Prostate cancer around the world. An overview

Construction of HClO activated near-infrared fluorescent probe for imaging hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is one of the most common malignancies in the liver with poor prognosis. In order to improve the prognosis and overall survival of patients with HCC, it is important to identify it at early stage and resect it precisely. Cell microenvironment, active compounds, and enzymes may change during the cancerization of hepatocytes. Hypochlorous acid (HClO), one of the most significant signal molecules in the cellular signaling pathway, plays an important role in many cellular processes. To detect and treat liver cancers, it is imperative to study how HClO levels change in hepatocytes. However, developing fluorescent probes specific to liver cells to detect HClO still challenging. Herein, we designed and synthesized a NIR hepatocyte-specific fluorescent probe (MBH-MT) that displayed excellent optical properties for detecting HClO in biological samples. Cell imaging experiment conducted with the unique probe MBH-MT, showed that the biocompatible sensor is capable of monitoring HClO and distinguishing normal cells from cancer cells (e.g., HepG2, HUVEC, RAW264.7, L02 and HK-2 cells). An organ imaging experiment with the probe MBH-MT demonstrated its effectiveness in diagnosing and imaging hepatocellular carcinoma in vivo. MBH-MT's in situ imaging also demonstrated that it can target and image mouse hepatocellular carcinomas. Furthermore, MBH-MT has also successfully been used to diagnose and guide liver cancer surgery early. In the future, we expect that this powerful tool may be help in the detection and imaging of hepatocellular carcinoma, which may affect a large number of people.

Optimizing biopsy strategy for prostate cancer: Bayesian framework of network meta-analysis and hierarchical summary receiver operating characteristic model for diagnostic accuracy

Overdiagnosis and overtreatment are well known problems in prostate cancer (PCa). The transrectal ultrasound (TRUS) Guided biopsy (GB) as a current gold standard investigation has a low positive detection rate resulting in unnecessary biopsies. The choice of optimal biopsy strategy needs to be defined. Therefore, we undertook a Bayesian network meta analysis (NMA) and Bayesian prediction in the hierarchical summary receiver operating characteristic (HSROC) model to present a method for optimizing biopsy strategy in PCa. Twenty eight relevant studies were retrieved through online databases of EMBASE, MEDLINE, and CENTRAL up to February 2020. Markov chain Monte Carlo simulation and Surface Under the Cumulative RAnking curve were used to calculate the rank probability using odds ratio with 95% credible interval. HSROC model was used to formulate the predicted true sensitivity and specificity of each biopsy strategy. Six different PCa biopsy strategies including transrectal ultrasound GB (TRUS GB), fusion GB (FUS GB), fusion + transrectal ultrasound GB (FUS + TRUS GB), magnetic resonance imaging GB (MRI GB), transperineal ultrasound GB (TPUS GB), and contrast enhanced ultrasound GB were analyzed in this study with a total of 7584 patients. These strategies were analyzed on five outcomes including detection rate of overall PCa, clinically significant PCa, insignificant PCa, complication rate, and HSROC. The rank probability showed that the overall PCa detection rate was higher in FUS + TRUS GB, MRI GB, and FUS GB. In terms of clinically significant PCa detection, FUS + TRUS GB and FUS GB had a relatively higher clinically significant PCa detection rate, whereas TRUS GB had a relatively lower rate for clinically significant PCa detection rate. MRI GB (91% and 81%) and FUS GB (82% and 83%) had the highest predicted true sensitivity and specificity, respectively, whereas TRUS GB (62% and 83%) had a lower predicted true sensitivity and specificity. MRI GB, FUS GB, and FUS + TRUS GB were associated with lower complication rate, whereas TPUS GB and TRUS GB were more associated with higher complication rate. This NMA and HSROC model highlight the important finding that FUS + TRUS GB, FUS GB, and MRI GB were superior compared with other strategies to avoid the overdiagnosis and overtreatment of PCa. FUS GB, MRI GB, and FUS + TRUS GB had lower complication rates. These results may assist in shared decision making between patients, carers, and their surgeons.

