Vascular endothelial growth factor (VEGF) and prostate pathology

PURPOSE: Previous studies suggest that vascular endothelial growth factor (VEGF) circulating levels might improve identification of patients with prostate cancer but results are conflicting. Our aim was to compare serum VEGF levels across different prostate pathologies (including benign prostatic hyperplasia, prostatitis, high grade prostate intraepithelial neoplasia and prostate cancer) in patients at high risk of prostate cancer. MATERIALS AND METHODS: We consecutively enrolled 186 subjects with abnormal digital rectal examination and/or total PSA (tPSA) = 2.5 ng/mL. Blood was collected before diagnostic ultrasound guided trans-rectal prostate biopsy, or any prostate oncology treatment, to measure PSA isoforms and VEGF. Unconditional logistic regression was used to compute age-, tPSA- and free/total PSA-adjusted odds ratios (OR) and respective 95 percent confidence intervals (95 percent CI) for the association between serum VEGF and different prostatic pathologies. RESULTS: Prostate biopsy main diagnoses were normal or benign prostatic hyperplasia (27.3 percent), prostatitis (16.6 percent), and prostatic cancer (55.0 percent). The median VEGF levels (ng/mL) in these groups were 178.2, 261.3 and 266.4 (p = 0.029), respectively, but no significant differences were observed for benign vs. malignant pathologies (215.2 vs. 266.4, p = 0.551). No independent association was observed between VEGF (3rd vs. 1st third) and prostate cancer, when compared to benign conditions (adjusted OR = 1.44; CI 95 percent: 0.64-3.26). CONCLUSIONS: In patients at high risk of prostate cancer, circulating VEGF levels have no clinical role in deciding which patients should be submitted to prostate biopsy. Prostatitis patients, often with higher PSA levels, also present high serum levels of VEGF, and their inclusion in control groups might explain the heterogeneous results in previous studies.

Coffee and gastric cancer: systematic review and meta-analysis

Efetuamos uma revisão sistemática dos estudos publicados avaliando a associacão entre café e câncer de estômago. Identificamos estudos de coorte e caso-controle na PubMed e nas listas de referências. Foram obtidas estimativas conjuntas do risco por meta-análise de 23 estudos (método de efeitos aleatórios). A heterogeneidade foi explorada por estratificacão e meta-regressão. O odds ratio (OR) conjunto para a associacão entre café e câncer gástrico (categoria de exposicão mais elevada vs. mais baixa) foi de 0,97 (IC95 por cento: 0,86-1,09), semelhante para estudos de coorte (OR = 1,02; IC95 por cento: 0,76-1,37) e caso-controle (populacional: OR = 0,90; IC95 por cento: 0,70-1,15; hospitalar: OR = 0,97; IC95 por cento: 0,83-1,13). O OR foi de 1,26 (IC95 por cento: 1,02-1,57) para cinco estudos efetuados nos Estados Unidos, 0,97 (IC95 por cento: 0,82-1,14) para cinco estudos japoneses, 0,98 (IC95 por cento: 0,81-1,17) para cinco estudos europeus, e 0,64 (IC95 por cento: 0,47-0,86) para dois estudos sul-americanos. Nesta meta-análise não observamos efeito significativo do consumo de café na ocorrência de câncer gástrico. Contudo, o conhecimento dos níveis de exposicão a diferentes constituintes do café poderá permitir uma melhor compreensão deste resultado e o verdadeiro contributo do café para a ocorrência de câncer.