Prostatic Acid Phosphatase (PAP), Interleukin-8 (IL-8), and Cytotoxic T-Lymphocyte–Associated Protein 4 (CTLA-4) as Complementary Prognostic Biomarkers to Prostate-specific Antigen (PSA) in Prostate Cancer
Abstract
BACKGROUND: Prostate-specific antigen (PSA) is frequently used for prostate cancer screening and diagnosis, however its low specificity and incapacity to differentiate aggressive from indolent disease reduces its clinical utility. It is necessary to identify biomarkers that can complement PSA to increase the prognostic accuracy of prostate cancer. Emerging evidence suggests that androgen-related factors and immune mediators are involved in prostate cancer progression. Therefore, to identify more accurate markers of prostate cancer progression, several androgen-related and immunological parameters were evaluated alongside serum PSA to determine their potential as complementary prognostic biomarkers.
METHODS: A cross-sectional study was performed involving 60 prostate cancer subjects age ranged 50-74 years and 60 healthy men within the same age range as control. Blood samples from subjects and controls were collected, then testosterone, dihydrotestosterone (DHT), androgen receptor (AR), prostatic acid phosphatase (PAP), interleukin (IL)-8, cytotoxic T-lymphocyte–associated protein 4 (CTLA-4), transforming growth factor-β (TGF-β), IL-35 and PSA were assessed using the enzyme-linked immunosorbent assay (ELISA) in serum.
RESULTS: All parameters showed significant differences between prostate cancer subjects and control, with higher PSA level in prostate cancer subjects (10.2±2.8 ng/mL). AR, PAP, IL-8, IL-35, and CTLA-4 were independently associated with PSA level in predicting prostate cancer progression (p<0.05). However, after multivariable analysis, only PAP, IL-8, and CTLA-4 had shown overall association with PSA serum, which all three show positive correlation.
CONCLUSION: After integrated model analysis, only PAP, IL-8, and CTLA-4 remained significantly associated with PSA levels, indicating that combination of PSA, PAP, IL-8, and CTLA-4 levels might account for a substantial proportion of progression and biochemical activity in prostate cancer patients, and may serve as potential combined biomarker.
KEYWORDS: interleukin-35, prostate cancer, interleukin-8, prostate-specific antigen, testosterone
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DOI: https://doi.org/10.18585/inabj.v18i4.4261
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