Diagnostic Value of GSTP1, RASSF1, AND RASSF2 Methylation in Serum of Prostate Cancer Patients.

PURPOSE: Considering the inadequacy of PSA measurement in the diagnosis of prostate cancer, it is aimed to establish a potential liquid biopsy diagnostic panel. MATERIALS AND METHODS: 39 patients who underwent TRUS-biopsy and 15 healthy volunteers were included. Approximately 15 ml of venous blood samples taken from healthy volunteers and patients before biopsy were separated as plasma. Hypermethylation status of GSTP1 and RASSF1:RASSF2 genes was revealed in cfDNA materials collected from plasma samples. Correlation of this epigenetic change detected in PCa, BPH and healthy volunteer groups with pathology results was examined. RESULTS: Pathology reports of 39 patients included were 13 PCa, 3 ASAP, 3 HGPIN, and 20 BPH. In total, 3 of the patients with PCa had positive GSTP1, 4 had RASSF1 and 9 had positive RASSF2 methylation. It was seen that RASSF2 had the highest sensitivity (69%), specificity (39%) and NPV (80%), while RASSF1 had the highest PPV (30%). When the binary combinations of genes were examined it was observed that the GSTP1:RASSF1 combination had the highest sensitivity (46%), specificity (76%) and NPV (82%). When the methylation of all three genes was examined, it was observed that the sensitivity was quite low (8%), but the specificity (83%) increased significantly. CONCLUSION: Although we observed that the GSTP1 and RASSF1 methylation positivity rates that we examined in our study were higher in patients without prostate cancer, we found that the RASSF2 methylation rate was higher in patients with prostate cancer. randomized controlled studies are needed.

Parapelvic Renal Cyst Treatment with Flexible Ureteroscopy: Single Centre Experience.

BACKGROUND: This study aimed to assess the feasibility, safety, and efficacy of an endoscopic parapelvic renal cyst (PRC) incision using flexible ureterorenoscopy (fURS). MATERIAL AND METHODS: We retrospectively reviewed data concerning 16 patients in whom PRC incisions had been performed using fURS between January 2016 and January 2022. Two patients were excluded from the study owing to a lack of follow-up information. The cysts of all the patients were evaluated preoperatively by computed tomography. The patients' age, gender, cyst size, presenting symptoms, postoperative complications, and pre- and post-treatment visual analogue scale (VAS) scores were evaluated. Surgical success was defined as a reduction of more than half of the cyst size in the sixth postoperative month. RESULTS: A total of 14 patients were included in this study. The patients' mean age was 52.6 ± 8.8 years, and the mean cyst size was 69.1 ± 15.5 mm. Twelve (85.7%) patients presented with flank pain. Clavien-Dindo grade 1 complications were observed in two patients (14.3%), and grade 2 complications were observed in one (7.1%). The median VAS scores were significantly lower after treatment than before in patients who presented with flank pain (2 (1-2.8) vs 8 (7-8), respectively; p = 0.002). Surgical success rate was detected in 11 patients (78.6%) six months after the treatment. CONCLUSIONS: Endoscopic incision of the PRC is a feasible treatment modality with high success rates and low complication rates. However, multicentre studies with larger populations and longer follow-ups are needed to evaluate the lasting effects.

The impact of single positive surgical margin features on biochemical recurrence after robotic radical prostatectomy

ABSTRACT Objective: Parameters predictive of biochemical or clinical recurrence after Radical Prostatectomy (RP) were determined as pre-treatment PSA value, pathologic tumor stage, tumor grade and presence of Positive Surgical Margin (PSM), extracapsular extension and seminal vesicle invasion and the status of pelvic lymph nodes. The aim of our study is to evaluate the effect of additional features in patients undergoing RP in our clinic. Materials and Methods: We studied 556 RP operations performed between 2009 and 2016 for prostate cancer at this clinic. Preoperative and postoperative data of the patients were retrospectively reviewed. RP specimens were examined by two pathologists specialized in this subject. Of these patients, 78 (14.02%) patients with PSM were included in the study. The pathology slides of these patients were reassessed. The length of PSM (mm), localization (apex, basis and posterolateral) and Gleason pattern at this margin was determined and statistical correlations with BCR were calculated. Results: The mean follow-up after the RP of 41 patients included in the study was 37.4 ± 13.2 months. During the follow-up period of the patients, BCR was observed in 16 patients (39.02%). No statistically significant difference was observed in age and prostate volume between the groups with and without BCR development (p > 0.05). Preoperative PSA level was found to be statistically significantly higher in the group with BCR development compared to the group without recurrence (p = 0.004). In-group comparisons in each aforementioned Gleason score groups were performed in terms of BCR development and the preoperative Gleason score in the group with development of recurrence was found to be statistically significantly higher compared to the group without recurrence (p = 0.007). The length of the surgical margin was measured as 7.4 ± 4.4 mm in the BCR-developing group and 4.7 ± 3.8 mm in the no-BCR- developing group; it was statistically significantly higher in the group with development of recurrence (p = 0.03). Conclusion: Length and location of the PSM and the Gleason score detected in the PSM region could not predict biochemical recurrence according to the results of this present study. However high preoperative PSA value is an independent prognostic factor for biochemical recurrence.

