ABSTRACT
Objective: To analyze the relationship between Prostate Imaging Reporting and Data System (PI-RADS) scores and the pathological results of transperineal magnetic resonance-ultrasound fusion guided biopsy. Methods: The clinical data, magnetic resonance imaging (MRI) results and prostate puncture biopsies of 517 patients who were assigned to PI-RADS score of 4 or 5 and underwent transperineal magnetic resonance-ultrasound fusion guided biopsy at The First Affiliated Hospital of Nanjing Medical University from June 2019 to March 2022 were retrospectively analyzed. Patients were divided into the PI-RADS 4 and PI-RADS 5 groups according to their PI-RADS scores and were stratified by their prostate specific antigen (PSA) values (PSA<10 ng/ml vs. PSA 10-20 ng/ml). The pathological negative rates from the biopsy, the distribution of the grade groups according to the grading system by World Health Organization/International Society of Urological Pathology (WHO/ISUP), the detection rates of prostate cancer (PCa) and clinically significant prostate cancer (CsPCa)between the groups were compared. Results: 369 patients with a PI-RADS score of 4 and 148 patients with a PI-RADS score of 5 were included in our research. The overall detection rates of PCa and CsPCa were 77.8% (402/517) and 66.7% (345/517), respectively. In the PI-RADS 4 group, patients with prostate negative biopsies or in WHO/ISUP 1, 2, 3, 4, or 5 grade groups accounted for 28.2%, 12.7%, 20.1%, 17.1%, 18.4% and 3.5%, respectively, whereas in the PI-RADS 5 group the rates were 7.4%, 6.8%, 22.3%, 22.3%, 26.4%, and 14.9%, respectively. The difference was statistically significant (P<0.001). The detection rates of PCa and CsPCa in the PI-RADS 4 group [71.8% (265/369) vs. 59.1% (218/369), P<0.001] were lower than those of the PI-RADS 5 group [92.6% (137/148) vs. 85.8% (127/148), P<0.001]. In the PI-RADS 4 group, the proportion of patients classified into WHO/ISUP 4-5 grade groups was lower than that of patients in the PI-RADS 5 group [22.0% (81/369) vs 41.2% (61/148) (P<0.001)]. The detection rates of PCa and CsPCa in the PSA<10 ng/ml stratification were less than that in the PSA 10-20 ng/ml stratification[74.1% (281/379) vs. 87.7% (121/138), P=0.001], and [60.9% (231/379) vs. 82.6% (114/138), P<0.001]. For patients with PSA<10 ng/ml, the detection rates of PCa and CsPCa in the PI-RADS 4 group were less than those in the PI-RADS5 group [70.9% (217/306) vs. 87.7% (64/73), P=0.003], and [56.2% (172/306) vs. 80.8% (59/73), P<0.001]. For those with a PSA value of 10-20 ng/ml, the detection rates of PCa and CsPCa in the PI-RADS 4 group were less than those in the PI-RADS 5 group [76.2% (48/63) vs. 97.3% (73/75), P<0.001], and [73.0% (46/63) vs. 90.7% (68/75), P=0.006]. There were statistically significant differences in the proportions of patients with prostate negative biopsy and those falling into WHO/ISUP grade groups 1, 2, 3, 4, or 5 (P<0.001) between the PI-RADS 4 group and the PI-RADS 5 group in both stratifications. Conclusions: In this study, the detection rates of CsPCa and PCa in the PI-RADS 4 group were less than those in the PI-RADS 5 group. With the increase of PI-RADS scores, the detection rate of high-grade PCa increased. The same results held for patients with PSA<10 ng/ml or with PSA 10-20 ng/ml.
