الفهرس 
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Abstract
Prostate cancer (PCa) is a common health problem that in the majority of cases starts to develop at the age of 50 years, reaching its peak at 60–70 years of age. It is the second most common cancer in men.
Current screening techniques are based on a measurement of serum prostate specific antigen (PSA) levels and a digital rectal examination (DRE). A decisive diagnosis of PCa is based on transrectal ultrasound-guided prostate biopsies.
Most prostate cancers are associated with palpably normal prostates and are detected on the basis of elevation in PSA level. However the use of serum PSA as a cancer-specific detection test has some well-recognized limitations.
There is therefore an urgent need for new and more effective non-invasive biomarkers for PCa that can help to better identify which patients should undergo further diagnostic tests and also help to detect which patients will develop an aggressive tumor and, therefore, will need immediate treatment.
The aim of this study was directed to evaluate the role of SEPP1-Ala234Thr single nucleotide polymorphism (SNP) in the occurrence of PCa and assess its effect on markers of Se status, to investigate the relation between plasma Selenium (Se), plasma selenoprotein P (SePP) and serum PSA levels in patients with PCa and to Study the value of plasma levels of Se and SePP as markers of PCa.
In order to achieve this goal, this study included 74 adult male patients, admitted to the genitourinary surgery department through Tuesday uro-oncology clinic at the Alexandria Main University Hospital, during one year duration, between January 2015 and January 2016. Patients younger than 55 years old and those with lower urinary tract symptoms (LUTS) due to stones or bladder malignancies were excluded.
All patients included in this study were subjected to detailed history taking, DRE, Prostate volume measurement using ultrasound abdomen and pelvis. Patients with suspicious DRE and/or with serum total PSA level more than 10ng/ml were subjected to trans-rectal ultrasound guided prostatic biopsy to diagnose PCa.
Patients were divided according to biopsy into group I (Pathologically proven PCa patients) and group II (Non-cancer patients) which was further subdivided into benign prostatic hyperplasia (BPH) patients with cancer free biopsy and patients not indicated for biopsy.
The following laboratory tests were performed for all patients:
• Measurement of serum total PSA level using automated chemiluminescence technique.
• Determination of the plasma level of Se by Atomic absorption technique.
• Determination of the plasma level of SePP using an ELISA technique.
• Genotyping for SEPP1-Ala234Thr SNP using TaqMan SNP Genotyping Assay.
The following results were obtained:
1. There was significantly lower Se in prostatic adenocarcinoma patients than non-cancer patients.
2. There was an insignificant decrease in SePP levels in prostatic adenocarcinoma patients compared to non-cancer patients.
3. There was no statistically significant difference between prostatic adenocarcinoma patients and non-cancer patients regarding SEPP1-Ala234Thr SNP.
4. The (C/C) genotype was associated with lower plasma SePP levels. There was no difference in serum PSA and plasma Se levels between genotypes of SEPP1-Ala234Thr SNP.
5. A negative significant correlation between serum PSA and plasma Se in the total samples was found. No significant correlation between plasma Se and plasma SePP in different studied groups was found.
6. By plotting a receiver-operating characteristic (ROC) curve, the sensitivity of serum PSA in detecting PCa has been estimated to be 95.24% and its specificity has been shown to be 90.57 % while plasma Se level had a sensitivity of 90.48% and a specificity of 73.58%. Plasma SePP had a sensitivity of 85.71% and a specificity of 39.62%. When combined together, plasma Se and plasma SePP had a sensitivity of 76.19% and a specificity of 92.45%, serum PSA and plasma Se showed a sensitivity of 100 % and a specificity of 98.11%, while serum PSA and plasma SePP had a sensitivity of 100 % and a specificity of 92.45%.