Possible Role of Advanced Glycation End Products (AGEs) In the Clinical
Course of Prostate Neoplasies Among Patients with and without Type 2
Diabetes Mellitus
Abstract
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: A total 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.