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Introduction: In our previous studies it was concluded that the zinc (Zn) level in in human expressed prostatic fluid (EPF) is a first candidate with the role of offering a new, simple, fast, reliable, and non-invasive diagnostic tool for prostate cancer (PCa) screening. However it was unclear how other non-prostatic diseases inherent of the old persons, including heart diseases, atherosclerosis, diabetes, asymptomatic cancer of different localization and some others, impact on a chemical element composition of expressed prostatic fluid. Thus, the purpose of this study was to evaluate whether significant changes in the levels of Zn in EPF exist in patients with bladder cancer (BC). Methods: Prostatic fluid levels of Zn were prospectively evaluated in 17 patients with BC and 51 healthy male inhabitants (control group). Measurements were performed using 109Cd radionuclide-induced energy dispersive X-ray fluorescent microanalysis developed by us. Results: Mean value  standard deviation of mean (MSD) for concentration of Zn in the EPF of healthy males and patients with BC was 573202 mg/L and 625±108 mg/L, respectively. Using both parametric Student’s t-test and non-parametric Wilcoxon-Mann-Whitney U-test it was shown that the Zn concentration in the EPF of patients with BC did not differ from that in healthy subjects. Conclusion: Such serious illness as BC did not impact on the Zn concentration in the EPF., {"references":["aitt HE. Global trends and prostate cancer: A review of incidence, detection, and mortality as influenced by race, ethnicity, and geographic location. Am J Mens Health. 2018;12(6):1807-23 doi: 10.1177/1557988318798279.","Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017. CA Cancer J Clin. 2017;67(1) 7-30. doi: 10.3322/caac.21387.","Qi D, Wu C, Liu F, Gu K, Shi Z, Liu X, et al. Trends of prostate cancer incidence and mortality in Shanghai, China from 1973 to 2009. 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Objective: Prostate specific antigen (PSA) does not provide the high reliability and precision that is required for an accurate screening for prostate cancer (PCa). The aim of our study was to search for a simple, rapid, direct, preferably non-invasive, and highly accurate biomarker and procedure for the screening for PCa. Method: The levels of trace elements (TE) Br, Fe, Rb, Sr, and Zn were prospectively evaluated in expressed prostatic fluid (EPF). Also Zn/Br, Zn/Fe, Zn/Rb, Zn/Sr concentration ratios as well as ZnRb and (ZnRb)/Fe concentration combinations were calculated for EPF samples, obtained from 38 apparently healthy males and from 33, 51, and 24 patients with chronic prostatitis, benign prostatic hyperplasia, and PCa, respectively. Measurements were performed using an energy dispersive X-ray fluorescent (EDXRF) microanalysis. Results: It was found that in the EPF of cancerous prostates the levels of Rb, Zn, Zn/Br, Zn/Fe, Zn/Sr, ZnRb, and (ZnRb)/Fe were significantly lower in comparison with those in the EPF of normal, inflamed, and hyperplastic prostates. For example, in comparison hyperplastic with cancerous prostates p values obtained using Student’s t-test and Wilcoxon-Mann-Whitney U-test were Conclusions: The levels of TE and their combinations in EPF, obtained by EDXRF, is a fast, reliable, andnon-invasive diagnostic tool that can be successfully used by local, non- urologist physicians at the point-of-care to provide a highly effective PCa screening and as an additional confirmatory test before a prostate gland biopsy.