Different therapeutic regimens in the treatment of metastatic prostate cancer by performing a Bayesian network meta-analysis

BACKGROUND

Although androgen deprivation therapy with or without chemotherapy are currently the mainstay of therapy for metastatic prostate cancer, accumulating data suggested the survival benefits from definitive local therapy such as radical prostatectomy or radiation therapy. Hence, this network meta-analysis was aimed to provide a hierarchy of different therapeutic regimens for mPCa.

METHODS

Relevant studies were retrieved comprehensively by searching the online databases of PubMed, EMBASE and Web of Science, published before July 1st, 2018. With the help of R-3.4.0 software and "gemtc-0.8.2" package, network meta-analysis was performed by random-effect model within a Bayesian framework. Hazard ratios and corresponding 95% credible intervals were calculated by Markov chain Monte Carlo methods. The surface under the cumulative ranking curve was also incorporated to rank the corresponding therapeutic regimens.

RESULTS

A total of 55,363 cases from 17 studies were ultimately involved in this study. Ten different therapeutic regimens and three clinical endpoints were finally assessed. As illustrated by our results, local therapy (such as radical prostatectomy or radiation therapy) could provide a relatively more favorable survival rate than systematic therapies (no local therapy, androgen deprivation therapy or androgen deprivation therapy + chemotherapy). Meanwhile, in the comparison of radiation therapy, brachytherapy and intensity modulated radiation therapy were among the best two therapies. Furthermore, radical prostatectomy had a relatively lower cancer specific mortality or all-cause mortality than brachytherapy or intensity modulated radiation therapy, in the comparison of local therapy, whereas brachytherapy showed a relatively longer overall survival than radical prostatectomy.

CONCLUSIONS

Our results indicated that local therapy was better than no local therapy. In a comprehensive comparison of three clinical endpoints (overall survival, cancer specific mortality or all-cause mortality), radical prostatectomy had a relatively lower cancer specific mortality or all-cause mortality than radiation therapy, whereas brachytherapy was superior to radical prostatectomy for overall survival.

Prostate cancer in the Arab population. An overview

This review evaluated prostate cancer studies from around the world and investigated the causes of differences among them. Prostate cancer incidence and mortality rates showed significant discrepancies between countries and ethnicities. In North America as well as in other western countries, the most common cancer was found to be prostate cancer; however, it appears to be not as prevalent among men in the Middle East and North Africa. Statistics show that screening of prostate-specific antigen levels should be applied depending on ethnicity and age. Other environmental aspects such as dietary and androgenic factors are believed to have caused these differences.

Depression and Health-Related Quality of Life and Their Association With Resourcefulness in Survivors of Prostate Cancer

OBJECTIVE

This study aimed to identify the determinants of depressive symptoms (DSs) and health-related quality of life (HRQOL) in survivors of prostate cancer (PC).

METHODS

This study used a descriptive, correlational design to assess a sample of 133 individuals with PC. The participants were face-to-face interviewed to collect demographic data and disease characteristics, assess self-control schedule, and survey health status. Correlation analysis, Student's t-test, ANOVA, and regression analysis were applied.

RESULTS

Over half the patients had depressive symptoms, and 96.1% had erectile dysfunction. Lack of resourcefulness was found to decrease PC-specific quality of life (PCQOL) and physical quality of life (PQOL). The participants who were more resourceful showed a better mental quality of life (MQOL) and PQOL (r=0.53**; r=0.41**) and fewer DSs (r=-0.52**). Most participants were stage II and IV, and there were significantly different effects on PQOL and MQOL related to cancer stage. Regarding the different outcomes of various therapies, the findings suggested that survivors of PC who underwent radical prostatectomy were more likely to have a better MQOL than those who underwent other treatments. In addition, resourcefulness had mediating effects on pain, PQOL/MQOL, and DSs in the patients with PC.

CONCLUSIONS

Good mental health and resourcefulness can help patients with PC reduce pain and enhance positive thinking and may augment PQOL and MQOL.

