Exploration of the relationship and clinical importance between galectin 9, beta-catenin and cathepsin B levels in patients with prostate cancer in Iraq

Prostate cancer is the second most frequent cancer diagnosis made in men and the fifth leading cause of death worldwide. Prostate cancer may be asymptomatic at the early stage and often has an indolent course that may require only active surveillance. Early detection and treatment significantly improve survival rates. While many cases grow slowly, aggressive forms can spread and be difficult to treat, making research into better diagnostic tools and therapies crucial. The disease also has significant health, psychological, and economic impacts, highlighting the need for effective prevention, early detection, and personalized treatment strategies. There is a clinically unmet need to develop biomarkers that will help in the diagnosis and control of PCa treatment strategies. Many new biomarkers for serum, urine, and even tissue samples can be studied and used to find the relationship with PCa. From this point, this study aims to investigate whether serum Galectin 9 (Gal-9), human Beta-Catenin (CTNNβ1), and human Cathepsin B (CTSB) levels are associated with PCa and whether they can serve as biomarkers or predictors of progressive PCa in patients. Also, investigate the relationship between Gal-9, human CTNNβ1, human CTSB, human hepcidin, and GDF15 with PCa compared with healthy men for a new prognostic of prostate cancer that will help improve the management of prostate cancer patients in Iraq. Our study is important because it is the first study to elucidate Gal-9, CTSB, and CTNNβ1. From October 2023 to March 2024, the subjects were selected from Anbar Teaching Hospital, Anbar Cancer Center, Heet General Hospital, and Kirkuk Teaching Hospital. The subjects of this study were divided into two groups, the patient group consisted of 50 patients with PCa and the control group consisted of 40 healthy individuals. Serum Gal-9, human CTSB, human CTNNβ1, GDF15, and hepcidin hormone levels were measured by ELISA kits. The Gal-9 levels of the patient group (127.14±52.49) were higher than those of the healthy group (39.64±16.28). The human CTNNβ1 concentration in the patient group (1.77±0.52) was higher than that in the healthy group (0.68±0.19). The human CTSB values of the patient group were higher than those of the healthy group (116.02±39.44 and 80.40±24.76), respectively. GAL-9, Human CTNNβ1 and Human CTSB values of the participants showed a statistically significant difference according to the groups (P < 0.05). GDF15 levels of the patient (743.22±277.311) were higher than the healthy group (453.96±137.98). The hepcidin hormone levels of the patient group (36.91±13.45) were higher than those of the healthy group (17.51±6.34). The participants' GDF15 and human hepcidin values showed a statistically significant difference between the patient and healthy groups (P < 0.05). The PSA levels of the participants differed significantly between the groups (t=16.094; p=0.000), with the patient group showing a higher PSA value (25.28±20.68) compared to the healthy group (0.87±0.33). The mean age of the patient and healthy groups was calculated as (64.82±10.03 and 58.80±8.32), respectively. The mean BMI of the patient group was calculated as 24.21±2.74, and the mean BMI of the control group was calculated as 29.05±3.96. In the PCa patient groups, Gal-9 showed a statistically significant positive correlation with age, human CTNNβ1, and serum human GDF15 levels (r = 0.319, p = 0.012; r = 0.286, p = 0.022), respectively. Serum human CTSB showed a statistically significant positive correlation with BMI and hepcidin hormone in PCa (r = -0.266, p = 0.031; r = 0.535, p = 0.0001), respectively. Serum PSA levels and human hepcidin hormone in PCa patient groups revealed a statistically significant relationship (P < 0.05). In concluded, this study revealed that serum Ga-9, Human CTSB, Human CTNNβ1 and hepcidin hormone concentrations were dramatically elevated in PCa patients. Consequently, circulating Gal-9, Human CTSB, Human CTNNβ1, hepcidin, and GDF15 may serve as diagnostic biomarkers for monitoring and predicting the incidence and progression of tumours in PCa patients. Due to this novel study, further research is necessary to determine the biochemical pathway by which Gal-9, Human CTSB, and Human CTNNβ1 impact prostate tumours and make it a more effective predictive agent for PCa patients.