Modern Molecular Diagnostic of Prostate Cancer in Young Men
DOI:
https://doi.org/10.47363/JPR/2023(5)163Keywords:
Prostate Cancer, Immunohistochemical Examination, Mutations, Cancer Screening, Young MenAbstract
Prostate cancer (PCa) is a public health problem. Among malignant neoplasms, it is the second most common (in 105 out of 185 countries of the world) and the main cause of death from cancer in men from 46 countries. In some cases, pathology is verified in men under 50 years of age, including at the stage of the metastatic process. Common methods of diagnosis of prostate cancer, including assessment of the PSA level, are not always accurate, and the algorithm for their use has not been finalized.
The Purpose of the Study: To determine a set of new molecular-genetic and histological research methods for early diagnosis of prostate cancer in young men (under 50 years of age).
Materials and Methods: Micro-preparations were studied and an IHC study of 10 samples of patients with prostate cancer aged 40-51 years after radical surgical treatment was performed. The tumor stages of the subjects (pT1cN0M0-pT2cN0M0), PSA level (3.5-9.86 ng/ml), malignancy criteria (4 – ISUP-1, 4 – ISUP-2, 2 – ISUP-3). All patients underwent robot-assisted radical prostatectomies.
Results: Reviewing the micropreparations by a third-party morphologist, all the ISUP criteria of the samples obtained were confirmed: a tumor in the apex of the gland was absent in 1 probe (10%), both lobes of the gland were represented in all samples, without perineural lymphovascular invasion and urethral lesions. The positive board of surgical resection – in 1 case (0.2 cm). During the IHC it was found: Ki-67 in 1-5% of samples, b-catenin – 3 points with membrane staining up to 100%, e-cadherin – from 1 to 3 points (pT1cN0M0 ISUP-1). Mutations of EGFR, TP-53 and BCL-2 were not detected. Losses of heterozygosity by BRCA2 – 1 case (pT2cN0M0 ISUP-2), RB-1 – in 1 (pT2aN0M0 ISUP-3), PTEN – in 2 samples (pT2cN0M0 ISUP-1 and ISUP-2).
Conclusion: A preliminary complex of molecular genetic and histological markers for early diagnosis of prostate cancer has been determined. Problems of early diagnosis are associated with a lack of sampling among young men, as well as the high cost of the proposed genetic studies.
