Serum PSA Levels Research Articles

Clinical Efficacy of SelectMDx for the Detection of Clinically Significant Prostate Cancer

Prostate Cancer (PCa) is the second most frequent cancer diagnosed in men. Elevated serum PSA levels (>4.0 ng/mL) detection is commonly used as a threshold for recommending the tissue biopsy. However, PSA serum levels are not adequate to correctly localize and stage PCa, and to determine its volume and aggressiveness. Therefore, there is a need for healthcare specialists to base the therapeutic decisions on new biomarkers and advanced imaging findings. SelectMDx is a novel non-invasive urine-based assay that measures the expression of two mRNA cancer-related biomarkers (HOXC6 and DLX1) combined with traditional clinical risk factors. Validation studies evidenced the higher precision of SelectMDx urine test to predict PCa. Combining the assay with multi-parametric magnetic resonance imaging (mpMRI) can improve PCa diagnosis and therefore the treatment. Compared to traditional diagnosis strategy, the use of the SelectMDx test in men with elevated PSA levels may lead to a reduction in overdiagnosis and overtreatment. SelectMDx has to be tested in larger and heterogeneous populations in diverse clinical settings to further assess its clinical validity and utility.

Predictive Value of Circulating Tumor Cells Detected by ISET® in Patients with Non-Metastatic Prostate Cancer Undergoing Radical Prostatectomy.

There is an unmet need for reliable biomarkers to predict prostate cancer recurrence after prostatectomy in order to better guide the choice of surgical treatment. We have evaluated the predictive value of the preoperative detection of Circulating Tumor Cells (CTC) for prostate cancer recurrence after surgery. A cohort of 108 patients with non-metastatic prostate adenocarcinoma undergoing radical prostatectomy was tested for the presence of CTC before prostatectomy using ISET®. Disease recurrence was assessed by the increase in serum PSA level after prostatectomy. The following factors were assessed for statistical association with prostate cancer recurrence: the presence of CTC, serum PSA, Gleason score, and pT stage using univariate and multivariate analyses, with a mean follow-up of 34.9 months. Prostate cancer recurrence was significantly associated with the presence of at least 1 CTC at the preoperative time point (p < 0.001; Predictive value = 0.83). Conversely, the absence of prostate cancer recurrence was significantly associated with the lack of CTC detection at diagnosis (Predictive value = 1). Our multivariate analysis shows that only CTC presence is an independent risk factor associated with prostate cancer recurrence after prostatectomy (p < 0.001). Our results suggest that CTC detection by ISET® before surgery is an interesting candidate predictive marker for cancer recurrence in patients with non-metastatic PCa.

Analysis of the Role of Comprehensive Treatment Model in the Treatment of Prostate Cancer.

The incidence of prostate cancer is gradually increasing. There are many methods for clinical treatment of prostate cancer, such as surgical treatment and endocrine treatment. In the case of advanced prostate cancer, we must not only extend patients' survival times but also enhance their quality of life. Endocrine medications are the most effective therapy for advanced prostate cancer. This research will investigate the therapeutic impact of a complete treatment model in prostate cancer in order to discover a trustworthy clinical treatment model. This research discovered that, as compared to endocrine treatment, radical resection of prostate cancer may diminish and reach lower serum PSA levels in a short amount of time, as well as sustain low PSA levels and delay progression to castration resistance. Moreover, the comprehensive treatment mode can effectively reduce the possibility of complications. The research results show that the comprehensive treatment model can play an important role in the treatment of prostate cancer.

The Relationship between the SUVmax Value Obtained in Ga-68 PSMA PET/CT and Lactate Dehydrogenase and Alkaline Phosphatase in Prostate Cancer

