Prostate-specific antigen reduction after empiric antibiotic treatment does not rule out biopsy in patients with lower urinary tract symptoms: prospective, controlled, single-center study

PSA change after antibiotic treatment should not affect decisionmaking on performing a prostate biopsy

BACKGROUND

To investigate the effect of antibiotic treatment on PSA when deciding on prostate biopsy.

METHODS

A total of 206 patients with an elevated PSA level (2.5-30) were included. Mp-MRI could be done on 129 patients. Patients were given ciprofloxacin (500 mg, b.i.d. p.o.) for 4 weeks and PSA measurements were repeated. Systematic prostate biopsy was performed regardless of PSA changes on all patients. Additionally, cognitive biopsies were performed from PI-RADs III, IV, and V lesions.

RESULTS

: Prostate cancer was detected in 36.4% of patients. 53.3% had Gleason score of 3+3, 46.7% had Gleason score ≥ 3+4. PSA values decreased in 56.3% and in 43.7% and remained the same or increased but cancer detection rates were not different: 34.5% vs. 38.9%, respectively (p = 0.514). PSA change in whole group was significant (6.38 ng/mL vs. 5.95 ng/mL, respectively (p = 0.01). No significant PSA decrease was observed in cancer patients (7.1 ng/mL vs. 7.05 ng/mL, p = 0.09), whereas PSA decrease was significant in patients with benign pathology (6.1 ng/mL vs. 5.5 ng/mL, p = 0.01). In patients with PI-RADs IV-V lesions, adenocarcinoma was present in 33.9% and 30.4% with or without PSA decrease, respectively (p = 0.209). Clinically significant cancer was higher in patients with after antibiotherapy PSA values >4 ng/mL regardless of PI-RADs grouping (p = 0.08). Addition of any PSA value to PI-RADs grouping did not have any significant effect on the detection of cancer.

DISCUSSION

PSA change after antibiotic treatment has no effect in detecting cancer and should not delay performing a biopsy.

Electrochemical prostate-specific antigen biosensors based on electroconductive nanomaterials and polymers

Prostate cancer (PCa), the second most malignant neoplasm in men, is also the fifth leading cause of cancer-related deaths in men globally. Unfortunately, this malignancy remains largely asymptomatic until late-stage emergence when treatment is limited due to the lack of effective metastatic PCa therapeutics. Due to these limitations, early PCa detection through prostate-specific antigen (PSA) screening has become increasingly important, resulting in a more than 50% decrease in mortality. Conventional assays for PSA detection, such as enzyme-linked immunosorbent assay (ELISA), are labor intensive, relatively expensive, operator-dependent and do not provide adequate sensitivity. Electrochemical biosensors overcome these limitations because they are rapid, cost-effective, simple to use and ultrasensitive. This article reviews electrochemical PSA biosensors using electroconductive nanomaterials such as carbon-, metal-, metal oxide- and peptide-based nanostructures, as well as polymers to significantly improve conductivity and enhance sensitivity. Challenges associated with the development of these devices are discussed thus providing additional insight into their analytic strength as well as their potential use in early PCa detection.

Antibacterial Capability, Physicochemical Properties, and Biocompatibility of nTiO₂ Incorporated Polymeric Scaffolds

Postoperative infection is a common risk which brings about failure in bone transplantation. In this study, nano titanium dioxide (nTiO₂) was incorporated into Polyetheretherketone/polyglycolicacid (PEEK/PGA) blends to construct antibacterial scaffolds via selective laser sintering. Antibacterial capability was assessed using Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus). The results demonstrated that the scaffolds with nTiO₂ presented an effective antibacterial activity, which might be attributed to that nTiO₂ would do the mechanical and oxidative damage to bacteria by occurring contact actions and generating reactive oxygen species (ROS), and thus killed bacteria from structure and function. Moreover, nTiO₂ could enhance the tensile strength and modulus of scaffolds due to the reinforcing effect and its uniform disperse. And the cell culture experiments showed that nTiO₂ stimulated cellular attachment and proliferation. Besides, it also elevated the hydrophily and thermal stability of scaffolds. These results suggested that the polymeric scaffolds incorporated nTiO₂ had potential application in bone tissue engineering.