Primary Fibrinolysis as the Presenting Sign of Metastatic Prostate Cancer: One Case Report and Literature Review.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3966-3966
Author(s):  
Rongfu Zhou ◽  
Jian Ouyang ◽  
Bing Chen ◽  
Ming Zhou ◽  
Yong Xu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Blood Cell ◽  
Metastatic Prostate Cancer ◽  
Specific Antigen ◽  
Serum Levels ◽  
Fresh Frozen Plasma ◽  
Bone Lesions ◽  
Thrombin Time ◽  
Normal Range ◽  
Free Psa

Abstract Primary fibrinolysis revealing a prostatic adenocarcinoma is rare. Most of the case are limited to biological abnormalities. Here, we describe an unusual case of hematuria and primary fibriolysis as the presenting manifestation of metastatic prostate cancer in a 52-year-old man. The patient consulted for hematuria, ecchymosis and bleeding gums for a month. B-type ultrasound examination showed normal image of prostate. Peripheral blood test showed that the counts of white blood cell, red blood cell and platelet were all in normal range. APTT, prothrombin time and thrombin time were normal. But fibrinogen levels continued to lower than 1.1g/l despite infusions of cryoprecipitate and fresh frozen plasma. Further tests suggested that D-dimer was 9.58 mg/l (normal range: <0.5mg/L), FDP 45 μg/ml, t-PA 90.30 ng/ml (1.00∼12.00 ng/ml), PAI-1 38.3 ng/ml (5.00∼45 ng/ml), α2-PI 118.00% (96.8∼118.8%), PLG 43.30% (57.8∼113.4%), prostate-specific antigen (PSA) 640.2 ng/ml (0∼4 ng/ml), Free PSA 64.2 ng/ml (0∼0.93 ng/ml). PET-CT revealed enhanced metabolizing rate of prostate with enlargement of lymph node in abdomen and multiple bone lesions including rib, vertebration and pelvis. Treatment with a luteinizing hormone-releasing hormone (LHRH) agonist (Diphereline) and a short course of an antiandrogen, led to normalization of all coagulation parameters within 2 weeks, and to clinical improvement and decline in the serum levels of PSA and fPSA. Three months later, the serum levels of PSA and fPSA were normal. We discuss the pathogenesis, differential diagnosis, and association of primary fibrinolysis with prostate cancer along with the management of this condition.

scholarly journals Prognostic role of docetaxel-induced suppression of free testosterone serum levels in metastatic prostate cancer patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Paula Kappler ◽  
Michael A. Morgan ◽  
Philipp Ivanyi ◽  
Stefan J. Brunotte ◽  
Arnold Ganser ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Metastatic Prostate Cancer ◽  
Cox Regression ◽  
Specific Antigen ◽  
Progression Free Survival ◽  
Serum Levels ◽  
Biologically Active ◽  
Free Form ◽  
Total Testosterone ◽  
The Impact

AbstractTo date, only few data concerning the biologically active, free form of testosterone (FT) are available in metastatic prostate cancer (mPC) and the impact of FT on disease, therapy and outcome is largely unknown. We retrospectively studied the effect of docetaxel on FT and total testosterone (TT) serum levels in 67 mPC patients monitored between April 2008 and November 2020. FT and TT levels were measured before and weekly during therapy. The primary endpoint was overall survival (OS). Secondary endpoints were prostate-specific antigen response and radiographic response (PSAR, RR), progression-free survival (PFS), FT/TT levels and safety. Median FT and TT serum levels were completely suppressed to below the detection limit during docetaxel treatment (FT: from 0.32 to < 0.18 pg/mL and TT: from 0.12 to < 0.05 ng/mL, respectively). Multivariate Cox regression analyses identified requirement of non-narcotics, PSAR, complete FT suppression and FT nadir values < 0.18 pg/mL as independent parameters for PFS. Prior androgen-receptor targeted therapy (ART), soft tissue metastasis and complete FT suppression were independent prognostic factors for OS. FT was not predictive for treatment outcome in mPC patients with a history of ART.

Clinically insignificant improvement of prostate cancer prediction by addition of sex steroid hormones and SHBG serum levels to serum PSA, fPSA%, and age in a screening setting

2012 ◽  
Vol 11 (2) ◽  
Author(s):  
Isabel Heidegger ◽  
Marina Popovscaia ◽  
Reinhold Ramoner ◽  
Georg Schäfer ◽  
Birgit Stenzel ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Steroid Hormones ◽  
Specific Antigen ◽  
Free Testosterone ◽  
Serum Levels ◽  
Sex Hormone Binding Globulin ◽  
Sex Steroid ◽  
Sex Steroid Hormone ◽  
Cancer Prediction ◽  
Free Psa