Objectives: ALP and LDH are serum markers of prognostic importance in prostate cancer patients. PET/CT imaging with Ga-68 PSMA has played an important role in prostate cancer imaging in recent years. Our aim in this study was to evaluate the relationship and prognostic significance between SUVmax values obtained with Ga-68 PSMA PET/CT and LDH and ALP levels in prostate cancer patients. Methods: We retrospectively evaluated 61 prostate cancer patients who had Ga-68 PSMA PET/CT imaging and who did not have a prostatectomy between 2019 and 2020. PSA, ALP and LDH levels were measured in all patients before or after imaging within a maximum of 28 days. Results: The median age of the patients included in this study was 73 (range: 57–89) and all 61 patients were prostatic adenocarcinoma. 50 (82%) of the patients had distant metastasis in Ga-68 PSMA PET/CT. There was a significant positive correlation between serum LDH and PSA levels. There was a positive correlation between serum ALP and PSA levels. A negative correlation was found between ALP levels and prostate SUVmax. Conclusions: While negative correlation was found between SUVmax and ALP levels, no correlation was found between LDH levels and SUVmax. High ALP levels were found to be related to metastasis rates and severity and high serum PSA levels.

Elévation du taux de PSA sérique : Corrélation histologique avec les biopsies des tumeurs prostatiques au Togo

INTRODUCTION : Le but de ce travail est de déterminer la corrélation entre le taux sérique de PSA et les résultats anatomopathologiques des biopsies prostatiques dans notre pratique. MATERIELS ET METHODES : Il s’agit d’une étude rétrospective et descriptive allant du 1er janvier 2016 au 31 décembre 2020 (cinq ans) dans les services d’Urologie, les laboratoires d’Anatomie et Cytologie Pathologiques du Centre Hospitalier Universitaire Sylvanus Olympio (CHUSO) et de la clinique Autel d’Élie. Ont été inclus tous les dossiers de patients présentant une tumeur prostatique ayant reçu une biopsie et enregistrés dans les dit-services durant la période d’étude. RESULTATS : Deux cent huit dossiers de biopsie pour tumeurs prostatiques ont été colligés. L’âge moyen des patients était de 66,37 ± 9,85 ans. La tranche d’âge la plus représenté était celle de [60 – 70[ ans. Le taux moyen de PSA des patients était de 793,53 ng/ml. Des 208 biopsies prostatiques réalisées, les adénocarcinomes (ADC) représentaient 64,4% (n=134). Les patients ayant un adénocarcinome avaient un taux moyen de PSA de 1.209,37 ng/ml. Pour les adénomyomes, le taux moyen était de 40,52 ng/ml. Soixante-et-neuf patients ayant un adénocarcinome (33,2%) avaient un taux de PSA ≥100 ng/ml. CONCLUSION : Nous avions noté une relation statistiquement significative entre le taux de PSA total et la découverte de cancer. Ainsi toutes élévation du taux de PSA doit conduire à la réalisation de biopsie pour une confrontation histologique. Cependant, il n’existait pas de relation statistiquement significative entre l’élévation du PSA total et le grade histologique.

Relationship between endogenous testosterone and prostate carcinoma.

Prostate cancer incidence is rising rapidly worldwide, which includes Asian countries too. There are a lot of controversies regarding the link between endogenous testosterone levels and prostate disorders. This study was conducted to understand the value of serum testosterone in predicting the risk and occurrence of prostate carcinoma. Eighty males in the age group of 50-80 years, out of which forty were diagnosed as Prostate cancer patients and forty were healthy controls matched with respect to age and sex, were recruited in the study. Serum testosterone and serum prostate-specific antigen levels were estimated in both groups. Serum testosterone levels were low in 67.5% and normal in 32.5% of the patients of prostate cancer. In comparison with the controls, serum PSA levels were observed to be higher in prostate cancer patients (P < 0.001). Analysis of the data was done with the help of an unpaired t-test, and P < 0.05 was considered to be statistically significant. Androgens promote cellular differentiation and proliferation of prostate epithelial cells via the genetic alterations in the TMPRSS2 gene and ETS (E26 transforming sequences) transcription factor genes involved in cell proliferation and tumor cell invasion. These genes are found to be over-expressed in prostate carcinomas. Suppression of testosterone by prostate cancer-induced production of inhibin that initiates the hypothalamic-pituitary axis negative feedback mechanism might be the reason for lower levels of serum testosterone in prostate carcinoma patients. Hence, screening of elderly men above 60 years of age for serum testosterone levels should be done for early identification of prostate carcinoma as well as a better prognosis in the management of the disease.

