Background The diagnostic benefit of prostate specific antigen (PSA) is limited, owing to its lack of specificity, particularly in men with PSA levels of 4.0 to 10.0 ng/mL. Therefore, there is a need for more specific and sensitive biomarkers to improve diagnostic accuracy and to predict prostate cancer (PCa) progression. Assessing the expression levels of specific microRNAs (miRNAs) in patients with PCa may be helpful in detecting cancer and predicting the cancer prognosis and its evolution, and may serve as markers to decide the treatment. We examined the expression levels of five miRNAs (let‐7c, miR‐21, miR‐145, miR‐185, and miR‐221) on patients with low‐risk PCa who had been eligible for active surveillance but underwent radical prostatectomy. We investigated the correlation between the relative expression of miRNAs and clinicopathologic parameters to evaluate their clinical significance. Materials and Methods Total RNA was isolated from the tumor and the corresponding non‐neoplastic prostate tissue of 45 patients who underwent radical prostatectomy. Quantitative reverse transcriptase‐polymerase chain reaction was used to measure the levels of let‐7c, miR‐21, miR‐145, miR‐185, miR‐221, and RNU6B expression, using TaqMan MicroRNA Assays. miRNA expression was examined in low‐risk PCa, and miRNAs' association with Gleason upgraded (GU) and biochemical recurrent (BR) patients was evaluated. Results We observed that miR‐21 and miR‐182 were overexpressed; conversely, let‐7c, miR‐145, and miR‐221 were underexpressed in patients with low‐risk PCa. GU patients (n = 16) and non‐upgraded patients (n = 28) were compared. miR‐145 was downregulated significantly in the GU group (P = 0.03). Similarly, miR‐221 was downregulated significantly in patients with BR (n = 14) compared with non‐recurrent patients (n = 30) (P = 0.04). Receiver operator characteristics (ROC) curve analysis revealed that miR‐221 levels were significantly associated with BR in patients with a cut‐off <−1.666, a value at which sensitivity was 70% and specificity 71% (area under curve [AUC] = 0.705, P = 0.030). Conclusions There is still a need for a tumor marker with higher sensitivity and specificity than that of PSA. Among the five miRNAs examined, miR‐221 was most associated with biochemical recurrence in low‐risk PCa.

Introduction:Despite the well-known findings related to malignity in DRE such as nodule and induration, asymmetry of prostatic lobes, seen relatively, were investigated in a few studies as a predictor of prostate cancer so that there is no universally expected conclusion about asymmetry. We aimed to compare cancer detection rate of normal, asymmetric or suspicious findings in DRE by using biopsy results.Materials and Methods:Data of 1495 patients underwent prostate biopsy between 2006-2014 were searched retrospectively. Biopsy indications were abnormal DRE and or elevated PSA level(>4ng/mL). DRE findings were recorded as Group 1: Benign DRE, Group 2: Asymmetry and Group 3: Nodule/induration. Age, prostatic volume, biopsy results and PSA levels were recorded.Results:Mean age, prostate volume and PSA level were 66.72, 55.98 cc and 18.61ng/ mL respectively. Overall cancer detection rate was 38.66 % (575 of 1495). PSA levels were similar in group 1 and 2 but significantly higher in group 3. Prostatic volume was similar in group 1 and 2 and significantly lower in Group 3.Malignity detection rate of group 1,2 and 3 were 28.93%, 34.89% and 55.99% respectively. Group 1 and 2 were similar (p=0.105) but 3 had more chance for cancer detection.Conclusion:Nodule is the most important finding in DRE for cancer detection. Only an asymmetric prostate itself does not mean malignity.

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