AbstractVarious findings implicate sex hormones in prostate growth and development and also in prostate carcinogenesis. We investigated if addition of sex steroid hormone and sex hormone binding globulin (SHBG) serum levels to standard risk assessment parameters [prostate-specific antigen (PSA), free PSA percentage (fPSA%), and age] improves prostate cancer prediction in a PSA screening setting. Steroid hormones testosterone (T), free testosterone (fT), and estradiol (E2), and binding protein SHBG levels were measured in 762 men undergoing prostate biopsy due to suspect PSA serum levels. Prostate cancer was diagnosed in 286 (37.5%) of these men. Our data confirmed that PSA (mean BE=5.09; mean CA=6.05; p=1.24×10

scholarly journals The Weight of HLA-DPA1 rs3077 Single Nucleotide Polymorphism in Prostate Cancer, a Multicenter Study

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Mohammed Jayed Alenzi ◽  
Amany A. Ghazy ◽  
Diaa-Eldin Taha
Keyword(s):  
Prostate Cancer ◽  
Specific Antigen ◽  
Serum Levels ◽  
Arab Countries ◽  
Control Group ◽  
Single Nucleotide ◽  
Genetic Transmission ◽  
Free Psa ◽  
Protective Allele ◽  
Total Prostate Specific Antigen

Prostate cancer (PCa) has almost the highest genetic transmission that mimics an autosomal dominance hereditary pattern of cancers in some families. Its incidence in Arab countries was reported to be steadily increasing. Aim. To determine the relevance of HLA-DPA1 rs3077 (A/G) SNP with prostate cancer’s risk and/or severity. Subjects and Methods. Forty PCa patients and forty age matched patients with benign prostatic hyperplasia (BPH), as a control group, were enrolled in the study. Serum levels of urea, creatinine, total prostate-specific antigen (PSA), and free PSA were measured. PSA ratio was determined as well. Genotyping of HLA-DPA1 rs3077 (A/G) SNP was done using real-time PCR. Results. The measured lab parameters, except free PSA, were significantly higher among PCa patients in comparison to controls ( P < 0.001 ∗ ). Moreover, PSA ratio was significantly high among PCa patients ( P < 0.001 ∗ ). HLA-DPA1 rs3077 GG genotype was more frequent in PCa patients and the associated OR was 2.546 ( P = 0.059 ), while AA genotype was more frequent in the control group and the associated OR was 0.145 ( P = 0.081 ). Frequency of G allele was higher among PCa patients than the control group while A allele frequency was significantly decreased ( P = 0.034 ∗ ) (protective allele). On multivariate analysis, there is no significant correlation found between HLA-DPA1 rs3077 SNP and PSA ratio (OR = 4.5, 95% CI = 1.2–17.4, P = 0.856 ). Conclusion. HLA-DPA1 rs3077 G allele could be a risk factor for prostate cancer. However, HLA-DPA1 rs3077 SNP has no relation to PCa severity.

scholarly journals PHI density prospectively improves prostate cancer detection

2021 ◽  
Author(s):  
Carsten Stephan ◽  
Klaus Jung ◽  
Michael Lein ◽  
Hannah Rochow ◽  
Frank Friedersdorff ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Specific Antigen ◽  
Roc Curves ◽  
Grey Zone ◽  
Net Benefit ◽  
Threshold Probability ◽  
Free Psa ◽  
Prostate Health Index ◽  
Magnetic Resonance Imaging Mri ◽  
Prostate Health

Abstract Purpose To evaluate the Prostate Health Index (PHI) density (PHID) in direct comparison with PHI in a prospective large cohort. Methods PHID values were calculated from prostate-specific antigen (PSA), free PSA and [− 2]proPSA and prostate volume. The 1057 patients included 552 men with prostate cancer (PCa) and 505 with no evidence of malignancy (NEM). In detail, 562 patients were biopsied at the Charité Hospital Berlin and 495 patients at the Sana Hospital Offenbach. All patients received systematic or magnetic resonance imaging (MRI)/ultrasound fusion-guided biopsies. The diagnostic accuracy was evaluated by receiver operating characteristic (ROC) curves comparing areas under the ROC-curves (AUC). The decision curve analysis (DCA) was performed with the MATLAB Neural Network Toolbox. Results PHID provided a significant larger AUC than PHI (0.835 vs. 0.801; p = 0.0013) in our prospective cohort of 1057 men from 2 centers. The DCA had a maximum net benefit of ~ 5% for PHID vs. PHI between 35 and 65% threshold probability. In those 698 men within the WHO-calibrated PSA grey-zone up to 8 ng/ml, PHID was also significantly better than PHI (AUC 0.819 vs. 0.789; p = 0.0219). But PHID was not different from PHI in the detection of significant PCa. Conclusions Based on ROC analysis and DCA, PHID had an advantage in comparison with PHI alone to detect any PCa but PHI and PHID performed equal in detecting significant PCa.