Robotic radical prostatectomy in high-risk prostate cancer: current perspectives

Around 20%–30% of patients diagnosed with prostate cancer (PCa) still have high-risk PCa disease (HRPC) that requires aggressive treatment. Treatment of HRPC is controversial, and multimodality therapy combining surgery, radiation therapy, and androgen deprivation therapy have been suggested. There has been a trend toward performing radical prostatectomy (RP) in HRPC and currently, robot-assisted laparoscopic RP (RARP) has become the most common approach. Number of publications related to robotic surgery in HRPC is limited in the literature. Tissue and Tumor characteristics might be different in HRPC patients compared to low-risk group and increased surgical experience for RARP is needed. Due to the current literature, RARP seems to have similar oncologic outcomes including surgical margin positivity, biochemical recurrence and recurrence-free survival rates, additional cancer therapy needs and lymph node (LN) yields with similar complication rates compared to open surgery in HRPC. In addition, decreased blood loss, lower rates of blood transfusion and shorter duration of hospital stay seem to be the advantages of robotic surgery in this particular patient group. RARP in HRPC patients seems to be safe and technically feasible with good intermediate-term oncologic results, acceptable morbidities, excellent short-term surgical and pathological outcomes and satisfactory functional results.

Gradual reduction of testosterone using a gonadotropin-releasing hormone vaccination delays castration resistance in a prostate cancer model

In a previous study aimed to design a novel prostate cancer vaccine, the authors of the present study demonstrated the advantage of combining the adjuvants Montanide ISA 51 with very small size proteoliposomes (VSSP) to promote a significant humoral immune response to gonadotropin-releasing hormone (GnRH) in healthy animals. The present study compared the efficacy of this vaccine formulation versus the standard treatment currently available in terms of preventing the development of tumors in DD/S mice injected with Shionogi carcinoma (SC) 115 cells. The results demonstrated that 5 non-vaccinated control mice exhibited a fast tumor growth, and succumbed to the disease within 19-31 days. Mice immunized with the GnRH/Montanide ISA 51/VSSP vaccine exhibited a moderate decline in testosterone levels that was associated with a decrease in anti-GnRH antibody titers, which lead to a sustained tumor growth inhibition. In total, 2 mice in the immunized group exhibited complete remission of the tumor for the duration of the present study. In addition, castrated mice, which were used as a control for standard hormonal therapy, exhibited an accelerated decrease in tumor size. However, tumor relapse was observed between days 50 and 54, and between days 65 and 85, following the injection of SC 155 cells. Therefore, these mice were sacrificed at day 90. The present study concludes that the slow and moderate reduction of testosterone levels observed using the GnRH-based vaccine may delay the appearance of castration resistance in a Shionogi prostate cancer model. These findings suggest that this vaccine may be used to delay castration resistance in patients with prostate cancer.

Molecular mechanisms of curcumin and its semisynthetic analogues in prostate cancer prevention and treatment

Primary prostate cancer, also known as prostate adenocarcinoma (PCa), is a devastating cancer in men worldwide. Europe and developing countries of Asia have fewer reported cases of prostate cancer compared to increasing cases in the United States with higher incidence in Black men. Risk factors associated with prostate cancer are aging, genetics, lifestyle, high body mass index as well as carcinogenic exposure to carbon-containing fuels, tobacco, and charbroiled meats. Hormone therapy and radical prostatectomy are commonly implemented treatments. The >20.000 prostate cancer deaths of 2013 suggest that there exists a need for enhanced chemopreventive and therapeutic agents for prostate cancer treatment. Fruits, vegetables, and red wines contain high levels of polyphenolic levels. Consumption of these products may provide chemoprevetion of PCa. Curcumin, the major compound from the turmeric rhizome Curcuma longa has long been used for medicinal purposes as an antiseptic and wound healing. This review focuses on curcumin's therapeutic effectiveness in vitro and in vivo in prostate cancer models. The review will highlight the mechanisms of actions of curcumin in the signaling pathways of prostate cancer.

