Evaluation of biomarker canine-prostate specific arginine esterase (CPSE) for the diagnosis of benign prostatic hyperplasia

Abstract

BackgroundBenign prostatic hyperplasia (BPH) is the most common canine prostatic disorder. Although most or even all intact male dogs may develop BPH by 5–8 years of age, many show no clinical signs. Taking into account the non-specific character of clinical and ultrasonographic findings, a new diagnostic approach has recently been proposed based on the augmentation of blood canine prostate-specific arginine esterase (CPSE) in hyperplasic dogs. The aim of the present study was to verify CPSE levels in negative controls and hyperplasic dogs, considering cytological findings as the reference method and taking into account the fact that controls were middle-aged intact dogs (median of 5.0 years), contrarily to previous studies carried out with very young control dogs.ResultsSignificant differences of median CPSE levels were found between controls and hyperplasic dogs (29.1 versus 160.7 ng/mL, respectively); and significant positive correlations were found between median CPSE levels and age or prostatic volume (r = 0.549 and 0.448, respectively; p < 0.001). Sensitivity, specificity, positive and negative likelihood ratios put into evidence the good performance of the test. The agreement between methods was found to be very high, notably between CPSE levels and cytological results (Cohen’s kappa coefficients above 0.8).ConclusionsConsidering the results all together, measurement of CPSE is confirmed as a useful and accurate method and should be considered as an alternative or complementary tool to conventional methods for the diagnosis of BPH in middle-aged dogs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12917-017-0996-5) contains supplementary material, which is available to authorized users.

Rhodesian Ridgebacks have an increased risk to develop benign prostatic hyperplasia

“…In the present study, we used the CPSE concentration of 60 ng/ml as a threshold CPSE value to characterize the prostate gland status. This value had been set by Pinheiro et al (), who validated the same test system regarding cytological criteria of BPH. Holst et al () set the threshold of CPSE at 90 ng/ml, based on a 2.5‐fold increase in the prostatic size compared with the size of younger dogs.…”

“…The suitability of the blood plasma CPSE concentration as an indicator of BPH was evaluated in a large variety of breeds excluding the Rhodesian Ridgeback breed (Gobello & Corrada, ; Gobello et al, ; Lévy et al, , ; Holst et al, ; Pinheiro et al, ; Alonge et al, ). In our study, the correlations of CPSE with age and prostate gland volume (Table ) may confirm this assessment.…”

“…Significantly higher CPSE concentrations in blood serum of dogs with BPH have been found compared with those with healthy prostate glands and in dogs with other prostatic diseases like bacterial prostatitis and prostate gland carcinoma (Bell et al, ; Klausner, Johnston, & Bell, ; Lévy et al, , ). By means of this, blood serum CPSE concentrations may serve as a valuable indicator for early diagnosis of BPH and for controlling the effect during medical therapy of BPH (Alonge, Melandri, Leoci, Lacalandra, & Aiudi, ; Gobello, Castex, & Corrada, ; Gobello & Corrada, ; Pinheiro et al, ). CPSE concentrations of ≤50 ng/ml (Alonge et al, ), ≤60 ng/ml (Pinheiro et al, ) and ≤90 ng/ml (Holst et al, ) were set as threshold values for dogs with healthy prostate glands using different test systems, especially for identifying BPH in asymptomatic dogs.…”

Clinical approach to prostatic diseases in the dog

“…The employ of an anti‐oestrogenic compound, tamoxifen citrate, is also reported in the literature; it gives a competitive block on oestrogen receptors with a mixed agonist‐antagonist mechanism (Corrada et al, ). Moreover, some authors suggest the use of plants extract to treat BPH (Odenthal, ), while others demonstrated the efficacy of pulsed electromagnetic field therapy on BHP in dogs with no apparent side effects (Leoci, Aiudi, Silvestre, Lissner, & Lacalandra, ). When large cysts are present, the surgical treatments proposed in literature are drainage, resection of the cyst with or without drainage placement, omentalization, marsupialization and partial or total prostatectomy (Smith, ).…”

CPSE determination and detection of canine prostatic diseases: The importance of a specific diagnosis

“…It should be emphasized that, although CPSE could be augmented in other conditions like prostatitis, it occurs because hyperplasia is probably also present in those cases (Bell et al, ). For instance, regarding prostatitis, our previous work evidenced that both elevated and normal CPSE levels could be found (Pinheiro et al, ).…”