Background and objective: the prostate gland is subject to various disorders and of them chronic prostatitis (CP) is a complex disease. Various studies indicate some discrepancies regarding zinc (Zn) levels in prostatic fluid of normal and inflamed glands. The present study evaluated by systematic analysis the published data for Zn levels analyzed in expressed prostatic fluid (EPF) of normal and inflamed glands. Methods: The present systematic analysis included 25 studies, all of which were published in the years from 1961 to 2018 and selected by searching the databases Scopus, PubMed, MEDLINE, ELSEVIER-EMBASE, Cochrane Library, and the Web of Science. The articles were analyzed and “Median of Means” and “Range of Means” were used to examine heterogeneity of Zn concentrations in two groups of subjects – apparently healthy men “N” and patients with prostatitis “P”. Moreover, using the ratios of prostatic fluid Zn in “P” group to prostatic fluid Zn in “N” group (ZnP/ZnN) obtained (or calculated by us) in the reviewed studies, “Median of Means” and “Range of Means” for these ratios were found. The objective analysis was performed on data from the 25 studies, with total 285 subjects in “P” group and more than 900 subjects in “N” group. Results: The range of means of Zn concentration reported in the literature for normal EPF varies widely from 47.1 mg/L to 825 mg/L with median of means 501 mg/L. The range of means of Zn concentration for EPF of untreated prostatitis varies also widely from 56 mg/L to 491 mg/L, with median of means 268 mg/L. Thus, the obtained median of means for Zn concentration in normal human prostatic fluid is about two times higher than median of mean values of the element content in EPF of inflamed prostate. In other words, the analysis of 25 studies with discordant data regarding prostatic fluid concentration of Zn demonstrated that there is a significantly diminished concentration of Zn in EPF of patients with prostatitis compared to controls. Conclusion: There is a significant relationship between lowered Zn concentrations in prostatic fluid and prostatitis, but because of small sample size and high data heterogeneity, we recommend other primary studies.

Key Topics The burden of prostate cancer (PrCa) Proximal fluids of the prostate gland Current PrCa screening and diagnosis PrCa biomarkers in proximal fluids Commercially available genetic tests for PrCa using proximal fluids Key Points Globally, PrCa is the commonest cancer diagnosed in men. Current diagnosis still relies on serum PSA tests. The shortfalls in accuracy with the PSA test leads to unnecessary prostate biopsies that potentially result in overdiagnosis and overtreatment. The proximal fluid of the prostate gland, expressed prostatic fluid, is enriched with PrCa biomarkers. Commercially available PrCa proximal fluid biomarker tests include Progensa PCA3, SelectMDx, and ExoDx.

The traditional office diagnosis of prostatitis has been based on clinical history, rectal palpation of the gland, and a microscopic examination of the expressed prostatic fluid. In light of present day information this approach appears to be incomplete. We have examined 41 consecutive patients with complaints of prostatitis along with 17 controls. In each case expressed prostatic fluid was collected under sterile conditions. On each specimen, we performed a bacterial culture, microscopic examination for white blood cells, and assay for zinc. The intent of this protocol was to classify clearly those with bacterial prostatitis from those with nonbacterial prostatitis and prostatodynia. We believe this approach is simple to perform even in the setting of a busy office practice.

Human prostatic fluid contains many distinct proteins that have only been partially characterized. Separations conducted with newer and more sensitive electrophoretic techniques afford an opportunity not only to identify the presence of previously unrecognized proteins but also a means to detect alterations that may occur secondary to aging and disease. Utilizing SDS polyacrylamide gel electrophoresis, the protein components of expressed prostatic fluid from 106 infection-free patients of varying ages were separated and specific protein bands quantitated by densitometry. Examination of the electrophoretic patterns obtained revealed the separation of only six protein components in sufficient quantity to allow further analysis. The variability of the individual components increased with advancing age. Patients less than 30 years of age had a more stable pattern when compared with those greater than 55 years of age. There did not appear to be any demonstrable difference between those patients with benign prostatic hyperplasia and prostatic carcinoma. Comparisons of one protein component to another demonstrated significant difference between young and old patients. Analysis of protein concentrations of prostatic fluid failed to reveal any significant differences related either to age or disease. Age specific changes in human prostatic secretions have not been previously described. Further studies are planned to isolate and identify the variable components of prostatic fluid in an effort to gain further understanding of the metabolic alterations associated with aging as well as with benign and malignant growth of the human prostate.