Possible Role of Advanced Glycation End Products (AGEs) In the
Clinical Course of Prostate Neoplasies Among Patients with and without
Type 2 Diabetes Mellitus
Aim: The cognate receptor expression of AGE (RAGE; receptor for
AGE) on malignant tissues in diabetic patients has been suggested as a
co-factor in determining the clinical course and prognosis. We aimed to
search this relationship between RAGE expression and clinicopathological
features of prostate neoplasia.
Methods: Atotal of 197 patients; 64 (diabetic n=24;
non-diabetic n=40) with benign prostate hyperplasia, and 133 (diabetic
n=71; non-diabetic n=62) with localized (LPCa)/metastatic prostate
cancer (MetPCa) were included the study. The expression of RAGE was
studied by immunohistochemically on prostate specimens. The RAGE score
was assessed in the specimens according to the extent of
immunoreactivity and staining intensity.
Results: The RAGE scores of BPH patients (diabetic and
non-diabetic) were found as negative. Patients with both LPCa and MetPCa
showed significantly higher scores, respectively (LPCa and MetPCa vs.
BPH; p<0.01). RAGE scores of diabetic patients with LPCa and
MetPCa were found to be 4.71±3.14 and 4.97±3.69, respectively. RAGE
scores of the non-diabetic patients who had LPCa and MetPCa were
1.52±1.87 and 1.69±1.58, respectively. When compared both groups with
LPCa, RAGE scores of the diabetic patients were significantly higher
than that of the non-diabetics (p=0.01). Similar results were revealed
as for the patients with MetPCa (4.97±3.69 vs. 1.69±1.58 (diabetic vs.
non-diabetic), respectively (p<0.01).
Conclusion: We found a high rate of RAGE expression in malign
prostate neoplasias to the BPH. Furthermore, as expected, higher scores
were demonstrated in those with diabetes than non-diabetics. Disease
progression and survival parameters were worse in the patients with high
RAGE levels. RAGE may be useful in the diagnosis of prostate cancer and
in determining its prognosis.
Keywords : AGE, Type 2 Diabetes Mellitus, Prostate,
Carcinogenesis