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Saleh et al. Improvement of prostate cancer detection

risk of PCa development. However, in these studies, METHODS
PSA remains the best PCa predictor. Another meta-
[20]
analysis research found a positive relation between This study included 72 patients with PCa (mean age
IGFBP-3 and PCa risk. However, the controversy 70.8 ± 5.3 years), 70 BPH patients (mean age 69.5 ±
over the contradicted results of IGF-1 and IGFBP-3 7.3 years) and 56 healthy males (mean age 67.3 ± 7.2
in these studies has been attributed to many factors years) were randomly recruited among the volunteers
such as race, study design and assay features. [22] of matched socioeconomic conditions and who did not
[21]
have any known significant disease. Full history and
Chromogranin A (CgA) is a member of the granin clinical data were recorded for all subjects, and PCa
family, of 439 kDa glycoprotein, and exists in the patients were classified into localized PCa (n = 54)
secretory dense-core granules that contribute to the and metastatic PCa (n = 18). BPH and healthy male
storage of peptide hormones and catecholaminein individuals (n = 126) were grouped as control. Patients
all endocrine and neuroendocrine (NE) cells. Thus, with PCa underwent digital rectal examination, trans-
it can be released from NE cells in a heterogeneous rectal ultrasonography, guided biopsy of the prostate,
circulating molecular form and is considered one of the computed tomography scanning of the pelvis, bone
most abundant components of secretory granules. scanning, and histopathological examination to assess
[23]
While its function is unknown, through previous metastatic disease and determine disease stage.
decades a growing body of evidence has suggested
that CgA is released in abnormal amounts by many Blood samples
malignant NE cells, which may influence different A 10 mL blood sample was drawn in the morning after
components of the tumor stroma and engage with the overnight fasting from healthy subjects and one week
regulation of tumor growth and progression. However, following digital rectal examination for patients with
increased blood CgA levels have been established as prostatic diseases at the time of diagnosis.
a useful indicator in the diagnosis of many NE tumors, Serums of blood samples were separated and stored at
but the use of this marker for clinical management is -20 °C in a deep freeze until the date of analysis. Serum
still controversial. [23,24] Therefore, research has been levels of IGF-1, IGFBP-3, CgA, total (tPSA) and free
dedicated to its prognostic and diagnostic importance, PSA (fPSA) were measured by chemiluminescence
but with little supporting evidence for its use beyond ELISA technique IMMULITE, DPC (Diagnostic
common screening methods. Several studies Products Corporation, Los Angeles, CA, USA).
[8]
have reported that elevated CgA concentrations are
associated with high-grade and advanced stage Statistical analysis
PCa. Some studies have indicated that increased Serum concentrations of CgA, IGF-1, IGFBP-3, tPSA
serum CgA exceeded PSA increase as a marker of and fPSA in addition to combination among parameters
progression to hormone-refractory disease. Therefore, were expressed as arithmetic mean and standard
it is possible to use CgA to monitor metastatic PCa deviation. Statistical analysis was accomplished by
patients under androgen blockade. Some indicate using the statistical package IBM SPSS V20. Data
[25]
CgA utility in early diagnosis, particularly when used in between the groups were compared and the statistical
combination with free/total PSA ratio, however, some significance of mean values was determined by
[26]
studies found that CgA does not precisely differentiate applying independent sample t-test and Mann-Whitney
malignant disease. Similar debate occurs regarding test. The significance level was established at the P
[27]
CgA and tumor features and CgA does not show value of < 0.05. The validity (sensitivity and specificity),
[28]
any advantage in the prognosis of PCa recurrence accuracy of each parameter and ratios thereof were
after radical prostatectomy or radiotherapy. calculated by area under curve (AUC) in receiver
[29]
Inconsistencies may be attributed to the transient and operating characteristics (ROC) curve analysis.
reversible process of neuroendocrine differentiation
(NED) in most malignant prostate tumors; thus, these RESULTS
NE molecules are not constantly detectable. [5,30]
A total of 54 cases of localized PCa patients, mean age
This study is dedicated to evaluate the validity of 70.3 ± 6.3 years, and 18 metastatic patients, mean age
IGF-1, IGFBP-3, CgA and combination with PSA in 71.1 ± 5.5 years, were grouped as PCa patients with a
diagnosis of patients with localized and metastatic mean age of 70.8 ± 5.3 years (P > 0.05). Seventy BPH
PCa. The secondary objective was to compare the patients, mean age 69.5 ± 7.3 years, and 56 healthy
advantage of these markers in differentiation of PCa male individuals, mean age 67.3 ± 7.2 years, were also
patients. included as a control group with a mean age of 68.3 ±
84 Journal of Cancer Metastasis and Treatment ¦ Volume 3 ¦ May 24, 2017