medical College Teaching Hospital, Morang, Nepal

INTRODUCTION: Prostate cancer is the most common malignant tumor in men over the age of 65 years. It is the second most common cause of cancer related death in men after lung cancer but it can be completely cured if detected at an early stage. Most frequently encountered diseases of the prostate are benign prostatic hyperplasia, prostatitis and carcinoma. Increased prostate specific antigen levels are found to be closely associated with prostate cancer. It is a tumour marker which is a glycoprotein and is expressed by both normal and neoplastic prostate tissue. This study was done to determine the correlation between histopathological diagnosis in prostatic biopsy and serum prostatic specific antigen level. &#x0D; MATERIALS AND METHODS: This is a hospital based cross sectional study carried out in the Department of Pathology, Birat Medical College Teaching Hospital from February 15, 2020 to October 15, 2020. A total of 84 cases were included in this study. All representative tissue sections were taken, paraffin embedded blocks were prepared and stained with hematoxylin and eosin stain. Histopathological examination was done and it’s association with serum prostatic specific antigen level was observed. &#x0D; RESULTS: In the biopsy findings, Benign Prostatic Hyperplasia (BPH) was the most common case seen in 41 (48.8%) cases out of 84 cases with maximum incidence seen in 60-69 years age group (13 cases). A total of 10 (11.9%) cases were those of prostatic adenocarcinoma and were seen in the 70-79 years age group. Majority of benign cases (BPH and BPH with prostatitis) were seen in the PSA range of 0-7ng/ml. Maximum cases of Prostatic Intraepithelial Neoplasia (PIN) were seen in the PSA range of 0-7 or 7.1-14 ng/ml and adenocarcinoma in the range of &gt;20ng/ml. The finding showed that adenocarcinoma is associated with increased level of serum PSA level. &#x0D; CONCLUSIONS: PSA is a specific marker for prostatic tissue. It can be raised in benign lesions of the prostate due to membrane disruption. However, an increased PSA level above 20 ng/ml increases the chance of detecting malignant lesions.

Relationship with Metalloproteinase 13, E-cadherin, Homocysteine and Co Factors Folic Acid and Vitamin B12 in Patients Diagnosed with Prostate Cancer

Introduction:: Prostate cancer (Pc) is the most frequent neoplasia in men and the second cause of death in Brazil. Objective:: To analyze the interactions and biologicals responses of Pc oxidative stress and prostatespecific antigen (PSA), E-cadherin and MMP-13. Demonstrate whether the increase of the amount of the form of E-cadherin found in the plasma of Pc patients, correlates with decrease of the PSA. Methods:: Samples were obtained through peripheral venipuncture to analyse parameters of biomarkers pc as PSA, E-cadherin, MMP-13, Homocysteine, Folic acid, Vitamin B12, Testosterone T and free following the patients diagnosis, 3 and 6 months during their treatment to analyze the biological responses of Pc oxidative stress. Results:: The analysis was performed by using immunoenzymatic assay. Statistical data processed through Excel in Windows Vista and analyzed through the Shapiro-wilk Test, ANOVA, and Spearman Test. An increase in the concentration of E-cadherin (p = 0.02), as a decrease in concentration of PSA (p &lt; 0.001), total testosterone (p &lt; 0.001) and free testosterone (p = 0.02) was observed during the treatment period without significant alterations in the remaining markers for either of the periods. Discussion:: It was found that during treatment of men diagnosed with pc that there was an an increase in the concentration of plasmatic E-cadherin, which was negatively correlated with the concentrations of folic acid (-0,03 (0,87) rs (p). It was observed that the levels of hcy are positively correlated with concentrations of total testosterone and a negative correlation. Vitamins B12 remained within the parameters of normality during the entire study. Conclusion:: P.S.A levels were free and total testosterone levels decreased. In this way, monitoring the folic acid, E-cadherin dosages of patients during the treatment phases can effectively complement in the face of remission, since it would be a way of preventing abnormal cell replications, with a clinical view prudent so that the cell methylation cycle is not affected.

Correlation between prostate volume and prostate-specific antigen in patients diagnosed with benign prostatic hyperplasia

Background: Prostate volume (PV) and serum prostate specific antigen (PSA) have been consistently linked to benign prostatic hyperplasia (BPH) disease progression especially when prostate volumes are &gt;30mls and PSA&gt;1.5ng/ml. PSA is produced by the ductal epithelial cells of the prostate. Understanding the natural history of prostate diseases requires knowledge of prostate volume and PSA.Objective: We set out to determine the correlation between prostate volume and PSA in our cohorts of men diagnosed with BPH.Methodology: Information from the case notes of 120 patients were retrieved including history, physical examination and result of relevant investigations. Data collated were analyzed using the statistical package for social sciences (SPSS) version 20.0 software.Results: Mean age of the patients was 64.95±9.22 years while mean PV and PSA were respectively 70.20±52.01mls and 4.58±3.32ng/ml. Correlation between PV and PSA was statistically significant: r= .407, P value was set at &lt;.05.Conclusion: We concluded that PV and serum PSA levels have a direct relationship.

