Steven Lehrer

Serum Interleukin-8 is Elevated in Men with Prostate Cancer and Bone Metastases

Aalinkeel et al. (1) have recently reported that gene expression of angiogenic factors correlates with metastatic potential of prostate cancer cells. The rationale for the study of Aalinkeel et al. is that a variety of growth factors, among them interleukin-8 (il-8), can induce angiogenesis (2). Further, parathyroid hormone related peptide (PTHrP) acts to induce il-8 production in prostate cancer cells via an intracrine pathway independent of its classical nuclear localization sequence. This novel pathway could mediate the effects of PTHrP on the progression of prostate cancer (3). We measured il-8 in the serum of 39 men with biopsy-proven prostate cancer. Their average age was 69 +/- 9 (mean +/- SD). Serum il-8 was measured with an automated chemiluminometric high sensitivity il-8 protein assay (Immulite, Diagnostic Products Corporation, Los Angeles, CA). We noted a significant elevation of il-8 in men with bone metastases, diagnosed by Tc-99 MDP bone scan, when compared to men with localized disease (Figure 1). Aalinkeel et al. found that il-8 was significantly higher in the more metastatic PC-3 and DU-145 prostate cancer cell lines, when compared to the poorly metastatic LnCAP cells. The results of our study of il-8 in men with prostate cancer support the findings of Aalinkeel et al. Therefore, new anti-angiogenic therapies targeting specific genes controlling prostate tumor metastasis may be of benefit in treating prostate cancer.

Putative protein markers in the sera of men with prostatic neoplasms

To describe the preliminary identification of serum proteins that may be diagnostic markers in prostate cancer.

C‐reactive protein is significantly associated with prostate‐specific antigen and metastatic disease in prostate cancer

To further analyse the relationship of c‐reactive protein (CRP) levels to prostate cancer, by measuring CRP in men with prostate cancer and benign prostatic hypertrophy (BPH), as chronic inflammation has long been linked to cancers with an infectious cause and CRP is a nonspecific marker for inflammation, associated with prostate cancer incidence and progression.

Urinary symptom flare after brachytherapy for prostate cancer is associated with erectile dysfunction and more urinary symptoms before implantation.

To examine the relationship of ‘symptom flare’ with sexual function and lower urinary tract symptoms (LUTS) before brachytherapy, as we noted that after brachytherapy for prostate cancer, some patients had recurrent LUTS after an asymptomatic period; this secondary exacerbation of symptoms (‘symptom flare’) occurred at ≈2 years after implantation and was transient in most patients.

Past pregnancy is associated with axillary node involvement in women with breast cancer

In 186 women with breast cancer, there was a progressive increase in the proportion of axillary nodal involvement as the number of pregnancies increased from zero to two or more (P = 0.026). Logistic regression analysis demonstrated that this effect was independent of the known relationship of age and tumor size to nodal involvement. Race and history of breast feeding had no influence on nodal involvement. Cancer 1992; 69:981–983.

Nomograms for determining the probability of axillary node involvement in women with breast cancer

We have previously reported that a history of pregnancy is independently associated with axillary node involvement in breast cancer patients. We have now studied additional women with breast cancer and have used our data and the logistic model to produce nomograms for determining the risk of axillary node involvement, based on tumor size, age, and number of pregnancies. There was an increase in the incidence of axillary node involvement in women with a history of pregnancy. To exclude the confounding effect that tumor size or age might have on node involvement, logistic regression was performed. Pregnancy, tumor size, and age were the three independent variables. History of pregnancy had a significant effect on node involvement (P=0.036) that was independent of tumor size and age. Nomograms were constructed from these data. Surgeons do not perform an axillary dissection in every breast cancer patient. If the axilla is clinically negative and the tumor small, the surgeon, medical oncologist, and radiation oncologist may decide that a dissection need not be done. The nomograms in this article may allow for a more methodical choice of patients for axillary dissection. Moreover, a radiation oncologist might use the nomograms to help decide whether to irradiate an undissected axilla.

Obesity may protect against benign brain tumors

Sir, We read with great interest the article by Eby [1]. We agree with the author that ionic zinc content of the lozenges may be one of the factors responsible for the beneficial effect in common cold. Some other relevant negative factors include zinc lozenges producing side-effects and compromising the compliance as well as masking, higher than therapeutic dose of zinc being used in some of the trials, etc. [2,3]. First one (side-effects compromising compliance as well as masking) may be responsible for the varied effects in these trials. In the recent review [4], we included 14 double-blind placebocontrolled trials in the analysis of side-effects of zinc formulations (lozenges or syrup). The data was entered into Review Manager 5 for analysis, and odds ratio (OR) with 95% confidence interval (CI) was calculated. P-value < 0.05 was taken as significant. We found that, zinc lozenges are more likely to produce side-effects than syrup formulations. The results were as follows: any side-effect [lozenge, 2.15 (1.36–3.38) (P = 0.001) versus syrup, 1.03 (0.64–1.66) (P = 0.9)]; bad taste [lozenge, 3.24 (2.25–4.67) (P < 0.0001) versus syrup, 1.15 (0.55–2.39) (P = 0.71)]; nausea [lozenge, 2.46 (1.56– 4.89) (P = 0.0001) versus syrup, 1.24 (0.50–3.08) (P = 0.64)]; diarrhoea [lozenge, 2.09 (0.92–4.75) (P = 0.08) versus syrup, 1.34 (0.30–6.09) (P = 0.7)]; dry mouth [lozenge, 1.42 (0.95–2.11) (P = 0.09) versus syrup, 1.13 (0.43–3.01) (P = 0.8)]. To conclude, in addition to analysis of various formulations of zinc, importance should also be given to the side-effect profile, Medical Hypotheses 77 (2011) 308–313