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Sample records for biopsy related prostate

  1. Optimizing prostate biopsy for repeat transrectal prostate biopsies patients

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    Xiaojun Deng; Jianwei Cao; Feng Liu; Weifeng Wang; Jidong Hao; Jiansheng Wan; Hui Liu

    2014-01-01

    Objective:Diagnosis of patients with negative prostate biopsy and persistent suspicion of prostate cancer re-mains a serious problem. In this study, we investigated the application of optimizing prostate biopsy for patients who need repeat prostate biopsy. Methods:In this prospective, non-randomized phase-I clinical trial, the prostate cancer detection rate of initial detection scheme was compared with optimizing prostate biopsy scheme. The number of punctures of initial detection scheme was the same as that of optimizing prostate biopsy scheme. The puncture direction of optimizing prostate biopsy was a 45° angle to the sagittal plane from front, middle, and back. The two cores from each lateral lobe were horizontal y inwardly inclined 45°. Results:A total of 45 patients with initial negative biopsy for cancer were received the optimizing prostate biopsy scheme. The cancer detection rate was 17.8%(8/45), and prostate intraepithelial neoplasm (PIN) was 6.7%(3/45). The pa-tients receiving repeat transrectal prostate biopsies were pathological y diagnosed as lower Gleason grade prostate cancers. Conclusion:The cancer detection rate of repeat biopsy prostate cancer is lower than that of initial biopsy. Our study showed that the optimizing prostate biopsy is important to improve the detection rate of repeat transrectal prostate biopsies patients.

  2. Ultrasound- and MRI-Guided Prostate Biopsy

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    ... Resources Professions Site Index A-Z Ultrasound- and MRI-Guided Prostate Biopsy Ultrasound- and MRI-guided prostate ... MRI-guided Prostate Biopsy? What is Ultrasound- and MRI-guided Prostate Biopsy? Ultrasound- and MRI-guided prostate ...

  3. Ultrasound- and MRI-Guided Prostate Biopsy

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Ultrasound- and MRI-Guided Prostate Biopsy Ultrasound- and MRI- ... Ultrasound-and MRI-guided Prostate Biopsy? What is Ultrasound- and MRI-guided Prostate Biopsy? Ultrasound- and MRI- ...

  4. Prostate cancer detection upon transrectal ultrasound-guided biopsy in relation to digital rectal examination and prostate-specific antigen level: what to expect in the Chinese population?

    Directory of Open Access Journals (Sweden)

    Jeremy YC Teoh

    2015-01-01

    Full Text Available We investigated the prostate cancer detection rates upon transrectal ultrasound (TRUS-guided biopsy in relation to digital rectal examination (DRE and prostate-specific antigen (PSA, and risk factors of prostate cancer detection in the Chinese population. Data from all consecutive Chinese men who underwent first TRUS-guided prostate biopsy from year 2000 to 2013 was retrieved from our database. The prostate cancer detection rates with reference to DRE finding and PSA level of 50 ng ml−1 were investigated. Multivariate logistic regression analyses were performed to investigate for potential risk factors of prostate cancer detection. A total of 2606 Chinese men were included. In patients with normal DRE, the cancer detection rates were 8.6%, 13.4%, 21.8%, 41.7% and 85.2% in patients with PSA 50 ng ml−1 respectively. In patients with abnormal DRE, the cancer detection rates were 12.4%, 30.2%, 52.7%, 80.6% and 96.4% in patients with PSA 50 ng ml−1 respectively. Older age, smaller prostate volume, larger number of biopsy cores, presence of abnormal DRE finding and higher PSA level were associated with increased risk of prostate cancer detection upon multivariate logistic regression analyses (P < 0.001. Chinese men appeared to have lower prostate cancer detection rates when compared to the Western population. Taking the different risk factors into account, an individualized approach to the decision of TRUS-guided biopsy can be adopted.

  5. Infection after transrectal ultrasonography-guided prostate biopsy: increased relative risks after recent international travel or antibiotic use.

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    Patel, Uday; Dasgupta, Prokar; Amoroso, Peter; Challacombe, Ben; Pilcher, James; Kirby, Roger

    2012-06-01

    Study Type - Prognosis (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Septicaemia is the most frequent cause of hospitalization after transtrectal prostate biopsy; fatalities have been reported and the incidence is on the rise. This study shows that men with a history of recent international travel or antibiotic use have up to four times increased risk of septicaemia and hospitalization. When they do occur, infections are usually due to multi-resistant E coli and additional care, e.g. delay before biopsy, different antibiotic prophylaxis or transperineal biopsy, should be considered in these cases. OBJECTIVE • To study the infection rate after prostate biopsy in those who have travelled overseas or used antibiotics in the 4 weeks before biopsy. PATIENTS AND METHODS • A total of 316 men with a mean (range) age of 61 (45-85) years were studied. All had undergone transrectal ultrasonography (TRUS)-guided prostate biopsy after standard antibiotic prophylaxis. • Before their biopsy the patients were risk stratified and a history of recent international travel or antibiotic use was recorded. • Those who suffered sufficiently severe infection/sepsis so as to require hospitalization were identified at the end of the study period. • The characteristics of these patients and the types of infections were explored and the relative risk (RR) of infection after recent travel or antibiotic use was calculated. RESULTS • Of the 316 men, 16 were hospitalized with infection. • The group with (n= 16) and without (n= 300) infection were equivalent in age, prostate-specific antigen level, disease status and number of biopsy cores taken. • Either recent travel or antibiotic use were independent risk factors for infection [travel: 8/16 vs 76/300; P= 0.04; RR 2.7 and antibiotic use: 4/16 vs 20/300; P= 0.025; RR 4]. There was no significant pattern in the countries visited or the type of antibiotic used. • Culture results were

  6. SATURATION BIOPSY OF THE PROSTATE (REVIEW

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    A. V. Sadchenko

    2014-07-01

    Full Text Available Prostate biopsy is the principal method of diagnois of prostate cancer, allowing to start the adequate treatment. The tactics of the patients, which have negative initial biopsy, is a subject of discussion. Saturation biopsy is a “gold standard„ of diagnostics of PCA with repeat biopsy. Saturation biopsy of the prostate is not a primary procedure, usually apply in patients with negative biopsies in anamnesis, patients with multifocal PIN and ASAP. Saturation biopsy allows to more precisely predict the volume and degree of malignancy of PCA, that can be used for planning tactics of active surveillance and focal therapy.

  7. Different Methods for Prostate Biopsy and Biopsy Protocols

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    Mahyar Ghafoori

    2011-05-01

    Full Text Available Prostate carcinoma is one of the most common"nmalignancies among men. Increasing mortality rates due"nto prostate carcinoma have been observed worldwide."nThis disease usually progresses imperceptibly, for this"nreason; screening programs aimed at early detection"nhave been developed. The prostate specific antigen"n(PSA test is among the best screening tools available"nin medicine today because it is recognized as the best"nmarker for its early detection."nIn case of abnormal rise in PSA, the patient usually"nrefers for prostate biopsy under the guide of trans"nrectal ultrasonography (TRUS. Different methods are"nrecognized for prostate biopsy that may be divided"ninto two main categories namely, systematic biopsy"nand targeted biopsy."nIn systematic biopsy we divide the prostate gland"nrandomly to different sections and obtain biopsy"nspecimens from each section.The protocol of systematic biopsy is different among"ndifferent institutions. The number of biopsy specimens"ncould be started from less than 6 to more than 20"nbiopsies in some institutions. Increasing the number"nof biopsy specimens increases the detection rate for"nprostate cancer increasing the complications such"nas post biopsy prostatitis and septicemia, which are"nthe most important, as well. In scheduling a biopsy"nprotocol with high number of biopsies it is preferred"nto hospitalize the patient and prescribe intravenous"nantibiotics."nTargeted biopsy of the prostate means obtaining biopsy"nspecimens from a pathologic lesion that is suspicious"nfor prostate cancer. Different modalities could be"nused for detecting prostate cancer within the prostate"ngland. Transrectal ultrasonography, ultrasonography"nwith the use of ultrasound contrast agents, MRI of the"nprostate with the use of endorectal coil, dynamic MR"nstudy with contrast agent, diffusion weighted imaging"nof the prostate and MR spectroscopy all could help"nin the detection of a suspicious tumoral mass in the

  8. Biopsy of the prostate guided by transrectal ultrasound: relation between warfarin use and incidence of bleeding complications

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    Ihezue, C.U. [Department of Radiology, Southampton General Hospital (United Kingdom); Smart, J. [Department of Radiology, Southampton General Hospital (United Kingdom); Dewbury, K.C. [Department of Radiology, Southampton General Hospital (United Kingdom)]. E-mail: keith.dewbury@suht.swest.nhs.uk; Mehta, R. [Department of Radiology, Southampton General Hospital (United Kingdom); Burgess, L. [Department of Radiology, Southampton General Hospital (United Kingdom)

    2005-04-01

    AIM: To determine the relation between warfarin use and the frequency of bleeding complications after biopsy of the prostate guided by transrectal ultrasound (TRUS). METHODS: Overall, 1022 consecutive patients with suspected prostatic disease were followed after biopsy. Warfarin and aspirin use was determined on the day of the procedure. A TRUS-guided biopsy was performed and patients were offered a questionnaire to complete 10 days after the procedure, to determine any immediate or delayed bleeding complications. Follow-up telephone calls were made to those who had not replied within the stipulated period. RESULTS: Of the 1000 patients who replied, 49 were receiving warfarin, 220 were receiving aspirin and 731 were not receiving any anticoagulant drugs. Of the 49 subjects reporting current use of warfarin, 18 (36.7%) experienced haematuria, compared with 440 (60.2%) of the patients receiving no anti-coagulant drugs who reported haematuria. This was statistically significant (p=0.001). Of the group receiving warfarin, 4 (8.2%) experienced haematospermia whereas 153 (21%) of the group receiving no anticoagulant medication reported haematospermia. This difference also was statistically significant (p=0.030). Rectal bleeding was experienced by 7 (14.3%) of the group receiving warfarin compared with 95 (13%) in the group without anticoagulant medication, but this was not statistically significant (p=0.80). We also demonstrated that there was no statistically significant association between the severity of the bleeding complications and medication with warfarin. CONCLUSION: None of the group receiving warfarin experienced clinically important bleeding complications. Our results suggest that the frequency and severity of bleeding complications were no worse in the warfarin group than in the control group and that discontinuing anticoagulation medication before prostate biopsy may be unnecessary.

  9. Strategies for prevention of ultrasound-guided prostate biopsy infections

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    Lu DD

    2016-07-01

    Full Text Available Diane D Lu, Jay D Raman Division of Urology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA Abstract: Prostate cancer is the most common cancer in male patients and the second leading cause of cancer-related mortality in males. To confirm the diagnosis of prostate cancer, an ultrasound-guided needle biopsy is necessary to obtain prostate tissue sufficient for histologic analysis by pathologists. Ultrasound-guided prostate needle biopsy can be accomplished via a transperineal or transrectal approach. The latter biopsy technique involves placing an ultrasound probe into the rectum, visualizing the prostate located just anterior to it, and then obtaining 12–14 biopsies. Each biopsy core requires piercing of the rectal mucosa which can inherently contribute to infection. The increasing infectious risk of prostate needle biopsy requires refinement and re-evaluation of the process in which the technique is performed. Such processes include (but are not limited to prebiopsy risk stratification, antibiotic prophylaxis, use of rectal preparations, and equipment processing. In the subsequent review, we highlight the current available information on different strategies to reduce the risk of infection following prostate needle biopsy. Keywords: prostate cancer, prostate biopsy, urinary tract infection, sepsis, complications

  10. Pain related and overall morbidity with TRUS guided prostate biopsy a prospective study

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    Sarvpreet S. Ubee

    2013-09-01

    Full Text Available Objective To assess analgesia requirement after trans-rectal ultrasound guided prostate biopsy(TRUSBx for appropriate counselling. Materials and Methods Prospectively, successive patients undergoing TRUSBx between July 2009 and November 2011 were given questionnaires prior to procedure. Standard 12-core TRUSBx under peri-prostatic block (10 mL of 1% lidocaine and antibiotic prophylaxis (oral ciprofloxacin, intravenous gentamicin and metronidazole suppository were performed. Pain perception was assessed using a Visual Analogue Score (VAS. Results Mean (range age of the 405 patients was 67.3 years (48-88. Mean VAS during the procedure was 2.93 and 2.20 on reaching home. Mean maximum VAS for the cohort on day 1 and day 2 were 1.27 and 0.7 respectively. 140 (35% were independent with some or minimal discomfort. 14 patients required assistance for some of their basic daily needs. 9 patients (2.2% were hospitalised due to sepsis. 131 patients (32.4% required additional oral analgesia following TRUSBx on days 0, 1 and 2. These patients were generally younger with a mean age for this group of 63.6 years (46-88. The difference in the mean age between those self-medicating and not was not statistically significant (p > 0.005. This group had mean VAS during the procedure of 4 and when patients reached home was 3.5. Mean maximum VAS on day 1 and 2 was 2.1 and 1.3 respectively. 11 patients required assistance from another adult. Conclusion A third of patients required self-medicated analgesia post-procedure. Age alone cannot be used as a criterion to identify patients who will subsequently require analgesia post-procedure, but a higher VAS during the procedure may be indicative. These patients must be counselled appropriately.

  11. A Prospective Randomized Trial of Two Different Prostate Biopsy Schemes

    Science.gov (United States)

    2016-07-03

    Prostate Cancer; Local Anesthesia; Prostate-Specific Antigen/Blood; Biopsy/Methods; Image-guided Biopsy/Methods; Prostatic Neoplasms/Diagnosis; Prostate/Pathology; Prospective Studies; Humans; Male; Ultrasonography, Interventional/Methods

  12. Contemporary update on pathology-related issues on routine workup of prostate biopsy: sectioning, tumor extent measurement, specimen orientation, and immunohistochemistry.

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    Montironi, Rodolfo; Lopez-Beltran, Antonio; Mazzucchelli, Roberta; Scarpelli, Marina; Galosi, Andrea B; Cheng, Liang

    2014-04-01

    While the prime goal of the needle biopsy is to diagnose prostatic adenocarcinoma (PCa), once PCa is detected further descriptive information regarding the type of cancer, amount of tumor, and grade in prostate needle cores forms the cornerstone for contemporary management of the patient and to assess the potential for local cure and the risk for distant metastasis. This review gives an update on selected pathology-related issues on routine workup of prostate biopsy with special references to adequate histologic sectioning necessary to maximize cancer yield, tumor extent measurements and methodologies, specimen orientation, and the role of immunohistochemistry in the evaluation of the prostate. Multiple factors influence the diagnostic yield of prostate biopsies. Many of these factors are fixed and uncontrollable. Other factors are controlled by the urologist, including number of cores obtained, method and location of biopsy, and amount of tissue obtained. The yield of cancer is also controlled by the pathologist and histotechnologist. It is necessary to report the number of cores submitted and the number of positive cores, thereby giving the fraction of positive cores. The percentage involvement by carcinoma with or without the linear extent of carcinoma of the single core with the greatest amount of tumor should also be provided. Using the marking technique, we can add a new pathological parameter: pathological orientation. Cancer or atypical lesions can be accurately located within the biopsy specimen and integrated to biopsy approach. Probably the most common use of immunohistochemistry in the evaluation of the prostate is for the identification of basal cells, which are absent with rare exception in adenocarcinoma of the prostate and in general positive in mimickers of prostate cancer. If a case is still considered atypical by a uropathology expert after negative basal cell staining, positive staining for alpha-methylacyl-CoA-racemase can help establish in 50

  13. Prostate biopsy tracking with deformation estimation

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    Baumann, Michael; Daanen, Vincent; Troccaz, Jocelyne

    2011-01-01

    Transrectal biopsies under 2D ultrasound (US) control are the current clinical standard for prostate cancer diagnosis. The isoechogenic nature of prostate carcinoma makes it necessary to sample the gland systematically, resulting in a low sensitivity. Also, it is difficult for the clinician to follow the sampling protocol accurately under 2D US control and the exact anatomical location of the biopsy cores is unknown after the intervention. Tracking systems for prostate biopsies make it possible to generate biopsy distribution maps for intra- and post-interventional quality control and 3D visualisation of histological results for diagnosis and treatment planning. They can also guide the clinician toward non-ultrasound targets. In this paper, a volume-swept 3D US based tracking system for fast and accurate estimation of prostate tissue motion is proposed. The entirely image-based system solves the patient motion problem with an a priori model of rectal probe kinematics. Prostate deformations are estimated with ...

  14. EFFICACY OF IMMUNOHISTOCHEMISTRY IN PROSTATE NEEDLE BIOPSIES

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    Tameem Afroz

    2016-10-01

    Full Text Available BACKGROUND Prostate needle biopsies can pose a major diagnostic challenge when it comes to differentiating adenocarcinoma and its variants from its benign mimics. In needle biopsies, when the suspicious focus is small, morphological features may not suffice to differentiate it from its morphologic mimics like atrophy, basal cell hyperplasia, reactive inflammatory changes, seminal vesicles and adenosis. Immunohistochemical marker for basal cells, p63 and prostate cancer specific marker, Alpha-Methylacyl-CoA Racemase (AMACR help in overcoming such diagnostic dilemmas. MATERIALS AND METHODS We analysed 157 prostate core needle biopsies over a period of 2 years. Routine Hematoxylin and Eosin (H and E sections and immunohistochemical markers for basal cells (p63 and prostate cancer specific marker (AMACR were used. Prospective study was done on prostate needle core biopsies. Biopsy was done under ultrasound guidance with an 18-gauge needle. Biopsy was done in patients with raised serum PSA levels for exclusion of prostate carcinoma. RESULTS Over a period of two years, 157 prostate core needle biopsies were studied. 83 were benign lesions comprising 69 benign prostatic hyperplasias, five basal cell hyperplasias, four granulomatous lesions and three showed atrophic changes. Two biopsies morphologically resembled seminal vesicles. Prostate cancer specific marker, AMACR was negative in all, but two lesions. In these two lesions, it showed weak nonspecific staining. Basal cell marker p63 showed a continuous staining pattern highlighting the basal cells in all the 69 cases of benign prostatic hyperplasia, 5 cases of basal hyperplasia showed positivity in all the hyperplastic basal cells. In the two cases of seminal vesicles, it showed intense basal cell positivity. It showed a discontinuous pattern in two of the four granulomatous lesions and showed a weak, but a continuous staining pattern in the atrophic lesions. 74 were adenocarcinomas; the predominant

  15. Ciprofloxacin-Ceftriaxone Combination Prophylaxis for Prostate Biopsy; Infective Complications

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    Alper Ozorak

    2014-03-01

    Full Text Available Aim: To present our clinical experience about infective complications due to ultrasound guided transrectal prostate biopsy under ciprofloxacin plus third-generation cephalosporin (Ceftriaxone combination prophylaxis. Material and Method: The 1193 patients that used combination of ceftriaxone 1 g intramuscular 1 hour before biopsy and ciprofloxacin 500 mg twice a day for 5 days after biopsy were included to study. Before biopsy, urine analysis and urinary cultures were not performed routinely. Serious infective complications such as acute prostatitis and urosepsis, causing microorganisms were evaluated. Results: Serious infective complications occurred in (1.3% 16 patients. Fifteen of them had acute prostatitis and urine culture results were positive in 10/15 patients for Escherichia coli. The strains were uniformly resistant to ciprofloxacin. Only 1 patient had urosepsis and his blood and urine cultures demonstrated extended- spectrum %u03B2-lactamase-producing (ESBL Escherichia coli also resistant to ciprofloxacin. Antibiotic treatment-related side effects were not observed in any patient. Discussion: Although there is not a certain procedure, ciprofloxacin is the most common used antibiotic for transrectal prostate biopsy prophylaxis. On the other hand, the incidence of ciprofloxacin resistant Escherichia coli strain is increasing. Thus, new prophylaxis strategies have to be discussed. Ceftriaxone plus ciprofloxacin prophylaxis is safe and can be useable option for prophylaxis of prostate biopsy.

  16. Reducing infection rates after prostate biopsy.

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    Wagenlehner, Florian M E; Pilatz, Adrian; Waliszewski, Przemyslaw; Weidner, Wolfgang; Johansen, Truls E Bjerklund

    2014-02-01

    Over the years, prostate biopsy has become the gold-standard technique for diagnosing prostate carcinoma. Worldwide, several million prostate biopsies are performed every year, most commonly using the transrectal approach. Preoperative antibiotic prophylaxis with fluoroquinolones has been shown to be effective for reducing infection rates. However, in recent years, an increase in febrile infection rates after transrectal prostate biopsy (from 1% to 4%) has been reported in retrospective and prospective studies. The predominant risk factor for infection seems to be the presence of fluoroquinolone-resistant bacteria in faeces. Patients at risk of fluoroquinolone resistance should receive carefully selected antibiotics at sufficient concentrations to be effective. Targeted prophylaxis after rectal flora swabbing has been shown to be efficacious compared with empirical antibiotic prophylaxis. Several forms of bowel preparations are under investigation, although none have yet been shown to significantly reduce infection rates. Perineal prostate biopsy is currently being evaluated as a strategy for preventing the inoculation of rectal flora, but limited data support this approach at present.