Time trends in prostate cancer mortality according to major geographic regions of Brazil: an analysis of three decades

The aim of this study was to analyze prostate cancer mortality and time trends in Brazil, according to major geographic regions, States, and age brackets. Data on deaths from 1980 to 2010 were obtained from the Mortality Information System. Mortality trends were estimated using Prais-Winsten generalized linear regression. An upward time trend was observed in mortality in all regions of Brazil, with a mean annual increase of 2.8%. The upward trend in mortality occurred in most of the age brackets, with a concentration of deaths in men 70 to 79 years of age (41%) and a significant increase in the 40 to 60-year age bracket. The mortality rate increased significantly in all age brackets in the Northeast, compared to the other regions of Brazil. The study highlighted the importance of redistributing deaths from ill-defined causes in order to correct the mortality rates. The results point to significant regional differences and the need for continuous monitoring of mortality from prostate cancer in Brazil.

TRPV6 calcium channel translocates to the plasma membrane via Orai1-mediated mechanism and controls cancer cell survival

Transient receptor potential vanilloid subfamily member 6 (TRPV6) is a highly selective calcium channel that has been considered as a part of store-operated calcium entry (SOCE). Despite its first discovery in the early 2000s, the role of this channel in prostate cancer (PCa) remained, until now, obscure. Here we show that TRPV6 mediates calcium entry, which is highly increased in PCa due to the remodeling mechanism involving the translocation of the TRPV6 channel to the plasma membrane via the Orai1/TRPC1-mediated Ca(2+)/Annexin I/S100A11 pathway, partially contributing to SOCE. The TRPV6 calcium channel is expressed de novo by the PCa cell to increase its survival by enhancing proliferation and conferring apoptosis resistance. Xenografts in nude mice and bone metastasis models confirmed the remarkable aggressiveness of TRPV6-overexpressing tumors. Immunohistochemical analysis of these demonstrated the increased expression of clinical markers such as Ki-67, prostate specific antigen, synaptophysin, CD31, and CD56, which are strongly associated with a poor prognosis. Thus, the TRPV6 channel acquires its oncogenic potential in PCa due to the remodeling mechanism via the Orai1-mediated Ca(2+)/Annexin I/S100A11 pathway.

Towards the use of non-psychoactive cannabinoids for prostate cancer

The palliative effects of Cannabis sativa (marijuana), and its putative main active ingredient, Δ(9) -tetrahydrocannabinol (THC), which include appetite stimulation, attenuation of nausea and emesis associated with chemo- or radiotherapy, pain relief, mood elevation, and relief from insomnia in cancer patients, are well-known. Because of the adverse psychoactive effects of THC, numerous recent preclinical studies have been focused on investigating other non-psychoactive constituents of C. sativa, such as cannabidiol, for potential therapeutic use. In this issue of the British Journal of Pharmacology, De Petrocellis and colleagues present comprehensive evidence that plant-derived cannabinoids, especially cannabidiol, are potent inhibitors of prostate carcinoma viability in vitro. They also showed that the extract was active in vivo, either alone or when administered with drugs commonly used to treat prostate cancer (the anti-mitotic chemotherapeutic drug docetaxel (Taxotere) or the anti-androgen bicalutamide (Casodex)) and explored the potential mechanisms behind these antineoplastic effects.

Microarray-based identification of individual HERV loci expression: application to biomarker discovery in prostate cancer

The prostate-specific antigen (PSA) is the main diagnostic biomarker for prostate cancer in clinical use, but it lacks specificity and sensitivity, particularly in low dosage values¹​​. ‘How to use PSA' remains a current issue, either for diagnosis as a gray zone corresponding to a concentration in serum of 2.5-10 ng/ml which does not allow a clear differentiation to be made between cancer and noncancer² or for patient follow-up as analysis of post-operative PSA kinetic parameters can pose considerable challenges for their practical application^3,4. Alternatively, noncoding RNAs (ncRNAs) are emerging as key molecules in human cancer, with the potential to serve as novel markers of disease, e.g. PCA3 in prostate cancer^5,6 and to reveal uncharacterized aspects of tumor biology. Moreover, data from the ENCODE project published in 2012 showed that different RNA types cover about 62% of the genome. It also appears that the amount of transcriptional regulatory motifs is at least 4.5x higher than the one corresponding to protein-coding exons. Thus, long terminal repeats (LTRs) of human endogenous retroviruses (HERVs) constitute a wide range of putative/candidate transcriptional regulatory sequences, as it is their primary function in infectious retroviruses. HERVs, which are spread throughout the human genome, originate from ancestral and independent infections within the germ line, followed by copy-paste propagation processes and leading to multicopy families occupying 8% of the human genome (note that exons span 2% of our genome). Some HERV loci still express proteins that have been associated with several pathologies including cancer^7-10. We have designed a high-density microarray, in Affymetrix format, aiming to optimally characterize individual HERV loci expression, in order to better understand whether they can be active, if they drive ncRNA transcription or modulate coding gene expression. This tool has been applied in the prostate cancer field (Figure 1).

