Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Human Kallikrein-2, Prostate Specific Antigen and Free-Prostate Specific Antigen in Combination to Discriminate Prostate Cancer from Benign Diseases in Syrian Patients

  • Bachour, Dala-Maria (Master Student, Faculty of Pharmacy, Damascus University) ;
  • Chahin, Emil (Department of Clinical Biochemistry and Microbiology, Damascus University) ;
  • Al-Fahoum, Sahar (Department of Clinical Biochemistry and Microbiology, Damascus University)
  • Published : 2015.11.04
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Abstract

Background: The high incidence of prostate cancer as the most common malignancy in males in many countries raises the question of developing reliable detection tests. The prostate specific antigen (PSA) test is the most widely used for screening for prostate cancer; however, its low specificity elevates the number of unnecessarily biopsies. Serum human kallikrein-2 (hK2) is considered as a promising marker, and especially its ratio to fPSA, for predicting the presence of malignancy to select the best choice referring to biopsy or surveillance. In this study, we investigated the role of hK2 and its combinations with other markers to discriminate prostate cancer from benign diseases in Syrian patients. Materials and Methods: In this prospective oriented cross-sectional cohort study, serum samples were collected from patients referred to many Hospitals in Damascus, Syria, between May 2011 and March 2012, and diagnosed with biopsy proven benign prostate hyperplasia (BPH) or prostate cancer (PCa). Serum was analyzed for hK2, PSA and fPSA, and the ratios of fPSA/PSA and hK2/fPSA were calculated. Results: We found that mean hK2/fPSA ratios were significantly higher (P=0.01) in prostate cancer patients than in the BPH or control groups. Also the ratio hk2/fPSA gave the largest area under the curve (AUC:0.96) which was significantly larger than for fPSA/PSA (AUC:0.41) indicative of higher specificity. Conclusions: Our results demonstrate that the ratio of hK2/fPSA might be superior to the use of fPSA/PSA alone. The hK2 could be shown to enhance the early detection of prostate cancer; especially the ratio hK2/fPSA improves specificity and hence may reduce the number of negative biopsies.