Increasing incidence of prostate cancer in Taiwan: A study of related factors using a nationwide health and welfare database.

Over the past decades, the incidence of prostate cancer in Taiwan kept rising. Many possible factors including the utility of prostate specific antigen tests, lifestyle remodeling, and patient's comorbidities may contribute to the increasing of incidence or prostate cancer. We aim to use the nationwide Health and Welfare Database (HWD) to investigate possible associated factors.We used HWD, a nationwide database of medical information, to assess the incidence of prostate cancer, utilization of prostate-specific antigen (PSA) test, and underlying diseases of patients and to evaluate whether there was a common trend among these factors.In total, 32,508 patients with newly diagnosed prostate cancer from 2006 to 2013 were identified. The incidence rate of prostate cancer per 100,000 men increased from 35.47 in 2006 to 52.87 in 2012. The number of patients with prostate cancer and underlying diseases related to metabolic syndrome increased every year. The number of total PSA tests and patients undergoing PSA testing, as well as average times of PSA testing per person in the whole population, increased every year. The average PSA test times of patients with newly diagnosed prostate cancer within 3 years before the diagnosis of prostate cancer also increased every year. There was a high correlation between the average PSA test times and the number of patients with newly diagnosed prostate cancer (r2 = 0.9734).The trends of incidence of prostate cancer, utilization of PSA testing, and underlying diseases related to metabolic syndrome at the diagnoses of cancer were similar, increasing every year in the study period. The results suggested that increasing use of PSA tests may increase the diagnosis of prostate cancers. Underlying diseases related to metabolic syndrome might also affect the incidence of prostate cancer.

223Ra-Dichloride Response Evaluation Using 18F-Fluciclovine PET/CT and Bone Scintigraphy in a Patient With Castration-Resistant Metastatic Prostate Cancer

A 66-year-old man was diagnosed with metastatic prostate cancer to the bones. The patient started Ra-dichloride (Xofigo) therapy in April 2019. Tc-MDP bone scan and F-fluciclovine (Axumin) PET/CT showed discordant but overall complementary findings that indicated disease progression after 5 doses of Xofigo therapy. The patient's prostate-specific antigen increased from 33.81 ng/mL at baseline before Xofigo therapy and up to 394.3 ng/mL after the fifth dose of Xofigo treatment. Because of disease progression, Xofigo therapy was discontinued.

Role of Chronic Inflammation as a Predictor of Upstaging/Upgrading in Prostate Cancer: Finding a New Group Eligible for Active Surveillance.

We aimed to investigate the correlation between presence of inflammation and pathology upgrading/upstaging in patients with prostate cancer. A retrospective study was accomplished on 315 patients with prostate cancer, eligible for active surveillance except prostate-specific antigen (PSA) level (PSA<30ng/dL), who underwent radical prostatectomy between 2005 and 2015. Patients were divided into two groups based on needle biopsy: A; with evidence of inflammation (chronic prostatitis) and B; without inflammation. The frequency of upstaging and upgrading in both groups was compared in different ranges of PSA level (<10, 10-20 and 20-30ng/dL). Upgrading/Upstaging was defined as increase from one prognostic grade group to another. Statistical analyses were performed to investigate the relation between inflammation and upgrading/upstaging. The mean age of the patients was 68.2 years and the mean PSA level was 10.2 ng/mL. Chronic prostatitis was identified in 82 of 315 cases therefore upgrading/upstaging were seen in only three patients (3.7%) while 39 of 233 (16.7%) patients without inflammation had upgrading/upstaging in final pathology (P = 0.003). Other variables including the patient's PSA before surgery, PSA density, and the presence of hypoechoic areas in ultrasound had a significant relationship with the incidence of postoperative upgrading/upstaging. Among studied variables, presence of inflammation in biopsies was found to be the most important predictor of upstaging/upgrading (OR: 0.205). Our data demonstrated that patients with concurrent prostatitis and PCa may have a better prognosis even if the PSA level is higher than 10ng/mL.

