ADIPONECTIN, LEPTIN AND MMP-3 PLASMATIC LEVELS CANNOT IDENTIFY HIGH-RISK PROSTATE CANCER IN PATIENTS UNDERGOING BIOPSY

Introduction/Aim: To reduce the diagnosis of indolent prostatecancer (PCa) and to prevent progression of aggressive tumorsare two important targets in urological oncology. Prostate specificantigen (PSA) demonstrates low accuracy in the earlydetection of high risk tumors. There is some evidence inliterature that obese patients and/or patients affected bymetabolic syndrome (MS) might be at higher risk forbiologically aggressive PCa characterized by Gleason patterns4 or 5. The aim of our study was to investigate the correlationbetween the body mass index (BMI) class, serum levels ofadiponectin, leptin and metalloproteinase 3 (MMP-3) that arebiomarkers related to MS and the detection at biopsy ofGleason patterns 4 and 5. Materials and Methods: Consecutivepatients undergoing prostate biopsy for PSA levels ≥4 ng/mland/or positive digital rectal examination were included. Patients were classified in relation to BMI. Blood samples for the evaluation of adiponectin, leptin and MMP-3 werecollected. A 12-core transrectal prostate biopsy was performed.Serum adiponectin, leptin and MMP-3 were measured using“Human Leptin Instant ELISA”, “Human Adiponectin ELISA”,“Human MMP-3 ELISA” kits, respectively. Statistical analysiswas performed to relate the plasmatic levels of the abovementionedbiomarkers to the presence of Gleason patterns 4and 5 at biopsy. Results: Fifty-six patients were enrolled.Median serum levels of leptin, adiponectin and MMP-3 were0.829 ng/ml, 1.72 ng/ml and 1.767 ng/ml, respectively. Inrelation to BMI class, the plasmatic levels of leptin and MMP-3 were higher in obese (p=0.02) and in normal-weight patients(p=0.02), respectively. No statistically significant differencewas detected in serum levels of leptin (p=0.18), adiponectin(p=0.68) and MMP-3 (p=0.49) between the 24 patients(42.8%) with diagnosis of PCa and the 30 patients (53.7%)with a negative biopsy. Comparing the levels of biomarkers in11/24 patients (45.8%) with Gleason 6 (3+3) and in 13/24 (54.2%) showing Gleason patterns 4 and 5 at biopsy, again, nostatistically significant difference in leptin (p=0.4), adiponectin(p=0.6) and MMP-3 (p=0.5) levels was found. Conclusion: Inour preliminary study, we found increased plasmatic levels ofleptin and MMP-3 in obese and normal-weight patientsundergoing prostate biopsy, respectively. The significance ofthis finding, in patients with an elevated PSA, is uncertain. Onthe other hand, no other statistical difference was foundbetween BMI, plasmatic levels of leptin, adiponectin, MMP-3and detection of an aggressive Gleason pattern at biopsy.