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References

  1. Arafa MA, Rabah DM, Wahdan IH (2012). Awareness of general public towards cancer prostate and screening practice in arabic communities: a comparative multi-center study. Asian Pac J Cancer Prev, 13, 4321-6. https://doi.org/10.7314/APJCP.2012.13.9.4321
  2. Baade PD, Yu XQ, Smith DP, et al (2015). Geographic disparities in prostate cancer outcomes--review of international patterns. Asian Pac J Cancer Prev, 16, 1259-75. https://doi.org/10.7314/APJCP.2015.16.3.1259
  3. Bashir MN, Ahmad MR, Malik A (2014). Risk factors of prostate cancer: a case-control study in faisalabad, pakistan. Asian Pac J Cancer Prev, 15, 10237-40.
  4. Becker C, Piironen T, Pettersson K, et al (2000). Clinical value of human glandular kallikrein 2 and free and total prostatespecific antigen in serum from a population of men with prostate-specific antigen levels 3.0 ng/ mL or greater. Urol, 55, 694-9. https://doi.org/10.1016/S0090-4295(99)00585-3
  5. Borgono CA, Diamandis EP (2004). The emerging roles of human tissue kallikreins in cancer. Nat Rev Cancer, 4, 876-90. https://doi.org/10.1038/nrc1474
  6. Boyle P, Severi G, Giles GG. (2003). The epidemiology of prostate cancer. Urol Clin North Am, 30, 209-17. https://doi.org/10.1016/S0094-0143(02)00181-7
  7. Chiu PK, Wong AY, Hou SM, et al (2011). Effect of body mass index on serum prostate-specific antigen levels among patients presenting with lower urinary tract symptoms. Asian Pac J Cancer Prev, 12, 1937-40.
  8. Choubey VK, Sankhwar SN, Carlus SJ, et al (2015). SRD5A2 gene polymorphisms and the risk of benign prostatic hyperplasia but not prostate cancer. Asian Pac J Cancer Prev, 16, 1033-6. https://doi.org/10.7314/APJCP.2015.16.3.1033
  9. Daniyal M, Siddiqui ZA, Akram M, et al (2014). Epidemiology, etiology, diagnosis and treatment of prostate cancer. Asian Pac J Cancer Prev, 15, 9575-8. https://doi.org/10.7314/APJCP.2014.15.22.9575
  10. El Ezzi AA, Zaidan WR, El-Saidi MA, et al (2014). Association of benign prostate hyperplasia with polymorphisms in vdr, cyp17, and srd5a2 genes among lebanese men. Asian Pac J Cancer Prev, 15, 1255-62. https://doi.org/10.7314/APJCP.2014.15.3.1255
  11. Esfahani M, Ataei N, Panjehpour M (2015). Biomarkers for evaluation of prostate cancer prognosis. Asian Pac J Cancer Prev, 16, 2601-11. https://doi.org/10.7314/APJCP.2015.16.7.2601
  12. Heidenreich A, Bellmunt J, Bolla M, et al (2011). EAU guidelines on prostate cancer. part 1: screening, diagnosis, and treatment of clinically localized disease. Europ Urol, 59, 61-71. https://doi.org/10.1016/j.eururo.2010.10.039
  13. Herrala AM, Porvari KS, Kyllonen AP, et al (2001). Comparison of human prostate specific glandular kallikrein 2 and prostate specific antigen gene expression in prostate with gene amplification and overexpression of prostate specific glandular kallikrein 2 in tumor tissue. Cancer, 92, 2975-84. https://doi.org/10.1002/1097-0142(20011215)92:12<2975::AID-CNCR10113>3.0.CO;2-K
  14. Jansen FH, Roobol M, Jenster G, et al (2009). Screening for prostate cancer in 2008 II: the importance of molecular subforms of prostate-specific antigen and tissue kallikreins. European Urol, 55, 563-74. https://doi.org/10.1016/j.eururo.2008.11.040
  15. Madu CO, Lu Y (2010). Novel diagnostic biomarkers for prostate cancer. J Cancer, 6, 150-77.
  16. Martin BJ, Finlay JA, Sterling K, et al (2004). Early detection of prostate cancer in african-american men through use of multiple biomarkers: human kallikrein 2 (hK2), prostatespecific antigen (PSA), and free PSA (fPSA). Prostate Cancer Prostatic Diseases, 7, 132-7. https://doi.org/10.1038/sj.pcan.4500706
  17. Murray NP, Reyes E, Fuentealba C, (2014). Extended use of p504s positive primary circulating prostate cell detection to determine the need for initial prostate biopsy in a prostate cancer screening program in chile. Asian Pac J Cancer Prev, 15, 9335-9. https://doi.org/10.7314/APJCP.2014.15.21.9335
  18. Nam RK, Diamandis EP, Toi A, et al (2000). Serum human glandular kallikrein-2 protease levels predict the presence of prostate cancer among men with elevated prostate-specific antigen. J Clin Oncol, 18, 1036-42.
  19. Ozbek E, Otunctemur A, Dursun M,(2014). The metabolic syndrome is associated with more aggressive prostate cancer. Asian Pac J Cancer Prev, 15, 4029-32. https://doi.org/10.7314/APJCP.2014.15.9.4029
  20. Raaijmakers R, de Vries SH, Blijenberg BG, et al (2007). hK2 and free PSA, a prognostic combination in predicting minimal prostate cancer in screen-detected men within the PSA range 4-10 ng/ml. Eur Urol, 52, 1358-64. https://doi.org/10.1016/j.eururo.2007.04.037
  21. Salim EI, Moore MA, Al-Lawati JA, et al (2009). Cancer epidemiology and control in the arab world - past, present and future. Asian Pac J Cancer Prev, 10, 3-16.
  22. Scorilas A, Plebani M, Mazza S, et al (2003). Serum human glandular kallikrein (hK2) and insulin likegrowth factor1 (IGF-1) improve the discrimination between prostate cancer and benign prostatic hyperplasia in combination with total and %free PSA. Prostate, 54, 220-9. https://doi.org/10.1002/pros.10186
  23. Shamseddine A, Saleh A, Charafeddine M, et al (2014). Cancer trends in Lebanon: a review of incidence rates for the period of 2003-2008 and projections until 2018. Popul Health Metr, 12, 4. https://doi.org/10.1186/1478-7954-12-4
  24. Shariat SF, Roehrborn CG (2008). Using biopsy to detect prostate cancer. Rev Urol, 10, 262-80.
  25. Stephan C, Jung K, Nakamura T, et al (2006). Serum human glandular kallikrein 2 (hK2) for distinguishing stage and grade of prostate cancer. Int J Urol, 13, 238-43. https://doi.org/10.1111/j.1442-2042.2006.01276.x
  26. Thorek DL, Evans MJ, Carlsson SV, et al (2013). Prostatespecific kallikrein-related peptidases and their relation to prostate cancer biology and detection. Established relevance and emerging roles. Thromb Haemost, 110, 484-92. https://doi.org/10.1160/TH13-04-0275
  27. Vickers AJ, Cronin AM, Aus G, Pihl CG, et al (2008). A panel of kallikrein markers can reduce unnecessary biopsy for prostate cancer: data from the european randomized study of prostate cancer screening in Goteborg, Sweden. BMC Med, 6, 19. https://doi.org/10.1186/1741-7015-6-19
  28. Woo HY, Park H, Kwon MJ, et al (2012). Association of prostate specific antigen concentration with lifestyle characteristics in Korean men. Asian Pac J Cancer Prev, 13, 5695-9. https://doi.org/10.7314/APJCP.2012.13.11.5695