The Cytokine Profile and Prostate Specific Antigen Levels in Prostate Cancer Patients at Kenyatta National Hospital
Mwirigi, Liza Kiende
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Prostate cancer (PCa) is Kenya‘s most frequently diagnosed cancer of men with an incidence rate of 32 per 100,000 and mortality rate of 12 per 100,000. It is also the leading cancer in terms of incidence and mortality in men from Africa and the Caribbean and the numbers may double by 2030. Prostate Specific Antigen (PSA) is the main diagnostic biomarker used for screening patients currently. Biopsy histology is the only confirmatory test, but it is invasive and tedious to perform. There is an urgent need to develop other accurate biomarkers that can be used for screening and diagnosis. Cytokines have potential but have not been extensively studied as biomarkers. The objectives of this study were to evaluate the cytokine profile, determine the PSA levels in PCa patients and the risk factors that lead to the development of PCa. The study profiled six cytokines (interleukin-2 (IL-2), interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-10 (IL-10), interferon gamma (IFN-Gamma) and tumor necrosis factor alpha (TNF-Alpha) and the total PSA levels in the serum of 45 PCa patients, 7 benign prostate enlargement (BPE) patients and 7 healthy males as controls. Cytokines were measured using a highly sensitive cytometric bead array technique. PSA levels were determined using enzyme linked immunosorbent assay (ELISA) technique. A questionnaire was used to determine the demographic and risk factors that lead to the development of PCa. Statistical analysis was performed using statistical package for social sciences (SPSS) version 21. Analysis of variance (ANOVA) was used to compare the means of the cytokines and PSA levels in the different Gleason scores of the PCa patients. Pearson correlation was used to correlate the six individual cytokines and PSA levels. Statistical significance was set at the level of p<0.05 for both the ANOVA and the Pearson correlation test. The results showed that serum levels of all cytokines and PSA were significantly (p<0.05) higher in the PCa and the BPE patients. The PCa patients with a Gleason score of 8-10 had the highest levels of all the cytokines followed by those with a Gleason score of 5-7, then those with a Gleason score of 2-4. TNF-Alpha and IL-6 were the cytokines with the highest levels while IL-4 and IL-10 had the lowest levels. The cytokine levels among the BPE patients were less than those of the PCa patients. The PSA levels were also significantly higher (p=0.002) in the BPE and PCa patients and they were significantly correlated (p=0.01) with the six cytokines in the two study groups. Kenyan men who are above 50 years are at risk of suffering from PCa. These results indicated that cytokine profiles in PCa patients are distinct by the stage of the disease. TNF-Alpha, IL-6, IFN-Gamma, IL-2 and IL-4 may be potential early diagnostic biomarkers for prostate cancer. The current data forms a basis for further investigations.