Health-related quality of life in prostate cancer

BACKGROUND

With new treatment options, the prognosis of prostate cancer (PCa) has improved in recent decades, and health-related quality of life (HRQoL) has become an important outcome of treatment. HRQoL scores are also essential for health economic analyses concerning treatment options for the disease. This study assesses HRQoL scores in different health states of PCa, compares the results obtained by different HRQoL instruments, compares the HRQoL of PCa patients with that of the general population, and explores factors associated with the resultant HRQoL scores.

MATERIAL AND METHODS

An observational cross-sectional study among PCa patients in the Helsinki and Uusimaa Hospital District between September 2009 and December 2010. A total of 630 PCa patients (aged 43-92) assessed their HRQoL with the generic 15D and EQ-5D, as well as the cancer-specific EORTC QLQ-C30 questionnaires. Patients were divided into five mutually exclusive groups based on disease state: Loc1 (local disease, first six months after diagnosis; n = 47), Loc2 (local disease, 0.5-1.5 years after diagnosis or recurrence; n = 158), Loc3 (local disease, more than 1.5 years after diagnosis; n = 317), Metastatic (after detection of metastases; n = 89) and Palliative care (n = 19). Multivariate analysis served to evaluate the factors associated with the HRQoL scores.

RESULTS

The utility scores were highest at baseline. Markedly impaired HRQoL was seen first at the more advanced states of the disease. All HRQoL instruments studied were consistent in all states of the disease, yet the HRQoL scores obtained varied widely. Symptoms of fatigue and pain, and background variables of financial difficulties and age were the most important factors associated with poor HRQoL.

CONCLUSIONS

All instruments provided valuable insight into PCa patients' overall HRQoL. Management of cancer-related symptoms is important in maintaining patients' HRQoL, but more attention should also focus on financial difficulties.

Validation of a sequential extraction and liquid chromatography-tandem mass spectrometric method for determination of dihydrotestosterone, androstanediol and androstanediol-glucuronide in prostate tissues

Androgens are key mediators of prostate development and function, a role that extends to the development of prostate diseases such as benign prostatic hyperplasia (BPH) and prostate cancer. In prostate, DHT is the major androgen and reduction and glucuronidation are the major metabolic pathways for DHT elimination. A streamlined method for quantitation of dihydrotestosterone (DHT), 5α-androstan-3α,17β-diol (3α-diol), and 3α-diol glucuronide (diol-gluc) was established and validated for use with archived prostate tissue specimens to facilitate examination of the roles of the underlying metabolism. This involved a sequential 70/30 hexane/ethyl acetate (hex/EtOAc) extraction of steroids, followed by an ethyl acetate extraction for diol-gluc. Derivatization of the hex/EtOAc fraction with2-fluoro-1-methylpyridinium p-toluene-4-sulfonate (FMP) was used to enhance sensitivity for hydroxyl steroids and liquid chromatography-tandem mass spectrometry (LC-MS/MS) was utilized for analysis of both fractions. The method was validated with calibration standards followed by recovery assessment from spiked samples of BPH and normal prostate. Lower limits of quantitation (LLOQ) were 50 pg/g, 20 pg/g and 100 pg/g for DHT, 3α-diol and diol-gluc, respectively for extracts from 50mg equivalents of tissue. Prepared samples were stable for up to three weeks at 4 °C and 37 °C. The method provides excellent sensitivity and selectivity for determination of tissue levels of DHT, 3α-diol, and diol-gluc. Furthermore, this protocol can easily be extended to other hydroxyl steroids, is relatively straightforward to perform and is an effective tool for assessing steroid levels in archived clinical prostate samples.