Comparison of PHI and PHI Density for Prostate Cancer Detection in a Large Retrospective Caucasian Cohort

2021 ◽  
pp. 1-6
Author(s):  
Robert Peters ◽  
Carsten Stephan ◽  
Klaus Jung ◽  
Michael Lein ◽  
Frank Friedersdorff ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Roc Curves ◽  
Net Benefit ◽  
Threshold Probability ◽  
Free Psa ◽  
Prostate Health Index ◽  
Caucasian Cohort ◽  
Prostate Health

<b><i>Background:</i></b> Beyond prostate-specific antigen (PSA), other biomarkers for prostate cancer (PCa) detection are available and need to be evaluated for clinical routine. <b><i>Objective:</i></b> The aim of the study was to evaluate the Prostate Health Index (PHI) density (PHID) in comparison with PHI in a large Caucasian group &#x3e;1,000 men. <b><i>Methods:</i></b> PHID values were used from available patient data with PSA, free PSA, and [−2]pro­PSA and prostate volume from 3 former surveys from 2002 to 2014. Those 1,446 patients from a single-center cohort included 701 men with PCa and 745 with no PCa. All patients received initial or repeat biopsies. The diagnostic accuracy was evaluated by receiver operating characteristic (ROC) curves comparing area under the ROC curves (AUCs), precision-recall approach, and decision curve analysis (DCA). <b><i>Results:</i></b> PHID medians differed almost 2-fold between PCa (1.12) and no PCa (0.62) in comparison to PHI (48.6 vs. 33; <i>p</i> always &#x3c;0.0001). However, PHID and PHI were equal regarding the AUC (0.737 vs. 0.749; <i>p</i> = 0.226), and the curves of the precision-recall analysis also overlapped in the sensitivity range between 70 and 100%. DCA had a maximum net benefit of only ∼5% for PHID versus PHI between 45 and 55% threshold probability. Contrary, in the 689 men with a prostate volume ≤40 cm<sup>3</sup>, PHI (AUC 0.732) showed a significant larger AUC than PHID (AUC 0.69, <i>p</i> = 0.014). <b><i>Conclusions:</i></b> Based on DCA, PHID had only a small advantage in comparison with PHI alone, while ROC analysis and precision-recall analysis showed similar results. In smaller prostates, PHI even outperformed PHID. The increment for PHID in this large Caucasian cohort is too small to justify a routine clinical use.

scholarly journals Usefulness of the prostate health index in predicting the presence and aggressiveness of prostate cancer among Korean men: a prospective observational study

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jae Yoon Kim ◽  
Ji Hyeong Yu ◽  
Luck Hee Sung ◽  
Dae Yeon Cho ◽  
Hyun-Jung Kim ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Specific Antigen ◽  
Significant Proportion ◽  
Health Index ◽  
Free Psa ◽  
Prostate Health Index ◽  
Total Psa ◽  
Prostate Health

Abstract Background We aimed to evaluate the usefulness of the Beckman Coulter prostate health index (PHI) and to compare it with total prostate-specific antigen (PSA) levels and related derivatives in predicting the presence and aggressiveness of prostate cancer (PCa) in the Korean population. Methods A total of 140 men who underwent their first prostate biopsy for suspected PCa were included in this prospective observational study. The diagnostic performance of total PSA, free PSA, %free PSA, [–2] proPSA (p2PSA), %p2PSA, and PHI in detecting and predicting the aggressiveness of PCa was estimated using the receiver operating characteristic curve (ROC) and logistic multivariate regression analyses. Results Of 140 patients, PCa was detected in 63 (45%) of participants, and 48 (76.2%) of them had significant cancer with a Gleason score (GS) ≥ 7. In the whole group, the area under the curve (AUC) for ROC analysis of tPSA, free PSA, %fPSA, p2PSA, %p2PSA, and PHI were 0.63, 0.57, 0.69, 0.69, 0.72, and 0.76, respectively, and the AUC was significantly greater in the PHI group than in the tPSA group (p = 0.005). For PCa with GS ≥ 7, the AUCs for tPSA, free PSA, %fPSA, p2PSA, %p2PSA, and PHI were 0.62, 0.58, 0.41, 0.79, 0.86, and 0.87, respectively, and the AUC was significantly greater in the PHI group than in the tPSA group (p < 0.001). In the subgroup with tPSA 4–10 ng/mL, both %p2PSA and PHI were strong independent predictors for PCa (p = 0.007, p = 0.006) and significantly improved the predictive accuracy of a base multivariable model, including age, tPSA, fPSA and %fPSA, using multivariate logistic regression analysis. (p = 0.054, p = 0.048). Additionally, at a cutoff PHI value > 33.4, 22.9% (32/140) of biopsies could be avoided without missing any cases of aggressive cancer. Conclusions This study shows that %p2PSA and PHI are superior to total PSA and %fPSA in predicting the presence and aggressiveness (GS ≥ 7) of PCa among Korean men. Using PHI, a significant proportion of unnecessary biopsies can be avoided.

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