The Comparison and Estimation of the Prognostic Value of Lipid Profiles in Patients With Prostate Cancer Depends on Cancer Stage Advancement

Efficacy of plasma atherogenic index in predicting malignancy in the presence of Prostate Imaging-Reporting and Data System 3 (PI-RADS 3) prostate lesions

PURPOSE

Plasma atherogenic index (PAI) was shown to be positively correlated with the presence of malignity in patients with suspicious findings for renal cell cancer and colon cancer in reported studies. In this study, we aimed to evaluate whether there is an association with the presence of malignity in patients PI-RADS 3 prostate lesions and PAI.

METHODS

This retrospective study reviewed the data of 139 patients who underwent transrectal ultrasonography-guided systematic and cognitive fusion prostate biopsy for PI-RADS 3 lesions in multiparametric magnetic resonance imaging. The patients were divided to two groups as malign (n = 33) and benign (n = 106). The association between age, body mass index, comorbidities, smoking status, prostate-specific antigen (PSA), PSA density, free/total PSA, prostate weight, lesion diameter, triglyceride value, high-density lipoprotein-cholesterol value, PAI value data and presence of malignity were investigated by descriptive, multivariate and receiver-operating characteristic (ROC) analysis.

RESULTS

PSA, PSAD, lesion diameter and PAI value were statistically significantly higher in the malignant group compared to the benign group, and the free/total PSA ratio was lower. In multivariate logistic regression analysis, PSA > 9.9 ng/ml, free/total PSA < 12.1%, lesion diameter > 13.5 mm and PAI > 0.13 were identified as independent risk factors for presence of prostate malignancy.

CONCLUSION

PAI was found to be a predictive parameter for prostate cancer in PI-RADS 3 prostate lesions. Our study can open new thoughts about PAI as metric to assess the prostate cancer risk.

The Effect of Radiotherapy on the Concentration of Plasma Lipids in Elderly Prostate Cancer Patients

Lipids play an important role in processes such as the formation of membrane cells or in steroidogenesis, where androgens which stimulate the proliferation of prostate cancer (PCa) cells are produced. Previous studies presented links between cholesterol (CHOL) and PCa and concluded that cholesterol homeostasis changes in PCa patients during treatment and with age. This study further examines the correlation between the lipid profile, the treatment used, and the subjects’ age. Ninety-one subjects (Group 1: >69 years; Group 2: ≤69) histopathologically diagnosed with PCa were tested. Total CHOL, triglycerides (TG), high-density lipoprotein (HDL), low density lipoprotein (LDL), and very low density lipoprotein (VLDL) were assessed from blood taken before the entire course of radiotherapy (RT) and in 3-month intervals after the treatment was completed, for up to 4 years (range: palliative and radical). In all the subjects, the CHOL decreased over time after RT (p = .0445) with a simultaneous increase of prostate specific antigen (PSA) concentration (p = .0366). A faster decrease of HDL was observed with a higher concentration of PSA (p = .0053) and Gleason score (p = .0304). In all the subjects, the HDL decreased after RT (p = .0159) but in the older palliative group the HDL decrease progressed more slowly (p = .0141). It could be stated, that after radical therapy TG levels tended to be consistently higher among younger men relative to the elderly (p = .0151). But it was observed that RT treatment could lead to a decrease in the lipid serum concentration.

Lipid Status During Combined Treatment in Prostate Cancer Patients

The aim of this study was to provide a specific review of current medical literature regarding the lipid profile during prostate carcinoma (PCa) treatment. The main aim was to analyze the results presented by different authors and to find a commonality in the changes occurring during the treatment-hormonotherapy. The levels of total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL) cholesterol, and low-density lipoprotein (LDL) cholesterol were measured before and after the follow-up treatment. The manuscripts reviewed came from the period between 2008 and 2016. The size of the studies ranged from 16 participants to 310. The mean age was from 65 to 74 years in all studies. The Q test was used to attain all lipid parameters and to specify heterogeneity (p < .0001). After 12 months of androgen deprivation therapy (ADT), the patients had a significantly higher level serum TC and TG.

Lipid Metabolism and Endocrine Resistance in Prostate Cancer, and New Opportunities for Therapy

Prostate cancer (PCa) is the most common cancer in men, and more than 10% of men will be diagnosed with PCa during their lifetime. Patients that are not cured with surgery or radiation are largely treated with endocrine therapies that target androgens or the androgen receptor (AR), a major driver of PCa. In response to androgen deprivation, most PCas progress to castrate resistant PCa, which is treated with anti-androgens like enzalutamide, but tumors still progress and become incurable. Thus, there is a critical need to identify cellular pathways that allow tumors to escape anti-androgen therapies. Epidemiological studies suggest that high-fat diets play important roles in PCa progression. Lipid metabolism rewires the PCa metabolome to support growth and resistance to endocrine therapies, although the exact mechanisms remain obscure. Therapeutic effects have been observed inhibiting several aspects of PCa lipid metabolism: Synthesis, uptake, and oxidation. Since AR remains a driver of PCa in advanced disease, strategies targeting both lipid metabolism and AR are starting to emerge, providing new opportunities to re-sensitize tumors to endocrine therapies with lipid metabolic approaches.