Subject(s)
Male , Humans , Prostatic Neoplasms/pathology , Prostate-Specific Antigen/analysis , Magnetic Resonance Imaging/methods , Retrospective Studies , Image-Guided Biopsy/methodsABSTRACT
Objective: To analyze the relationship between Prostate Imaging Reporting and Data System (PI-RADS) scores and the pathological results of transperineal magnetic resonance-ultrasound fusion guided biopsy. Methods: The clinical data, magnetic resonance imaging (MRI) results and prostate puncture biopsies of 517 patients who were assigned to PI-RADS score of 4 or 5 and underwent transperineal magnetic resonance-ultrasound fusion guided biopsy at The First Affiliated Hospital of Nanjing Medical University from June 2019 to March 2022 were retrospectively analyzed. Patients were divided into the PI-RADS 4 and PI-RADS 5 groups according to their PI-RADS scores and were stratified by their prostate specific antigen (PSA) values (PSA<10 ng/ml vs. PSA 10-20 ng/ml). The pathological negative rates from the biopsy, the distribution of the grade groups according to the grading system by World Health Organization/International Society of Urological Pathology (WHO/ISUP), the detection rates of prostate cancer (PCa) and clinically significant prostate cancer (CsPCa)between the groups were compared. Results: 369 patients with a PI-RADS score of 4 and 148 patients with a PI-RADS score of 5 were included in our research. The overall detection rates of PCa and CsPCa were 77.8% (402/517) and 66.7% (345/517), respectively. In the PI-RADS 4 group, patients with prostate negative biopsies or in WHO/ISUP 1, 2, 3, 4, or 5 grade groups accounted for 28.2%, 12.7%, 20.1%, 17.1%, 18.4% and 3.5%, respectively, whereas in the PI-RADS 5 group the rates were 7.4%, 6.8%, 22.3%, 22.3%, 26.4%, and 14.9%, respectively. The difference was statistically significant (P<0.001). The detection rates of PCa and CsPCa in the PI-RADS 4 group [71.8% (265/369) vs. 59.1% (218/369), P<0.001] were lower than those of the PI-RADS 5 group [92.6% (137/148) vs. 85.8% (127/148), P<0.001]. In the PI-RADS 4 group, the proportion of patients classified into WHO/ISUP 4-5 grade groups was lower than that of patients in the PI-RADS 5 group [22.0% (81/369) vs 41.2% (61/148) (P<0.001)]. The detection rates of PCa and CsPCa in the PSA<10 ng/ml stratification were less than that in the PSA 10-20 ng/ml stratification[74.1% (281/379) vs. 87.7% (121/138), P=0.001], and [60.9% (231/379) vs. 82.6% (114/138), P<0.001]. For patients with PSA<10 ng/ml, the detection rates of PCa and CsPCa in the PI-RADS 4 group were less than those in the PI-RADS5 group [70.9% (217/306) vs. 87.7% (64/73), P=0.003], and [56.2% (172/306) vs. 80.8% (59/73), P<0.001]. For those with a PSA value of 10-20 ng/ml, the detection rates of PCa and CsPCa in the PI-RADS 4 group were less than those in the PI-RADS 5 group [76.2% (48/63) vs. 97.3% (73/75), P<0.001], and [73.0% (46/63) vs. 90.7% (68/75), P=0.006]. There were statistically significant differences in the proportions of patients with prostate negative biopsy and those falling into WHO/ISUP grade groups 1, 2, 3, 4, or 5 (P<0.001) between the PI-RADS 4 group and the PI-RADS 5 group in both stratifications. Conclusions: In this study, the detection rates of CsPCa and PCa in the PI-RADS 4 group were less than those in the PI-RADS 5 group. With the increase of PI-RADS scores, the detection rate of high-grade PCa increased. The same results held for patients with PSA<10 ng/ml or with PSA 10-20 ng/ml.
Subject(s)
Male , Humans , Prostatic Neoplasms/pathology , Prostate-Specific Antigen/analysis , Magnetic Resonance Imaging/methods , Retrospective Studies , Image-Guided Biopsy/methodsABSTRACT
<p><b>OBJECTIVE</b>To investigate the expressions and action mechanisms of nerve growth factor (NGF) receptors TrkA and p75NTR in the oncogenesis and progression of prostate cancer (PCa).</p><p><b>METHODS</b>Using immunohistochemistry, we detected the expressions of TrkA and p75NTR in 62 PCa and 35 benign prostatic hyperplasia (BPH) samples, and conducted statistical analysis on the basis of clinical data.</p><p><b>RESULTS</b>Independent-samples t-test showed that, along with poorer tissue differentiation or higher clinical stage of PCa, the expression of TrkA was significantly up-regulated, that of p75NTR remarkably down-regulated, and the expression ratio of TrkA to p75NTR markedly increased. The TrkA/p75NTR ratio was 0.32 in the BPH, 0.52 in the PCa tissue with Gleason score of 6, 1.65 in the PCa tissue with Gleason score of 7, 5.75 in the PCa tissue with Gleason score ≥ 8, 0.89 in the clinical stage of pT2, 1.5 in pT3 a, 3.75 in pT3b, and 7.00 in pTxN1.</p><p><b>CONCLUSION</b>The abnormally increased expression ratio of TrkA to p75NTR might be one of the essential features of malignant transformation of prostate cells. A higher TrkA/p75NTR expression ratio may be associated with a lower tissue differentiation, a higher clinical stage or Gleason score, and therefore a poorer prognosis.</p>
