Evaluating engrailed-2 and cytokines in urine with serum PSA as potential biomarkers in patients with prostatism at Moi Teaching and Referral Hospital, Eldoret, Kenya

Abstract

Background: Prostatism is a clinical syndrome, occurring mostly in older men, usually caused by enlargement of the prostate gland and manifested by irritative and obstructive symptoms. Prostate cancer (CaP) is the most common non-cutaneous and the second leading cause of cancer related death in men. It is a disease in which cells in the prostate gland become abnormal and start to grow uncontrollably, forming tumours. The prostate specific antigen (PSA) test has been shown to be of low specificity and low sensitive and unable to differentiate the various forms of prostatism. Engrailed 2 and pro-inflammatory cytokines may be able to distinguish and stage protatism.

Objective: To evaluate EN-2 and Cytokines in urine with serum PSA as potential biomarkers in patients with prostatism.

Design: Cross sectional study

Setting: Moi Teaching and Referral Hospital, Eldoret, Kenya.

Subjects: Thirty nine (39) respondents were recruited in to the study. Thirteen (13) cases of prostate cancer and twenty six (26) controls were matched by age.

Results: The mean age of cases was 73.1years and controls 71.1 years. Over 92.3% of the cases and 73.1% of controls had PSA values >4.0ng/ml. Both groups had elevated levels of urinary EN-2, which were statistically not significant. IL-6 and TNF-α expressions were higher in cases compared to controls with p-values of 0.0001 and 0.04 respectively. There was a good correlation between urinary IL-6 levels and urinary TNF-α levels (r=0.49)

Conclusion: EN-2 expression in urine was not a predictive marker, however, IL-6 and TNF-α levels were elevated in urine of CaP patients. The potential for using these cytokines as urinary biomarkers to distinguish prostatism should be further explored.