A New Promising Pathway in Aggressive Prostate Cancer: Treg/mir-let8c/lin28b.

The progress of prostate cancer entails complex contemporaneous tumor developmental events in diverse stages that they are still yet to be clarified. miRNAs might accompany to balance between regulatory and cytotoxic T cells in tumors. Here, we investigated miRNAs and Regulatory T cell (Treg) marker FOXP3 expressions within prostate cancer spectrum. Thirty-eight prostate cancer patients enrolled within two groups to the study as having Gleason Score ≤ 7 (Group-1) and ≥ 8 (Group-2) that compared to 19 benign prostate hyperplasia controls. Twelve miRNAs expressions were analyzed by real time PCR from paraffin-embedded prostate tissue samples. Correlations between serum PSA levels, immunohistochemical staining of CD3, CD4, FOXP3 and miRNA expressions were analyzed. In our study, hsa-let7c-3p significantly 1,52 (p=0.018) and 1,84 (p=0.0095) fold down- regulated whereas, miR-141-3p was significantly 2,36 (p=0.0006) and 2,24 (p=0.001) fold upregulated in the prostate cancer patients compared to benign prostate hyperplasia in group 1 and 2, respectively. Only CD4 (p=0.004) and PSA (p<0.001) have statistically significant differences among groups when compared to benign prostate hyperplasia. miR-143-p, miR-221-3p, hsa-let7c-3p and miR-17-3p expressions were significantly correlated with regulatory T cell marker FOXP3 expression. For the first time, we reported significantly altered expression levels of miRNAs (miR-let7c, miR221, miR-146a, miR-141, miR-143, miR17) and correlations between Treg marker FOXP3 in the aggressive prostate cancer patients suggesting that prostate cancer progression might be under the regulation of crosstalk between Tregs and miRNAs.

A Synthetic Small Molecule Carbazole SH-I-125 Degrades Androgen Receptor and Overcomes Castration-Resistance and Enzalutamide-Resistance in Prostate Cancer Cells

Resistance to clinical anti-androgens is an ongoing problem in the treatment of castration-resistant prostate cancer (CRPC). Although second generation anti-androgens demonstrate initial clinical benefit, patients often develop resistance to these therapies, evidenced by rising serum PSA levels and disease progression. Several mechanisms including the expression of androgen receptor (AR) splice variants contribute to the reactivation of AR signaling in drug-resistant prostate cancer. Novel therapies that target AR signaling and suppress growth in castration-resistant and anti-androgen-resistant prostate cancer are essential for the effective management of advanced disease. We developed a synthetic small molecule analog of mahanine, SH-I-125, a compound with the ability to disrupt androgen receptor signaling and induce apoptosis in castration-resistant and drug-resistant prostate cancer cellular models. SH-I-125 disrupted AR signaling and induced apoptosis in CRPC cells and anti-androgen-resistant prostate cancer cells in a manner more effective than clinical anti-androgens, enzalutamide and ARN509. Furthermore, SH-I-125 decreased full-length AR and its splice variant AR-V7 levels in 22Rv1 prostate cancer cells by a proteasome-dependent mechanism. These findings indicate the therapeutic potential of SH-I-125 in prostate cancer patients that have progressed on currently approved therapies for CRPC.

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.

Correlation between serum PSA, gleason score and histopathological grading of adenocarcinoma of prostate in patients undergoing TRUS guided prostatic biopsy in a tertiary care centre of Southern India

Background Prostate cancer is the second most common cancer and the fifth leading cause of cancer deaths worldwide. Serum psa, a glycoprotein and a serine protease, which is increased in all prostatic diseases but markedly elevated levels are indicative of carcinoma prostate. The present study was done to evaluate the histopathologyof carcinoma of prostate in trus guided prostatic biopsy specimens and correlate serum psa levels with gleason score and grade groups. Methods A hundred patients presented with luts and suspicious of carcinoma prostate underwent trus guided 16 core prostatic biopsy. Histopathological examination, gleason scores and grades of biopsies were obtained. Based on the gleason scores, patients with carcinoma of the prostate were divided into five-grade groups. Mean serum psa levels were calculated and correlated with gleason score and grade groups. Results Malignancy was found in 69 per cent of cases, of which 68 patients were found to have adenocarcinoma of the prostate, one patient found to have undifferentiated carcinoma of the prostate. The total number of patients in each gleason grade groups were obtained, and the mean serum psa levels of these patients in each group were calculated. Mean serum psa levels in each group are group 1 (21.3 ng/ml), group 2 (58.4 ng/ml), group 3 (73.6 ng/ml), group 4 (118.4 ng/ml), group 5 (96.3 ng/ml). Conclusion Serum psa is a highly sensitive tumour marker with low specificity, and its levels are increased in many benign and iatrogenic conditions. Psa has a high negative predictive value which is essential in ruling out malignancy. In our study, higher serum psa levels were correlated with higher gleason score and grades.