Correlation study between benign prostatic fluid interleukin levels and prostate specific antigen in patients with benign prostatic hyperplasia complicated with prostatitis

Objective To study the correlation between benign prostatic fluid interleukin levels and prostate specific antigen(PSA) in patients with benign prostatic hyperplasia(BPH) complicated with prostatitis. Methods The clinical data of 115 patients with BPH treated in our hospital from July 2014 to January 2018 were retrospectively analyzed. The situation of concurrent prostatitis, prostatic fluid interleukin levels, total PSA(TPSA) and free PSA(FPSA) and FPSA/TPSA were analyzed. Results In the 115 BPH patients, 76 patients had prostatitis, including 37 cases of grade I inflammation, 25 cases of II-grade inflammation, and 13 cases of grade III inflammation. The extent of inflammation and the degree of inflammation in the grade III-grade inflammation group were significantly higher than those in the I-grade and II-grade inflammation groups, and the differences were statistically significant(P 0.05). According to Pearson linear correlation analysis, there was no significant correlation between prostatic fluid IL-2 and PSA and FPSA in patients with BPH complicated with prostatitis(P>0.05). Prostatic fluid IL-6, IL-8, IL-10 were positively correlated with TPSA and FPSA(P<0.05). Conclusions BPH complicated with prostatitis is a risk factor for elevated PSA in patients, and the levels of IL-6, IL-8, IL-10 in prostatic fluid have a good correlation with PSA. Clinically, the diagnosis and treatment of BPH complicated with prostatitis can be performed according this, and improve clinical efficacy. Key words: Prostatic Hyperplasia; Interleukins; Prostate-Specific Antigen

Incidentally Detected 18F-FDG-Avid Prostate Cancer Diagnosed Using a Novel Fusion Biopsy Platform

Background: Localized prostate cancer rarely undergoes a shift in metabolism towards aerobic glycolysis, a process known as the Warburg Effect. Because of this, positron emission tomography (PET)/CT imaging using 2-deoxy-2-[18F]fluoro-d-glucose (18F-FDG) is uncommonly used to evaluate patients with early-stage prostate cancer. However, men undergoing an 18F-FDG PET/CT for unrelated reasons will on occasion be found to have radiotracer uptake within the prostate gland. The appropriate work-up of these patients is poorly defined. Case Presentation: We present the case of a 61-year-old man with a history of tonsillar squamous cell carcinoma who was incidentally found on 18F-FDG PET/CT to have a hypermetabolic nodule within the prostate. The patient's prostate-specific antigen level was 2.1 ng/cc and digital rectal examination revealed no abnormalities. The patient underwent a targeted prostate biopsy of the lesion using the KOELIS Trinity biopsy platform, which uniquely allows for the real-time overlay of transrectal ultrasonography and PET/CT images. Targeted biopsy revealed Gleason score 4 + 3 = 7 (grade group 3) prostate cancer. Conclusion: Although the incidental detection of 18F-FDG uptake within the prostate is uncommon, more than half of all patients will be found to have prostate cancer. Based on this case and our review of the available medical literature, it is our belief that men with incidentally detected uptake of 18F-FDG within the prostate should undergo further evaluation with a prostate biopsy. This recommendation is supported by data suggesting that 18F-FDG-avid prostate cancer represents a more aggressive clinical phenotype.

Population pharmacokinetic–pharmacodynamic modelling of the relationship between testosterone and prostate specific antigen in patients with prostate cancer during treatment with leuprorelin

This investigation aimed to quantitatively characterize the relationship between the gonadotropin-releasing hormone agonist leuprorelin, testosterone (T) and prostate specific antigen (PSA) concentrations over time, to aid identification of a target T concentration that optimises the balance of the benefits of T suppression whilst reducing the risk of side effects related to futile over-suppression. Data from a single dose study to investigate the effect of leuprorelin in a 6-month depot formulation on T and PSA in prostate cancer patients were analysed using a population pharmacokinetic-pharmacodynamic modelling approach. The developed model was qualified using external data from 3 studies, in which the effect of different formulations of leuprorelin on T and PSA was evaluated in prostate cancer patients. The effect of leuprorelin on the relationship between T and PSA was adequately characterized by the Romero model with minor modifications, combined with a turnover model to describe the delay in response between T and PSA. The data were significantly better described when assuming a minimum PSA level that is independent on the treatment-related reduction in T, as compared to a model with a proportional reduction in PSA and T. The model-based analysis suggests that on a population level, reducing T concentrations below 35ng/dL does not result in a further decrease in PSA levels (>95% of the minimal PSA level is reached). More data are required to support this relationship in the lower T and PSA range.

Serum Levels of Lipocalin-2 and Prostate Specific Antigen in Patients with Prostate Cancer; A Comparative Study

Serum Levels of Lipocalin-2 and Prostate Specific Antigen in Patients with Prostate Cancer; A Comparative Study