Seminal citrate is superior to PSA for detecting clinically significant prostate cancer

Abstract

Purpose: To establish whether the citrate concentration in the seminal fl uid ([CI-TRATE]) 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.

Metabolomics profiling of seminal plasma in obesity‐induced asthenozoospermia

“…Its concentration is the primary factor affecting seminal pH and has been promoted as a biomarker of prostate function and prostate cancer. 17,18 Besides citrate, the levels of succinic acid and aconitic acid, TCA cycle intermediates, were significantly decreased in the ON and OA group in our study. In the seminal fluid, pyruvate is either secreted from seminal glands or generated by a catabolic process of fructose metabolism.…”

“…Citrate is the initial product of the tricarboxylic acid (TCA) cycle and is abundantly accumulated by glandular epithelial cells in the human prostate's peripheral region. Its concentration is the primary factor affecting seminal pH and has been promoted as a biomarker of prostate function and prostate cancer 17,18 . Besides citrate, the levels of succinic acid and aconitic acid, TCA cycle intermediates, were significantly decreased in the ON and OA group in our study.…”

Personalized Medicine for Prostate Cancer: Is Targeting Metabolism a Reality?

“…phosphorylation to produce ATP, normal prostate epithelium depends on aerobic glycolysis with glucose and aspartate as the primary carbon donors (17). In malignant prostate tissues, ZIP1 expression and citrate production are decreased, while ACO2 expression is increased, converting prostate cells from citrateproducing to a citrate-oxidizing phenotype (18)(19)(20)(21)(22). These changes enhance the capacity for energy production to support proliferation and metastasis, and provide evidence that metabolic adaptation occurs in prostate cancer (Figure 2).…”

Impact of lifestyle in prostate cancer patients. What should we do?

“…Qin et al found that prostate cancer antigen 3 (PCA3) distinguishes healthy patients from patients with PCa; this biomarker is over--expressed in more than 95% of PCa cells. The influence of ethnicity on PCA3 is not clear; we need more studies to conclude differential diagnosis of PCa (9)(10)(11).…”