  17. Guidelines for processing and reporting of prostatic needle biopsies

    NARCIS (Netherlands)

    Th.H. van der Kwast (Theo); C. Lopes; C. Santonja; C.G. Pihl; I. Neetens; P. Martikainen (Pekka); S. di Lollo; L. Bubendorf; R.F. Hoedemaeker

    2003-01-01

    textabstractThe reported detection rate of prostate cancer, lesions suspicious for cancer, and prostatic intraepithelial neoplasia (PIN) in needle biopsies is highly variable. In part, technical factors, including the quality of the biopsies, the tissue processing, and histopatholo

  18. Study of prostate biopsy robot system

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yong-de; ZHANG Long; ZHAO Yan-jiang; ZHANG Yan-hua

    2009-01-01

    A system for prostate biopsy with robot assistance was proposed. The system consists of Motoman robot, needle insertion mechanism, and control software. A experiment was held with this software, and it proved that the whole system is simple, reliable and good application.

  19. Preparation and management of complications in prostate biopsies

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    Chiang Jeng Tyng

    2013-12-01

    Full Text Available Transrectal ultrasonography-guided biopsy plays a key role in prostate sampling for cancer detection. Among interventional procedures, it is one of the most frequent procedures performed by radiologists. Despite the safety and low morbidity of such procedure, possible complications should be promptly assessed and treated. The standardization of protocols and of preprocedural preparation is aimed at minimizing complications as well as expediting their management. The authors have made a literature review describing the possible complications related to transrectal ultrasonography-guided prostate biopsy, and discuss their management and guidance to reduce the incidence of such complications.

  20. Current status of transrectal ultrasound-guided prostate biopsy in the diagnosis of prostate cancer

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    Raja, J. [Department of Radiology, St George' s Hospital, Tooting, London (United Kingdom)]. E-mail: jowadraja@gmail.com; Ramachandran, N. [Department of Radiology, St George' s Hospital, Tooting, London (United Kingdom); Munneke, G. [Department of Radiology, St George' s Hospital, Tooting, London (United Kingdom); Patel, U. [Department of Radiology, St George' s Hospital, Tooting, London (United Kingdom)

    2006-02-15

    In contemporary practice, most prostate cancers are either invisible on ultrasound or indistinguishable from concurrent benign prostatic hyperplasia. Diagnosis therefore rests on prostate biopsy. Biopsies are not simply directed at ultrasonically visible lesions, as these would miss many cancers; rather the whole gland is sampled. The sampling itself is systematic, using patterns based on prostate zonal anatomy and the geographical distribution and frequency of cancer. This review explains the evolution of the prostate biopsy technique, from the classical sextant biopsy method to the more recent extended biopsy protocols (8, 10, 12, >12 and saturation biopsy protocols). Extended protocols are increasingly being used to improve diagnostic accuracy, especially in those patients who require repeat biopsy. This trend has been facilitated by the ongoing improvement in safety and acceptability of the procedure, particularly with the use of antibiotic prophylaxis and local anaesthesia. The technical details of these extended protocols are discussed, as are the current data regarding procedure-related morbidity and how this may be minimized.

  1. PSA and androgen-related gene (AR, CYP17, and CYP19) polymorphisms and the risk of adenocarcinoma at prostate biopsy

    DEFF Research Database (Denmark)

    dos Santos, Rodrigo Mattos; de Jesus, Carlos Márcio Nóbrega; Trindade Filho, José Carlos Souza;

    2008-01-01

    The aim of the present study was to examine the impact of polymorphisms in prostate-specific antigen (PSA) and androgen-related genes (AR, CYP17, and CYP19) on prostate cancer (PCa) risk in selected high-risk patients who underwent prostate biopsy. Blood samples and prostate tissues were obtained...... for DNA analysis. Single-nucleotide polymorphisms in the 50-untranslated regions (UTRs) of the PSA (substitution A>G at position-158) and CYP17 (substitution T>C at 50-UTR) genes were detected by polymerase chain reaction (PCR)-restriction fragment length polymorphism assays. The CAG and TTTA repeats...... in the AR and CYP19 genes, respectively, were genotyped by PCR-based GeneScan analysis. Patients with the GG genotype of the PSA gene had a higher risk of PCa than those with the AG or AA genotype (OR=3.79, p=0.00138). The AA genotype was associated with lower PSA levels (6.44 +/- 1.64 ng=mL) compared...

  2. MRI-Guided Robotic Prostate Biopsy: A Clinical Accuracy Validation

    OpenAIRE

    Xu, Helen; Lasso, Andras; Vikal, Siddharth; Guion, Peter; Krieger, Axel; Kaushal, Aradhana; Whitcomb, Louis L.; Fichtinger, Gabor

    2010-01-01

    Prostate cancer is a major health threat for men. For over five years, the U.S. National Cancer Institute has performed prostate biopsies with a magnetic resonance imaging (MRI)-guided robotic system.

  3. Mycobacterium abscessus complex bacteremia due to prostatitis after prostate biopsy.

    Science.gov (United States)

    Chen, Chung-Hua; Lin, Jesun; Lin, Jen-Shiou; Chen, Yu-Min

    2016-10-01

    We present the case of a 49-year-old man, who developed Mycobacterium abscessus complex (M. abscessus complex) bacteremia and prostatitis after prostate biopsy. The patient was successfully treated with amikacin with imipenem-cilastatin with clarithromycin. Infections caused by M. abscessus complex have been increasingly described as a complication associated with many invasive procedures. Invasive procedures might have contributed to the occurrence of the M. abscessus complex. Although M. abscessus complex infection is difficult to diagnose and treat, we should pay more attention to this kind of infection, and the correct treatment strategy will be achieved by physicians.

  4. Prostate biopsy strategies: current state of the art.

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    Mian, Badar M

    2004-05-01

    Prostate-specific antigen testing and prostate biopsy have revolutionized our ability to detect prostate cancer at an early stage. The transrectal ultrasound-guided biopsy procedure has undergone a number of modifications over the past 10 years to meet our goal of early detection of cancer at a curable stage. Biopsy schemes have evolved from lesion-directed biopsies to systematic mapping of the peripheral zone of the prostate, which harbors almost all of the significant tumor foci. An increase in the number of biopsy cores from 6 to 10 (or 12) has resulted in a significant improvement in the detection of clinically localized cancer, without any appreciable increase in the number of indolent cancers. Current biopsy schemes also have enhanced our ability to determine the true prognostic value of pathologic lesions such as high-grade prostatic intraepithelial neoplasia and atypical small acinar proliferation which have been associated with cancer detection in repeat biopsies. I discuss the rationale behind, and the outcomes of, various biopsy strategies. More than 15 years after PSA testing was popularized for early detection, a number of men are presenting for evaluation regarding repeat prostate biopsy for various clinical indications. The indications, biopsy scheme, and cancer detection rates for repeat prostate biopsy are discussed in detail.

  5. Ultrasound-guided transrectal extended prostate biopsy: a prospective study

    Institute of Scientific and Technical Information of China (English)

    Mohammed Ahmed Al-Ghazo; Ibrahim Fathi Ghalayini; Ismail Ibrahim Matalka

    2005-01-01

    Aim: To evaluate the diagnostic value of the 10 systematic transrectal ultrasound-guided (TRUS) prostate biopsy compared with the sextant biopsy technique for patients with suspected prostate cancer. Methods: One hundred and fifty-two patients with suspected prostate cancer were included in the study. Patients were entered in the study because they presented with high levels of prostate specific antigen (PSA) (over 4 ng/mL) and/or had undergone an abnormal digital rectal examination (DRE). In addition to sextant prostate biopsy cores, four more biopsies were obtained from the lateral peripheral zone with additional cores from each suspicious area revealed by transrectal ultrasound. Sextant, lateral peripheral zone and suspicious area biopsy cores were submitted separately to the pathological department. Results: Cancer detection rates were 27.6% (42/152) and 19.7% (30/152) for the 10-core and sextant core biopsy protocols, respectively. Adding the lateral peripheral zone (PZ) to the sextant prostate biopsy showed a 28.6% (12/42) increase in the cancer detection rate in patients with positive prostate cancer (P < 0.01).The cancer detection rate in patients who presented with elevated PSA was 29.3% (34/116). When serum PSA was 4-10 ng/mL TRUS-guided biopsy detected cancer in 20.6%, while the detection rate was 32.4% and 47.0% when serum PSA was 10-20 ng/mL and above 20 ng/mL, respectively. Conclusion: The 10 systematic TRUS-guided prostate biopsy improves the detection rate of prostate cancer by 28.6% when compared with the sextant biopsy technique alone, without increase in the morbidity. We therefore recommend the 10-core biopsy protocol to be the preferred method for early detection of prostate cancer.

  6. Optical coherence elastography (OCE) as a method for identifying benign and malignant prostate biopsies

    Science.gov (United States)

    Li, Chunhui; Guan, Guangying; Ling, Yuting; Lang, Stephen; Wang, Ruikang K.; Huang, Zhihong; Nabi, Ghulam

    2015-03-01

    Objectives. Prostate cancer is the most frequently diagnosed malignancy in men. Digital rectal examination (DRE) - a known clinical tool based on alteration in the mechanical properties of tissues due to cancer has traditionally been used for screening prostate cancer. Essentially, DRE estimates relative stiffness of cancerous and normal prostate tissue. Optical coherence elastography (OCE) are new optical imaging techniques capable of providing cross-sectional imaging of tissue microstructure as well as elastogram in vivo and in real time. In this preliminary study, OCE was used in the setting of the human prostate biopsies ex vivo, and the images acquired were compared with those obtained using standard histopathologic methods. Methods. 120 prostate biopsies were obtained by TRUS guided needle biopsy procedures from 9 patients with clinically suspected cancer of the prostate. The biopsies were approximately 0.8mm in diameter and 12mm in length, and prepared in Formalin solution. Quantitative assessment of biopsy samples using OCE was obtained in kilopascals (kPa) before histopathologic evaluation. The results obtained from OCE and standard histopathologic evaluation were compared provided the cross-validation. Sensitivity, specificity, and positive and negative predictive values were calculated for OCE (histopathology was a reference standard). Results. OCE could provide quantitative elasticity properties of prostate biopsies within benign prostate tissue, prostatic intraepithelial neoplasia, atypical hyperplasia and malignant prostate cancer. Data analysed showed that the sensitivity and specificity of OCE for PCa detection were 1 and 0.91, respectively. PCa had significantly higher stiffness values compared to benign tissues, with a trend of increasing in stiffness with increasing of malignancy. Conclusions. Using OCE, microscopic resolution elastogram is promising in diagnosis of human prostatic diseases. Further studies using this technique to improve the

  7. Prostate biopsy with image fusion: system validation and clinical results (abstract)

    NARCIS (Netherlands)

    Kruecker, J.; Kadoury, S.; Xu, S.; Turkbey, B.; Choyke, P.; Pinto, P.; Wood, B.

    2011-01-01

    Purpose Prostate cancer (PCA) is the second most frequent cause of cancer-related death in men in the United States and Europe. Transrectal ultrasound (TRUS) guided systematic prostate biopsy is the standard of care for detection and diagnosis of PCA. However, due to inadequate visualization of PCA

  8. Thin-needle aspiration biopsy of the prostate.

    Science.gov (United States)

    Koss, L G; Woyke, S; Schreiber, K; Kohlberg, W; Freed, S Z

    1984-05-01

    The authors summarize the current status of thin-needle aspiration biopsy of the prostate and evaluate the accomplishments and limitations of this method of diagnosis. Historical developments, indications, technique, contraindications, complications, cytology of aspirates, diagnostic efficacy of aspirates, and grading of prostatic carcinomas are discussed.

  9. Biopsym : a learning environment for transrectal ultrasound guided prostate biopsies

    CERN Document Server

    Thomas, Janssoone; Vadcard, Lucile; Mozer, Pierre; Troccaz, Jocelyne

    2010-01-01

    This paper describes a learning environment for image-guided prostate biopsies in cancer diagnosis; it is based on an ultrasound probe simulator virtually exploring real datasets obtained from patients. The aim is to make the training of young physicians easier and faster with a tool that combines lectures, biopsy simulations and recommended exercises to master this medical gesture. It will particularly help acquiring the three-dimensional representation of the prostate needed for practicing biopsy sequences. The simulator uses a haptic feedback to compute the position of the virtual probe from three-dimensional (3D) ultrasound recorded data. This paper presents the current version of this learning environment.

  10. Detection rate of clinically insignificant prostate cancer increases with repeat prostate biopsies

    Institute of Scientific and Technical Information of China (English)

    Bumsoo Park; Seong-Soo Jeon; Sung-Ho Ju; Byong-Chang Jeong; Seong-Il Seo; Hyun-Moo Lee; Han-Yong Choi

    2013-01-01

    To analyze if clinically insignificant prostate cancer (ClPC) is more frequently detected with repeat prostate biopsies,we retrospectively analyzed the records of 2146 men diagnosed with prostate cancer after one or more prostate biopsies.The patients were divided into five groups according to the number of prostate biopsies obtained,e.g.group 1 had one biopsy,group 2 had two biopsies and group 3 had three biopsies.Of the 2146 patients diagnosed with prostate cancer,1956 (91.1%),142 (6.6%),38 (1.8%),9 (0.4%) and 1 (0.1%) men were in groups 1,2,3,4 and 5,respectively.Groups 4 and 5 were excluded because of the small sample sizes.The remaining three groups (groups 1,2 and 3) were statistically analyzed.There were no differences in age or prostate-specific antigen level among the three groups.ClPC was detected in 201 (10.3%),28 (19.7%) and 9 (23.7%) patients in groups 1,2 and 3,respectively (P<0.001).A multivariate analysis showed that the number of biopsies was an independent predictor to detect CIPC (0R=2.688 for group 2; 0R=4.723 for group 3).In conclusion,patients undergoing multiple prostate biopsies are more likely to be diagnosed with CIPC than those who only undergo one biopsy.However,the risk still exists that the patient could have clinically significant prostate cancer.Therefore,when counseling patients with regard to serial repeat biopsies,the possibility of prostate cancer overdiagnosis and overtreatment must be balanced with the continued risk of clinically significant disease.

  11. Elevated Prostate Health Index (phi and Biopsy Reclassification During Active Surveillance of Prostate Cancer

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    Darian Andreas

    2016-07-01

    Full Text Available The Prostate Health Index (phi has been FDA approved for decision-making regarding prostate biopsy. Phi has additionally been shown to positively correlate with tumor volume, extraprostatic disease and higher Gleason grade tumors. Here we describe a case in which an elevated phi encouraged biopsy of a gentleman undergoing active surveillance leading to reclassification of his disease as high risk prostate cancer.

  12. The results of transrectal prostate biopsy in patients with low levels of prostate specific antigen

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    Ahmet Ali Sancaktutar

    2012-06-01

    Full Text Available Objectives: The aim of this study is to evaluate the resultsof prostate biopsy of patients who had the prostatespecificantigen (PSA levels below 4 ng/ml.Material and methods: The medical records of 63 patientswho underwent transrectal prostate biopsy, betweenJanuary 2005 and December 2011, due to suspicionof prostate cancer with the PSA levels under 4 ng/mlwere retrospectively reviewed.Results: Transrectal Prostate biopsy was performed to63 patients. Prostate cancer was detected in 12 (19%patients. The mean value of PSA was 2.5 ng/ml. TheGleason score of Prostate cancer patients was 6,8 (5-7and the number of positive cores were 3.Conclusions: The rate of prostate cancer was found as19% in patients with levels of PSA under 4 ng/ml and thisratio is compatible with the results of previous reports.

  13. Mitochondria, prostate cancer, and biopsy sampling error.

    Science.gov (United States)

    Parr, Ryan L; Mills, John; Harbottle, Andrew; Creed, Jennifer M; Crewdson, Gregory; Reguly, Brian; Guimont, François S

    2013-04-01

    Mitochondria and their associated genome are emerging as sophisticated indicators of prostate cancer biology. Alterations in the mitochondrial genome (mtgenome) have been implicated in cell proliferation, metastatic behavior, androgen independence, as a signal for apoptosis, and as a predictor of biochemical recurrence. Somatic mutation patterns in complete mtgenomes are associated with prostate specific antigen levels (PSA) in prostate cancer patients and a large-scale mtgenome deletion (3.4 kb) is consistent with a prostate "cancerization" field effect. This review will focus on the biological characteristics of mitochondria and their direct clinical application to prostate cancer. Mitochondrial science is currently influencing clinical prostate cancer diagnostics and the rapid progress in this area indicates future, break-through contributions in the general field of oncology.

  14. Dissemination of tuberculosis after biopsy of primary tubercular prostate: a case report

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    Onkar Jha

    2015-01-01

    Full Text Available Only 15-20% of extrapulmonary tuberculosis (TB has been attributed to TB of the urogenital system and often Results from haematogenous spread from an active site of infection. Isolated involvement of prostate by TB is relatively less common. The incidence of primary prostatic TB is unknown and in its truest sense is a very rare entity. Here, we report the case of a patient with primary prostatic TB who was misdiagnosed as nonspecific granulomatous inflammation on transrectal ultrasound-guided biopsy of the prostate, who later presented to our centre after 4 months with disseminated TB. The rarity of the case prompted us to report this case.

  15. Clinical value of core length in contemporary multicore prostate biopsy.

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    Sangchul Lee

    Full Text Available There is little data about the clinical value of core length for prostate biopsy (PBx. We investigated the clinical values of various clinicopathological biopsy-related parameters, including core length, in the contemporary multi-core PBx.Medical records of 5,243 consecutive patients who received PBx at our institution were reviewed. Among them, 3,479 patients with prostate-specific antigen (PSA ≤ 10 ng/ml level who received transrectal ultrasound (TRUS-guided multi (≥ 12-core PBx at our institution were analyzed for prostate cancer (PCa. Gleason score upgrading (GSU was analyzed in 339 patients who were diagnosed with low-risk PCa and received radical prostatectomy. Multivariate logistic regression analyses for PCa detection and prediction of GSU were performed.The mean age and PSA of the entire cohort were 63.5 years and 5.4 ng/ml, respectively. The overall cancer detection rate was 28.5%. There was no statistical difference in core length between patients diagnosed with PCa and those without PCa (16.1 ± 1.8 vs 16.1 ± 1.9 mm, P = 0.945. The core length was also not significantly different (16.4 ± 1.7 vs 16.4 ± 1.6mm, P = 0.889 between the GSU group and non-GSU group. Multivariate logistic regression analyses demonstrated that the core length of PBx did not affect PCa detection in TRUS-guided multi-core PBx (P = 0.923 and was not prognostic for GSU in patients with low-risk PCa (P = 0.356.In patients undergoing contemporary multi-core PBx, core length may not have significant impact on PCa detection and also GSU following radical prostatectomy among low-risk PCa group.

  16. Widespread high grade prostatic intraepithelial neoplasia on biopsy predicts the risk of prostate cancer: A 12 months analysis after three consecutive prostate biopsies

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    Cosimo De Nunzio

    2013-06-01

    Full Text Available Purpose: To evaluate the risk of prostate cancer (PCa on a third prostate biopsy in a group of patients with two consecutive diagnoses of high grade intraepithelial neoplasia (HGPIN. Materials and methods: From November 2004 to December 2007, patients referred to our clinic with a PSA ! 4 ng/ml or an abnormal digital rectal examination (DRE were scheduled for trans-rectal ultrasound (TRUS guided 12-core prostate biopsy. Patients with HGPIN underwent a second prostate biopsy, and if the results of such procedure yielded a second diagnosis of HGPIN, we proposed a third 12-core needle biopsy regardless of PSA value. Crude and adjusted logistic regressions were used to assess predictors of PCa on the third biopsy. Results: A total of 650 patients underwent 12 cores transrectal ultrasound prostatic biopsy in the study period. Of 147 (22% men with a diagnosis of HGPIN, 117 underwent a second prostatic biopsy after six months and 43 a third biopsy after other six months. After the third biopsy, 19 patients (34% still showed HGPIN, 15 (35% were diagnosed with PCa and 9 (21% presented with chronic prostatitis. Widespread HGPIN on a second biopsy was significantly associated with PCa on further biopsy (!2 = 4.04, p = 0.04. Moreover, the presence of widespread HGPIN significantly predicted the risk of PCa on crude and adjusted logistic regressions. Conclusions: Widespread HGPIN on second biopsy is associated with the presence of PCa on a third biopsy. Nonetheless, the relationship between HGPIN and PCa remains complex and further studies are needed to confirm our findings.

  17. TRANSRECTAL ULTRASOUND GUIDED PROSTATIC NERVE BLOCKADE FOR PAIN CONTROL DURING TRANSRECTAL PROSTATE BIOPSY

    Institute of Scientific and Technical Information of China (English)

    YANG Liu-ping; DENG Jun-hong; ZHONG Hong; HU Jian-bo; WEI Hong-ai; WANG Liang-sheng

    2005-01-01

    Objective: To assess the effect of transrectal ultrasound guided prostatic nerve blockade on the discomfort associated with systematic biopsy of the prostate. Methods: 73 patients receiving systematic 13 cores biopsy of the prostate were randomized into two groups. Group A(37 cases) received an injection of 5 ml 1% lidocaine into the prostatic neurovascular bundles on each side at the base of the prostate under ultrasound guidance and group B(36 cases) received 5 ml saline injection (0.9% sodium chloride) at the same site. Pain during biopsy was assessed by using a 10-point linear visual analog score (VAS) immediately after the biopsy. Results: The mean pain scores during transrectal prostate biopsy were significantly lower in group A than group B(1.1±0.6 versus 5.9±3.1, t=4.81, P<0.01). During this study no patient in either group had any adverse effect from the injection. Conclusion: Transcrectal ultrasound guided prostatic nerve blockade is a safe and efficacious method for providing satisfactory anesthesia in transrectal prostate biopsy. We recommend its routine administration in all patients during this procedure.