Best practices in robot-assisted radical prostatectomy: recommendations of the Pasadena Consensus Panel

CONTEXT

Radical retropubic prostatectomy (RRP) has long been the most common surgical technique used to treat clinically localized prostate cancer (PCa). More recently, robot-assisted radical prostatectomy (RARP) has been gaining increasing acceptance among patients and urologists, and it has become the dominant technique in the United States despite a paucity of prospective studies or randomized trials supporting its superiority over RRP.

OBJECTIVE

A 2-d consensus conference of 17 world leaders in prostate cancer and radical prostatectomy was organized in Pasadena, California, and at the City of Hope Cancer Center, Duarte, California, under the auspices of the European Association of Urology Robotic Urology Section to systematically review the currently available data on RARP, to critically assess current surgical techniques, and to generate best practice recommendations to guide clinicians and related medical personnel. No commercial support was obtained for the conference.

EVIDENCE ACQUISITION

A systematic review of the literature was performed in agreement with the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement.

EVIDENCE SYNTHESIS

The results of the systematic literature review were reviewed, discussed, and refined over the 2-d conference. Key recommendations were generated using a Delphi consensus approach. RARP is associated with less blood loss and transfusion rates compared with RRP, and there appear to be minimal differences between the two approaches in terms of overall postoperative complications. Positive surgical margin rates are at least equivalent with RARP, but firm conclusions about biochemical recurrence and other oncologic end points are difficult to draw because the follow-up in existing studies is relatively short and the overall experience with RARP in locally advanced PCa is still limited. RARP may offer advantages in postoperative recovery of urinary continence and erectile function, although there are methodological limitations in most studies to date and a need for well-controlled comparative outcomes studies of radical prostatectomy surgery following best practice guidelines. Surgeon experience and institutional volume of procedures strongly predict better outcomes in all relevant domains.

CONCLUSIONS

Available evidence suggests that RARP is a valuable therapeutic option for clinically localized PCa. Further research is needed to clarify the actual role of RARP in patients with locally advanced disease.

Psychological aspects of prostate cancer: a clinical review

Prostate cancer is the most common non-skin cancer in men. It is fraught with both physical and psychological symptomatology. Depression, anxiety, stress, fatigue, pain and psychosocial factors all affect the patient with prostate cancer. Impotence, erectile dysfunction, sexual issues and incontinence in these patients complicate matters further. Anxiety may exist both before testing and while awaiting test results. Confusion over choosing from various interventions often adds to anxiety and depression in these patients. Various demographic factors and the developmental stage of the couple affect these psychological symptoms. The caregiver may undergo significant psychological turmoil while caring for a patient diagnosed with prostate cancer, which is addressed. The role of nurses in the management of prostate cancer is discussed. The present review looks at psychological issues in patients with prostate cancer from a clinical perspective, with the aim of highlighting these issues for the clinical urologist dealing with these patients. It also explores the consultation-liaison relationship between psychiatrists, psychologists and urologists as a team for the multimodal management of prostate cancer.

Comparative study of frequency of different lymphocytes subpopulation in peripheral blood of patients with prostate cancer and benign prostatic hyperplasia

PURPOSE

Benign prostatic hyperplasia (BPH) and prostate cancer (PC) are the most common urologic diseases among men over fifty and, until recently, they were considered to be caused by the impaired immune response. Despite many studies designed to investigate T-cell-based antitumor immunity, the role of innate immune cells in BPH and PC is still poorly understood. In this study the frequency of different leukocytes subpopulation in peripheral blood of BPH, PC patients and in healthy volunteers was analysed and compared.

