Vol. 45 (6): 1113-1121, November – December, 2019

doi: 10.1590/S1677-5538.IBJU.2018.0730


Emerson Pereira Gregorio 1, Antonio Paulo Alexandrino 2, Ivania Terezinha Albrecht Schuquel 3, Willian Ferreira da Costa 3, Marco Aurelio de Freitas Rodrigues 2
1 Pontifícia Universidade Católica do Paraná (PUCPR), Faculdade de Medicina, Londrina, PR, Brasil; 2 Disciplina de Urologia, Departamento de Cirurgia Clínica, Universidade Estadual de Londrina (UEL), Londrina, PR, Brasil; 3 Departamento de Química, Universidade Estadual de Maringá (Universidade Estadual de Maringá-UEM), Maringá, PR, Brasil


Purpose: To establish whether the citrate concentration in the seminal fl uid ([CITRATE]) measured by means of high-resolution nuclear magnetic resonance spectroscopy (1HNMRS) is superior to the serum prostate-specifi c antigen (PSA) concentration in detecting of clinically signifi cant prostate cancer (csPCa) in men with persistently elevated PSA.
Materials and Methods: The group of patients consisted of 31 consecutively seen men with histological diagnosis of clinically localized csPCa. The control group consisted of 28 men under long-term follow-up (mean of 8.7 ± 3.0 years) for benign prostate hyperplasia (BPH), with persistently elevated PSA (above 4 ng/mL) and several prostate biopsies negative for cancer (mean of 2.7 ± 1.3 biopsies per control). Samples of blood and seminal fl uid (by masturbation) for measurement of PSA and citrate concentration, respectively, were collected from patients and controls. Citrate concentration in the seminal fl uid ([CITRATE]) was determined by means of 1HNMRS. The capacities of PSA and [CITRATE] to predict csPCa were compared by means of univariate analysis and receiver operating characteristic (ROC) curves.
Results: Median [CITRATE] was signifi cantly lower among patients with csPCa compared to controls (3.93 mM/l vs. 15.53 mM/l). There was no signifi cant difference in mean PSA between patients and controls (9.42 ng/mL vs. 8.57 ng/mL). The accuracy of [CITRATE] for detecting csPCa was signifi cantly superior compared to PSA (74.8% vs. 54.8%).
Conclusion: Measurement of [CITRATE] by means of 1HNMRS is superior to PSA for early detection of csPCa in men with elevated PSA.

Keywords: Prostate-Specifi c Antigen; Prostate cancer, familial [Supplementary Concept]; Citrates

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