  18. Upgrading and upstaging in prostate cancer: From prostate biopsy to radical prostatectomy.

    Science.gov (United States)

    D'Elia, Carolina; Cerruto, Maria Angela; Cioffi, Antonio; Novella, Giovanni; Cavalleri, Stefano; Artibani, Walter

    2014-11-01

    Prostate cancer (CaP) is the most common malignancy in men and the second cause of cancer-related mortality after lung cancer. Several studies have evaluated the correlation between bioptic and pathological Gleason score (GS), documenting a correlation ranging between 30 and 60%. The aim of this study was the evaluation of the association between bioptic and pathological GS in a series of patients undergoing prostate needle biopsy and subsequent radical prostatectomy. We also aimed to evaluate the possible prognostic factors of upgrading and upstaging. We prospectively collected and retrospectively reviewed data from 300 consecutive patients who underwent radical retropubic or robot-assisted prostatectomy at our Institution. Patients who underwent prostate needle biopsy, transrectal or transperineal, with a minimum of 5 samples, were included in this study. Upgrading and downgrading were defined as increase or decrease, respectively, from one prognostic grade group to another, similar to up- or downstaging. The mean age of the patients was 62.97 years and the mean prostate-spesific antigen (PSA) level was 7.83 ng/ml. A total of 51.3% of the population underwent a transperineal prostate biopsy. The most frequently represented bioptic GS was 3+3 (64.0%) followed by 3+4=7 (15.6%); the most frequent pathological Gleason score was 3+4 (44.3%), followed by 3+3 (31.0%). With reagard to the bioptic GS 4-5-6 group, approximately half of the specimens (46.7%) were subsequently upgraded to GS 3+4, and 5.3% to 4+3. With regards to the bioptic GS 3+4 group, 57.4% was confirmed in the surgical specimen. In the 4+3 group, 23.5% of the cases was downgraded to 3+4 and 35.3% was confirmed. With regards to stage, ~39.7% of the patients received an upstaging on the pathological specimen. We evaluated the correlations between preoperative serum PSA level, prostate volume, digital rectal examination and biopsy type and none of the variables considered exhibited a correlation with any

  19. Nonspecific Presentation of a Multiloculated Prostatic Abscess After Transurethral Prostatic Biopsy for Elevated Prostate-specific Antigen Level

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    Nilay M. Gandhi

    2014-11-01

    Full Text Available Prostate postbiopsy infectious complications typically present in the form of prostatitis and uncommonly urosepsis. Prostatic abscesses are generally found after multiple bouts of prostatitis and are associated with a clinically septic picture requiring intensive care unit admission and resuscitation. We report the case of a 65-year-old man who presented with prostatic abscess in the setting of nonspecific urinary symptoms after transrectal ultrasonography–guided prostate biopsy. At 4-month follow-up, he is currently free of disease with undetectable prostate-specific antigen level and negative imaging.

  20. Significance of microvessel density in prostate cancer core biopsy

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    Salapura-Dugonjić Aleksandra

    2015-01-01

    Full Text Available Background/Aim. In prostate tumors, angiogenesis, measured as microvessel density, is associated with tumor stage and Gleason score. The aim of this study was determine neovascularization of prostatic adenocarcinomas in core biopsies and corresponding prostatectomies. Methods. The study population included 61 patients who underwent radical prostatectomy (RP for localized prostate carcinoma patients and did not receive chemohormonal, or radiation therapy before surgery. Tumor blocks were immunostained using the endothelial-specific antibody CD31 and subsequently evaluated at x 400 magnification in both biopsies and corresponding prostatectomies. Results. When comparing microvessel density in core biopsies and corresponding prostatectomies, no statistically significant difference was found (p > 0.1. A statistically significant positive correlation was found when determining correlation between microvessel density (as linear and categorical variable, i.e. with the cut-off value of 48 that was associated with the Gleason score (p 0.1. Conclusion. Microvessel density can be reliably applied to needle prostate biopsy specimens. Quantification of the microvascular density in biopsies is an accurate pre-operative predictor of tumor stage, discriminating between organconfined and organ-extending neoplasms.

  1. Transrectal Ultrasound-guided Systematic 13-Core Prostate Biopsy to Diagnose Prostate Carcinoma

    Institute of Scientific and Technical Information of China (English)

    Liuping Yang; Junhong Deng; Hong Zhong; Jianbo Hu; Hongai Wei; Liangsheng Wang

    2005-01-01

    OBJECTIVE To evaluate the clinical value of transrectal ultrasound guided systematic 13-core prostate biopsy.METHODS A total of 213 patients referred for abnormal digital rectal examination and/or with a prostate specific antigen of 4 ng/ml or greater underwent transrectal ultrasound guided systematic 13-core prostate biopsy. This procedure was conducted in addition to the standard sextant biopsies in which cores were taken from the far lateral and middle regions of the gland as described by Eskew. Fathological findings of the additional regions were compared with those of the sextant regions.RESULTS Of the 213 patients 31% had cancer on biopsy (66/213). Of the 66 patients with prostate cancer 14 (21%) had carcinoma only in the additional regions, which would have remained undetected had the sextant biopsy technique been used alone (P<0.05). No severe complications occurred among the patients who underwent transrectal ultrasound guided systematic 13-core prostate biopsy.CONCLUSION Our data demonstrated that transrectal ultrasound guided systematic 13-core prostate biopsy can significantly increase the cancer detection rate. It is safe and efficacious, and should be recommended for use clinically.

  2. Pathological extension of prostate cancer as defined by gleason score on biopsy

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    Marcos F. Dall'oglio

    2005-08-01

    Full Text Available INTRODUCTION: Based on the importance of the Gleason score on the behavior of prostate adenocarcinoma, this study attempts to predict the extension of prostate adenocarcinoma pre-operatively, as defined by the Gleason score on biopsy, in individuals who will undergo radical prostatectomy. MATERIALS AND METHODS: We selected 899 individuals who underwent retropubic radical prostatectomy from 1988 to 2004. Clinical and pathological data obtained in the preoperative period were retrospectively analyzed through digital rectal examinations of the prostate, initial serum PSA levels and pathological data provided by biopsy. The Gleason score on biopsy was assessed and divided into 3 groups: 2 to 6, 7, and 8 to 10, and correlated with the possibility of the disease being confined to the prostate. RESULTS: From the 899 selected patients, 654 (74% showed Gleason scores of 2 to 6, 165 (18% had a score of 7 and 80 (9% had scores of 8 to 10 on biopsy. The likelihood of confined diseases, extraprostatic extensions, invasion of seminal vesicles and lymph nodal involvement were respectively: 74%, 18%, 8% and 0.8% for a Gleason score of 2 to 6, 47%, 30%, 19% and 4% for a Gleason score of 7, and 49%, 29%, 18% and 4% for a Gleason score of 8 to 10. CONCLUSION: In patients who will undergo radical prostatectomy due to prostate adenocarcinoma, a Gleason score of 7 on biopsy shows the same behavior as a Gleason score of 8 to 10 in relation to extension of disease.

  3. High-risk prostate cancer: value of multi-modality 3T MRI-guided biopsies after previous negative biopsies

    NARCIS (Netherlands)

    Fütterer, J.J.; Verma, S.; Hambrock, T.; Yakar, D.; Barentsz, J.O.

    2012-01-01

    Transrectal ultrasound-guided biopsy is the gold standard for prostate cancer detection. The latter detection rates of random systematic TRUS-guided biopsy do not exceed 44\\%. As a consequence other biopsy methods have been explored. One of these methods is MR-guided biopsy (MRGB), which revealed de

  4. Targeted MRI-guided prostate biopsy: are two biopsy cores per MRI-lesion required?

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    Schimmoeller, L.; Quentin, M.; Blondin, D.; Dietzel, F.; Schleich, C.; Thomas, C.; Antoch, G. [University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany); Hiester, A.; Rabenalt, R.; Albers, P.; Arsov, C. [University Dusseldorf, Medical Faculty, Department of Urology, Dusseldorf (Germany); Gabbert, H.E. [University Dusseldorf, Medical Faculty, Department of Pathology, Dusseldorf (Germany)

    2016-11-15

    This study evaluates the feasibility of performing less than two core biopsies per MRI-lesion when performing targeted MR-guided in-bore prostate biopsy. Retrospectively evaluated were 1545 biopsy cores of 774 intraprostatic lesions (two cores per lesion) in 290 patients (66 ± 7.8 years; median PSA 8.2 ng/ml) regarding prostate cancer (PCa) detection, Gleason score, and tumor infiltration of the first (FBC) compared to the second biopsy core (SBC). Biopsies were acquired under in-bore MR-guidance. For the biopsy cores, 491 were PCa positive, 239 of 774 (31 %) were FBC and 252 of 771 (33 %) were SBC (p = 0.4). Patient PCa detection rate based on the FBC vs. SBC were 46 % vs. 48 % (p = 0.6). For clinically significant PCa (Gleason score ≥4 + 3 = 7) the detection rate was 18 % for both, FBC and SBC (p = 0.9). Six hundred and eighty-seven SBC (89 %) showed no histologic difference. On the lesion level, 40 SBC detected PCa with negative FBC (7.5 %). Twenty SBC showed a Gleason upgrade from 3 + 3 = 6 to ≥3 + 4 = 7 (2.6 %) and 4 to ≥4 + 3 = 7 (0.5 %). The benefit of a second targeted biopsy core per suspicious MRI-lesion is likely minor, especially regarding PCa detection rate and significant Gleason upgrading. Therefore, a further reduction of biopsy cores is reasonable when performing a targeted MR-guided in-bore prostate biopsy. (orig.)

  5. Three different anesthesia techniques for a comfortable prostate biopsy

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    Adnan Sahin

    2015-01-01

    Discussion: Enabling pain and discomfort control in patients is very important during TRUS-guided prostate biopsy. In our study, we observed that the periprostatic block enables more comfortable compared with patient groups with intrarectal lidocaine gel and pudendal block and better reduction in pain scores.

  6. Saturation biopsy improves preoperative Gleason scoring of prostate cancer.

    Science.gov (United States)

    Kahl, Philip; Wolf, Susanne; Adam, Alexander; Heukamp, Lukas Carl; Ellinger, Jörg; Vorreuther, Roland; Solleder, Gerold; Buettner, Reinhard

    2009-01-01

    We evaluated the differences between conventional needle biopsy (CB) and saturation biopsy (SB) techniques with regard to the prediction of Gleason score, tumor stage, and insignificant prostate cancer. Data from a total number of 240 patients were analyzed. The main group, consisting of 185 patients, was diagnosed according to a saturation prostate needle biopsy protocol (SB), by which more than 12 cores were taken per biopsy. The control group was diagnosed using CB, by which 12 or less than 12 cores were taken per biopsy (n=55). In the main group, the Gleason score of the biopsy was confirmed in 19.5%, in the control group in 23.5% according to the prostatectomy specimen (p=0.50). Upgrading after the operation was found in 56.7% in the main group and in 60% in the control group (p=0.24). Downgrading after the operation was found in 23.9% in the main group and in 16.3% in the control group (p=0.24). If the Gleason score of the postoperative specimens differed by only one point from the biopsy, we considered this a minor deviation. In the main group, 59% of the carcinomas were preoperatively classified correctly or revealed minor deviation in Gleason scores. In contrast, only 47% of the carcinomas in the control group were assessed correctly or with minor deviation in Gleason scores. Thus, the main group demonstrated a better rate of preoperative prediction in tumor grading assessed by Gleason score (p=0.05). In addition, the Gleason scores of both protocols were assigned to three groups (Gleason 7), and the group changes from the biopsy to the prostatectomy specimen were found to be significantly more frequent in the CB group (p=0.04). There was no significant difference between the two types of biopsy techniques regarding tumor stage or the detection of insignificant carcinomas. The advantage of the extensive prostate needle biopsy technique (SB) is a better preoperative prediction of the Gleason score as well as the risk groups with Gleason scores 7. Both

  7. Intravenous piperacillin/tazobactam plus fluoroquinolone prophylaxis prior to prostate ultrasound biopsy reduces serious infectious complications and is cost effective

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    Remynse LC

    2011-08-01

    Full Text Available Louis C Remynse III, Patrick J Sweeney, Kevin A Brewton, Jay M LonswayUrology Associates of Battle Creek, PC, Battle Creek, MI, USAAbstract: Infectious complications related to prostate ultrasound and biopsy have increased in the past decade with the emergence of increasing fluoroquinolone bacterial resistance. We investigated the addition of intravenous (iv piperacillin/tazobactam immediately prior to prostate ultrasound and biopsy with standard fluoroquinolone prophylaxis to determine if it would decrease the incidence of serious infectious complications after prostate ultrasound and biopsy. Group 1 patients were a historic control of 197 patients who underwent prostate ultrasound and biopsy with standard fluoroquinolone prophylaxis. Group 2 patients, 104 patients, received standard fluoroquinolone prophylaxis and the addition of a single dose of iv piperacillin/tazobactam 30 minutes prior to prostate ultrasound and biopsy. There were ten serious bacterial infectious complications in group 1 patients. No patients in group 2 developed serious bacterial infections after prostate ultrasound and biopsy. There was approximately a 5% incidence of serious bacterial infection in group 1 patients. Subgroup analysis revealed an almost 2.5 times increased risk of infection in diabetes patients undergoing prostate ultrasound and biopsy. There was a 10% risk of serious bacterial infection in diabetics compared with a 3.8% risk group 1 nondiabetes patients. The addition of a single dose of iv piperacillin/tazobactam along with standard fluoroquinolone prophylaxis substantially reduces the risk of serious bacterial infection after prostate ultrasound and biopsy (P < 0.02.Keywords: piperacillin/tazobactam, fluoroquinolone, prostate biopsy, infectious complications

  8. Probability modeling of the number of positive cores in a prostate cancer biopsy session, with applications.

    Science.gov (United States)

    Serfling, Robert; Ogola, Gerald

    2016-02-10

    Among men, prostate cancer (CaP) is the most common newly diagnosed cancer and the second leading cause of death from cancer. A major issue of very large scale is avoiding both over-treatment and under-treatment of CaP cases. The central challenge is deciding clinical significance or insignificance when the CaP biopsy results are positive but only marginally so. A related concern is deciding how to increase the number of biopsy cores for larger prostates. As a foundation for improved choice of number of cores and improved interpretation of biopsy results, we develop a probability model for the number of positive cores found in a biopsy, given the total number of cores, the volumes of the tumor nodules, and - very importantly - the prostate volume. Also, three applications are carried out: guidelines for the number of cores as a function of prostate volume, decision rules for insignificant versus significant CaP using number of positive cores, and, using prior distributions on total tumor size, Bayesian posterior probabilities for insignificant CaP and posterior median CaP. The model-based results have generality of application, take prostate volume into account, and provide attractive tradeoffs of specificity versus sensitivity. Copyright © 2015 John Wiley & Sons, Ltd.

  9. Individualized prostate biopsy strategy for Chinese patients with different prostate-specific antigen levels

    Institute of Scientific and Technical Information of China (English)

    Bo Dai; Ding-Wei Ye; Yun-Yi Kong; Yi-Jin Shen; Bo-Hua Wang

    2008-01-01

    Aim: To evaluate the best individualized prostate biopsy strategies for Chinese patients with suspected prostate cancer. Methods: The present study included 221 Chinese patients who underwent transrectal ultrasound guided prostate biopsies for the first time. All patients underwent the same 10-core biopsy protocol. In addition to the Hodge sextant technique, four more biopsies were obtained from the base and middle regions of bilateral peripheral zones.The differences between 10-core and sextant strategies in cancer detection among patients with different prostate specific anitgen (PSA) levels were evaluated. The relationship between PSA level, number of positive biopsy cores and organ-confined cancer rate in prostate cancer patients was also analyzed. Results: The overall prostate cancer detection rate was 40.7% in the 221 patients. The 10-core strategy increased cancer detection by 6.67% (6/90) in our patients (P 50 ng/mL (P 50 ng/mL. For patients with PSA ranging from 20.1 ng/mL to 50 ng/mL, the 10-core strategy should be applied in patients with life expectancy > 10 years and the sextant strategy should be applied in those with life expectancy < 10 years.

  10. Image Registration for Targeted MRI-guided Transperineal Prostate Biopsy

    Science.gov (United States)

    Fedorov, Andriy; Tuncali, Kemal; Fennessy, Fiona M.; Tokuda, Junichi; Hata, Nobuhiko; Wells, William M.; Kikinis, Ron; Tempany, Clare M.

    2012-01-01

    Purpose To develop and evaluate image registration methodology for automated re-identification of tumor-suspicious foci from pre-procedural MR exams during MR-guided transperineal prostate core biopsy. Materials and Methods A hierarchical approach for automated registration between planning and intra-procedural T2-weighted prostate MRI was developed and evaluated on the images acquired during 10 consecutive MR-guided biopsies. Registration accuracy was quantified at image-based landmarks and by evaluating spatial overlap for the manually segmented prostate and sub-structures. Registration reliability was evaluated by simulating initial mis-registration and analyzing the convergence behavior. Registration precision was characterized at the planned biopsy targets. Results The total computation time was compatible with a clinical setting, being at most 2 minutes. Deformable registration led to a significant improvement in spatial overlap of the prostate and peripheral zone contours compared to both rigid and affine registration. Average in-slice landmark registration error was 1.3±0.5 mm. Experiments simulating initial mis-registration resulted in an estimated average capture range of 6 mm and an average in-slice registration precision of ±0.3 mm. Conclusion Our registration approach requires minimum user interaction and is compatible with the time constraints of our interventional clinical workflow. The initial evaluation shows acceptable accuracy, reliability and consistency of the method. PMID:22645031

  11. Gleason score and laterality concordance between prostate biopsy and prostatectomy specimens

    OpenAIRE

    2009-01-01

    Objectives: Prostate biopsy involvement and Gleason score guide treatment decisions in prostate cancer. We evaluated concordance in Gleason score and laterality between biopsy and radical retropubic prostatectomy (RRP) specimens and factors that influenced this relationship. Material and Methods: We reviewed 538 prostate cancer diagnoses at a Veterans Affairs medical center (2000-2005) to identify men with prostate biopsy and RRP specimens. During this time there was a move from limited (6 co...

  12. Prostate Biopsy Sampling Causes Hematogenous Dissemination of Epithelial Cellular Material

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    Sam Ladjevardi

    2014-01-01

    Full Text Available The extent of epithelial cellular material (ECM occurring in venous blood samples after diagnostic core needle biopsy (CNB was studied in 23 patients with CNB diagnosed prostate cancer without provable metastases and 15 patients without cancer. The data show a significant increase of ECM in the peripheral blood sampled 20 seconds or 30 minutes after the last of 10 CNB procedures compared to the number of ECM detectable in the blood samples taken before the performance of CNB. The data indicate that diagnostic CNB of prostate cancer causes an extensive tissue trauma with a potential risk of cancer cell dissemination.

  13. Prostate Ultrasound

    Medline Plus

    Full Text Available ... as detailed as with the transrectal probe. An MRI of the pelvis may be obtained as an ... Benign Prostatic Hyperplasia (BPH) Prostate Cancer Ultrasound- and MRI-Guided Prostate Biopsy Images related to Ultrasound - Prostate ...

  14. Outcomes and trends of prostate biopsy for prostate cancer in Chinese men from 2003 to 2011.

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    Rong Na

    Full Text Available BACKGROUND: Prostate-specific antigen (PSA screening is growing in popularity in China, but its impact on biopsy characteristics and outcomes are poorly understood. OBJECTIVE: Our objective was to characterize prostate biopsy outcomes and trends in Chinese men over a 10-year period, since the increasing use of PSA tests. METHODS: All men (n = 1,650 who underwent prostate biopsy for PCa at Huashan Hospital, Shanghai, China from 2003-2011 were evaluated. Demographic and clinical information was collected for each patient, including age, digital rectal examination (DRE, transrectal ultrasound (prostate volume and nodule, total prostate-specific antigen (tPSA levels and free PSA ratio (fPSA/tPSA prior to biopsy. Prostate biopsy was performed using six cores before October 2007 or ten cores thereafter. Logistic regression and multivariate analysis were used to evaluate our data. RESULTS: The overall positive rate of prostate biopsy for PCa was 47% and the rate decreased significantly over the years from 74% in 2003 to 33% in 2011 (P-trend = 0.004. Age at diagnosis was slightly increased (P-trend = 0.04 while fPSA/tPSA was significantly decreased (P-trend = 1.11×10-5. A statistically significant trend was not observed for tPSA levels, prostate volume, or proportion of positive nodule. The model including multiple demographic and clinical variables (i.e., age, DRE, tPSA, fPSA/tPSA and transrectal ultrasound results (AUC = 0.93 statistically outperformed models that included only PSA (AUC = 0.85 or fPSA/tPSA (AUC = 0.66 to predict PCa risks (P<0.05. Similar results were observed in a subgroup of men whose tPSA levels were lower than 20 ng/mL (AUC = 0.87, vs. AUC of tPSA  = 0.62, P<0.05. CONCLUSIONS: Detection rates of PCa and high-grade PCa among men that underwent prostate biopsy at the institution has decreased significantly in the past 10 years, likely due to increasing use of PSA tests. Predictive performance of

  15. Efficacy and cost analysis of transrectal ultrasound-guided prostate biopsy under monitored anesthesia

    Institute of Scientific and Technical Information of China (English)

    Sung Gu Kang; Bum Sik Tae; Sam Hong Mine; Young Hwu Ko; Seok Ho Kang; Jeong Gu Lee; Je Jong Kim; Jun Cheon

    2011-01-01

    @@ Sedation may result in reduction in pain during transrectal ultrasound(TRUS)-guided prostate biopsies.We aimed to evaluate the efficacy and safety of a combination of propofol and remifentanil infusion during TRUS-guided prostate biopsy and the related increases in health care costs.From January to September 2010,100 men undergoing a transrectal prostate biopsy were randomized into two groups.In Group 1,[50]patients received a combined infusion of propofol and remifentanil; in Group 2,[50]patients received lidocaine jelly.After TRUS-guided biopsies were performed,pain and patient satisfaction were evaluated by a 10-point visual analog scale (VAS),and a cost-related patient satisfaction questionnaire was completed by all patients.Patients were also asked whether they would be willing to undergo repeat biopsy by the same method.Patients in Group 1 showed a significantly lower VAS score than those in Group 2 (mean VAS score: 0.9士1.1 versus 6.312.5; P<0.001).In addition,the patient satisfaction scale was significantly higher in Group 1(P=0.002).Although the overall cost was significantly higher in Group 1(P=0.006),patient satisfaction scales considering cost were also higher in this group (P=0.009).A combination of propofol and remifentanil is a safe and effective way to decrease patient pain and increase patient satisfaction during TRUS-guided prostate biopsy.Although the costs were higher in the group that received sedation,as expected,the patients exhibited heightened satisfaction and willingness to repeat biopsies by the same method.

