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Identifying genetic biomarkers for diagnosis of prostate cancer in South African men

Background and Aim: Prostate cancer (PCa) is the leading cancer diagnosis amongst South African men. The incidence of PCa is 68.0 per 100 000 Age Standardized Rate (ASR) and the mortality rates are 27.9 per 100 000 ASR; Globocan 2018. Diagnosis of PCa is based on a combination of digital rectal exam...

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Main Author: Salukazana, Samkele Azola
Other Authors: Kaestner, Lisa
Format: Thesis
Language:English
Published: Division of General Surgery 2021
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access_status_str Open Access
author Salukazana, Samkele Azola
author2 Kaestner, Lisa
author_browse Kaestner, Lisa
Salukazana, Samkele Azola
author_facet Kaestner, Lisa
Salukazana, Samkele Azola
author_sort Salukazana, Samkele Azola
collection Thesis
description Background and Aim: Prostate cancer (PCa) is the leading cancer diagnosis amongst South African men. The incidence of PCa is 68.0 per 100 000 Age Standardized Rate (ASR) and the mortality rates are 27.9 per 100 000 ASR; Globocan 2018. Diagnosis of PCa is based on a combination of digital rectal examination, prostate-specific antigen (PSA) and histology. Several biomarkers have been used to increase the sensitivity and specificity of PSA in distinguishing patients with PCa from those with benign prostatic hyperplasia (BPH). These include fractionated PSA, free/total PSA ratio, −2proPSA, prostate cancer antigen 3 and prostate health index amongst others. Biomarkers are needed to differentiate BPH from PCa due to a lack of specificity of these markers with PSA levels above 4.0 ng/ml. The aim of this study is to investigate gene expression patterns of South African men in 9 PCa and 10 BPH patients in order to distinguish between the two groups. Methods: Ethical approval was obtained (HREC 454/2012). Patients scheduled for transurethral resection of the prostate were recruited from the Western Cape. RNA was extracted from prostate tissue using the AllPrep DNA/RNA/miRNA Universal Kit (Qiagen). Complementary DNA was synthesized from RNA using the SuperScript IV VILO Master Mix (Thermo Fischer Scientific). Gene expression was analyzed with the Human Prostate Cancer RT2 Profiler PCR Array and SYBR Green Master Mix. Data were analyzed with the GeneGlobe RT2 and miScript PCR Array Data Analysis Centre from Qiagen. Results: The cohort included patients from different ethnic groups namely, Caucasians, Mixedand African ancestry. The PCa group has an age range from 56 to 75 years (mean 65) while the BPH group was slight older ranging from 60 to 76 years (mean 68). PSA levels range from 24 to 5000 ng/ml (mean 1252 ng/ml, median 185) for the PCa group and 11 to 58 ng/mL (mean 25 ng/ml, median 22) for the BPH group. The following genes were downregulated 2-fold in the PCa group with p values s <0.05; IGF1, PTEN, GSTP1, SOCS3, EGR3, GPX3, TIMP3, ZNF185, DKK3, PTGS2, FOXO1, ARNTL, TNFRSF10D, CCND1, and DLC1, upregulated genes included; CDH1, MKI67, TMPRSS2, ERG, CDKN2A, FASN, and AR but were not statistically significant. At a fold change threshold of 1.5, the following additional genes were downregulated in the PCa group with p values <0.05; DAXX, EGFR, RASSF1, SOX4, and TIMP2, upregulated genes were ACACA, AR, CDKN2A, ERG and FASN but were also not statistically significant. The study shows similarly differentially expressed genes as seen in international studies. Of note PTEN, MKI67 and FASN which are associated with poor prognosis. EGR3 was downregulated in our study and this has been associated aggressive disease and predict relapse after PCa treatment. This could explain the high mortality demonstrated in South African epidemiological studies. Conclusion: We identified a group of differentially expressed genes that have potential in distinguishing PCa and BPH patients with PSA values above 10 ng/ml. A larger population study is needed to further evaluate the clinical significance of our findings.