Clinical Effects of Jiawei Danggui Beimu Kushen Pills in the Treatment of Prostate Cancer and Their Influence on the Expression of Serum Prostate Specific Antigen.

Objective To observe the clinical effects of Jiawei Danggui Beimu Kushen pills in treating prostate cancer and their influence on the expression of serum prostate specific antigen. Methods A total of 234 prostate cancer patients were selected and randomly divided into observation group and control group, with 117 cases in each group. The control group was given oral bicalutamide tablets, while the observation group was treated with Jiawei Danggui Beimu Kushen pills on the basis of the control group. The treatment efficacy, IPSS score, TCM syndrome score, VAS score, quality-of-life score, and immune function of the two groups were compared before and after treatment. The serum PSA and f-PSA levels of patients before treatment and after 30 days, 90 days, and 180 days of treatment in the two groups were compared. The five-year cumulative survival rate and the incidence of adverse reactions were compared between the two groups. Results After treatment, the total effective rate of the observation group was 88.03% (103/117), which was higher than that of the control group 69.23% (81/117); the difference was statistically significant (P < 0.05). After treatment, the IPSS score, TCM syndrome score, and VAS score of the two groups were reduced, and those in the observation group were lower than those in the control group; the difference was statistically significant (P < 0.05). After treatment, the quality-of-life scores of the two groups increased, and the observation group was higher than the control group; the difference was statistically significant (P < 0.05). Before treatment, there was no significant difference in serum PSA levels and f-PSA levels when comparing between the two groups of patients (P > 0.05). With the increase of treatment time, the two index levels of the two groups were gradually decreased. After 180 days of treatment, the two index levels of the two groups of patients were significantly lower than those before treatment, and the two index levels of the observation group were significantly lower than those of the control group; the difference was statistically significant (P < 0.05). After treatment, the levels of IgM and IgA in the two groups were decreased, and the level of IgG was increased. The difference between the two groups in the levels of each index before and after treatment was statistically significant (P < 0.05), and the difference between the two groups in the levels of each index after treatment was also statistically significant (P < 0.05). The five-year cumulative survival rate of the observation group was 69.23%, and the five-year cumulative survival rate of the control group was 46.15% (P < 0.05). There was no statistically significant difference between the two groups in the incidence of dizziness, fatigue, and gastrointestinal reactions (P > 0.05), but the difference in the incidence of dysuria as well as dysuria and hematuria was statistically significant (P < 0.05). Conclusion Jiawei Danggui Beimu Kushen pills are effective in treating prostate cancer, which can effectively reduce the patients' IPSS score and TCM syndrome scores, relieve the pain, and improve the quality of life of patients. They also have a potential role in regulating serum PSA levels, clearing tumor lesions, reducing postoperative complications, and improving related symptoms.

Atypical Metastases in the Abdomen and Pelvis From Biochemically Recurrent Prostate Cancer: 11C-Choline PET/CT With Multimodality Correlation.