  16. The results of transperineal versus transrectal prostate biopsy: a systematic review and meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Peng-Fei Shen; Yu-Chun Zhu; Wu-Ran Wei; Yong-Zhong Li; Jie Yang; Yu-Tao Li; Ding-Ming Li; Jia Wang; Hao Zeng

    2012-01-01

    This systematic review was performed to compare the efficacy and complications of transperineal (TP) vs.transrectal (TR) prostate biopsy.A systematic research of PUBMED,EMBASE and the Cochrane Library was performed to identify all clinical controlled trials on prostate cancer (PCa) detection rate and complications achieved by TP and TR biopsies.Prostate biopsies included sextant,extensive and saturation biopsy procedures.All patients were assigned to a TR group and a TP group.Subgroup analysis was performed according to prostate-specific antigen (PSA) levels and digital rectal examination (DRE) findings.The Cochrane Collaboration's RevMan 5.1 software was used for the meta-analysis.A total of seven trials,including three randomized controlled trials (RCTs) and four case- control studies (CCS),met our inclusion criteria.There was no significant difference in the cancer detection rate between the sextant TR and TP groups (risk difference (RD),-0.02; 95% confidence interval (Cl),-0.08-0.03; P=0.34).Meta-analysis for RCTs combined with CCS showed that there was no difference in the cancer detection rate between the extensive TR and TP group (RD,-0.01; 95% CI,-0.05-0.04; P=0.81).There was no significant difference in PCa detection rate between the saturation TR and TP approaches (31.4% vs.25.7%,respectively; P=0.3).There were also no significant differences in cancer detection between the TR and TP groups in each subgroup.Although the data on complications were not pooled for the meta-analysis,no significant difference was found when comparing TR and TP studies.TR and TP biopsies were equivalent in terms of efficiency and related complications.TP prostate biopsy should be an available and alternative procedure for use by urologists.

  17. Life-threatening meningitis resulting from transrectal prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    Zhou-Jun Shen; Shan-Wen Chen; Hua Wang; Xie-Lai Zhou; Ju-Ping Zhao

    2005-01-01

    After antibiotic prophylaxis with metronidazole and levofloxacin, a transrectal sextant biopsy was performed under the guide of transrectal ultrasonography (TRUS) for a 75-year-old suspicious patient with prostate adenocarcinoma.Although antibiotics were also given after this procedure, the patient still developed fever, anxious, agrypnia and headache. Blood cultures remained negative. Lumbar puncture was performed and was consistent with Escherichia coli bacterial meningitis.

  18. Rare complication after a transrectal ultrasound guided prostate biopsy: a giant retroperitoneal hematoma.

    Science.gov (United States)

    Chiancone, Francesco; Mirone, Vincenzo; Fedelini, Maurizio; Meccariello, Clemente; Pucci, Luigi; Carrino, Maurizio; Fedelini, Paolo

    2016-05-24

    Common complications related to transrectal ultrasound (TRUS) guided prostatic needle biopsy are hematuria, hematospermia, and hematochezia. To the best of our knowledge, we report the second case of a very large hematoma extending from the pelvis into the retroperitoneal space in literature.A 66-year-old man with a serum prostate-specific antigen (PSA) of 5.4 ng/ml was admitted to our department for a TRUS-guided prostatic needle biopsy. Laboratory values on the day before biopsy, including coagulation studies, were all normal. The patients did not take any anticoagulant drugs. No immediate complications were encountered. Nevertheless, 7 hours after the biopsy, the patient reached our emergency department with severe diffuse abdominal pain, hypotension, tachycardia, and confusional state. He underwent an ultrasonography and then a computed tomography (CT) scan that showed "a blood collection in the pelvis that extending to the lower pole of left kidney associated with a focus of active contrast extravasation, indicating active ongoing prostate bleeding." Consequently, he underwent a diagnostic angiography that showed no more contrast extravasation, without the need of embolization. Management of hematoma has been conservative and hematoma was completely reabsorbed 4 months later.

  19. A review of repeat prostate biopsies and the influence of technique on cancer detection: our experience.

    LENUS (Irish Health Repository)

    Quinlan, M R

    2012-02-01

    BACKGROUND: Follow-up of patients with an initial negative prostate biopsy, but surrounding whom a suspicion of prostate cancer persists, is difficult. In addition, debate exists as to the optimal technique for repeat prostate biopsy. AIMS: To assess the cancer detection rate on repeat prostate biopsy. METHODS: We reviewed patients who underwent prostate biopsy in our department in 2005 who had >or=1 previous biopsy within the preceding 5 years. Cancer detection rate on repeat biopsy and the influence of the number of biopsy cores were recorded. RESULTS: Cancer detection rate on repeat biopsy was 15.4%, with approximately 60% detected on the first repeat biopsy, but approximately 10% not confirmed until the fourth repeat biopsy. Gleason score was similar regardless of the time of diagnosis (6.1-6.5). Mean interval between first biopsy and cancer diagnosis (range 18-55 months) depended on the number of repeat procedures. There was an association between the number of biopsy cores and cancer detection. CONCLUSIONS: This study supports the practice of increasing the number of cores taken on initial and first repeat biopsy to maximise prostate cancer detection and reduce the overall number of biopsies needed.

  20. Anterior prostate biopsy at initial and repeat evaluation: is it useful to detect significant prostate cancer?

    Directory of Open Access Journals (Sweden)

    Pietro Pepe

    2015-10-01

    Full Text Available ABSTRACT Purpose: Detection rate for anterior prostate cancer (PCa in men who underwent initial and repeat biopsy has been prospectively evaluated. Materials and Methods: From January 2013 to March 2014, 400 patients all of Caucasian origin (median age 63.5 years underwent initial (285 cases and repeat (115 cases prostate biopsy; all the men had negative digital rectal examination and the indications to biopsy were: PSA values > 10 ng/mL, PSA between 4.1-10 or 2.6-4 ng/mL with free/total PSA≤25% and ≤20%, respectively. A median of 22 (initial biopsy and 31 cores (repeat biopsy were transperineally performed including 4 cores of the anterior zone (AZ and 4 cores of the AZ plus 2 cores of the transition zone (TZ, respectively. Results: Median PSA was 7.9 ng/mL; overall, a PCa was found in 180 (45% patients: in 135 (47.4% and 45 (36% of the men who underwent initial and repeat biopsy, respectively. An exclusive PCa of the anterior zone was found in the 8.9 (initial biopsy vs 13.3% (repeat biopsy of the men: a single microfocus of cancer was found in the 61.2% of the cases; moreover, in 7 out 18 AZ PCa the biopsy histology was predictive of significant cancer in 2 (28.5% and 5 (71.5% men who underwent initial and repeat biopsy, respectively. Conclusions: However AZ biopsies increased detection rate for PCa (10% of the cases, the majority of AZ PCa with histological findings predictive of clinically significant cancer were found at repeat biopsy (about 70% of the cases.

  1. Incidental seminal vesicle amyioidosis observed in diagnostic prostate biopsies-are routine investigations for systemic amyloidosis warranted?

    Institute of Scientific and Technical Information of China (English)

    Zichu Yang; Alexander Laird; Ashley Monaghan; Morag Seywright; Imran Ahmad; Hing Y Leung

    2013-01-01

    Seminal vesicle (SV) amyloidosis is a well-documented histological entity,but it is observed infrequently.Its incidence is on the rise,which is probably related to the increasing use of prostate biopsies to investigate patients with elevated serum prostate-specific antigen levels.Here,we report seven cases of incidental SV amyloidosis over a 3-year period and consider their relationship to the previously suggested aetiological factors.Based on our series,we conclude that incidental localized SV amyloidosis observed in diagnostic prostate biopsies does not warrant formal investigations for systemic amyloidosis.

  2. [Pilot study on predictive value of plasmatic levels of 9 angiogenetic biomarkers in selection of patients candidate to prostate biopsy].

    Science.gov (United States)

    Serretta, Vincenzo; Scurria, Salvatore; Dispensa, Nino; Chiapparrone, Gaetano; Provenzano, Sandro; Caruso, Stefano; Bronte, Giuseppe; Cicero, Giuseppe; Russo, Antonio

    2013-01-01

    To reduce the number of negative prostate biopsies in patients with elevated PSA serum levels represents a major challenge in urological oncology. Angiogenetic factors might be involved in initial stages of prostate cancer and might represent useful tools in patients' selection for prostate biopsy. The plasmatic levels of Angiopoietin-2, Follistatin, G-CSF, HGF, IL-8, Leptin, PDGF-BB, PECAM-1 and VEGF were measured by BioPlex immunoassay in patients undergoing prostate biopsy for palpable prostate nodule and/or elevated PSA levels (≥4 ng/mL). They were related with biopsy results. ROC curve analysis was exploited to test the diagnostic accuracy of each biomarker by AUC calculation. A potential cut-off level was computed. Fifty patients were entered. Median PSA was 6.8 ng/mL. A prostate nodule was palpable in 18 (36%) patients. The median number of biopsy cores was 12. Prostate cancer was detected in 25 (50%) and ASAP and PIN in 2 more patients (4%) respectively. Among the 9 considered biomarkers, only leptin showed an interesting diagnostic performance with an AUC of 0.781, at a cut-off value of 2.11 ng/mL, demonstrating a sensitivity of 78%, a specificity of 77% and a positive predictive value of 85%. Main limitations of our study are the exploratory design and the criteria adopted for patients' selection determining a detection rate for prostate cancer above the usual range. Leptin only, in our preliminary study, shows promising diagnostic accuracy for the selection of patients candidate to prostate biopsy. Further studies are required to confirm its diagnostic value and its relation with BMI.

  3. Gleason score and laterality concordance between prostate biopsy and prostatectomy specimens

    Directory of Open Access Journals (Sweden)

    Kenneth G. Nepple

    2009-10-01

    Full Text Available Objectives: Prostate biopsy involvement and Gleason score guide treatment decisions in prostate cancer. We evaluated concordance in Gleason score and laterality between biopsy and radical retropubic prostatectomy (RRP specimens and factors that influenced this relationship. Material and Methods: We reviewed 538 prostate cancer diagnoses at a Veterans Affairs medical center (2000-2005 to identify men with prostate biopsy and RRP specimens. During this time there was a move from limited (6 core to extended (12 core biopsy schemes. Discordance in Gleason score was defined as any change in Gleason score. Results: 152 men underwent RRP with biopsy showing Gleason 7 in 8%. Biopsy involvement was unilateral in 59% and bilateral in 41%. Compared to the biopsy, RRP Gleason score was concordant in 76 (50%, higher in 51 (34%, and lower in 25 (16%. Bilateral involvement was concordant in 97%, while unilateral involvement was concordant in only 20%. Both Gleason score and laterality were concordant in only 26%. Gleason concordance was higher in those with 8 or more cores compared to < 8 cores taken (54% vs. 34%, p = 0.046, but concordance was not affected by age, PSA, prostate volume, or length of time from biopsy to RRP. During later years, concordance did not improve despite taking more cores. Conclusions: Prostate biopsy underestimated prostatectomy Gleason score in 34% of men and bilateral involvement in 80% of those with unilateral disease on biopsy. Taking at least eight cores improves the accuracy of the prostate biopsy.

  4. TU-CD-BRB-12: Radiogenomics of MRI-Guided Prostate Cancer Biopsy Habitats

    Energy Technology Data Exchange (ETDEWEB)

    Stoyanova, R; Lynne, C; Abraham, S; Patel, M; Jorda, M; Kryvenko, O; Ishkanian, A; Abramowitz, M; Pollack, A [University of Miami, Miami, FL (United States); Tachar, M; Erho, N; Buerki, C; Lam, L; Davicioni, E [GenomeDx Biosciences Inc., Vancouver, British Columbia (Canada)

    2015-06-15

    Purpose: Diagnostic prostate biopsies are subject to sampling bias. We hypothesize that quantitative imaging with multiparametric (MP)-MRI can more accurately direct targeted biopsies to index lesions associated with highest risk clinical and genomic features. Methods: Regionally distinct prostate habitats were delineated on MP-MRI (T2-weighted, perfusion and diffusion imaging). Directed biopsies were performed on 17 habitats from 6 patients using MRI-ultrasound fusion. Biopsy location was characterized with 52 radiographic features. Transcriptome-wide analysis of 1.4 million RNA probes was performed on RNA from each habitat. Genomics features with insignificant expression values (<0.25) and interquartile range <0.5 were filtered, leaving total of 212 genes. Correlation between imaging features, genes and a 22 feature genomic classifier (GC), developed as a prognostic assay for metastasis after radical prostatectomy was investigated. Results: High quality genomic data was derived from 17 (100%) biopsies. Using the 212 ‘unbiased’ genes, the samples clustered by patient origin in unsupervised analysis. When only prostate cancer related genomic features were used, hierarchical clustering revealed samples clustered by needle-biopsy Gleason score (GS). Similarly, principal component analysis of the imaging features, found the primary source of variance segregated the samples into high (≥7) and low (6) GS. Pearson’s correlation analysis of genes with significant expression showed two main patterns of gene expression clustering prostate peripheral and transitional zone MRI features. Two-way hierarchical clustering of GC with radiomics features resulted in the expected groupings of high and low expressed genes in this metastasis signature. Conclusions: MP-MRI-targeted diagnostic biopsies can potentially improve risk stratification by directing pathological and genomic analysis to clinically significant index lesions. As determinant lesions are more reliably

  5. The role of transperineal template biopsies of the prostate in the diagnosis of prostate cancer: a review.

    Science.gov (United States)

    Abdulmajed, Mohamed Ismat; Hughes, Daniel; Shergill, Iqbal Singh

    2015-03-01

    The incidence of prostate cancer has shown a significant increase, highlighting the importance of early diagnosis. Current practice considers histological diagnosis a necessity in the majority of the cases. The limitations of transrectal biopsies led to the development of the promising transperineal prostatic biopsies. The latter offers a safer approach by avoiding the rectum, utilizing brachytherapy template grid to detect anterior zone disease and provides accurate prostatic mapping by systematically sampling the whole gland. It also helps to direct biopsies based on images obtained from previous prostate scanning and identify those eligible for focal therapy to direct focal treatment accurately. The current literature provides enough reassurance that transperineal template biopsies are effective, efficient and superior to the traditional and inaccurate transrectal biopsies. The absence of consensus on the technical aspect of template biopsies is a drawback, yet it highlights the need to develop robust guidelines to standardize the procedure.

  6. Sex Steroid Metabolism in Benign and Malignant Intact Prostate Biopsies: Individual Profiling of Prostate Intracrinology

    Directory of Open Access Journals (Sweden)

    Daniele Gianfrilli

    2014-01-01

    Full Text Available In vitro studies reveal that androgens, oestrogens, and their metabolites play a crucial role in prostate homeostasis. Most of the studies evaluated intraprostatic hormone metabolism using cell lines or preprocessed specimens. Using an ex vivo model of intact tissue cultures with preserved architecture, we characterized the enzymatic profile of biopsies from patients with benign prostatic hyperplasia (BPH or cancer (PC, focusing on 17β-hydroxy-steroid-dehydrogenases (17β-HSDs and aromatase activities. Samples from 26 men who underwent prostate needle core biopsies (BPH n = 14; PC n = 12 were incubated with radiolabeled 3H-testosterone or 3H-androstenedione. Conversion was evaluated by TLC separation and beta-scanning of extracted supernatants. We identified three major patterns of conversion. The majority of BPHs revealed no active testosterone/oestradiol conversion as opposed to prostate cancer. Conversion correlated with histology and PSA, but not circulating hormones. Highest Gleason scores had a higher androstenedion-to-testosterone conversion and expression of 17β-HSD-isoenzymes-3/5. Conclusions. We developed an easy tool to profile individual intraprostatic enzymatic activity by characterizing conversion pathways in an intact tissue environment. In fresh biopsies we found that 17β-HSD-isoenzymes and aromatase activities correlate with biological behaviour allowing for morphofunctional phenotyping of pathology specimens and clinical monitoring of novel enzyme-targeting drugs.

  7. PCA3 and PCA3-Based Nomograms Improve Diagnostic Accuracy in Patients Undergoing First Prostate Biopsy

    Directory of Open Access Journals (Sweden)

    Virginie Vlaeminck-Guillem

    2013-08-01

    Full Text Available While now recognized as an aid to predict repeat prostate biopsy outcome, the urinary PCA3 (prostate cancer gene 3 test has also been recently advocated to predict initial biopsy results. The objective is to evaluate the performance of the PCA3 test in predicting results of initial prostate biopsies and to determine whether its incorporation into specific nomograms reinforces its diagnostic value. A prospective study included 601 consecutive patients addressed for initial prostate biopsy. The PCA3 test was performed before ≥12-core initial prostate biopsy, along with standard risk factor assessment. Diagnostic performance of the PCA3 test was evaluated. The three available nomograms (Hansen’s and Chun’s nomograms, as well as the updated Prostate Cancer Prevention Trial risk calculator; PCPT were applied to the cohort, and their predictive accuracies were assessed in terms of biopsy outcome: the presence of any prostate cancer (PCa and high-grade prostate cancer (HGPCa. The PCA3 score provided significant predictive accuracy. While the PCPT risk calculator appeared less accurate; both Chun’s and Hansen’s nomograms provided good calibration and high net benefit on decision curve analyses. When applying nomogram-derived PCa probability thresholds ≤30%, ≤6% of HGPCa would have been missed, while avoiding up to 48% of unnecessary biopsies. The urinary PCA3 test and PCA3-incorporating nomograms can be considered as reliable tools to aid in the initial biopsy decision.

  8. Serum testosterone as a biomarker for second prostatic biopsy in men with negative first biopsy for prostatic cancer and PSA>4ng/mL, or with PIN biopsy result

    Science.gov (United States)

    Fiamegos, Alexandros; Varkarakis, John; Kontraros, Michael; Karagiannis, Andreas; Chrisofos, Michael; Barbalias, Dimitrios; Deliveliotis, Charalampos

    2016-01-01

    Abstract Introduction: Data from animal, clinical and prevention studies support the role of androgens in prostate cancer growth, proliferation and progression. Results of serum based epidemiologic studies in humans, however, have been inconclusive. The present study aims to define whether serum testosterone can be used as a predictor of a positive second biopsy in males considered for re-biopsy. Material and Methods: The study included 320 men who underwent a prostatic biopsy in our department from October 2011 until June 2012. Total testosterone, free testosterone, bioavailable testosterone and prostate pathology were evaluated in all cases. Patients undergoing a second biopsy were identified and biopsy results were statistically analyzed. Results: Forty men (12.5%) were assessed with a second biopsy. The diagnosis of the second biopsy was High Grade Intraepithelial Neoplasia in 14 patients (35%) and Prostate Cancer in 12 patients (30%). The comparison of prostatic volume, total testosterone, sex hormone binding globulin, free testosterone, bioavailable testosterone and albumin showed that patients with cancer of the prostate had significantly greater levels of free testosterone (p=0.043) and bioavailable T (p=0.049). Conclusion: In our study, higher free testosterone and bioavailable testosterone levels were associated with a cancer diagnosis at re-biopsy. Our results indicate a possible role for free and bioavailable testosterone in predicting the presence of prostate cancer in patients considered for re-biopsy. PMID:27532110

  9. Initial prostate biopsy: development and internal validation of a biopsy-specific nomogram based on the prostate cancer antigen 3 assay

    NARCIS (Netherlands)

    Hansen, J.; Auprich, M.; Ahyai, S.A.; Taille, A. De La; Poppel, H. van; Marberger, M.; Stenzl, A.; Mulders, P.F.A.; Huland, H.; Fisch, M.; Abbou, C.C.; Schalken, J.A.; Fradet, Y.; Marks, L.S.; Ellis, W.; Partin, A.W.; Pummer, K.; Graefen, M.; Haese, A.; Walz, J.; Briganti, A.; Shariat, S.F.; Chun, F.K.