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provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
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spelling oai:open.uct.ac.za:11427/32961 Identifying genetic biomarkers for diagnosis of prostate cancer in South African men Salukazana, Samkele Azola Kaestner, Lisa Wium, Mariet Zerbini, Luiz Prostate cancer PCa South African men mortality rates Background and Aim: Prostate cancer (PCa) is the leading cancer diagnosis amongst South African men. The incidence of PCa is 68.0 per 100 000 Age Standardized Rate (ASR) and the mortality rates are 27.9 per 100 000 ASR; Globocan 2018. Diagnosis of PCa is based on a combination of digital rectal examination, prostate-specific antigen (PSA) and histology. Several biomarkers have been used to increase the sensitivity and specificity of PSA in distinguishing patients with PCa from those with benign prostatic hyperplasia (BPH). These include fractionated PSA, free/total PSA ratio, −2proPSA, prostate cancer antigen 3 and prostate health index amongst others. Biomarkers are needed to differentiate BPH from PCa due to a lack of specificity of these markers with PSA levels above 4.0 ng/ml. The aim of this study is to investigate gene expression patterns of South African men in 9 PCa and 10 BPH patients in order to distinguish between the two groups. Methods: Ethical approval was obtained (HREC 454/2012). Patients scheduled for transurethral resection of the prostate were recruited from the Western Cape. RNA was extracted from prostate tissue using the AllPrep DNA/RNA/miRNA Universal Kit (Qiagen). Complementary DNA was synthesized from RNA using the SuperScript IV VILO Master Mix (Thermo Fischer Scientific). Gene expression was analyzed with the Human Prostate Cancer RT2 Profiler PCR Array and SYBR Green Master Mix. Data were analyzed with the GeneGlobe RT2 and miScript PCR Array Data Analysis Centre from Qiagen. Results: The cohort included patients from different ethnic groups namely, Caucasians, Mixedand African ancestry. The PCa group has an age range from 56 to 75 years (mean 65) while the BPH group was slight older ranging from 60 to 76 years (mean 68). PSA levels range from 24 to 5000 ng/ml (mean 1252 ng/ml, median 185) for the PCa group and 11 to 58 ng/mL (mean 25 ng/ml, median 22) for the BPH group. The following genes were downregulated 2-fold in the PCa group with p values s <0.05; IGF1, PTEN, GSTP1, SOCS3, EGR3, GPX3, TIMP3, ZNF185, DKK3, PTGS2, FOXO1, ARNTL, TNFRSF10D, CCND1, and DLC1, upregulated genes included; CDH1, MKI67, TMPRSS2, ERG, CDKN2A, FASN, and AR but were not statistically significant. At a fold change threshold of 1.5, the following additional genes were downregulated in the PCa group with p values <0.05; DAXX, EGFR, RASSF1, SOX4, and TIMP2, upregulated genes were ACACA, AR, CDKN2A, ERG and FASN but were also not statistically significant. The study shows similarly differentially expressed genes as seen in international studies. Of note PTEN, MKI67 and FASN which are associated with poor prognosis. EGR3 was downregulated in our study and this has been associated aggressive disease and predict relapse after PCa treatment. This could explain the high mortality demonstrated in South African epidemiological studies. Conclusion: We identified a group of differentially expressed genes that have potential in distinguishing PCa and BPH patients with PSA values above 10 ng/ml. A larger population study is needed to further evaluate the clinical significance of our findings. 2021-02-24T08:31:10Z 2021-02-24T08:31:10Z 2020 2021-02-24T08:30:51Z Master Thesis Masters MMed http://hdl.handle.net/11427/32961 eng application/pdf Division of General Surgery Faculty of Health Sciences
spellingShingle Prostate cancer
PCa
South African men
mortality rates
Salukazana, Samkele Azola
Identifying genetic biomarkers for diagnosis of prostate cancer in South African men
thesis_degree_str Master's
title Identifying genetic biomarkers for diagnosis of prostate cancer in South African men
title_full Identifying genetic biomarkers for diagnosis of prostate cancer in South African men
title_fullStr Identifying genetic biomarkers for diagnosis of prostate cancer in South African men
title_full_unstemmed Identifying genetic biomarkers for diagnosis of prostate cancer in South African men
title_short Identifying genetic biomarkers for diagnosis of prostate cancer in South African men
title_sort identifying genetic biomarkers for diagnosis of prostate cancer in south african men
topic Prostate cancer
PCa
South African men
mortality rates
url http://hdl.handle.net/11427/32961
work_keys_str_mv AT salukazanasamkeleazola identifyinggeneticbiomarkersfordiagnosisofprostatecancerinsouthafricanmen