Prostatic phyto-oestrogen tissue levels in different Austrian regions.

INTRODUCTION: A number of studies suggest that the low incidence of prostate cancer as well as benign prostatic enlargement in Asia depends on the extended consumption of phyto-oestrogens in these parts of the world. In most Asian men, phyto-oestrogen levels are multiple higher compared to Austrian (European) men. The aim of our study was to evaluate, according to the East-West decline, whether there were significant differences within the Austrian population. We compared prostate phyto-oestrogen tissue levels of men living in three different geographical regions of Austria. We further compared men living in rural and urban environments. MATERIAL AND METHODS: Prostatic tissue samples of 103 men undergoing surgery for benign prostatic hyperplasia or prostate cancer were collected and frozen at -40 degrees C. In tissue samples, enterolactone (representative for lignans) and genistein levels (representative for isoflavones) were determined in duplicate by monoclonal antibody-based immunoassays. We subsequently compared tissue levels of men living in rural and urban environments and different geographical regions of Austria. RESULTS: Prostatic enterolactone tissue levels were similar in men living in an urban (median 19.1 ng/g dry weight, range 1.5-76.4) or rural environment (median 15.7 range 0.6-140.6) p = 0.99. The respective values for genistein were 20.5 ng/g dry weight (range 4.6-47.4) and 9.3 (range 0.1-156.7) p = 0.77. Furthermore, enterolactone (p = 0.1) and genistein (p = 0.65) levels were similar in three different geographic regions in Austria. CONCLUSION: No significant differences regarding genistein and enterolactone were found between our study populations. However, we found a wide variation between individual patients.

Follow-up of men obtaining a six-core versus a ten-core benign prostate biopsy 7 years previously.

The aim of this study is to evaluate the proportion of repeat biopsies after 7 years in men with an initial benign six- or ten-core biopsy as well as the incidence of prostate cancer (PC) in the repeat biopsies. In this retrospective longitudinal study, 116 men with an elevated prostate-specific antigen (PSA) and/or a suspicious digital rectal examination (DRE) who have had a benign prostate biopsy between January 1997 and September 1997 were included. Fifty-eight men had an initial benign six-core biopsy (median PSA 7.5 ng/ml, range 0.3-67) (group A), and 58 men had an initial benign ten-core biopsy (median PSA 7.5 ng/ml, range 0.8-91.4) (group B). We analysed men with a pathological PSA velocity, a persistently elevated PSA, an abnormal DRE, a high-grade prostatic intraepithelial neoplasia or atypical adenomatous hyperplasia, or atypical small acinar proliferation as indication for rebiopsy. Furthermore, we analysed a subgroup with exclusively an increased PSA velocity (>0.75 ng/ml per year) as indication for rebiopsy. In group A, 14 men had a follow-up biopsy. In this group, follow-up biopsies yielded PC in eight men (13.8%), six (10.3%) had a negative follow-up biopsy. In contrast, in group B only four men (3.4%) had a follow-up biopsy (P=0.005). Two of them (3.4%) had PC (P=0.02), two cases (3.4%) showed a benign histology (P=0.06). The use of an extended biopsy protocol at the initial evaluation reduces the number of repeat biopsies required and decreases the number of PC detection in the follow-up biopsy cohort.