    2013-01-01

    BACKGROUND: Urinary prostate cancer antigen 3 (PCA3) assay in combination with established clinical risk factors improves the identification of men at risk of harboring prostate cancer (PCa) at initial biopsy (IBX). OBJECTIVE: To develop and validate internally the first IBX-specific PCA3-based nomo

  10. Antibiotic prophylaxis for transrectal ultrasound biopsy of the prostate in Ireland.

    LENUS (Irish Health Repository)

    Smyth, L G

    2012-03-01

    Prostate cancer is the most common solid cancer affecting men in Ireland. Transrectal ultrasound (TRUS) biopsies of the prostate are routinely performed to diagnose prostate cancer. They are, in general, a safe procedure but are associated with a significant risk of infective complications ranging from fever, urinary tract infection to severe urosepsis. At present, there are no recommended national guidelines on the use of antibiotic prophylaxis to minimise the risk of infective complications post-TRUS biopsy.

  11. Design of a predictive targeting error simulator for MRI-guided prostate biopsy

    OpenAIRE

    Avni, Shachar; Vikal, Siddharth; Fichtinger, Gabor

    2010-01-01

    Multi-parametric MRI is a new imaging modality superior in quality to Ultrasound (US) which is currently used in standard prostate biopsy procedures. Surface-based registration of the pre-operative and intra-operative prostate volumes is a simple alternative to side-step the challenges involved with deformable registration. However, segmentation errors inevitably introduced during prostate contouring spoil the registration and biopsy targeting accuracies. For the crucial purpose of validating...

  12. Photoacoustic and Ultrasonic Image-Guided Needle Biopsy of the Prostate

    Science.gov (United States)

    2015-10-01

    AWARD NUMBER: W81XWH-14-1-0024 TITLE: Photoacoustic and Ultrasonic Image-Guided Needle Biopsy of the Prostate PRINCIPAL INVESTIGATOR: Richard...light sources to yield multi-spectral photoacoustic (PA) imaging data in excised prostate tissue. Two types of interstitial sources – a directional...ANSI Std. Z39.18 Photoacoustic and Ultrasonic Image-Guided Needle Biopsy of the Prostate 34 Table of Contents Page 1. Introduction

  13. Can non-malignant biopsy features identify men at increased risk of biopsy-detectable prostate cancer at re-screening after 4 years?

    NARCIS (Netherlands)

    Wolters, Tineke; Roobol, Monique J.; Schroder, Fritz H.; van der Kwast, Theodorus H.; Roemeling, Stijn; van der Cruijsen-Koeter, Ingrid W.; Bangma, Chris H.; van Leenders, Geert J. L. H.

    2008-01-01

    OBJECTIVES To identify pathological features in non-malignant sextant prostate needle biopsies and assess their predictive value for detecting prostate cancer on biopsy 4 years later. PATIENTS AND METHODS We selected and reviewed the biopsy specimens of 121 men that were diagnosed as non-malignant d

  14. Significant impact of transperineal template biopsy of the prostate at a single tertiary institution

    Directory of Open Access Journals (Sweden)

    Sean Huang

    2015-01-01

    Conclusions: Transperineal biopsy at our institution showed a high rate of disease-upgrading, with a large proportion involving anterior and transition zones. A significant amount of patients went on to receive curative treatment. TPB is a valuable diagnostic procedure with minimal risk of developing urosepsis. We believe TBP should be offered as an option for all repeat prostate biopsies and considered as an option for initial prostate biopsy.

  15. Intraprostatic locations of tumor foci of higher grade missed by diagnostic prostate biopsy among potential candidates for active surveillance

    Science.gov (United States)

    Kim, Kwangmo; Lee, Jung Keun; Choe, Gheeyoung; Hong, Sung Kyu

    2016-01-01

    To establish optimal biopsy scheme for selection of candidates for active surveillance (AS) among prostate cancer (PCa) patients, information on topographical distribution of tumor foci of higher grade missed by contemporary biopsy amongst potential candidates of AS would certainly be useful. Thus we analyzed topographic distribution of tumor foci by examining prostatectomy specimens in 444 patients who underwent radical prostatectomy for low risk PCa. Anterior and posterior prostate areas were demarcated by a horizontal line drawn at midpoint of prostatic urethra. Among 444 subjects, patients with upgrading showed relatively higher prevalence of index tumor foci in anterior prostate than those without upgrading, though not reaching statistical significance (p = 0.252). Meanwhile, among 135 (30.4%) patients with very low risk PCa, patients with upgrading showed significantly higher prevalence of index tumor foci in anterior prostate than those without upgrading (52.2% vs 33.8%; p = 0.031). In conclusions, tumor foci of higher grade missed by diagnostic biopsy were mostly located in anterior prostate among very low risk PCa patients. Such finding would be concrete evidence to support the notion that more efforts are needed to increase accuracy in detecting tumor foci in anterior prostate among potential candidates for AS. PMID:27827421

  16. The criteria for the decision of transrectal US-guided prostate biopsy: Can we reduce the number of unnecessary biopsies?

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Joon Hyung; Cho, Jae Ho; Ahn, Jay Hong; Chang, Jay Chun [Yeungnam University College of Medicine, Taegu (Korea, Republic of)

    2001-09-15

    To establish the criteria which can safely reduce the number of unnecessary biopsies by comparing the transrectal ultrasonography (TRUS) findings, serum prostate-specific antigen (PSA), and prostate specific antigen density (PSAD) in the decision of criteria for the prostatic biopsy using TRUS. Two hundred and twenty patients underwent TRUS- guided prostate biopsy due to elevated PSA and/or focal nodule on TRUS were included. Sixty five (27.5%) patients were confirmed as prostate cancer, and remained 155 (70.5%) patients were reported as benign diseases including benign prostate hyperplasia. The sensitivity, specificity and accuracy of TRUS, PSA and PSAD were evaluated and the single criterion or the combination of the criteria which can safely reduce the unnecessary biopsies without missing prostatic cancer were investigated. The sensitivity, specificity and accuracy of TRUS, PSA (cut-off value, 4 ng/ml) and PSAD (cut-off level, 0.2 ng/ml/cm{sup 3}) were 78.5%/95.4%/95.4%/27.8%/51.6%/64/5%, 42.7%/64.5%/73.6%, respectively. PSAD cut-off level 0.2 ng/ml/cm{sup 3} was the most excellent single criterion for the decision of prostatic biopsy and the number of unnecessary biopsies was 100 cases. But 3 cases of prostatic cancer which the PSAD level was below 0.2 ng/ml/cm{sup 3} were included and in all these 3 cases, a focal nodule was detected on TRUS. Therefore, we applied these two criteria at once and the biopsies of 30 cases (13.6%) are unnecessary. With the single criterion, we could not obtain the satisfactory results but by the combinations of criteria (TRUS and PSAD), 30 (13.6%) cases are unnecessary biopsies without missing cancer. We think that the short term follow-up may be a substitute for the immediate when nodular lesion is suspicious on TRUS and serum PSAD level is below 0.2 ng/ml/cm{sup 3}.

  17. Near-infrared pulsed light to guide prostate biopsy

    Science.gov (United States)

    Boutet, J.; Debourdeau, M.; Laidevant, A.; Hervé, L.; Allié, C.; Vray, D.; Dinten, J.-M.

    2011-03-01

    The protocol for prostate cancer diagnosis, currently based on ultrasound guided biopsy, is limited by a lack of relevance. To improve this protocol, a new approach was proposed combining optical and ultrasound measurements to guide biopsy specifically to the tumors. Adding an optical measurement modality into an already existing ultrasound probe is challenging as the overall size of the system should not exceed a given dimension so as to fit the operative environment. Moreover, examination should not take more than 15 min to avoid any complication. A combined ultrasound and optical endorectal probe was designed to comply with the constraints of the sterilization protocols, the examination duration and required compactness. Therefore a totally innovative pulsed laser source has been designed to meet compactness requirements while providing accurate time-resolved measurements. A dedicated multi-channel photon counting system was optimized to decrease the examination duration. A fast reconstruction method based on the analysis of the intensity and time of flight of the detected photons has been associated to provide 3D localization of fluorescent dots almost immediately after acquisition. The bi-modal probe was capable of withstanding the sterilization procedures. The performance of the compact laser source has been shown at the same level as that of a standard laboratory Titane:Sapphire laser. The dedicated photon counting solution was capable of acquiring optical data in less than one minute. To evaluate the overall performance of the system in dealing with a realistic background signal, measurements and reconstructions were conducted on prostate mimicking phantom and in vivo.

  18. Association between HIV status and Positive Prostate Biopsy in a Study of U.S. Veterans

    Directory of Open Access Journals (Sweden)

    Wayland Hsiao

    2009-01-01

    Full Text Available HIV infection is associated with increased incidence of malignancies, such as lymphomas and testicular cancers. We reviewed the relationship between HIV infection and prostate cancer in a contemporary series of prostate biopsy patients. The study is a retrospective analysis of consecutive prostate biopsies performed at a VA Medical Center. The indications for performing a prostate biopsy included an abnormal digital rectal examination and/or an elevated PSA. Patients were categorized according to their HIV status, biopsy results, and various demographic and clinical characteristics. Univariate and multivariate analyses compared distributions of HIV status, and various clinical and demographic characteristics. The adjusted measures of association between HIV status and positive biopsy were expressed as odds ratios (ORs and corresponding 95% confidence intervals (CI. The likelihood of positive biopsy was significantly higher among 18 HIV-positive patients compared to patients with negative HIV tests (adjusted OR = 3.9; 95% CI: 1.3–11.5. In analyses restricted to prostate cancer patients, HIV-positive patients were not different from the remaining group with respect to their prostate cancer stage, PSA level, PSA velocity, PSA density, or Gleason grade. There is an association between HIV infection and prostate biopsy positive for carcinoma in a population referred for urologic workup. Further confirmation of this association by prospective studies may impact the current screening practices in HIV patients.

  19. Mapping of transrectal ultrasonographic prostate biopsies: quality control and learning curve assessment by image processing

    CERN Document Server

    Mozer, Pierre; Chevreau, Gregoire; Moreau-Gaudry, Alexandre; Bart, Stephane; Renard-Penna, Raphaele; Comperat, Eva; Conort, Pierre; Bitker, Marc-Olivier; Chartier-Kastler, Emmanuel; Richard, Francois; Troccaz, Jocelyne

    2009-01-01

    Objective: Mapping of transrectal ultrasonographic (TRUS) prostate biopsies is of fundamental importance for either diagnostic purposes or the management and treatment of prostate cancer, but the localization of the cores seems inaccurate. Our objective was to evaluate the capacities of an operator to plan transrectal prostate biopsies under 2-dimensional TRUS guidance using a registration algorithm to represent the localization of biopsies in a reference 3-dimensional ultrasonographic volume. Methods: Thirty-two patients underwent a series of 12 prostate biopsies under local anesthesia performed by 1 operator using a TRUS probe combined with specific third-party software to verify that the biopsies were indeed conducted within the planned targets. RESULTS: The operator reached 71% of the planned targets with substantial variability that depended on their localization (100% success rate for targets in the middle and right parasagittal parts versus 53% for targets in the left lateral base). Feedback from this ...

  20. Beyond Diagnosis: Evolving Prostate Biopsy in the Era of Focal Therapy

    Directory of Open Access Journals (Sweden)

    J. L. Dominguez-Escrig

    2011-01-01

    Full Text Available Despite decades of use as the “gold standard” in the detection of prostate cancer, the optimal biopsy regimen is still not universally agreed upon. While important aspects such as the need for laterally placed biopsies and the importance of apical cancer are known, repeated studies have shown significant patients with cancer on subsequent biopsy when the original biopsy was negative and an ongoing suspicion of cancer remained. Attempts to maximise the effectiveness of repeat biopsies have given rise to the alternate approaches of saturation biopsy and the transperineal approach. Recent interest in focal treatment of prostate cancer has further highlighted the need for accurate detection of prostate cancer, and in response, the introduction of transperineal template-guided biopsy. While the saturation biopsy approach and the transperineal template approach increase the detection rate of cancer in men with a previous negative biopsy and appear to have acceptable morbidity, there is a lack of clinical trials evaluating the different biopsy strategies. This paper reviews the evolution of prostatic biopsy and current controversies.

  1. Extracellular vesicles such as prostate cancer cell fragments as a fluid biopsy for prostate cancer.

    Science.gov (United States)

    Brett, S I; Kim, Y; Biggs, C N; Chin, J L; Leong, H S

    2015-09-01

    Extracellular vesicles (EVs) are cell-derived vesicles generated through a process of cell membrane shedding or storage vesicle release, as occurs during apoptosis, necrosis or exocytosis. Initially perceived as cellular by-products or 'dust' of insignificant biological importance, recent research has shed light on the role of EVs as mediators of intercellular communication, blood coagulation and disease progression. The prostate is a source of EVs and their abundance in complex biological fluids such as plasma, serum and urine make them compelling entities for a 'fluid biopsy'. As such, prostate cancer cell fragments (PCCF) are EVs generated by the tumor resident within the prostate and are also present in blood, expressing a portion of biomarkers representative of the primary tumor. High-throughput analytical techniques to determine biomarker expression on EVs is the last hurdle towards translating the full potential of prostate EVs for clinical use. We describe current state-of-the-art methods for the analysis of prostate-derived EVs in patient fluids such as plasma and the challenges that lie ahead in this emerging field of translational research.

  2. Complications and risk factors in transrectal ultrasound-guided prostate biopsies

    Directory of Open Access Journals (Sweden)

    Carlos Márcio Nóbrega de Jesus

    Full Text Available CONTEXT AND OBJECTIVE: Prostate biopsy is not a procedure without risk. There is concern about major complications and which antibiotics are best for routine use before these biopsies. The objective was to determine the rate of complications and the possible risk factors in prostate biopsies. DESIGN AND SETTING: Prospective study, Faculdade de Medicina de Botucatu. METHODS: Transrectal ultrasound (TRUS guided prostate biopsies were carried out in 174 patients presenting either abnormality in digital rectal examinations (DRE or levels higher than 4 ng/ml in prostate-specific antigen (PSA tests, or both. RESULTS: Hemorrhagic complications were the most common (75.3%, while infectious complications occurred in 19% of the cases. Hematuria was the most frequent type (56%. Urinary tract infection (UTI occurred in 16 patients (9.2%. Sepsis was observed in three patients (1.7%. The presence of an indwelling catheter was a risk factor for infectious complications (p < 0.05. Higher numbers of biopsies correlated with hematuria, rectal bleeding and infectious complications (p < 0.05. The other conditions investigated did not correlate with post-biopsy complications. CONCLUSIONS: Post-biopsy complications were mostly self-limiting. The rate of major complications was low, thus showing that TRUS guided prostate biopsy was safe and effective. Higher numbers of fragments taken in biopsies correlated with hematuria, rectal bleeding and infectious complications. An indwelling catheter represented a risk factor for infectious complications. The use of aspirin was not an absolute contraindication for TRUS.

  3. Touch imprint cytology of prostate core needle biopsy specimens: A useful method for immediate reporting of prostate cancer

    Directory of Open Access Journals (Sweden)

    Berna Aytac

    2012-01-01

    Conclusions: TIC smears can provide an immediate and reliable cytological diagnosis of prostate carcinoma. It may clearly help the rapid detection of carcinoma, particularly in highly suspected cases that had negative routine biopsy results for malignancy with abnormal serum prostate specific antigen (PSA levels and atypical digital rectal examination.

  4. Transrectal Ultrasound Guided Biopsy of the Prostate: Is the Information Accessible, Usable, Reliable and Readable?

    Science.gov (United States)

    Redmond, Ciaran E.; Nason, Gregory J.; Kelly, Michael E.; McMahon, Colm; Cantwell, Colin P.; Quinlan, David M.

    2015-01-01

    Background/Aims To evaluate the accessibility, usability, reliability and readability of Internet information regarding transrectal ultrasound (TRUS) guided biopsy of the prostate. Materials and Methods The terms “prostate biopsy”, “TRUS biopsy” and “transrectal ultrasound guided biopsy of the prostate” were separately entered into the each of the top 5 most accessed Internet search engines. Websites were evaluated for accessibility, usability and reliability using the LIDA tool – a validated tool for the assessment of health related websites. Website readability was assessed using the Flesch Reading Ease Score and the Flesch Kincaid Grade Level. Results Following the application of exclusion criteria, 82 unique websites were analyzed. There was a significant difference in scores depending on authorship categories (p ≤ 0.001), with health related charity websites scoring highest (mean 122.29 ± 13.98) and non-academic affiliated institution websites scoring lowest (mean 87 ± 19.76). The presence of advertisements on a website was associated with a lower mean overall LIDA tool score (p = 0.024). Only a single website adhered to the National Institutes for Health recommendations on readability. Conclusions This study demonstrates variability in the quality of information available to Internet users regarding TRUS biopsies. Collaboration of website design and clinical acumen are necessary to develop appropriate websites for patient benefit. PMID:26195961

  5. Safety of ultrasound-guided transrectal extended prostate biopsy in patients receiving low-dose aspirin

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    Ioannis Kariotis

    2010-06-01

    Full Text Available PURPOSE: To determine whether the peri-procedural administration of low-dose aspirin increases the risk of bleeding complications for patients undergoing extended prostate biopsies. MATERIALS AND METHODS: From February 2007 to September 2008, 530 men undergoing extended needle biopsies were divided in two groups; those receiving aspirin and those not receiving aspirin. The morbidity of the procedure, with emphasis on hemorrhagic complications, was assessed prospectively using two standardized questionnaires. RESULTS: There were no significant differences between the two groups regarding the mean number of biopsy cores (12.9 ± 1.6 vs. 13.1 ± 1.2 cores, p = 0.09. No major biopsy-related complications were noted. Statistical analysis did not demonstrate significant differences in the rate of hematuria (64.5% vs. 60.6%, p = 0.46, rectal bleeding (33.6% vs. 25.9%, p = 0.09 or hemospermia (90.1% vs. 86.9%, p = 0.45. The mean duration of hematuria and rectal bleeding was significantly greater in the aspirin group compared to the control group (4.45 ± 2.7 vs. 2.4 ± 2.6, p = < 0.001 and 3.3 ± 1.3 vs. 1.9 ± 0.7, p < 0.001. Multivariate logistic regression analysis revealed that only younger patients (mean age 60.1 ± 5.8 years with a lower body mass index (< 25 kg/m2 receiving aspirin were at a higher risk (odds ratio = 3.46, p = 0.047 for developing hematuria and rectal bleeding after the procedure. CONCLUSIONS: The continuing use of low-dose aspirin in patients undergoing extended prostatic biopsy is a relatively safe option since it does not increase the morbidity of the procedure.

  6. Prostate cancer antigen 3 test for prostate biopsy decision: a systematic review and meta analysis

    Institute of Scientific and Technical Information of China (English)

    Luo Yong; Gou Xin; Huang Peng; Mou Chan

    2014-01-01

    Background The specificity for early interventions of prostate-specific antigen (PSA) in prostate cancer (PCa) is not satisfactory.It is likely that prostate cancer antigen 3 (PCA3) can be used to predict biopsy outcomes more accurately than PSA for the early detection of PCa.We systematically reviewed literatures and subsequently performed a meta-analysis.Methods A bibliographic search in the database of Embase,Medline,Web of Science,NCBI,PubMed,CNKI,and those of health technology assessment agencies published before April 2013 was conducted.The key words used were "prostatic neoplasms","prostate","‘prostate,' ‘carcinoma' or ‘cancer' or ‘tumor',or ‘PCa,'" and free terms of "upm3","pca3","dd3","aptimapca 3",and "prostate cancer antigen 3".All patients were adults.The intervention was detecting PCA3 in urine samples for PCa diagnosis.We checked the quality based on the QUADAS criteria,collected data,and developed a meta-analysis to synthesize results.Twenty-four studies of diagnostic tests with moderate to high quality were selected.Results The sensitivity was between 46.9% and 82.3%; specificity was from 55% to 92%; positive predictive value had a range of 39.0%-86.0%; and the negative predictive value was 61.0%-89.7%.The meta-analysis has heterogeneity between studies.The global sensitivity value was 0.82 (95% Cl 0.72-0.90); specificity was 0.962 (95% Cl 0.73-0.99); positive likelihood ratio was 2.39 (95% Cl 2.10-2.71); negative likelihood ratio was 0.51 (95% Cl 0.46-0.86); diagnostic odds ratio was 4.89 (95% Cl 3.94-6.06); and AUC in SROC curve was 0.744 1.Conclusion PCA3 can be used for early diagnosis of PCa and to avoid unnecessary biopsies.

  7. Prostate Biopsy Assistance System with Gland Deformation Estimation for Enhanced Precision

    CERN Document Server

    Baumann, Michael; Daanen, Vincent; Troccaz, Jocelyne

    2009-01-01

    Computer-assisted prostate biopsies became a very active research area during the last years. Prostate tracking makes it possi- ble to overcome several drawbacks of the current standard transrectal ultrasound (TRUS) biopsy procedure, namely the insufficient targeting accuracy which may lead to a biopsy distribution of poor quality, the very approximate knowledge about the actual location of the sampled tissues which makes it difficult to implement focal therapy strategies based on biopsy results, and finally the difficulty to precisely reach non-ultrasound (US) targets stemming from different modalities, statistical atlases or previous biopsy series. The prostate tracking systems presented so far are limited to rigid transformation tracking. However, the gland can get considerably deformed during the intervention because of US probe pres- sure and patient movements. We propose to use 3D US combined with image-based elastic registration to estimate these deformations. A fast elastic registration algorithm that...