Subject(s)
Humans , Male , Immunohistochemistry , Neoplasm Grading , Neoplasm Staging , Nerve Tissue Proteins , Metabolism , Prognosis , Prostatic Hyperplasia , Pathology , Prostatic Neoplasms , Pathology , Receptor, trkA , Metabolism , Receptors, Nerve Growth Factor , Metabolism , Up-RegulationABSTRACT
<p><b>OBJECTIVE</b>To evaluate the effect of adjuvant hormonal therapy (AHT) immediately after radical surgery for high- risk organ-confined or locally advanced prostate cancer using the PSA-related biochemical relapse rate within 2 years after surgery.</p><p><b>METHODS</b>We retrospectively analyzed 62 cases of high-risk organ-confined or locally advanced prostate cancer. The patients were treated by laparoscopic radical prostatectomy or radical retropubic prostatectomy after MRI and ECT systemic bone imaging examination, which revealed no regional lymph node or bone metastasis. Thirty-two of the patients (group A) received AHT orally or subcutaneously from 2 weeks to 1 months after operation, and another 30 (group B) were left untreated. We followed up the patients for 2 years, measuring the serum PSA level every 3 months, performing ECT every 6 months, and recording the adverse reactions, medication dura- tion, and the patients'quality of life.</p><p><b>RESULTS</b>All the operations were successfully accomplished. The rate of 2-year biochemical relapse-free survival was 78.13% (25/32) in group A and 53.33% (16/30) in group B.</p><p><b>CONCLUSION</b>AHT immediately after radical surgery can improve the rate of biochemical relapse-free survival of the patients with high-risk organ-confined or locally advanced prostate cancer and check the progression and metastasis of the disease.</p>
Subject(s)
Aged , Humans , Male , Middle Aged , Antineoplastic Agents, Hormonal , Therapeutic Uses , Chemotherapy, Adjuvant , Disease Progression , Disease-Free Survival , Laparoscopy , Neoplasm Recurrence, Local , Blood , Neoplasm Staging , Prostate-Specific Antigen , Blood , Prostatectomy , Methods , Prostatic Neoplasms , Blood , Drug Therapy , Pathology , General Surgery , Quality of Life , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To investigate the safety and feasibility of testis-sparing surgery (TSS) in the treatment of testicular tumor.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 8 cases of benign testicular tumor treated by TSS in our hospital from October 2005 to March 2012.</p><p><b>RESULTS</b>The 8 patients, aged 18-67 (mean 45) years, were preoperatively diagnosed with benign testicular tumor and all underwent partial testis resection. Rapid intraoperative pathology showed the incisal margins to be negative. Postoperative pathological examination confirmed Sertoli cell tumor in 3 cases, adenomatoid tumor in another 3, and mature teratoma in the other 2. The patients were followed up for 6 months to 7 years (mean 4 years), which revealed no relapse and metastasis, nor significant differences from the baseline in the testosterone level, IIEF score, and routine semen parameters.</p><p><b>CONCLUSION</b>Testis-sparing surgery is one of the effective options for the management of benign testicular tumor, which can maximally preserve the testis tissue and protect the patient's sexual function.</p>
Subject(s)
Adolescent , Adult , Aged , Humans , Male , Middle Aged , Neoplasm Recurrence, Local , Organ Sparing Treatments , Methods , Retrospective Studies , Sertoli Cell Tumor , Pathology , General Surgery , Teratoma , Pathology , General Surgery , Testicular Neoplasms , Pathology , General Surgery , TestisABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical characteristics and surgical treatment of penile Paget's disease.</p><p><b>METHODS</b>We retrospectively analyzed the treatment and follow-up data of 10 cases of penile Paget's disease surgically treated in Jiangsu Provincial Government Hospital and Jiangsu Provincial People's Hospital from 2008 to 2012.</p><p><b>RESULTS</b>All the 10 patients received expanded local resection of the lesion with reconstruction of the defects with scrotal skin flaps or free skin flaps from the thigh. All surgeries were successful and the postoperative course was uneventful with complete graft survival and no lymph node metastasis. IIEF scores obtained before and 1 -2 months after surgery showed no statistically significant differences in the penile erectile function (P = 0.229), sexual orgasm (P = 0.761), and sexual satisfaction (P = 0.801) of the patients.</p><p><b>CONCLUSION</b>When penile skin lesions suggest the possibility of Paget's disease, biopsy should be performed and surgery should follow as soon as possible. The ideal surgical option is expanded local resection of the lesion with reconstruction of the defects with scrotal skin flaps or free flaps according to the patient's specific conditions.</p>