PET with targeted radiotracers has become integral to mapping the location and burden of recurrent disease in patients with biochemical recurrence (BCR) of prostate cancer (PCa). PET with 11C-choline is part of the National Comprehensive Cancer Network and European Association of Urology guidelines for evaluation of BCR. With advances in PET technology, increasing use of targeted radiotracers, and improved survival of patients with BCR because of novel therapeutics, atypical sites of metastases are being increasingly encountered, challenging the conventional view that prostate cancer rarely metastasizes beyond bones or lymph nodes. The purpose of this article is to describe such atypical metastases in the abdomen and pelvis on 11C-choline PET (including metastases to the liver, pancreas, genital tract, urinary tract, peritoneum, abdominal wall, and perineural spread) and to present multimodality imaging features and relevant imaging pitfalls. Given atypical metastases' inconsistent relationship with the serum PSA level and the nonspecific presenting symptoms, atypical metastases are often first detected on imaging. Awareness of their imaging features is important because their detection affects clinical management, patient counseling, prognosis, and clinical trial eligibility. Such awareness is particularly critical because the role of radiologists in the imaging and management of BCR will continue to increase given the expanding regulatory approvals of other targeted and theranostic radiotracers.

Clinical Application of SPECT-CT Imaging with 99mTc-PSMA in Patients with Recurrent Prostate Cancer

Introduction: Prostate cancer is the most common malignancy in men in Europe. One of the important clinical problems is the early detection and visualization of recurrence after radical prostatectomy, radiation therapy or other radical topical treatment, in patients with PSA values above 0.2 ng/ml. With the introduction of molecular highly sensitive imaging methods after administration of radiolabeled prostate-specific membrane antigen (PSMA), it became possible to detect early functional changes associated with the development of a metastatic process in this disease, with a negative CT or MRI result. 99mTc-PSMA is a new radiopharmaceutical and is a small ligand that binds to the active core of PSMA. The aim of our study was to evaluate the clinical role of 99mTc-PSMA in imaging local recurrence and/or loco-regional and distant metastases in patients with recurrent prostate cancer and biochemical disease progression. Material and methods: A cohort of 36 prostate cancer patients was evaluated with established laboratory data for biochemical progression of the disease - increase in the serum value of the tumor marker PSA and its doubling time within 6 months. In 3/36 of the patients, prostate adenocarcinoma was accidentally detected after transurethral resection of the prostate. Hormonal and cytoreductive radiotherapy was performed in these patients as a therapy. The remaining 33/36 patients underwent radical treatment of primary cancer after a systematic or MRI/US fusion prostate biopsy. Results: All of these patients underwent a whole body scan followed by a targeted SPECT-CT study, 1–3 hours after intravenous administration of 99mTc-PSMA. The sensitivity of the SPECT-CT test with 99mTc-PSMA for the detection of recurrent prostate cancer in 36 followed patients was 84.37% (27/32), specificity - 100% (4/4) and accuracy - 86.11% 31/36). Conclusion: For the clinical application of 99mTc-PSMA SPECT-CT we can summarize that this method finds the greatest clinical application for early diagnosis of recurrent disease in patients with prostate cancer and biochemical progression, at serum PSA levels ≥0.50 ng / ml, in order to determine a personalized treatment for each individual patient. Key words: Prostate cancer, recurrent prostate cancer, 99mTc-PSMA, SPECT-CT

A STUDY ON CORRELATION OF SERUM PROSTATE SPECIFIC ANTIGEN WITH CLINICAL AND PATHOLOGICAL VARIABLES IN PATIENTS OF PROSTATOMEGALY