  8. Optical biopsy of the prostate: can we TRUST (trans-rectal ultrasound-coupled spectral tomography)?

    Science.gov (United States)

    Piao, Daqing; Jiang, Zhen; Bartels, Kenneth E.; Holyoak, G. Reed; Ritchey, Jerry W.; Rock, Kendra; Ownby, Charlotte L.; Bunting, Charles F.; Slobodov, Gennady

    2011-03-01

    Needle-based core-biopsy to locate prostate cancer relies heavily upon trans-rectal ultrasound (TRUS) imaging guidance. Ultrasonographic findings of classic hypoechoic peripheral zone lesions have a low specificity of ~28%, a low positive predictive value of ~29%, and an overall accuracy of ~43%, in prostate cancer diagnosis. The prevalence of isoechoic or nearly invisible prostate cancers on ultrasonography ranges from 25 to 42%. As a result, TRUS is useful and convenient to direct the needle trajectory following a systematic biopsy sampling template rather than to target only the potentially malignant lesion for focal-biopsy. To address this deficiency in the first-line of prostate cancer imaging, a trans-rectal ultrasound-coupled spectral tomography (TRUST) approach is being developed to non-invasively resolve the likely optical signatures of prostate malignancy. The approach has evolved from using one NIR wavelength to two NIR bands, and recently to three bands of NIR spectrum information. The concept has been evaluated on one normal canine prostate and three dogs with implanted prostate tumor developed as a model. The initial results implementing TRUST on the canine prostate tumor model includes: (1) quantifying substantially increased total hemoglobin concentration over the time-course of imaging in a rapidly growing prostate tumor; (2) confirming hypoxia in a prostatic cystic lesion; and (3) imaging hypoxic changes of a necrotic prostate tumor. Despite these interesting results, intensive technologic development is necessary for translating the approach to benefiting clinical practice, wherein the ultimate utility is not possibly to eliminate needle-biopsy but to perform focal-biopsy that is only necessary to confirm the cancer, as well as to monitor and predict treatment responses.

  9. Our Prostate Biopsy Results in The Patients with Prostate Specific Antigen Levels Below 4 ng/ml

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    Huseyin Aydemir

    2014-03-01

    Full Text Available Aim: The aim of this study is to evaluate the re¬sults of prostate biopsy of patients who had the prostate-specific antigen (PSA levels below 4 ng/ml. Material and Method: The medical records of 524 pa¬tients who underwent transrectal prostate biopsy be¬tween January 2010 and February 2013 in our clinic, due to suspi¬cion of prostate cancer were evaluated and histopathologic results of 43 patients whose PSA levels under 4 ng/ml were retrospectively revieved. Results: The mean age of patients was 64.63 ±7:42 and the mean level of PSA was 2.89 ±0.88ng /ml. A digital rectal examination (DRE had suspicious findings in 41(95.34% patients. Prostate adenocarcinoma was determined in 13 of (30.23% patients according to the biopsy result. The mean PSA value of these patients was 2.89 ±0.88 ng/ml and the mean gleason score of these patients was 6.41 ±0.87. The mean prostate volume of these patients was 41.46 ±11.95 cm3. Discussion: In our study, prostate cancer was identified in 30.3% of patients whose PSA levels were below 4 ng/ml. DRE, is still important for the evaluation of the prostate. According to our results, significant number of cancers can be detected in PSA below 4 ng/ml levels.

  10. Is it possible to predict low-volume and insignificant prostate cancer by core needle biopsies?

    DEFF Research Database (Denmark)

    Berg, Kasper Drimer; Toft, Birgitte Grønkaer; Røder, Martin Andreas;

    2013-01-01

    M: tumour ≤5% of total prostate volume and prostate-specific antigen (PSA) ≤10 ng/mL. In all definitions, Gleason score (GS) was ≤6 and the tumour was organ confined. Biopsies alone performed poorly as a predictor of unifocal and unilateral cancer in the prostatectomy specimens with positive predictive...

  11. Prevention and treatment of biopsy-related complications.

    Science.gov (United States)

    Satyanarayana, Ramgopal; Parekh, Dipen

    2014-02-01

    Transrectal biopsy of the prostate is necessary in the diagnosis of prostate cancer (PC). Though generally considered safe, patients encounter minor complications such as bleeding and urinary symptoms, and uncommonly, serious infections that may require antibiotic therapy, visits to the emergency room (ER) or hospital admission, causing morbidity and rarely even mortality. It is concerning that infections are on the rise due to resistant bacteria. Urologists will have to be aware of bacterial susceptibility studies to reduce such complications. This review focuses on prostate biopsy and its complications, and measures to reduce these complications in our practice.

  12. Cancer detection rates of different prostate biopsy regimens in patients with renal failure.

    Science.gov (United States)

    Hoşcan, Mustafa Burak; Özorak, Alper; Oksay, Taylan; Perk, Hakkı; Armağan, Abdullah; Soyupek, Sedat; Serel, Tekin Ahmet; Koşar, Alim

    2014-07-01

    We aimed to evaluate the cancer detection rates of 6-, 10-, 12-core biopsy regimens and the optimal biopsy protocol for prostate cancer diagnosis in patients with renal failure. A total of 122 consecutive patients with renal failure underwent biopsy with age-specific prostate-specific antigen (PSA) levels up to 20 ng/mL. The 12-core biopsy technique (sextant biopsy + lateral base, lateral mid-zone, lateral apex, bilaterally) performed to all patients. Pathology results were examined separately for each sextant, 10-core that exclude parasagittal mid-zones from 12-cores (10a), 10-core that exclude apex zones from 12-cores (10b) and 12-core biopsy regimens. Of 122 patients, 37 (30.3%) were positive for prostate cancer. The cancer detection rates for sextant, 10a, 10b and 12 cores were 17.2%, 29%, 23.7% and 30.7%, respectively. Biopsy techniques of 10a, 10b and 12 cores increased the cancer detection rates by 40%, 27.5% and 43.2% among the sextant technique, respectively. Biopsy techniques of 10a and 12 cores increased the cancer detection rates by 17.1% and 21.6% among 10b biopsy technique, respectively. There were no statistical differences between 12 core and 10a core about cancer detection rate. Adding lateral cores to sextant biopsy improves the cancer detection rates. In our study, 12-core biopsy technique increases the cancer detection rate by 5.4% among 10a core but that was not statistically different. On the other hand, 12-core biopsy technique includes all biopsy regimens. We therefore suggest 12-core biopsy or minimum 10-core strategy incorporating six peripheral biopsies with elevated age- specific PSA levels up to 20 ng/mL in patients with renal failure.

  13. Prostate biopsy: is age important for determining the pathological features in prostate cancer?

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    Alberto A. Antunes

    2005-08-01

    Full Text Available INTRODUCTION: The influence of age on the aggressiveness of prostate cancer (PCa is controversial. This study aims to assess the influence of age in determining the pathological features of biopsies from patients diagnosed with PCa. PATIENTS AND METHODS: We selected 1422 patients with clinical suspicion of PCa; among them, 547 (38.5% had received a diagnosis of adenocarcinoma. Patients were categorized into the following age groups: up to 50 years old, 51 to 60 years, 61 to 70 years, 71 to 80 years, and over 80 years. The evaluated variables were histological grade, presence of perineural invasion and estimate of tumor volume through measurement of the maximum percentage of tissue with cancer in one fragment and total percentage of tissue with cancer in the sample. RESULTS: The mean age of patients was 66.4 years, with age range from 32 to 94 years. The estimate of tumor volume by maximum percentage of tissue with cancer in one fragment (p = 0.064, total percentage of tissue with cancer in the sample (p = 0.443, and Gleason score (p = 0.485 were not statistically different in relation to the age groups under study. The presence of perineural invasion occurred more frequently among the 50 years and 81 years age groups when compared with patients aged from 51 to 60 and from 61 to 80 years (p = 0.005. CONCLUSIONS: Age did not represent a determining factor for pathological findings concerning Gleason score and estimate of tumor volume by the variables in use.

  14. Optimizing Performance and Interpretation of Prostate Biopsy : A Critical Analysis of the Literature

    NARCIS (Netherlands)

    Chun, Felix K. -H.; Epstein, Jonathan I.; Ficarra, Vincenzo; Freedland, Stephen J.; Montironi, Rodolfo; Montorsi, Francesco; Shariat, Shahrokh F.; Schroder, Fritz H.; Scattoni, Vincenzo

    2010-01-01

    Context: The number and location of biopsy cores and the interpretation of prostate biopsy in different clinical settings remain the subjects of continuing debate. Objective: Our aim was to review the current evidence regarding the performance and interpretation of initial, repeat, and saturation pr

  15. Poor glycemic control of diabetes mellitus is associated with higher risk of prostate cancer detection in a biopsy population.

    Directory of Open Access Journals (Sweden)

    Juhyun Park

    Full Text Available To evaluate the impact of glycemic control of diabetes mellitus (DM on prostate cancer detection in a biopsy population.We retrospectively reviewed the records of 1,368 men who underwent prostate biopsy at our institution. We divided our biopsy population into three groups according to their history of DM, and their Hemoglobin A1c (HbA1c level: a no-DM (DM- group; a good glycemic control (DM+GC group (HbA1c <6.5%; and a poor glycemic control (DM+PC group (HbA1c ≥6.5%. For sub-analyses, the DM+PC group was divided into a moderately poor glycemic control (DM+mPC group (6.5≤ HbA1c <7.5% and a severely poor glycemic control (DM+sPC group (HbA1c ≥7.5%.Among 1,368 men, 338 (24.7% had a history of DM, and 393 (28.7% had a positive biopsy. There was a significant difference in prostatic specific antigen density (PSAD (P = 0.037 and the frequency of abnormal DRE findings (P = 0.031 among three groups. The occurrence rate of overall prostate cancer (P<0.001 and high-grade prostate cancer (P = 0.016 also presented with a significantly difference. In the multivariate analysis, the DM+PC group was significantly associated with a higher rate of overall prostate cancer detection in biopsy subjects compared to the DM- group (OR = 2.313, P = 0.001 but the DM+PC group was not associated with a higher rate of high-grade (Gleason score ≥7 diseases detected during the biopsy (OR = 1.297, P = 0.376. However, in subgroup analysis, DM+sPC group was significantly related to a higher risk of high-grade diseases compared to the DM- group (OR = 2.446, P = 0.048.Poor glycemic control of DM was associated with a higher risk of prostate cancer detection, including high-grade disease, in the biopsy population.

  16. Percentage of Positive Biopsy Cores: A Better Risk Stratification Model for Prostate Cancer?

    Energy Technology Data Exchange (ETDEWEB)

    Huang Jiayi; Vicini, Frank A. [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Williams, Scott G. [Peter Maccallum Cancer Centre and University of Melbourne, Melbourne, Victoria (Australia); Ye Hong; McGrath, Samuel; Ghilezan, Mihai; Krauss, Daniel; Martinez, Alvaro A. [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Kestin, Larry L., E-mail: lkestin@comcast.net [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2012-07-15

    Purpose: To assess the prognostic value of the percentage of positive biopsy cores (PPC) and perineural invasion in predicting the clinical outcomes after radiotherapy (RT) for prostate cancer and to explore the possibilities to improve on existing risk-stratification models. Methods and Materials: Between 1993 and 2004, 1,056 patients with clinical Stage T1c-T3N0M0 prostate cancer, who had four or more biopsy cores sampled and complete biopsy core data available, were treated with external beam RT, with or without a high-dose-rate brachytherapy boost at William Beaumont Hospital. The median follow-up was 7.6 years. Multivariate Cox regression analysis was performed with PPC, Gleason score, pretreatment prostate-specific antigen, T stage, PNI, radiation dose, androgen deprivation, age, prostate-specific antigen frequency, and follow-up duration. A new risk stratification (PPC classification) was empirically devised to incorporate PPC and replace the T stage. Results: On multivariate Cox regression analysis, the PPC was an independent predictor of distant metastasis, cause-specific survival, and overall survival (all p < .05). A PPC >50% was associated with significantly greater distant metastasis (hazard ratio, 4.01; 95% confidence interval, 1.86-8.61), and its independent predictive value remained significant with or without androgen deprivation therapy (all p < .05). In contrast, PNI and T stage were only predictive for locoregional recurrence. Combining the PPC ({<=}50% vs. >50%) with National Comprehensive Cancer Network risk stratification demonstrated added prognostic value of distant metastasis for the intermediate-risk (hazard ratio, 5.44; 95% confidence interval, 1.78-16.6) and high-risk (hazard ratio, 4.39; 95% confidence interval, 1.70-11.3) groups, regardless of the use of androgen deprivation and high-dose RT (all p < .05). The proposed PPC classification appears to provide improved stratification of the clinical outcomes relative to the National

  17. THE PROGNOSTIC AND DIAGNOSTIC VALUE OF REPEATED TRANSRECTAL PROSTATE SATURATION BIOPSY

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    M. A. Kurdzhiev

    2014-08-01

    Full Text Available Objective: to determine the rate of prostate cancer (PC development after repeated transrectal saturation prostate biopsy (RTRSPB, to study the characteristics of diagnosed tumors, and to estimate their clinical significance from the data of radical retropubic prostatectomy (RRP.Materials and methods. The results of RTRSPB were analyzed in 226 patients with a later evaluation of a tumor from the results of RRP. All the patients underwent at least 2 prostate biopsies (mean 2.4. The average number of biopsy cores was 26.7 (range 24—30. The average value of total prostate-specific antigen before saturation biopsy was 7.5 (range 7.5 to 28.6 ng/ml. The mean age of patients was 62 years (range 53 to 70.  Results. PC was diagnosed in 14.6% of cases (33/226. An isolated lesion of the prostatic transition zone was in 12.1% of cases. If this zone had been excluded from the biopsy scheme, the detection rate of PC during saturation biopsy should be reduced by 13.8%. Better PC detectability during repeated saturation biopsy generally occurred due to the localized forms of the disease (93.3%. The agreement of Gleason tumor grading in the biopsy and prostatectomy specimens was noted in 66.7% of cases.Conclusion. Saturation biopsy allows prediction of a pathological stage of PC, Gleason grade of a tumor and its site localization with a greater probability. Most tumors detectable by saturation biopsy were clinically significant, which makes it possible to recommend RTRSPB to some cohort of high PC-risk patients 

  18. Clinicopathologic characteristics of anterior prostate cancer (APC), including correlation with previous biopsy pathology.

    Science.gov (United States)

    Magers, Martin J; Zhan, Tianyu; Udager, Aaron M; Wei, John T; Tomlins, Scott A; Wu, Angela J; Kunju, Lakshmi P; Lew, Madelyn; Feng, Felix Y; Hamstra, Daniel A; Siddiqui, Javed; Chinnaiyan, Arul M; Montgomery, Jeffrey S; Weizer, Alon Z; Morgan, Todd M; Hollenbeck, Brent K; Miller, David C; Palapattu, Ganesh S; Jiang, Hui; Mehra, Rohit

    2015-11-01

    Anterior-predominant prostate cancer (APC) is an incompletely understood entity which can be difficult to sample via transrectal biopsy. Seemingly favorable biopsy results may belie the potential aggressiveness of these tumors. Here, we attempt to characterize APC by retrospectively examining the clinicopathologic features of APC at radical prostatectomy and comparing our findings with prior biopsy information. We found that 17.4 % of patients in our study had APC. APC demonstrated a significantly lower (P value biopsy than non-transperineal saturation (i.e., transrectal ultrasound guided) biopsy strategies. Four patients (7 %) without transperineal saturation biopsy exhibited a significantly worse GS at RP than biopsy, compared to five patients (36 %) with transperineal saturation biopsy. Our findings corroborate the difficulty in detecting APC and suggest that APC is not a uniform disease with a wholly indolent phenotype. Dedicated long-term outcome data are needed in these patients. Additionally, alternative pathologic staging parameters may be necessary.

  19. Short-term prophylaxis with ciprofloxacin in extended 16-core prostate biopsy

    Directory of Open Access Journals (Sweden)

    Renato Caretta Chambó

    2015-02-01

    Full Text Available Objective To evaluate the safety, efficacy and possible complications of 16-core transrectal prostate biopsies using two doses of ciprofloxacin for prophylaxis of infectious complications. Materials and Methods Sixteen-core prostate biopsies were performed on a number of patients with different signs of potential prostate cancer. Complications were assessed both during the procedure and one week later. After the procedure, urine samples were collected for culture. The rate of post-biopsy complications, hospital visits and hospitalizations were also analyzed. Ciprofloxacin (500 mg was administered two hours before, and eight hours after the procedure. Results The overall rate of post-biopsy complications was 87.32%, being 5.4% of those considered major complications due to hemorrhage, or to urinary retention. Eight patients required hospital treatment post-biopsy. Fever occurred in just one patient (0.29%. There was no incidence of orchitis, epididymitis, prostatitis, septicemia, hospitalization, or death. The urine culture showed positive results in five patients (2.15%. Conclusion One-day prophylaxis with ciprofloxacin proved to be safe and effective in the prevention of infectious complications following 16-core prostate biopsies.

  20. Analysis of Preoperative Detection for Apex Prostate Cancer by Transrectal Biopsy

    Directory of Open Access Journals (Sweden)

    Tomokazu Sazuka

    2013-01-01

    Full Text Available Background. The aim of this study was to determine concordance rates for prostatectomy specimens and transrectal needle biopsy samples in various areas of the prostate in order to assess diagnostic accuracy of the transrectal biopsy approach, especially for presurgical detection of cancer in the prostatic apex. Materials and Methods. From 2006 to 2011, 158 patients whose radical prostatectomy specimens had been evaluated were retrospectively enrolled in this study. Concordance rates for histopathology results of prostatectomy specimens and needle biopsy samples were evaluated in 8 prostatic sections (apex, middle, base, and transitional zones bilaterally from 73 patients diagnosed at this institution, besides factors for detecting apex cancer in total 118 true positive and false negative apex cancers. Results. Prostate cancer was found most frequently (85% in the apex of all patients. Of 584 histopathology sections, 153 (49% from all areas were false negatives, as were 45% of apex biopsy samples. No readily available preoperative factors for detecting apex cancer were identified. Conclusions. In Japanese patients, the most frequent location of prostate cancer is in the apex. There is a high false negative rate for transrectal biopsy samples. To improve the detection rate, transperitoneal biopsy or more accurate imaging technology is needed.

  1. The diagnostic ability of an additional midline peripheral zone biopsy in transrectal ultrasonography-guided 12-core prostate biopsy to detect midline prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, In Pyeong; Kim, Sang Youn; Cho, Jeong Yeon; Lee, Myoung Seok; Kim, Seung Hyup [Dept. of Radiology, Seoul National University Hospital and Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul (Korea, Republic of)

    2016-01-15

    The goal of this study was to evaluate the diagnostic effect of adding a midline peripheral zone (PZ) biopsy to the 12-core biopsy protocol used to diagnose prostate cancer (PC), and to assess the clinical and pathologic characteristics of midline-positive PC in order to identify a potential subgroup of patients who would require midline PZ biopsy. This study included 741 consecutive patients who underwent a transrectal ultrasonography-guided, 12-core prostate biopsy with an additional midline core biopsy between October 2012 and December 2013. We grouped patients by the presence or absence of PC and subdivided patients with PC based on the involvement of the midline core. The clinical characteristics of these groups were compared, including serum prostate-specific antigen (PSA) concentrations, PSA density, and pathological features in the biopsy specimens. PC was detected in 289 patients (39.0%). Among the PC patients, 66 patients (22.8%) had midline PC. No patients were diagnosed with PC based only on a midline core. The Gleason scores, number of positive cores, tumor core length, serum PSA concentrations, and PSA density were significantly higher in patients with midline-positive PC (P<0.001). Furthermore, significant cancer was more frequent in the midline-positive group (98.5% vs. 78.0%). Patients showing a positive result for PC in a midline PZ biopsy were more likely to have multiple tumors or large-volume PC with a high tumor burden. However, our data indicated that an additional midline core biopsy is unlikely to be helpful in detecting occult midline PC.

  2. Inflammatory changes in biopsy specimens from patients with suspected prostate cancer

    Directory of Open Access Journals (Sweden)

    Zbigniew Wolski

    2013-06-01

    Full Text Available Introduction. Prostate cancer (PCa is one of the most commonly diagnosed cancers in elderly men, and accounts for 30% of all newly diagnosed cases of cancer. The development of the ‘clinically insignificant’ prostate cancer into its invasive form is still unclear, and it is believed that chronic inflammation may play its role, as proposed by De Marzo in 1999. However, there is no clear opinion on the subject of existence of dependencies between changes of the inflammatory type and PCa.Material and methods. The study involved 1,010 men, suspected of prostate cancer development by positive digital rectal examination (DRE and/or elevated PSA value. The 10 cores, TRUS guided biopsy was performed. In those with ASAP, HG–PIN or inflammation the second biopsy was proposed.Results. In the first biopsy PCa was diagnosed in 336 patients (33.27%. ASAP was found in 58 (5.74%, HG–PIN in 82 (8.11%, and the coexistence of both was found in 19 (1.88%. Chronic prostatitis was diagnosed in 101 (10% men. Of those who underwent second biopsy, PCa was diagnosed in six of 19 patients (31.57% who were diagnosed with HG–PIN in the first biopsy, in four of 40 (10% with BPH in the first biopsy, in four of 18 (22.22% with ASAP or LG–PIN together with ASAP, and in two out of five (40% with the coexistence of ASAP and HG–PIN. Malignancy was not confirmed in any of the patients in whom the diagnosis of BPH, HG–PIN, or ASAP was accompanied by chronic prostatitis.Conclusions. Chronic prostatitis does not significantly increase the value of PSA in patients with benign changes (BPH. The presence of prostatitis in the first biopsy did not predict cancer in subsequent biopsy, because the second biopsy did not reveal prostate cancer in any of the patients in whom prostatitis was diagnosed in the first biopsy.