Subject(s)
Adult , Aged , Humans , Male , Middle Aged , Follow-Up Studies , Paget Disease, Extramammary , General Surgery , Penile Neoplasms , General Surgery , Retrospective Studies , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical effect and application value of the modified method of prepuce-degloving repair (PDR) in the treatment of urethrocutaneous fistula (UCF) following hypospadias surgery.</p><p><b>METHODS</b>We retrospectively analyzed 87 cases of UCF caused by hypospadias repair from May 2001 to December 2011, of which 61 were treated by simple closure or Y-V plasty of the fistula (group A), and the other 26 by modified PDR (group B). We compared the success rate of surgery and long-term recurrence between the two groups.</p><p><b>RESULTS</b>The total success rates of repair were 78.7 and 96.2% in groups A and B, respectively. Thirteen cases in group A did not respond to surgery, of which 6 failed to be cured by the second operation but later were treated successfully by modified PDR. In comparison, there was only 1 case of failure in group B, which was cured by a second PDR.</p><p><b>CONCLUSION</b>Modified PDR can significantly improve the success rate and reduce the recurrence rate of UCF after hypospadias surgery, which deserves wide clinical application.</p>
Subject(s)
Child , Child, Preschool , Humans , Male , Foreskin , General Surgery , Hypospadias , General Surgery , Plastic Surgery Procedures , Methods , Retrospective Studies , Treatment Outcome , Urinary Fistula , General Surgery , Urologic Surgical Procedures, MaleABSTRACT
To investigate any association between renal cell carcinoma [RCC] and paraneoplastic syndromes [PNS]. The retrospective analysis included 1,028 patients of Chinese Han nationality with resectable RCC and PNS. The PNS included elevated erythrocyte sedimentation rate [ESR], hypertension, cachexia, anemia, pyrexia, abnormal liver function, hypercalcemia, polycythemia, varicocele and neuromyopathy. Staging was categorized as local [T1-2N0M0] and locally advanced [T3-4NxM0]. Among patients with at least one PNS, elevated ESR [p = 0.008], cachexia [p = 0.000], varicocele [p = 0.000] and pyrexia [p = 0.021] were related to advanced stage of RCC. Among patients with only one PNS, hypertension [p = 0.012] and hypercalcemia [p = 0.000] were related to advanced stage. The remaining PNS were not associated with tumor stage. Pyrexia, elevated ESR, cachexia and varicocele were related to advanced RCC. Hypertension and hypercalcemia occurring as single PNS, although also correlated with advanced stage, require further investigation
Subject(s)
Humans , Paraneoplastic Syndromes , Retrospective Studies , Blood SedimentationABSTRACT
<p><b>OBJECTIVE</b>To investigate the safety and feasibility of glans-preserving surgery in the treatment of superficial penile cancer (SPCa).</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 21 cases of SPCa treated by glans-preserving surgery in our hospital from January of 2003 to March of 2010.</p><p><b>RESULTS</b>The study included 21 SPCa patients aged 36 to 57 (mean 46) years, with superficial lesions involving the glans penis, coronary sulcus or shaft skin. The tumors were staged and graded TaG1 in 6 cases, TaG2 in 5, TisG1 in 2, TisG2 in 4, T1G1 in 3, and T1G2 in 1. All the patients underwent glans-preserving surgery to preserve the normal appearance and functional integrity of the glans penis, and all returned to normal sexual activity 1 month after operation, with good sexual function and sexual satisfaction. Postoperative follow-up lasted 2 to 7 (mean 5) years, and 2 cases of recurrence in situ found at 6 and 9 months, respectively, which were successfully managed by a second glans-preserving surgery.</p><p><b>CONCLUSION</b>Glans-preserving surgery is an effective method for superficial penile cancer. With proper selection of the patients, this procedure is technically safe, maximally preserves the penile appearance, and least affects the patients' sexual satisfaction.</p>
