Study Population
The prostate specimens of the study were obtained from the records of our university hospital. A total of 197 prostatic pre-operative biopsies and radical prostatectomy specimens from patients treated between 2009 and 2018 were studied. Of 197 samples, 87 belonged to localized prostate cancer, 46 to metastatic prostate cancer, and the remaining 64 specimens were from patients with benign prostate hyperplasia. All radical prostatectomy, TURP (Transurethral resection of the prostate) samples, and biopsies were initially evaluated by an expert pathologist and then radical prostatectomy, and biopsies specimens were graded according to the current international society of urological pathology (ISUP) grading system (Epstein et al. 2016). The Last update ISUP grade group has been considered the Gleason score: Grade Group 1= Gleason score ≤6, Grade Group 2= Gleason score 3+4=7, Grade Group 3= Gleason score 4+3=7, Grade Group 4= Gleason score 8, Grade Group 5= Gleason score ≥9, as well as modified morphological criteria for Gleason pattern 424.
Detailed questionnaires were administered at baseline consisting of age, smoking, family history of prostate cancer, history of hypertension, and type 2 diabetes mellitus. Fasting height and weight were measured, and Body mass index (BMI) was calculated in all patients. Fasting Plasma Glucose (FPG mg/dL), HbA1C (%, mmol/L), Total cholesterol (mg/dL), Low-Density Cholesterol (LDL, mg/dL), Triglycerides (mg/dL), Prostate-Specific Antigen (PSA) of all patients were recorded.
Imaging Techniques including Bone scan, Magnetic Resonance, and Computerized Tomography were performed in patients diagnosed with prostate cancer histopathologically after biopsy, according to D’amico risk classification and EAU (European Association of Urology) guidelines recommendations.