  3. Effect on hemostasis of an absorbable hemostatic gelatin sponge after transrectal prostate needle biopsy

    Directory of Open Access Journals (Sweden)

    Kohei Kobatake

    2015-04-01

    Full Text Available Objectives To examine the usefulness of an absorbable hemostatic gelatin sponge for hemostasis after transrectal prostate needle biopsy. Subjects and Methods The subjects comprised 278 participants who underwent transrectal prostate needle biopsy. They were randomly allocated to the gelatin sponge insertion group (group A: 148 participants and to the non-insertion group (group B: 130 participants. In group A, the gelatin sponge was inserted into the rectum immediately after biopsy. A biopsy-induced hemorrhage was defined as a case in which a subject complained of bleeding from the rectum, and excretion of blood clots was confirmed. A blood test was performed before and after biopsy, and a questionnaire survey was given after the biopsy. Results Significantly fewer participants in group A required hemostasis after biopsy compared to group B (3 (2.0% vs. 11 (8.5%, P=0.029. The results of the blood tests and the responses from the questionnaire did not differ significantly between the two groups. In multivariate analysis, only “insertion of a gelatin sponge into the rectum” emerged as a significant predictor of hemostasis. Conclusion Insertion of a gelatin sponge into the rectum after transrectal prostate needle biopsy significantly increases hemostasis without increasing patient symptoms, such as pain and a sense of discomfort.

  4. Decreased infiltration of macrophage scavenger receptor-positive cells in initial negative biopsy specimens is correlated with positive repeat biopsies of the prostate.

    Science.gov (United States)

    Nonomura, Norio; Takayama, Hitoshi; Kawashima, Atsunari; Mukai, Masatoshi; Nagahara, Akira; Nakai, Yasutomo; Nakayama, Masashi; Tsujimura, Akira; Nishimura, Kazuo; Aozasa, Katsuyuki; Okuyama, Akihiko

    2010-06-01

    Macrophage scavenger receptor (MSR)-positive inflammatory cells and tumor-associated macrophages (TAMs) have been reported to regulate the growth of various cancers. In this study, the infiltration of MSR-positive cells and TAMs was analyzed to predict the outcome of repeat biopsy in men diagnosed as having no malignancy at the first prostate biopsy. Repeat biopsy of the prostate was carried out in 92 patients who were diagnosed as having no malignancy at the first biopsy. Of these, 30 patients (32.6%) were positive for prostate cancer at the repeat biopsy. Tumor-associated macrophages and MSR-positive cells were immunohistochemically stained with mAbs CD68 and CD204, respectively. Six ocular measuring fields were chosen randomly under a microscope at x400 power in the initial negative biopsy specimens, and the mean TAM and MSR counts for each case were determined. No difference in TAM count was found between the cases with or without prostate cancer. By contrast, the MSR count in patients with cancer was significantly lower than that in patients without cancer at the repeat biopsy (P biopsies, or TAM count. Decreased infiltration of MSR-positive cells in negative first biopsy specimens was correlated with positive findings in the repeat biopsy. The MSR count might be a good indicator for avoiding unnecessary repeat biopsies.

  5. A biomedical engineering approach to mitigate the errors of prostate biopsy.

    Science.gov (United States)

    Ahmed, Hashim Uddin; Emberton, Mark; Kepner, Gordon; Kepner, Jeremy

    2012-02-07

    The current protocol for detecting and ruling out prostate cancer involves serum PSA testing followed by sampling of the prostate using a transrectal ultrasonography (TRUS)-guided biopsy. Many specialists have discussed how PSA screening has contributed to underdetection of clinically significant prostate cancer, overdiagnosis of clinically insignificant disease and poor risk stratification; however, little consideration has been given to the role of TRUS-guided biopsy in these errors. The performance of TRUS-guided biopsy is constrained by the biomechanical attributes of the sampling strategy, resulting in suboptimal detection efficiency of each core. By using a biomedical engineering approach, a uniform grid sampling strategy could be used to improve the detection efficiency of prostate biopsy. Moreover, the calibration of the sampling can be adjusted by altering the distance between needle deployments. Our model shows that for any given number of needle trajectories, a uniform grid approach will be superior to a divergent, nonuniform strategy for the detection of clinically important disease. This is an important message that should result in a move away from divergent sampling to a uniform grid approach for prostate biopsy.

  6. Low grade urothelial carcinoma mimicking basal cell hyperplasia and transitional metaplasia in needle prostate biopsy

    Directory of Open Access Journals (Sweden)

    Julian Arista-Nasr

    2016-04-01

    Full Text Available ABSTRACT Purpose The vast majority of urothelial carcinomas infiltrating the bladder are consistent with high-grade tumors that can be easily recognized as malignant in needle prostatic biopsies. In contrast, the histological changes of low-grade urothelial carcinomas in this kind of biopsy have not been studied. Materials and Methods We describe the clinicopathologic features of two patients with low-grade bladder carcinomas infiltrating the prostate. They reported dysuria and hematuria. Both had a slight elevation of the prostate specific antigen and induration of the prostatic lobes. Needle biopsies were performed. At endoscopy bladder tumors were found in both cases. Results Both biopsies showed nests of basophilic cells and cells with perinuclear clearing and slight atypia infiltrating acini and small prostatic ducts. The stroma exhibited extensive desmoplasia and chronic inflammation. The original diagnosis was basal cell hyperplasia and transitional metaplasia. The bladder tumors also showed low-grade urothelial carcinoma. In one case, the neoplasm infiltrated the lamina propria, and in another, the muscle layer. In both, a transurethral resection was performed for obstructive urinary symptoms. The neoplasms were positive for high molecular weight keratin (34BetaE12 and thrombomodulin. No metastases were found in either of the patients, and one of them has survived for five years. Conclusions The diagnosis of low-grade urothelial carcinoma in prostate needle biopsies is difficult and may simulate benign prostate lesions including basal cell hyperplasia and urothelial metaplasia. It is crucial to recognize low-grade urothelial carcinoma in needle biopsies because only an early diagnosis and aggressive treatment can improve the prognosis for these patients.

  7. Risk of prostate cancer diagnosis and mortality in men with a benign initial transrectal ultrasound-guided biopsy set

    DEFF Research Database (Denmark)

    Klemann, Nina; Røder, M Andreas; Helgstrand, J Thomas

    2017-01-01

    BACKGROUND: The risk of missing prostate cancer in the transrectal ultrasound-guided systematic biopsies of the prostate in men with suspected prostate cancer is a key problem in urological oncology. Repeat biopsy or MRI-guided biopsies have been suggested to increase sensitivity for diagnosis....... METHODS: Data were extracted from the Danish Prostate Cancer Registry-a population-based registry including all men undergoing histopathological assessment of prostate tissue. All men who were referred for transrectal ultrasound-guided biopsy for assessment of suspected prostate cancer between Jan 1, 1995......, and Dec 31, 2011, in Denmark were eligible for inclusion. Follow-up data were obtained on April 28, 2015. The primary endpoint was the cumulative incidence of prostate cancer-specific mortality, analysed in a competing risk setting, with death from other causes as the competing event. FINDINGS: Between...

  8. Development of a Novel Robot for Transperineal Needle Based Interventions: Focal Therapy, Brachytherapy and Prostate Biopsies

    CERN Document Server

    Long, Jean-Alexandre; Baumann, Michael; Descotes, Jean-Luc; Bolla, Michel; Giraud, Jean-Yves; Rambeaud, Jean-Jacques; Troccaz, Jocelyne; 10.1016/j.juro.2012.06.003

    2012-01-01

    Purpose: We report what is to our knowledge the initial experience with a new 3-dimensional ultrasound robotic system for prostate brachytherapy assistance, focal therapy and prostate biopsies. Its ability to track prostate motion intraoperatively allows it to manage motions and guide needles to predefined targets. Materials and Methods: A robotic system was created for transrectal ultrasound guided needle implantation combined with intraoperative prostate tracking. Experiments were done on 90 targets embedded in a total of 9 mobile, deformable, synthetic prostate phantoms. Experiments involved trying to insert glass beads as close as possible to targets in multimodal anthropomorphic imaging phantoms. Results were measured by segmenting the inserted beads in computerized tomography volumes of the phantoms. Results: The robot reached the chosen targets in phantoms with a median accuracy of 2.73 mm and a median prostate motion of 5.46 mm. Accuracy was better at the apex than at the base (2.28 vs 3.83 mm, p <...

  9. MR-guided biopsy of the prostate: Comparison of diagnostic specimen quality with 18G and 16G biopsy needles

    Energy Technology Data Exchange (ETDEWEB)

    Durmus, Tahir, E-mail: tahir.durmus@charite.de [Department of Radiology, Charité – Universitätsmedizin Berlin, Charité Campus Mitte, Berlin (Germany); Goldmann, Ulrike, E-mail: ulrike.goldmann@charite.de [Department of Pathology, Charité – Universitätsmedizin Berlin, Charité Campus Mitte, Berlin (Germany); Baur, Alexander D.J., E-mail: alexander.baur@charite.de [Department of Radiology, Charité – Universitätsmedizin Berlin, Charité Campus Mitte, Berlin (Germany); Huppertz, Alexander, E-mail: Alexander.huppertz@charite.de [Department of Radiology, Charité – Universitätsmedizin Berlin, Charité Campus Mitte, Berlin (Germany); Imaging Science Institute, Charité, Berlin (Germany); Schwenke, Carsten, E-mail: carsten.schwenke@scossis.de [SCO:SSiS Statistical Consulting, Berlin (Germany); Hamm, Bernd, E-mail: Bernd.hamm@charite.de [Department of Radiology, Charité – Universitätsmedizin Berlin, Charité Campus Mitte, Berlin (Germany); Franiel, Tobias, E-mail: tobias.franiel@med.uni-jena.de [Department of Radiology, Charité – Universitätsmedizin Berlin, Charité Campus Mitte, Berlin (Germany); Department of Radiology – Universitätsklinikum Jena (Germany)

    2013-12-01

    Purpose: To evaluate specimen quality and diagnostic differences between magnetic resonance (MR) compatible 16G and 18G biopsy needles in MR-guided biopsy (MRGB) of the prostate. Materials and methods: Semiautomatic MR compatible biopsy needles with a diameter of 16G (Group A) or 18G (Group B) were used to perform MRGB in 88 patients with suspected prostate cancer. After embedding and staining, length and width of all specimens (140 cores in Group A, 143 in Group B) were measured. Fragmentation, squeezing artifacts, and overall evaluability were evaluated using a quality score from 0 (no tissue) to 3 (optimal tissue quality). Groups were statistically compared; p-values <0.05 were regarded as significant. Results: Demographic data were not significantly different between Group A and B with a mean age of 63 ± 7.3 and 67 ± 5.7 years; and a mean prostate-specific antigen of 12.6 ± 10.3 ng/ml and 13.8 ± 11.6 ng/ml, respectively (p = 0.70). Area of longitudinally sectioned histological specimens was significantly larger in Group A than in Group B with 9.38 mm{sup 2} (8.74; 10.02) and 7.95 mm{sup 2} (7.32; 8.59), respectively (p = 0.002). However, there were significantly more cores without prostate tissue with 18 cores (12.9%) versus 3 cores (2.1%) in Groups A and B, respectively (p = 0.004). Fragmentation, squeezing artifacts, and overall evaluability were not statistically different between the two groups. The rate of prostate cancer in the cores was also not significantly different between Groups A and B (22.1% and 24.5%; p = 0.77). Conclusion: 16G biopsy needles do not provide a relevant diagnostic advantage over 18G needles in MRGB. Therefore, use of 18G needles is not discouraged and may even be preferred as it is not expected to result in a relevant degradation of specimen quality or compromise in prostate cancer detection rate.

  10. New Image-Based Techniques for Prostate Biopsy and Treatment

    Science.gov (United States)

    2012-04-01

    Stranded Seeds Following Prostate Brachytherapy Julio R. Lobo, Mehdi Moradi, Nick Chng, Ehsan Dehghan, William J. Morris, Gabor Fichtinger, and...statistical texture matching method. IEEE Trans. Med. Imaging 25(3), 256– 272 (2006) 4. Hodge , A.C., Fenster, A., Downey, D.B., Ladak, H.M.: Prostate boundary

  11. Endoclipping treatment of life-threatening rectal bleeding after prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    Panagiotis Katsinelos,; Jannis Kountouras,; Georgios Dimitriadis,; Grigoris Chatzimavroudis,; Christos Zavos,; Ioannis Pilpilidis,; George Paroutoglou,; George Germanidis,; Kostas Mimidis

    2009-01-01

    Rectal bleeding is frequently seen in patients undergoing transrectal ultrasound (TRUS)-guided multiple biopsy of the prostate, but is usually mild and stops spontaneously. We report what is believed to be the first case of life-threatening rectal bleeding following this procedure, which was successfully treated by endoscopic intervention through placement of three clips on the sites of bleeding. This case emphasizes endoscopic intervention associated with endoclipping as a safe and effective method to achieve hemostasis in massive rectal bleeding after prostate biopsy. Additionally, current data on the complications of the TRUS-guided multiple biopsy of the prostate and the options for treating fulminant rectal bleeding, a consequence of this procedure, are described.

  12. Well-differentiated prostate cancer in core biopsy specimens may be associated with extraprostatic disease

    Directory of Open Access Journals (Sweden)

    José Cury

    Full Text Available CONTEXT AND OBJECTIVE: Accurate determination of the Gleason score in prostate core biopsy specimens is crucial in selecting the type of prostate cancer treatment, especially for patients with well-differentiated tumors (Gleason score 2 to 4. For such patients, an inaccurate biopsy score may result in a therapeutic intervention that is too conservative. We evaluate the role of Gleason score 2-4 in prostate core-needle biopsies for predicting the final pathological staging following radical prostatectomy. DESIGN AND SETTING: Retrospective study at Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo. METHODS: We analyzed the medical records of 120 consecutive patients who underwent radical retropubic prostatectomy to treat clinical localized prostate cancer at our institution between December 2001 and July 2006. Thirty-two of these patients presented well-differentiated tumors (Gleason score 2 to 4 in biopsy specimens and were included in the study. The Gleason scores of the core-needle biopsies were compared with the pathological staging of the surgical specimens. RESULTS: Sixteen of the 32 patients (50% presented moderately differentiated tumors (Gleason score 5 to 7 in surgical specimens. Eighteen patients (56% had tumors with involvement of the prostate capsule and ten (31% had involvement of adjacent organs. Evaluating the 16 patients that maintained Gleason scores of 2 to 4 in the pathological staging of the surgical specimens, 11 (68.7% had focal invasion of the prostate capsule and five (31.25% had organ-confined disease. CONCLUSION: Well-differentiated tumors (Gleason score 2 to 4 seen in biopsies are not predictive of organ-confined disease.

  13. Development of a Hybrid Optical Biopsy Probe to Improve Prostate Cancer Diagnosis

    Science.gov (United States)

    2011-06-01

    taken on 3 identified regions for cancer, normal and BPH . The measured tissues will be then sliced out and sent to pathology for analysis. Blue and...cancer volumes (assessed by % involvement of the biopsy cores). Fresh prostatectomy sample will be brought to the pathology room immersed in saline...prostate surface as per the regular pathology protocol (blue dye for left side, orange dye for right side, green dye for anterior margin). (2) Prostate

  14. New indicator for prostate gland biopsy when malignancy is in question

    Directory of Open Access Journals (Sweden)

    Azmi A Haroun

    2011-01-01

    Full Text Available The aim of our study was to find out a new indicator with a higher specificity level than prostate prostate-specific antigen (PSA in order to achieve a better selection of patients who will undergo prostate biopsy. Trans-rectal ultrasound-guided prostate biopsy was performed in 135 patients who had elevated PSA level and/or palpable nodule on digital rectal examination. The PSA level was ≤10 ng/mL in 81 patients and >10 ng/mL in 54 patients. We designed a new formula consisting of prostate volume, patient′s age, and free prostate specific antigen. Its resultant was defined as prostate biopsy index and was compared with the most currently used parameters. Histology results yielded prostate gland malignancy in 40 (30% patients. Our new index differed significantly between the malignant and the non-malignant patient categories (P = 0.01. The ROC curve analysis at different specificity and sensitivity levels (85%, 90% and 95% and regarding the area under the curve (AUC, our new index was significantly better than the other studied parameters (P = 0.001. Additionally, the AUC in patients with a PSA level ≤10 ng/mL and bet-ween 10.1 and 20 ng/mL was 0.75 and 0.78, with a sensitivity of 91% and 83% and a specificity of 24% and 73%, respectively, at a cut-off point of 1.7. The overall sensitivity and specificity at the same point were 80% and 41%, respectively. In conclusion, the performance of our new index was superior to all other evaluated parameters. At 83% sensitivity with a cut-off point of 1.7, 63.5% of the performed biopsies could have been avoided in patients with a PSA level between 10.1 and 20 ng/mL.

  15. BiopSym: a simulator for enhanced learning of ultrasound-guided prostate biopsy

    CERN Document Server

    Sclaverano, Stefano; Vadcard, Lucile; Mozer, Pierre; Troccaz, Jocelyne

    2008-01-01

    This paper describes a simulator of ultrasound-guided prostate biopsies for cancer diagnosis. When performing biopsy series, the clinician has to move the ultrasound probe and to mentally integrate the real-time bi-dimensional images into a three-dimensional (3D) representation of the anatomical environment. Such a 3D representation is necessary to sample regularly the prostate in order to maximize the probability of detecting a cancer if any. To make the training of young physicians easier and faster we developed a simulator that combines images computed from three-dimensional ultrasound recorded data to haptic feedback. The paper presents the first version of this simulator.

  16. Systematic ultrasound-guided saturation and template biopsy of the prostate: Indications and advantages of extended sampling

    NARCIS (Netherlands)

    Isbarn, H.; Briganti, B.; Visschere, P.J. De; Futterer, J.J.; Ghadjar, P.; Giannarini, G.; Ost, P.; Ploussard, G.; Sooriakumaran, P.; Surcel, C.; Oort, I.M. van; Yossepowitch, O.; Bergh, R. van den

    2015-01-01

    OBJECTIVES: Prostate biopsy (PB) is the gold standard for the diagnosis of prostate cancer (PCa). However, the optimal number of biopsy cores remains debatable. We sought to compare contemporary standard (10-12 cores) vs. saturation (=18 cores) schemes on initial as well as repeat PB. METHODS: A non

  17. How does prostate biopsy guidance error impact pathologic cancer risk assessment?

    Science.gov (United States)

    Martin, Peter R.; Gaed, Mena; Gómez, José A.; Moussa, Madeleine; Gibson, Eli; Cool, Derek W.; Chin, Joseph L.; Pautler, Stephen; Fenster, Aaron; Ward, Aaron D.

    2016-03-01

    Magnetic resonance imaging (MRI)-targeted, 3D transrectal ultrasound (TRUS)-guided "fusion" prostate biopsy aims to reduce the 21-47% false negative rate of clinical 2D TRUS-guided sextant biopsy, but still has a substantial false negative rate. This could be improved via biopsy needle target optimization, accounting for uncertainties due to guidance system errors, image registration errors, and irregular tumor shapes. As an initial step toward the broader goal of optimized prostate biopsy targeting, in this study we elucidated the impact of biopsy needle delivery error on the probability of obtaining a tumor sample, and on the core involvement. These are both important parameters to patient risk stratification and the decision for active surveillance vs. definitive therapy. We addressed these questions for cancer of all grades, and separately for high grade (>= Gleason 4+3) cancer. We used expert-contoured gold-standard prostatectomy histology to simulate targeted biopsies using an isotropic Gaussian needle delivery error from 1 to 6 mm, and investigated the amount of cancer obtained in each biopsy core as determined by histology. Needle delivery error resulted in variability in core involvement that could influence treatment decisions; the presence or absence of cancer in 1/3 or more of each needle core can be attributed to a needle delivery error of 4 mm. However, our data showed that by making multiple biopsy attempts at selected tumor foci, we may increase the probability of correctly characterizing the extent and grade of the cancer.