METHODS

In a cross-sectional study 60 subjects were enrolled (20 patients with BPH or with PC and 20 healthy volunteers). Peripheral blood mononuclear cells (PBMC) were isolated and the percentage of T lymphocytes, natural killer (NK) and NKT cells, as well as subsets of T lymphocytes [CD3(+)CD56(-)CD4(+), T(regs) (CD4(+)CD25(+)FoxP3(+)) and CD3(+)CD56(-)CD8(+)] and NK cells (CD3(-)CD56(+dim) and CD3(-)CD56(+bright)) were analysed by flow cytometry. Intracellular content of interleukin-4 (IL-4) and interferon gamma (IFNγ in T lymphocytes, NK and NKT cells were also detected.

RESULTS

The percentage of T lymphocytes and their subsets in peripheral blood lymphocytes did not differ among investigated groups, while the frequency of Tregs was the highest in PC patients. The percentage of NK cell and their subsets did not differ among investigated groups. Negative correlation between PSA value, percentage of T lymphocytes and NK cells was observed only in PC patients. Highly positive correlation between the PSA value and the percentage of Tregs was found in PC patients.

CONCLUSION

Different frequencies in distinctly lymphocyte subpopulation in peripheral blood of healthy men, BPH and PC patients could be responsible for occurrence and progression of prostatic hyperplasia or tumour. Due to the ability of tumours to suppress the cognate T cell immune response, the cells of innate immunity (NKT and Tregs) may be playing a key role in the immunopathogenesis of PC and BPH.

The endocannabinoid system in prostate cancer

Cannabinoids, their receptors and their metabolizing enzymes are emerging as a new regulatory system, which is involved in multiple physiological functions. Normal prostate tissue expresses several constituents of the endocannabinoid system including the CB(1) receptor, receptors belonging to the transient receptor potential family and fatty acid amide hydrolase, a hydrolyzing enzyme, all of which have been localized in the glandular epithelia. Accumulating evidence indicate that the endocannabinoid system is dysregulated in prostate cancer, suggesting that it has a role in prostate homeostasis. Overexpression of several components of the endocannabinoid system correlate with prostate cancer grade and progression, potentially providing a new therapeutic target for prostate cancer. Moreover, several cannabinoids exert antitumoral properties against prostate cancer, reducing xenograft prostate tumor growth, prostate cancer cell proliferation and cell migration. Although the therapeutic potential of cannabinoids against prostate cancer is very promising, future research using animal models is needed to evaluate the influence of systemic networks in their antitumoral action.

Components of cell-matrix linkage as potential new markers for prostate cancer

Prostate cancer is one of the most common tumor diseases worldwide. Often being non-aggressive, prostate tumors in these cases do not need immediate treatment. However, about 20% of diagnosed prostate cancers tend to metastasize and require treatment. Existing diagnostic methods may fail to accurately recognize the transition of a dormant, non-aggressive tumor into highly malignant prostate cancer. Therefore, new diagnostic tools are needed to improve diagnosis and therapy of prostate carcinoma. This review evaluates existing methods to diagnose prostate carcinoma, such as the biochemical marker prostate-specific antigen (PSA), but also discusses the possibility to use the altered expression of integrins and laminin-332 in prostate carcinomas as diagnostic tools and therapeutic targets of prostate cancer.

Genetic and epigenetic changes in human prostate cancer

Acquired or inherited genetic alterations either alone or in combination with epigenetic alterations are associated with prostate carcinogenesis and its progression toward advance metastatic or castration-resistant disease. A major objective of translational cancer research in post-genome era is to discover the repertoire of genetic and epigenetic variations associated with prostate cancer. Genome-wide association studies have been at least partially successful in identifying potential germline polymorphisms and allelic imbalances such as microsatellite instability and loss of heterozygosity associated with prostate cancer susceptibility. Epigenetic mechanisms such as DNA hyper- or hypomethylation and histone modifications are reversible genetic alterations which allow stable inheritance of cellular phenotypes without any changes in the DNA sequence or quantity. Epigenetic modifications can potentially be used for the molecular classification, detection, and risk assessment in prostate cancer. Chemical inhibitors of DNA methyltransferases and histone deacetylases have been used in different clinical trials and hold promise as novel chemotherapeutics to be effective alone or in combination with other therapeutic interventions in prostate cancer.