Factors predicting duration and success of semirigid ureteroscopy for ureteral stones in different localizations / El papel diagnóstico de la proteína fijadora de ácidos grasos testiculares en la isquemia testicular: un estudio experimental controlado aleatorizado

Objetive: In this study, we aimed to determine the factors predicting the duration and successof semirigid ureteroscopy performed for the treatment ofureteral stones in different localizations.Materials and methods: Medical records of thepatients whom underwent semirigid ureteroscopy forurolithiasis in our centre between January 2015 and December 2019 were retrospectively reviewed. The studygroup composed of 170 patients and divided into threesubgroups; of which 54 in proximal ureter (31.8%), 51in the mid (30 %) and 65 (38.2%) in the distal ureter.Predictive factors of semirigid ureteroscopy duration andsuccess were determined by performance of correlationanalysis and multivariate analysis. Rresults: Overall stone-free rate was calculated as78.8%. Success rates for proximal, mid and distalureteral stones were 72.2% (39/54 patients), 74.5%(38/51 patients) and 87.7% (57/65 patients), respectively. Complications were present in 19 patients(11.2%). Multivariate analysis indicated that stone diameter and stone burden independently affected thestone-free rate. Statistically significant negative correlation was determined between success of the procedureand stone diameter, stone burden, impaction and moreproximal stone localization. While there was a statistically significant positive correlation between duration ofprocedure and stone burden, diameter, impaction, history of ipsilateral ureteroscopy and more proximal stonelocalization, there was negative correlation betweenduration of procedure and stone-free status.Conclusion: We conclude that stone diameter,stone burden, impaction and more proximal stone localization are common factors affecting both durationand success of semirigid ureteroscopy. In addition, stonesize and stone burden were determined as independentmarkers of stone-free status.(AU)

Objetivo: En este estudio determinamoslos factores predictores de la duración y el éxito de laureteroscopia semirígida realizada como tratamiento delas litiasis ureterales en diferentes localizaciones.Materiales y métodos: Revisamos retrospectivamente las historias clínicas de los pacientes que han sido sometidos a una ureteroscopia semirígida por litiasis ennuestro centro entre enero 2015 y diciembre 2019. Elgrupo de estudio está formado por 170 pacientes y dividido en 3 subgrupos: 54 con litiasis en uréter proximal(31,8%) 51 en medio (30%) y 65 (38,2%) en el uréterdistal. Los factores predictores de duración y éxito de laureteroscopia semirígida fueron determinados con análisis de correlación y multivariante.RESULTADOS: La tasa global libre de litiasis fue de78,8%. La tasa de éxito en uréter proximal, medio y distal fue de 72,2% (39/54 pacientes), 74,5% (38/51pacientes) y 87,7% (57/65 pacientes), respectivamente. Las complicaciones estuvieron presentes en 19 pacientes (11,2%). El análisis multivariante indicó que eldiámetro de la litiasis y el volumen afectaron de formaindependiente la tasa libre de litiasis. Una significaciónestadística negativa fue determinada entre el éxito delprocedimiento y el diámetro de la litiasis, volumen, impactación y localización proximal. Una significación estadística positiva entre la duración del procedimiento yel volumen de la litiasis, diámetro, impactación, previasureteroscopias y localización proximal. Se observó unacorrelación negativa entre la duración del procedimiento y el estado libre de litiasis.CONCLUSIÓN: Concluimos que el diámetro de la litiasis, volumen, impactación y localización proximal sonlos factores que afectan a la duración y el éxito de laureteroscopia semirígida. Además, el tamaño de la litiasis y el volumen fueron predictores independientes de latasa libre de litiasis.(AU)