Subject(s)
Adult , Humans , Male , Middle Aged , Carcinoma, Squamous Cell , General Surgery , Penile Neoplasms , General Surgery , Penis , General Surgery , Retrospective Studies , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the correlation between the polymorphism of the tumor necrosis factor-related apoptosis inducing ligand (TRAIL) and the genetic susceptibility to prostate cancer (PCa) in the Chinese Han population in Nanjing.</p><p><b>METHODS</b>We performed a case control study on 187 cases of PCa and 237 cancer-free healthy controls. Peripheral blood genome DNA was extracted from the subjects for analysis of the polymorphism of the TRAIL-716 locus by polymerase chain reaction-ligase detection reaction (PCR-LDR). The correlations between the susceptibility to PCa and different genotypes were compared.</p><p><b>RESULTS</b>An SNP (-716A/G) was found in the promoter of the TRAIL gene. AA, AG and GG genotypes were identified. Logistic regression analysis suggested that AG, GG and AG + GG genotypes had no significant correlation with the risk of PCa (OR = 0.89, 95% CI = 0.54 -1.47; OR = 0.94, 95% CI = 0.69 -1.27; OR = 0.87, 95% CI = 0.54 - 1.41).</p><p><b>CONCLUSION</b>The TRAIL-716 polymorphism is not directly related with the genetic susceptibility to PCa in the Chinese Han population of Nanjing.</p>
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Middle Aged , Asian People , Genetics , Case-Control Studies , China , Genetic Predisposition to Disease , Genotype , Polymorphism, Single Nucleotide , Prostatic Neoplasms , Genetics , TNF-Related Apoptosis-Inducing Ligand , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To investigate the association of the IL-6 -572C > G polymorphism with the risk of prostate cancer (PCa) in the Chinese Han population in Jiangsu and Anhui area.</p><p><b>METHODS</b>We obtained peripheral blood genome DNA from 200 PCa patients and 279 age-matched PCa-free healthy controls, analyzed the site polymorphism of IL-6 -572C > G with the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique, and studied the correlation of different genotypes with the susceptibility to PCa.</p><p><b>RESULTS</b>The subjects that carried the CCGG genotype had a risk of PCa 2.46 times that of the CC genotype carriers (95% CI = 1.41-4.29), and 2.47 times that of the CC/GC genotype carriers (95% CI = 1.47-4.17). This risk was significantly increased among the following subgroups of CCGG genotype carriers: age > 70 yr (OR = 3.06, 95% CI: 1.44-6.49), BMI > 23 kg/m2 (OR = 3.72, 95% CI: 1.79-7.74), no cigarette smoking (OR = 2.96, 95% CI: 1.30-6.72), alcohol drinking (OR = 2.73, 95% CI: 1.28-5.79), with a family history of cancer (OR = 6.67, 95% CI: 1.50-29.69).</p><p><b>CONCLUSION</b>In the Chinese Han population in Jiangsu and Anhui area, IL-6 -572C > G polymorphism is associated with the susceptibility to PCa, and GG might be a susceptible genotype to PCa.</p>
Subject(s)
Aged , Humans , Male , Asian People , Genetics , Case-Control Studies , China , Epidemiology , Gene Frequency , Genetic Predisposition to Disease , Genotype , Interleukin-6 , Genetics , Polymorphism, Single Nucleotide , Prostatic Neoplasms , Epidemiology , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To evaluate the technique and clinical outcomes of modified transperitoneal laparoscopic radical prostatectomy.</p><p><b>METHODS</b>A total of 105 patients received the operation with age ranging from 51 to 73 years from January 2008 to June 2010. Mean level of serum prostate specific antigen was 13.6 µg/L and mean prostatic volume was 45 ml. Pathological studies of biopsy confirmed the prostate carcinoma with Gleason score 6-8. Radionuclide bone scan revealed no metastasis. Based on previously retroperitoneal radical prostatectomy, modified technique was applied involving surgical approach, bladder neck dissection and vesicourethral anastomosis.</p><p><b>RESULTS</b>Mean operative time was 93 min (65 - 150 min). Intraoperative blood loss was 115 ml (50 - 400 ml). No complication of bowl injury occurred. Positive surgical margin was present in 24 patients. Normal continence were seen in 64 patients after catheter removed. Recovery of incontinence within 3 months was seen in 33 patients and 3 to 12 months in 5 patients respectively. Three patients with incontinence were still in the follow-up.</p><p><b>CONCLUSIONS</b>Transperitoneal laparoscopic radical prostatectomy provides large working space and clear anatomic exposure. Higher efficiency and lower complication rate are obtained through modified laparoscopic technique involving seminal vesicle isolation, bladder neck dissection and vesicourethral anastomosis.</p>