Background: In clinical practice, biopsies are generally performed only when the results ofprostate specific antigen (PSA) test or digital rectal examination (DRE) are abnormal. This leads to misdiagnosis of most small prostatic cancers present in many older men. Patients with lower urinary tract infection (LUTS) who have serum PSA levels higher than 4ng/ml are primarily advised to undergo prostate biopsy to rule out cancer. However, PSA is organ specific not disease specific, so the presence of other prostate diseases such as benign prostatic hyperplasia (BPH) and prostatitis may influence its effectiveness for cancer detection. Hence, the PSA based prostate cancer detection is fraught with high false positive rate.&#x0D; Aim:To evaluate the utility of PSA assay as a method of investigation in diagnosis of prostatic lesion.&#x0D; Objectives: The use of Serum PSA levels for the early detection of prostate cancer and evaluate its role with other modalities for diagnosis of prostate cancer and to diagnose different diseases of prostate, i.e. prostatitis, BPH in prostatomegaly, and its correlation with Serum PSA levels.&#x0D; Materials and Methods: This prospective descriptive study was conducted in Index Medical College, Hospital &amp; Research Centre, Indore, M.P,India in the period of August 2019 to July 2021. The patients were selected from the outdoor Department of General Surgery.&#x0D; Results: A total of 80 male patients presenting with LUTS were included. Their mean age was 68.66 years. The majority i.e. 41 of the study group were in the age group of 61-70 years. 42 of patients had Serum PSA &lt; 4ng/ml. Biopsy proven adenocarcinoma cases 34% of the cases are in the age group of 61-70 years. Out of the biopsy proven adenocarcinoma cases, DRE was suspicious of malignancy in 89%.&#x0D; Conclusion: Serum PSA levels have a significant correlation with the age group, with the increase in age there is rise in Serum PSA levels. Transabdominal ultrasound, DRE and Serum PSA has high sensitivity in diagnosis of prostatomegaly but it was found that none of the screening tool has got much efficacy in differentiating carcinoma prostate from benign hypertrophy, but the combination of DRE and Serum total PSA or DRE, Serum total PSA and ultrasound abdomen showed higher efficacy in diagnosis of carcinoma prostate. Increase in Serum PSA is directly related to carcinoma, but there is no absolute cut-off for Serum PSAfor diagnosis of carcinoma.&#x0D; Key-Words: Prostate specific antigen, Prostatomegaly, Benign Prostatic Hypertrophy, Digital Rectal Examination, International Prostate Severity Score, Carcinoma Prostate.

Prostate zones and cancer: lost in transition?

Localized prostate cancer shows great clinical, genetic and environmental heterogeneity; however, prostate cancer treatment is currently guided solely by clinical staging, serum PSA levels and histology. Increasingly, the roles of differential genomics, multifocality and spatial distribution in tumorigenesis are being considered to further personalize treatment. The human prostate is divided into three zones based on its histological features: the peripheral zone (PZ), the transition zone (TZ) and the central zone (CZ). Each zone has variable prostate cancer incidence, prognosis and outcomes, with TZ prostate tumours having better clinical outcomes than PZ and CZ tumours. Molecular and cell biological studies can improve understanding of the unique molecular, genomic and zonal cell type features that underlie the differences in tumour progression and aggression between the zones. The unique biology of each zonal tumour type could help to guide individualized treatment and patient risk stratification.

Magnetic resonance picture of changes in the prostate gland in patients with localized prostate cancer after radical external beam radiotherapy

Introduction. Magnetic resonance imaging (MRI) is a highly informative imaging technique, but now days is not recommended for detecting prostate cancer revealing after external beam radiation therapy (EBRT) at localized prostate cancer.Purpose of the study. To study the magnetic resonance imaging of changes in the prostate gland in patients with localized prostate cancer after radical EBRT. Materials and methods. Studied and compared the data of clinical and histological studies of a series of MRI in nine patients with prostate cancer before and after EBRT. Standard sequences (T2-weighted images, diffusion-weighted images, dynamic con trast enhancement) were used for MRI. Results. After irradiation, in a delayed period, atrophy and fibrotic changes occur in the structure of the prostate gland, which leads to a decrease in its size, uneven contours, and the impossibility of differentiating the zonal anatomy on T2-VI. After RT, the intensity of the MR signal from the tumor on DWI with a high b-factor decreases, the difference in the ADC of the peripheral, transient zones and the tumor is practically leveled. After RT, the hypervascularity of the tumor progressively decreases, there fore, in the delayed period, in most cases, type 3 of the contrast curve is observed in DCE. In general, MRI gives results consistent with the dynamics of serum PSA levels. However, one patient after EBRT showed signs of local progression on MRI without signs of biochemical progression.Conclusion. MRI can be used as a method for early diagnosis of local recurrence of prostate cancer after EBRT, however, its clinical significance requires further study.

