Diagnostic and Prognostic Significance of Prostate Specific Antigen and Serum Interleukin 18 and 10 in Patients with Locally Advanced Prostate Cancer: A Prospective Study


Background: Prostate cancer is one of the most common cancers afflicting men today. Prostate biopsy, aninvasive procedure is generally used for diagnoses but attempts are being made to find accurate and precise noninvasivebiomarkers. Diagnostic accuracy of prostate specific antigen (PSA) has been well documented. Seruminterleukin-18 (IL-18) and interleukin-10 (IL-10) have shown their diagnostic ability in other cancers but notinvestigated well in prostate cancer. This study, thus determines the diagnostic and prognostic significance ofPSA, IL-18 and IL-10 prospectively in patients with carcinoma prostate.
Methods: A total of 149 patients, aged40-84 yrs were investigated during April 2007 to July 2010 and recruited for this study after Institutional ethicalapproval. Of the total of 149 patients, 71 had biopsy proven prostate cancers (TNM stage: T2=17, T3=26 andT4=28) and 78 clinical benign prostate hyperplasia (BPH). Peripheral blood samples of all patients and 71 agematched control subjects were obtained at baseline and estimation of PSA, IL-18 and IL-10 was done by enzymelinked immunosorbent assay (ELISA). Carcinoma prostate patients were followed for three years. Data wereanalyzed with ANOVA, ROC curve analysis and survival analysis.
Results: The baseline levels of PSA, IL-18and IL-10 in all groups of carcinoma prostate were found to be significantly (p<0.01) higher than both Controland BPH. The levels of IL-18 and IL-10 also found to be elevated significantly in stage T3 (p<0.05) and T4(p<0.01) as compared to stage T2. The levels especially of IL-18 is found to be well associated with progressionof the disease of various groups (r=0.84, p<0.01). In contrast, IL-10 showed significant direct association withprogression of carcinoma (r=0.84, p<0.01) while inverse relation with survival duration (r=-0.48, p<0.01) andsurvival rate (χ2=8.98, p=0.0027; Hazard ratio=0.37, 95% CI=0.18-0.69).
Conclusions: Study concluded thatserum IL-18 has potential to be a better diagnostic marker with higher specificity and sensitivity and IL-10 maybe valuable as a prognostic marker than PSA in carcinoma prostate.