Subject(s)
Aged , Humans , Male , Middle Aged , Abdominal Cavity , General Surgery , Laparoscopy , Methods , Prostatectomy , Methods , Prostatic Neoplasms , General Surgery , Retrospective StudiesABSTRACT
Objective To discuss the treatment of ureteropelvic junction obstruction by laparoscopic pyeloplasty. Methods A retrospective review of consecutive laparoscopic pyeloplasty in 102 patients between September 2001 and December 2007 was performed. The ureterpelvic junction was dissected and the obstruction portion was excised. Anastomosis was then performed through the ureter and the renal pelvis walls with a stent. Results The mean operating time was 120 min and the average blood loss was 80ml. No major complication occurred intraoperative. The drainage was removed in 3-10 days. The average hospital stay was 8.5 days. The stent was kept for 30-60 days. IVU and B ultrasound examination revealed that the hydronephrosis alleviated during the follow-up and no anastomosis stricture occurred. Conclusions Laparoscopic dismembered pyeloplasty could provide lower morbidity, shorter hospital stay, and faster convalescence. It could be an effective treatment for ureteropelvic junction obstruction.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the association of the risk of prostate cancer (PCa) with the polymorphism of the CYP2E1 gene, smoking and drinking, and to explore the joint role of genes and living habits in PCa pathogenesis.</p><p><b>METHODS</b>We conducted a case-control study on 109 PCa patients and 202 age-matched non-PCa male controls, and detected the polymorphisms of CYP2E1 Rsa I and Pst I sites by PCR-RFLP using DNA from peripheral blood lymphocytes.</p><p><b>RESULTS</b>The history of deep smoking (OR = 2.29, 95% CI: 1.28 - 4.09) or heavy smoking (OR = 1.81, 95% CI: 1.02 - 3.22) was a risk factor. The CYP2E1 C1/C1 genotype significantly increased the risk of PCa (OR = 1.71, 95% CI: 1.04 - 2.82) and apparently interacted with drinking (OR = 2.21, 95% CI: 1.06 - 4.59). Heavy smokers with the C1/C1 genotype showed an increased risk of PCa (OR = 2.80, 95% CI: 1.20 - 6.56), as compared with non-smokers carrying the genotype of C1/C2 or C2/C2.</p><p><b>CONCLUSION</b>The risk of PCa obviously increases in individuals with both the CYP2E1 C1/C1 genotype and the habit of smoking or drinking, and it has a significant positive correlation with the dose of tobacco exposure.</p>
Subject(s)
Aged , Humans , Male , Middle Aged , Alcohol Drinking , Epidemiology , Genetics , Case-Control Studies , China , Epidemiology , Cytochrome P-450 CYP2E1 , Genetics , Genetic Predisposition to Disease , Polymorphism, Genetic , Prostatic Neoplasms , Epidemiology , Genetics , Smoking , Epidemiology , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical significance of prostate-specific antigen (PSA) screening in early detection of prostate cancer in Chinese men.</p><p><b>METHODS</b>PSA screening was performed in 8562 asymptomatic men who had been enrolled for health checkup and all were > or = 50 years old. Prostate biopsy was recommended for those with a serum PSA level > or = 4.0 ng/ml. The pathological and clinical features of the patients with prostate cancer detected by the PSA screening were compared with that of 82 clinically diagnosed prostate cancer patients during the same period.</p><p><b>RESULTS</b>Of the 8562 asymptomatic men, 719 had PSA levels > or = 4.0 ng/ml and biopsy was performed in 295 of them. Fifty-eight prostate cancers were detected. The biopsy rate was 41.0% and positive detection rate was 19.7%. The overall age distribution in the screening group and the clinical groups was not significantly different (P = 0.176). However, 41.4% (24/58) of the patients in screening group were > 75 years old, and significantly more than that in the clinical group (25.6%, P = 0.0491). The proportion of the patients with PSA levels > or = 20 ng/ml in the screening group was significantly less than that in the patients of the clinical group (44.8% vs. 75.6%, P = 0.0002). Whether in the patients whose age was > 75 years old (P < 0.05) or < or = 75 years old (P = 0.0002), the patients in the screening group had significantly lower Gleason scores < 7 (60.3% vs. 34.1%, P = 0.002), more T1 or T2 tumor (87.9% vs. 26.8%, P < 0.0001) and more chance to receive radical prostatectomy (50.0% vs. 18.3%, P < 0.0001) than the patients in the clinical group did. However, the distributions of PSA levels at diagnosis and biopsy Gleason scores were not significantly different between the above mentioned two groups (P > 0.05).</p><p><b>CONCLUSION</b>Prostate-specific antigen (PSA) screening is useful for early detection of prostate cancer in Chinese men aged > or = 50 years. The patients detected by PSA screening usually show a lower PSA level, Gleason scores and early clinical stage disease, and have more chance for radical prostatectomy than the clinically diagnosed patients.</p>