Variation of Serum PSA Levels in COVID-19 Infected Male Patients with Benign Prostatic Hyperplasia (BPH): A Prospective Cohort Studys

ObjectiveTo investigate the effect of SARS CoV-2 on serum total PSA levels in men with BPH diagnosed with COVID-19. MethodsThe PSA (Kit: Immunoassay Program- Cycle 18, Siemens Atellica IM Analyzer) levels in patients who had had a PSA check at least 3 months, but no more than 6 months, prior to diagnosis of acute COVID-19 infection, were examined retrospectively. PSA levels were measured and recorded from these patients on the first day of diagnosis of COVID-19. These patients were called back for urology outpatient follow-up at the third month after the end of the COVID-19 treatment. PSA levels measured in the pre-COVID-19 period, during the period of active infection with COVID-19, and in the post-COVID-19 period were compared. ResultsIn total, 91 patients had a serum PSA level of 1.58 ± 1.09 ng/mL in the pre-COVID-19 period, a serum PSA level of 4.34 ± 3.78 ng/mL measured in the COVID-19 period and 2.09 ± 2.70 ng/mL in the post-COVID-19 period. It was determined that the serum PSA level measured during active COVID-19 infection was statistically significantly higher than the PSA levels measured according to the pre-COVID-19 period and the post-COVID-19 period (P < .001, P < .001; respectively). ConclusionSARS-CoV-2 infection in men diagnosed with BPH causes significant increases in PSA levels during the active period of the disease. Measurement of PSA values used in the diagnosis, differential diagnosis, and follow-up of prostate diseases in the acute period of infection and in the early period after infection treatment may cause false evaluations that may affect the diagnosis and treatment steps of prostate diseases in these patients.

Study of serum prostate specific antigen levels in patients with prostate lesions

In order to see a relationship between histopathology and PSA levels, group of 100 men were studied which included obtaining there Histopathological diagnosis and serum PSA levels before surgical intervention. We found that most common pathology encountered in prostate specimen is BPH. Most of disease of prostate occur in the age group of 61-70 years. With increasing PSA levels the possibility of malignancy increases. But Poorly differentiated tumor may not correlate with PSA level because the tumor cells may not produce PSA as they have lost differentiation.

EDITORIAL COMMENT

Previous studies showed that consumption of certain plant-based foods such as tomato and soy products or their bioactive ingredients, lycopene and isoflavones, respectively, could be associated with lower PSA levels in prostate cancer patients.1-5 In this study, the authors have analyzed data from NHANES and found that dietary intake of vegetables and fruits is inversely associated with serum PSA levels, suggesting that certain phytochemicals may have anti-cancer effects. This finding has significant implications for disease management in different populations of patients with prostate cancer.

Time on treatment with abiraterone and enzalutamide in the Patient-overview Prostate Cancer in The National Prostate Cancer Register of Sweden

Background There are little and inconsistent data from clinical practice on time on treatment with the androgen receptor-targeted drugs (ART) abiraterone and enzalutamide in men with metastatic castration-resistant prostate cancer (mCRPC). We assessed time on treatment with ART and investigated predictors of time on treatment. Material and methods Time on treatment with ART in men with mCRPC in the patient-overview prostate cancer (PPC), a subregister of the National Prostate Cancer Register (NPCR) of Sweden, was assessed by use of Kaplan–Meier plots and Cox regression. To assess the representativity of PPC for time on treatment, a comparison was made with all men in NPCR who had a filling for ART in the Prescribed Drug Registry. Results 2038 men in PPC received ART between 2015 and 2019. Median time on treatment in chemo-naïve men was 10.8 (95% confidence interval 9.1–13.1) months for abiraterone and 14.1 (13.5–15.5) for enzalutamide. After the use of docetaxel, time on treatment was 8.2 (6.5–12.4) months for abiraterone and 11.1 (9.8–12.6) for enzalutamide. Predictors of a long time on treatment with ART were long duration of ADT prior to ART, low serum levels of PSA at start of ART, absence of visceral metastasis, good performance status, and no prior use of docetaxel. PPC captured 2522/6337 (40%) of all men in NPCR who had filled a prescription for ART. Based on fillings in the Prescribed Drug Registry, men in PPC had a slightly longer median time on treatment with ART compared to all men in NPCR, 9.6 (9.1–10.3) vs. 8.6 (6.3–9.1) months. Conclusions Time on treatment in clinical practice was similar or shorter than that in published RCTs, due to older age, poorer performance status and more comorbidities.