Circulating Prostate Gland Cells in Benign Prostatic Hyperplasia and Adenocarcinoma in Patients of African Heritage: Diagnosis by Liquid Biopsy: Preliminary Results

Abstract

Background: Benign prostatic hyperplasia and adenocarcinoma are two major urological conditions of the human prostate gland. Benign prostatic hyperplasia is due to increase in stromal cells and adenocarcinoma of the prostate is cancer of the epithelial cells. Cellular studies of the two conditions have relied on tissue biopsy material of the prostate. Liquid biopsy in the diagnosis and derivation of research materials has been orchestrated. Aim: To propagate in vitro circulating prostatic cells from patients of African heritage suffering from benign prostatic hyperplasia and adenocarcinoma of the prostate in order to facilitate the diagnosis of the two diseases by a liquid biopsy platform. Study Design: Hospital – cum - laboratory-based study. Place and Duration: Kilimanjaro Christian Medical University College, Tumaini University, Moshi, Tanzania. Twenty four months. Methodology: Eight ml of venous blood from 34 patients was used to culture prostatic cells in plasma before surgery. Plasma from 6 elderly men aged 59-79 years without lower urinary tract symptoms and 12 young men aged 22-35 years were included in the study as corresponding age control groups. Cells were cultured at 37°C in RPMI 1640 medium.  Results: Prostatic epithelial cells were detected in the medium and in the cytoplasm of monocytes of all 34 patients, 6 elderly men without lower urinary tract symptoms and 4 out of 12 young men. Prostatic epithelial cells and acini stained well with Giemsa and H&E stain, and presented with enlarged eccentric nucleoli. Androgen receptor in prostate epithelial cells was detected by an anti-androgen receptor monoclonal antibody. Stromal cells also grew from the plasma of 6 patients. Adenocarcinoma was detected histologically in only 3 of the 34 patients. Conclusion: The cultivation in vitro of prostatic epithelial cells by a liquid biopsy approach (blood sample) is expected to open a window in attempts at discovering CTC in adenocarcinoma of the prostate.