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Middle Aged , Biopsy , Early Detection of Cancer , Methods , Neoplasm Staging , Prostate-Specific Antigen , Blood , Prostatic Neoplasms , Blood , Diagnosis , PathologyABSTRACT
<p><b>OBJECTIVE</b>To investigate the association of XRCC1 Arg399Gln polymorphism, smoking and drinking with the risk of prostate cancer (PCa) in the population of Han nationality in Jiangsu and Anhui.</p><p><b>METHODS</b>A case-control study including 207 PCa patients and 235 age-matched controls was conducted. The polymorphisms of XRCC1 Arg399Gln sites were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique using genomic DNA isolated from peripheral blood lymphocytes. We compared the correlations between the susceptibility to PCa and different genotypes, and investigated the effect of smoking and drinking.</p><p><b>RESULTS</b>The heterozygous Arg/Gln genotype was associated with statistically significantly increased risk of PCa (OR = 1.55, 95% CI: 1.01-2.39) compared with those with Arg/Arg wild-type homozygote. An increased susceptibility to PCa was shown to be associated with the 399Gln allele (either the heterozygous Arg/Gln or the homozygous Gin/Gln genotypes, OR = 1.61, 95% CI: 1.07-2.44) , and heavy smokers (smoking index; > or =20) (OR = 1.94, 95% CI: 1.02-3.71) and superficial smokers (taking smoke into the mouth only) (OR = 2.44, 95% CI: 1.02-5.80) with 399Gln allele demonstrated a significantly increased risk in comparison with those carrying wild genotype.</p><p><b>CONCLUSION</b>XRCC1 Arg399Gln polymorphism might contribute to the susceptibility to PCa. The Arg/Gln and Gln/Gln genotypes might increase the risk of PCa and have synergistic effect with smoking.</p>
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Middle Aged , Alleles , Case-Control Studies , China , Epidemiology , DNA Repair , DNA-Binding Proteins , Genetics , Ethnicity , Genetic Predisposition to Disease , Genetics , Genotype , Polymerase Chain Reaction , Polymorphism, Genetic , Polymorphism, Restriction Fragment Length , Prostatic Neoplasms , Epidemiology , Genetics , X-ray Repair Cross Complementing Protein 1ABSTRACT
<p><b>AIM</b>To investigate the association among XRCC1 polymorphisms, smoking, drinking and the risk of prostate cancer (PCa) in men from Han, Southern China.</p><p><b>METHODS</b>In a case-control study of 207 patients with PCa and 235 cancer-free controls, frequency-matched by age, we genotyped three XRCC1 polymorphisms (codons 194, 280 and 399) using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RELP) method.</p><p><b>RESULTS</b>Among the three polymorphisms, we found that the XRCC1 Arg399Gln variant allele was associated with increased PCa risk (adjusted odd ratio [OR]: 1.67, 95% confident interval [CI]: 1.11-2.51), but the XRCC1 Arg194Trp variant allele had a 38% reduction in risk of PCa (adjusted OR: 0.62, 95% CI: 0.41-0.93). However, there was no significant risk of PCa associated with Arg280His polymorphism. When we evaluated the three polymorphisms together, we found that the individuals with 194Arg/Arg wild-type genotype, Arg280His and Arg399Gln variant genotypes had a significantly higher risk of PCa (adjusted OR: 4.31; 95% CI: 1.24-14.99) than those with three wild-type genotypes. In addition, we found that Arg399Gln variant genotypes had a significant risk of PCa among heavy smokers (adjusted OR: 2.04; 95% CI: 1.03-4.05).</p><p><b>CONCLUSION</b>These results suggest that polymorphisms of XRCC1 appear to influence the risk of PCa and may modify risks attributable to environmental exposure.</p>
Subject(s)
Aged , Humans , Male , Adenocarcinoma , Blood , Epidemiology , Genetics , China , Epidemiology , DNA-Binding Proteins , Blood , Genetics , Genetic Predisposition to Disease , Genotype , Odds Ratio , Polymorphism, Restriction Fragment Length , Prostatic Neoplasms , Blood , Epidemiology , Genetics , Risk Factors , Seroepidemiologic Studies , X-ray Repair Cross Complementing Protein 1ABSTRACT
