SOURCE:

Faculty: Medicine
Department: Chemical Pathology

CONTRIBUTORS:

Amah, U. K.
Ahaneku, J. E.
Onyenekwe, C. C

ABSTRACT:

Background. Prostate cancer is a major health problem worldwide and ranks as the second most common cause of cancer related death in men.Tumour markers are substances that aid in the detection, diagnosis and management of malignant growth. Prostate specific antigen (PSA) is one of the most widely used tumour marker and currently used for detection of prostate cancer (Pca). There is lack of consensus among researchers with respect to the benefits of PSA test. Evaluation of new biomarkers is therefore desirable for the diagnosis of prostate cancer.
Aim.This study evaluated the diagnostic potentials of some tumour markers in patients with prostate disorders in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.
Methodology.The is a prospective study involving 60 male subjects with prostate cancer, 60 male subjects with benign prostate hyperplasia (BPH) and 60 male control subjects between the ages of 50 and 90 years. Sarcosine, total antioxidant capacity (TAC), superoxide dismutase (SOD) and creatinine were assayed using colorimetric methods. Engrailed -2 gene proteins (EN- 2), 5-alpha reductase (5ARD), total PSA (TPSA) and free PSA (FPSA) were assayed using enzyme linked immunosorbent assay technique (ELISA). Vitamins C, D and E were assayed using gas chromatography mass spectroscopy (GC-MS), while Zn, Se and Mg were assayed using atomic absorption spectrophotometric (AAS) method. Statistical package for Social Sciences (SPSS) version 20 was used for data analysis.
Results. Sarcosine level (5.36±1.6nmol/l) in Pca group was statistically higher (p=0.0001) than in control (3±0.52 nmol/l). Sarcosine level in BPH (3.09±0.34nmol/l) did not differ significantly (p>0.05) from the controls. Sarcosine level was also significantly higher in the pca patients with metastasis than those without metastasis. The activity of 5ARD in BPH (6.55±1.9) and Pca (7.10±1.31ng/ml) was significantly higher than in in control (3.7±1.02ng/ml). Compared with control (15.23±7.3), the TAC was significantly lower (p=0.0001) in both BPH (7.40±2.60) and Pca (7.2±2.2nmol/l). The TPSA and FPSA (104±49.05 and 9.41±7.83 respectively) in Pca and BPH (42.80±49.15, 2.99±5.21 respectively) were significantly (p=0.0001) lower than in controls (5.24±4.97, 0.84±0.98). The SOD activity for Pca (1.41±0.63U/l) was significantly (P=0.0001) lower than the BPH (2.18±1.1) and control (2.11±0.96). The mean level of vitamin D for BPH and Pca were 10.91±13.49 and 8.82±14.66, these were significantly lower than the mean level of control (23.33±29.75mg/dl). Vitamin E level in controls (10.71±0.44mg/dl) was significantly higher than in BPH and Pca (6.17±7.87 and 6.07±0.48g/dl). There was no significant difference in the engrailed- 2 gene protein in Pca and BPH subjects compared with the controls. Selenium was significantly lower (p=0.02) in BPH (27.53±9.49) and in Pca (20.81±8.80) compared with control. Zinc was significantly lower in BPH (20.01±15.28) and in Pca (18.99±18.29) compared with control. Likewise, Mg was significantly lower (P=0.002) in BPH (3.18±0.22) and in Pca (1.89±1.79) compared (p=0.001) with control (5.17±1.06). The sensitivity (75%) and specificity (71%) of sarcosine as calculated using Bradley’s formula was higher than that of SOD (68%, 65%), 5ARD (58%, 68%), TPSA (38%, 45%) and TAC (31%, 61%) respectively.
Conclusion. This study showed that sarcosine was a more reliable biomarker for the diagnosis of prostate cancer than all the other biomarkers studied.