<p><b>AIM</b>To investigate the differences in microvessel densities (MVD) and the expressions of vascular endothelial growth factor (VEGF), VEGF-C and VEGF receptor-3 (VEGFR-3) between prostate cancer (PCa) tissues and adjacent benign tissues, and to explore the correlations among MVD, Jewett-Whitmore staging, Gleason scores and expressions of VEGF, VEGF-C and VEGFR-3 in the progression of PCa.</p><p><b>METHODS</b>An immunohistochemical approach was adopted to detect the expressions of CD34, VEGF, VEGF-C and VEGFR-3 in both cancer areas and peripheral benign areas of 71 primary prostatic adenocarcinoma specimens. A statistic analysis was then performed according to the experimental and clinic data.</p><p><b>RESULTS</b>Significantly upregulated expressions of VEGF, VEGF-C and VEGFR-3 were all found in malignant epithelium/cancer cells compared with adjacent benign epithelium (P<0.01). Patients in stage D had a significantly higher score than patients in stage A, B or C when comparing the expression of VEGF-C or VEGFR-3 in the tumor area (P<0.01). In addition, significant correlations were observed between Jewett-Whitmore staging and VEGF-C (r(s)=0.738, P<0.01), clinical staging and VEGFR-3 (r(s)=0.410, P<0.01), VEGF-C and Gleason scores (r(s)=0.401, P<0.01), VEGFR-3 and Gleason scores (r(s)=0.581, P<0.001) and MVD and VEGF (r(s)=0.492, P<0.001).</p><p><b>CONCLUSION</b>Increased expressions of VEGF and VEGF-C were closely associated with progression of PCa. The main contribution of increased VEGF expression for PCa progression was to upregulate MVD, which maintained the growth advantage of tumor tissue. However, the chief role of increased expressions of VEGF-C and VEGFR-3 was to enhance lymphangiogenesis and provide a main pathway for cancer cells to disseminate.</p>
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Middle Aged , Antigens, CD34 , Disease Progression , Gene Expression Regulation, Neoplastic , Neovascularization, Pathologic , Pathology , Prostatic Neoplasms , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth Factor C , Vascular Endothelial Growth Factor Receptor-3ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of high intensity focused ultrasound (HIFU) combined with endocrine therapy in the treatment of patients with prostate cancer.</p><p><b>METHODS</b>Twenty patients with prostate cancer were treated with extracorporeal HIFU device( model FEP-BY01 ) and androgen ablation, of whom 15 received orchiectomy and 5 LHRH-a. Fourteen patients of the total number were given flutamide in addition to castration.</p><p><b>RESULTS</b>The mean follow-up was 13.5 months (ranging 6 to approximately 30). Before and after the treatment, the prostate volume, prostate specific antigen (PSA), international prostate symptom score (IPSS) and maximal flow rate (Qmax) of the patients were (36.4 +/- 16.2) ml and (20.6 +/- 11.8) ml (P < 0.05), (32.2 +/- 10.4) ng/ml and (2.4 +/- 0.8) ng/ml (P < 0.01), 20. 5 +/- 6.5 and 13.6 +/- 7.5 (P < 0.05), (10.6 +/- 6.3) ml/s and (14.2 +/- 4.6) ml/s (P < 0.05), respectively. Mild hematuria and pain were noted in 5 and 8 patients respectively, and 1 patient underwent internal urethrotomy with a cold knife because of urethral stricture. er, with minimal complications.</p><p><b>CONCLUSION</b>HIFU combined with endocrine therapy is effective in the treatment of prostate canc-</p>
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Middle Aged , Antineoplastic Agents, Hormonal , Therapeutic Uses , Combined Modality Therapy , Flutamide , Therapeutic Uses , Follow-Up Studies , Gonadotropin-Releasing Hormone , Therapeutic Uses , Orchiectomy , Prostatic Neoplasms , Therapeutics , Treatment Outcome , Ultrasound, High-Intensity Focused, TransrectalABSTRACT
<p><b>OBJECTIVE</b>To study the diagnosis and treatment of acute prostatitis.</p><p><b>METHODS</b>The data of 35 cases of acute prostatitis who were admitted from January 2001 to March 2004 were reviewed. The main clinical manifestations were chills, fever, frequency, urgency and dysuria. All patients were treated with antibiotics and supportive measures. Two patients underwent surgical drainage for prostate abscess. Three patients were indwelled catheter for acute urinary retention.</p><p><b>RESULTS</b>All patients'temperatures returned to normal within 3 to 5 days. Blood and urine routine tests, urine culture and transurethral ultrasound examination results returned to normal 2 weeks later. Q maximal urinary flow rate improved in patients with dysuria.</p><p><b>CONCLUSIONS</b>After diagnosis of acute prostatitis, full-dose of sensitive antibiotics should be given to all patients for some time as early as possible. At the same time, supportive therapy may be important to some patients. Surgical drainage should be used for patients with prostate abscess.</p>