  18. Effectiveness of stress management in patients undergoing transrectal ultrasound-guided biopsy of the prostate

    Directory of Open Access Journals (Sweden)

    Chiu LP

    2016-02-01

    Full Text Available Li-Pin Chiu,1,2 Heng-Hsin Tung,3 Kuan-Chia Lin,3 Yu-Wei Lai,1,4 Yi-Chun Chiu,1,4 Saint Shiou-Sheng Chen,1,4 Allen W Chiu1,4 1Division of Urology, Taipei City Hospital, 2University of Taipei, General Education Center, 3School of Nursing, Department of Care Management, National Taipei University of Nursing and Health Science, 4Department of Urology, National Yang-Ming University School of Medicine, Taipei, Taiwan, Republic of China Background: To assess the utilization of stress management in relieving anxiety and pain among patients who undergo transrectal ultrasound (TRUS-guided biopsy of the prostate.  Methods: Eighty-two patients admitted to a community hospital for a TRUS biopsy of the prostate participated in this case-controlled study. They were divided into an experimental group that was provided with stress management and a control group that received only routine nursing care. Stress management included music therapy and one-on-one simulation education. Before and after the TRUS biopsy, the patients’ state-anxiety inventory score, pain visual analogue scale (VAS, respiratory rate, heart rate, and blood pressure were obtained.  Results: There were no differences in baseline and disease characteristics between the two groups. The VAS in both groups increased after the TRUS biopsy, but the difference in pre- and postbiopsy VAS scores was significantly lower in the experimental group (P=0.03. Patients in both groups experienced mild anxiety before and after the biopsy, but those in the experimental group displayed a significantly greater decrease in postbiopsy state-anxiety inventory score compared to the control group (P=0.02.Conclusion: Stress management can alleviate anxiety and pain in patients who received a TRUS biopsy of the prostate under local anesthesia. Keywords: anxiety, pain, stress management, transrectal ultrasound-guided biopsy of the prostate

  19. Is periprostatic nerve block a gold standard in case of transrectal ultrasound-guided prostate biopsy?

    Directory of Open Access Journals (Sweden)

    Ashok Kumar

    2013-01-01

    Conclusions: PNB provides better pain control in TRUS-guided prostate biopsy but still there is need of additional analgesic in the form of tramadol or INB. Tramadol has advantage of oral intake and analgesic effect at time of probe insertion and at nerve block. Both tramadol and INB may be used in combination along with PNB.

  20. Feasibility of a pneumatically actuated MR-compatible robot for transrectal prostate biopsy guidance

    NARCIS (Netherlands)

    Yakar, D.; Schouten, M.G.; Bosboom, D.G.H.; Barentsz, J.O.; Scheenen, T.W.J.; Futterer, J.J.

    2011-01-01

    PURPOSE: To assess the feasibility of using a remote-controlled, pneumatically actuated magnetic resonance (MR)-compatible robotic device to aid transrectal biopsy of the prostate performed with real-time 3-T MR imaging guidance. MATERIALS AND METHODS: This prospective study was approved by the ethi

  1. Ultrasound-guided seminal vesicle biopsies in prostate cancer

    NARCIS (Netherlands)

    Wymenga, LFA; Duisterwinkel, FJ; Groenier, K; Mensink, HJA

    2000-01-01

    Invasion of prostatic adenocarcinoma into the seminal vesicles (SV) is generally accepted as an index of poor prognosis. The pre-operative identification of SV invasion is an important element in staging since it may alter subsequent treatment decisions. We studied the possibility of diagnosing SV i

  2. Outbreak of Achromobacter xylosoxidans and Ochrobactrum anthropi Infections after Prostate Biopsies, France, 2014.

    Science.gov (United States)

    Haviari, Skerdi; Cassier, Pierre; Dananché, Cédric; Hulin, Monique; Dauwalder, Olivier; Rouvière, Olivier; Bertrand, Xavier; Perraud, Michel; Bénet, Thomas; Vanhems, Philippe

    2016-08-01

    We report an outbreak of healthcare-associated prostatitis involving rare environmental pathogens in immunocompetent patients undergoing transrectal prostate biopsies at Hôpital Édouard Herriot (Lyon, France) during August 13-October 10, 2014. Despite a fluoroquinolone-based prophylaxis, 5 patients were infected with Achromobacter xylosoxidans and 3 with Ochrobactrum anthropi, which has not been reported as pathogenic in nonimmunocompromised persons. All patients recovered fully. Analysis of the outbreak included case investigation, case-control study, biopsy procedure review, microbiologic testing of environmental and clinical samples, and retrospective review of hospital records for 4 years before the outbreak. The cases resulted from asepsis errors during preparation of materials for the biopsies. A low-level outbreak involving environmental bacteria was likely present for years, masked by antimicrobial drug prophylaxis and a low number of cases. Healthcare personnel should promptly report unusual pathogens in immunocompetent patients to infection control units, and guidelines should explicitly mention asepsis during materials preparation.

  3. Multi-parametric MRI-pathologic correlation of prostate cancer using tracked biopsies

    Science.gov (United States)

    Xu, Sheng; Turkbey, Baris; Kruecker, Jochen; Yan, Pingkun; Locklin, Julia; Pinto, Peter; Choyke, Peter; Wood, Bradford

    2010-02-01

    MRI is currently the most promising imaging modality for prostate cancer diagnosis due to its high resolution and multiparametric nature. However, currently there is no standard for integration of diagnostic information from different MRI sequences. We propose a method to increase the diagnostic accuracy of MRI by correlating biopsy specimens with four MRI sequences including T2 weighted MRI, Diffusion Weight Imaging, Dynamic Contrast Enhanced MRI and MRI spectroscopy. This method uses device tracking and image fusion to determine the specimen's position on MRI images. The proposed method is unbiased and cost effective. It does not substantially interfere with the standard biopsy workflow, allowing it to be easily accepted by physicians. A study of 41 patients was carried out to validate the approach. The performance of all four MRI sequences in various combinations is reported. Guidelines are given for multi-parametric imaging and tracked biopsy of prostate cancer.

  4. 老年男性前列腺特异抗原水平与直肠超声引导无痛前列腺穿刺结果的相关性分析%Relation of the prostate specific antigen level with the outcome of analgesic transrectal ultrasound-guided prostate biopsy by intravenous anesthesia in the older men

    Institute of Scientific and Technical Information of China (English)

    王振华; 魏金星; 张雪培

    2011-01-01

    Objective To investigate the relation of the prostate specific antigen (PSA) level with the outcome of analgesic transrectal ultrasound-guided prostate biopsy(ATUGPB) by intravenous anesthesia and clinical parameters in the older men with evaluated PSA. Methods The AUGPB with twelve cores by intravenous anesthesia were completed in 106 patients from September 2008 to August 2010 induding our outpatient and inpatient [mean age(68±7)years] with evaluated PSA(>4 ng/ml). According to the PSA level, the patients were divided into low-risk group(4 ng/ml20 ng/ml,24 cases). The parameters were recorded including biopsy time, visual analog pain scale score(VAS), prostate volume(PV), PSA density(PSAD), pathological outcome, anesthetic adverse events and complications. Results The mean biopsy time was(5.9±2.0)min, ninety eight cases(92%) had no pain(VAS=0)and no case occurred anesthetic adverse event. There were total 164 positive cores in 1272 cores, of which 36 cases were prostate cancer(Pca), 4 cases were prostate atypical hyperplasia and 4 cases were prostate intraepithelial neoplasia. The detection rate of Pca from low-risk group to high-risk group were respectively 10.9%, 33.3% and 87.5%, and that of benign prostatic hyperplasia(BPH) were 81.8%, 59.2% and 4.2%, the difference of them was significant(P4 ng/ml),平均年龄(68±7)岁,进行静脉麻醉下经直肠超声引导无痛前列腺12针系统首次穿刺.将PSA水平分为低危组(4 ng/ml20 ng/ml,24例).记录穿刺时间、视觉模拟疼痛评分(VAS)、PSA密度(PSAD)、前列腺体积(PV)、穿刺病理结果、麻醉不良事件.结果 平均穿刺时间(5.9±2.0)min,98例(92%)穿刺后无疼痛(VAS=0),无一例发生麻醉不良事件.共穿刺1272针,病理阳性164针,包括36例前列腺癌(Pca)、4例非典型增生、4例腺瘤样改变.低危、中危和高危组中Pca检出率分别为10.9%、33.3%和87.5%,良性前列腺增生(BPH)检出率分别为81.8%、59.2%和4.2%,

  5. Local anesthesia for pain control during transrectal ultrasound-guided prostate biopsy: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Yan P

    2016-10-01

    reported general or local complications related to local anesthesia.Conclusion: This meta-analysis indicates that a combination of PPNB and IRLA/IPNB is effective and safe in alleviating the pain during TRUS-guided prostate biopsy. Further high-quality RCTs are needed to validate this result. Keywords: local anesthesia, biopsy, meta-analysis, pain control, prostate

  6. Determination of Optimum Formalin Fixation Duration for Prostate Needle Biopsies for Immunohistochemistry and Quantum Dot FISH Analysis.

    Science.gov (United States)

    Sathyanarayana, Ubaradka G; Birch, Chandler; Nagle, Raymond B; Tomlins, Scott A; Palanisamy, Nallasivam; Zhang, Wenjun; Hubbard, Antony; Brunhoeber, Patrick; Wang, Yixin; Tang, Lei

    2015-01-01

    Prostate biopsy is the key clinical specimen for disease diagnosis. However, various conditions used during biopsy processing for histologic analysis may affect the performance of diagnostic tests, such as hematoxylin and eosin (H&E) staining, immunohistochemistry (IHC), or in situ hybridization (ISH). One such condition that may affect diagnostic test performance is fixation duration in 10% neutral buffered formalin (NBF). For example, prostate needle biopsies are often <1 mm in diameter and thus overfixed. It is important to understand the impact of tissue fixation duration on diagnostic test performance to enable optimized assay procedures. This study was designed to study the effect of 10% NBF fixation duration of prostate needle biopsy on multiplexed quantum dot (QD) ISH assay of ERG and PTEN, 2 genes commonly altered in prostate cancer. The samples were also evaluated for H&E staining and ERG and PTEN IHC. H&E staining and ERG and PTEN IHC were acceptable for all the durations of fixation tested. For QD ISH, we observed good signals with biopsy samples fixed from 4 to 120 hours. Biopsy specimens fixed between 8 and 72 hours gave the best signal as scored by the study pathologist. In a separate cohort of 18 routinely processed prostate biopsy cores, all cores were stained successfully with the QD ISH assay, and results were 100% concordant to ERG and PTEN IHC. We conclude that 8 to 72 hours duration of fixation for prostate needle biopsies in 10% NBF results in optimal QD ISH assay performance.

  7. Empiric antibiotics therapy for mildly elevated prostate specific antigen: Helpful to avoid unnecessary biopsies?

    Directory of Open Access Journals (Sweden)

    Andrea Fandella

    2014-09-01

    Full Text Available Purpose: The management of mildly elevated (4.0-10.0 ng/ml prostate specific antigen (PSA is uncertain. Immediate prostate biopsy, antibiotic treatment, or monitoring PSA level for 1-3 months is still in controversy. Materials and Methods: We retrospectively analysed the effect of empiric antibiotics on an increased PSA in a mono-institutional study. We analysed the data of 100 patients with a PSA of 4-10 ng/ml and normal digital rectal examination undergoing their first prostate biopsy. Patients were divided in two different cohorts. One cohort was submitted to antibiotic therapy (Levoxacin 500 mg daily for 20 days and both cohort had a re-dosing of PSA before the prostate biopsy. Results: Average age of the whole group of patients was 66.48 ± 8.32 years and their average initial PSA level was 6.67 ± 1.57 ng/mL. In the treated group (N = 49 29 patients had a decreasing PSA value from mean baseline PSA value of 6.6 ± 1.54 ng/ml to the re-dosed mean PSA level of 5.4 ± 1,61 ng/ml (p = 0.7; 20 patients didn’t experience a decrease PSA value, with a mean PSA level of 6.9 ± 1.68 ng/ml. In the control group (N = 51, 30 patients had a decrease of PSA level from mean baseline PSA level of 6.5 ± 1,59 ng/ml to a re-dosed PSA level of 5.5 ± 1.57 ng/ml; 21 patients didn’t experience a decrease of PSA value, with a mean PSA level of 6.7 ± 1.71 ng/ml. Multivariate analysis of age, PSA changes, antibiotics therapy and biopsy results (presence or absence of cancer revealed no significant difference between the two cohorts. Sepsis after biopsy occurred in 3 patient in the antibiotics group (6% and in one of the control group (2%. Conclusions: The study, even with some limitations, does not seem to show an advantage due to the administration of antibacterial therapy to reduce PSA values before prostate biopsy and subsequently to reduce unnecessary prostate biopsies.

  8. Diagnostic Accuracy of Robot-Guided, Software Based Transperineal MRI/TRUS Fusion Biopsy of the Prostate in a High Risk Population of Previously Biopsy Negative Men

    Directory of Open Access Journals (Sweden)

    Malte Kroenig

    2016-01-01

    Full Text Available Objective. In this study, we compared prostate cancer detection rates between MRI-TRUS fusion targeted and systematic biopsies using a robot-guided, software based transperineal approach. Methods and Patients. 52 patients received a MRIT/TRUS fusion followed by a systematic volume adapted biopsy using the same robot-guided transperineal approach. The primary outcome was the detection rate of clinically significant disease (Gleason grade ≥ 4. Secondary outcomes were detection rate of all cancers, sampling efficiency and utility, and serious adverse event rate. Patients received no antibiotic prophylaxis. Results. From 52 patients, 519 targeted biopsies from 135 lesions and 1561 random biopsies were generated (total n=2080. Overall detection rate of clinically significant PCa was 44.2% (23/52 and 50.0% (26/52 for target and random biopsy, respectively. Sampling efficiency as the median number of cores needed to detect clinically significant prostate cancer was 9 for target (IQR: 6–14.0 and 32 (IQR: 24–32 for random biopsy. The utility as the number of additionally detected clinically significant PCa cases by either strategy was 0% (0/52 for target and 3.9% (2/52 for random biopsy. Conclusions. MRI/TRUS fusion based target biopsy did not show an advantage in the overall detection rate of clinically significant prostate cancer.

  9. Color Doppler quantitative measures to predict outcome of biopsies in prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Strigari, Lidia; Marsella, Annelisa; Canitano, Stefano; Gomellini, Sara; Arcangeli, Stefano; Genovese, Elisabetta; Saracino, Biancamaria; Petrongari, Maria Grazia; Sentinelli, Steno; Crecco, Marcello; Benassi, Marcello; Arcangeli, Giorgio [Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Rome 00144 (Italy); Radiology Department, Regina Elena National Cancer Institute, Rome 00144 (Italy); Radiotherapy Department, Regina Elena National Cancer Institute, Rome 00144 (Italy); Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Center, Rome 00144 (Italy); Radiotherapy Department, Regina Elena National Cancer Center, Rome 00144 (Italy); Pathology Department, Regina Elena National Cancer Center, Rome 00144 (Italy); Radiology Department, Regina Elena National Cancer Center, Rome 00144 (Italy); Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Rome 00144 (Italy); Radiotherapy Department, Regina Elena National Cancer Institute, Rome 00144 (Italy)

    2008-11-15

    Purpose: The aim was to correlate the color Doppler flow activity pre- and postradiotherapy, using transrectal color Doppler ultrasonography (CDUS) and the 2 year positive biopsy rate after radiotherapy in patients with prostate cancer. Methods and materials: Analysis was carried out in 69 out of 160 patients who had undergone treatment with 3D-conformal radiotherapy (3D-CRT) to prostate and seminal vesicles. Patients were randomized to receive 80 Gy in 40 fractions in 8 weeks (arm A) and 62 Gy in 20 fractions in 5 weeks, 4 fractions per week (arm B). Color Doppler flow activity (CDFA) was evaluated calculating the vascularization index (VI), defined as the ratio between the colored and total pixels in the whole and peripheral prostate, delineated by a radiation oncologist on CDUS images, using EcoVasc a home-made software. The difference between the 2 year post- and pre-3D-CRT maximum VI (VI{sub max}), named {Delta}VI{sub max}, was calculated in the whole and peripheral prostate for each patient. Then, {Delta}VI{sub max} and the detected 2 year biopsy outcome were analyzed using the receiver operating characteristics (ROC) technique. Results: The VI{sub max} increased or decreased in patients with positive or negative biopsies, respectively, compared to the value before RT in both arms. The area under the ROC curve for {Delta}VI{sub max} in the whole and peripheral prostate is equal to 0.790 and 0.884, respectively. Conclusion: The {Delta}VI{sub max} index, comparing CDFA at 2 years compared to that before RT, allows the 2 year postradiotherapy positive biopsy rate to be predicted.

  10. Outcomes of Prostate Biopsy in Men with Hypogonadism Prior or During Testosterone Replacement Therapy

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    Daniel A Shoskes

    2015-12-01

    Full Text Available Introduction: The relationship between Testosterone Replacement Therapy (TRT and prostate cancer remains controversial. Most TRT studies show no change in prostate specific antigen (PSA but some men do have PSA rise or develop an abnormal digital rectal exam (aDRE. Our objective was to examine the biopsy results of men with symptomatic hypogonadism before or during therapy. Materials and Methods: Data was extracted from our medical record on men with hypogonadism who had a prostate biopsy within the past 4 years done by 3 Urologists with guideline driven practice patterns. Results: 96 men were identified. Mean age at biopsy was 63 (range 40–85 and median PSA was 3.78ng/dL (0.5–662. Of the 61 men not on TRT, median PSA was 4.34 (0.5 to 662 and mean total testosterone 254 (191–341. There were 29 (47.5% prostate cancers found (6 Gleason score 6, 13 Gleason score 7, 10 Gleason score 8 or 9. Of the 35 men on TRT, median PSA was 3.27 (0.5 to 13.7. The %PSA increase ranged from 2 to 251% (mean 93.5%. Mean total testosterone was 383 (146–792. Of the 14 men treated < 2 years, none had cancer. Of the 21 men treated 2 or more years 5 had cancer (2 Gleason score 6, 3 Gleason score 7. Conclusions: Men with hypogonadism and a clinical indication for biopsy often have prostate cancer, many high grade. No men with an initial PSA rise on TRT had cancer. Men on long term TRT should be monitored with PSA and DRE per guidelines.

  11. A tissue biopsy-based epigenetic multiplex PCR assay for prostate cancer detection

    Directory of Open Access Journals (Sweden)

    Van Neste Leander

    2012-06-01

    Full Text Available Abstract Background PSA-directed prostate cancer screening leads to a high rate of false positive identifications and an unnecessary biopsy burden. Epigenetic biomarkers have proven useful, exhibiting frequent and abundant inactivation of tumor suppressor genes through such mechanisms. An epigenetic, multiplex PCR test for prostate cancer diagnosis could provide physicians with better tools to help their patients. Biomarkers like GSTP1, APC and RASSF1 have demonstrated involvement with prostate cancer, with the latter two genes playing prominent roles in the field effect. The epigenetic states of these genes can be used to assess the likelihood of cancer presence or absence. Results An initial test cohort of 30 prostate cancer-positive samples and 12 cancer-negative samples was used as basis for the development and optimization of an epigenetic multiplex assay based on the GSTP1, APC and RASSF1 genes, using methylation specific PCR (MSP. The effect of prostate needle core biopsy sample volume and age of formalin-fixed paraffin-embedded (FFPE samples was evaluated on an independent follow-up cohort of 51 cancer-positive patients. Multiplexing affects copy number calculations in a consistent way per assay. Methylation ratios are therefore altered compared to the respective singleplex assays, but the correlation with patient outcome remains equivalent. In addition, tissue-biopsy samples as small as 20 μm can be used to detect methylation in a reliable manner. The age of FFPE-samples does have a negative impact on DNA quality and quantity. Conclusions The developed multiplex assay appears functionally similar to individual singleplex assays, with the benefit of lower tissue requirements, lower cost and decreased signal variation. This assay can be applied to small biopsy specimens, down to 20 microns, widening clinical applicability. Increasing the sample volume can compensate the loss of DNA quality and quantity in older samples.

  12. Stratification of the aggressiveness of prostate cancer using pre-biopsy multiparametric MRI (mpMRI).

    Science.gov (United States)

    Dwivedi, Durgesh Kumar; Kumar, Rajeev; Bora, Girdhar S; Thulkar, Sanjay; Sharma, Sanjay; Gupta, Siddhartha Datta; Jagannathan, Naranamangalam R

    2016-03-01

    Risk stratification, based on the Gleason score (GS) of a prostate biopsy, is an important decision-making tool in prostate cancer management. As low-grade disease may not need active intervention, the ability to identify aggressive cancers on imaging could limit the need for prostate biopsies. We assessed the ability of multiparametric MRI (mpMRI) in pre-biopsy risk stratification of men with prostate cancer. One hundred and twenty men suspected to have prostate cancer underwent mpMRI (diffusion MRI and MR spectroscopic imaging) prior to biopsy. Twenty-six had cancer and were stratified into three groups based on GS: low grade (GS ≤ 6), intermediate grade (GS = 7) and high grade (GS ≥ 8). A total of 910 regions of interest (ROIs) from the peripheral zone (PZ, range 25-45) were analyzed from these 26 patients. The metabolite ratio [citrate/(choline + creatine)] and apparent diffusion coefficient (ADC) of voxels were calculated for the PZ regions corresponding to the biopsy cores and compared with histology. The median metabolite ratios for low-grade, intermediate-grade and high-grade cancer were 0.29 (range: 0.16, 0.61), 0.17 (range: 0.13, 0.32) and 0.13 (range: 0.05, 0.23), respectively (p = 0.004). The corresponding mean ADCs (×10(-3) mm(2) /s) for low-grade, intermediate-grade and high-grade cancer were 0.99 ± 0.08, 0.86 ± 0.11 and 0.69 ± 0.12, respectively (p < 0.0001). The combined ADC and metabolite ratio model showed strong discriminatory ability to differentiate subjects with GS ≤ 6 from subjects with GS ≥ 7 with an area under the curve of 94%. These data indicate that pre-biopsy mpMRI may stratify PCa aggressiveness noninvasively. As the recent literature data suggest that men with GS ≤ 6 cancer may not need radical therapy, our data may help limit the need for biopsy and allow informed decision making for clinical intervention. Copyright © 2015 John Wiley & Sons, Ltd.

  13. In-bore setup and Software for 3T MRI-guided Transperineal Prostate Biopsy

    Science.gov (United States)

    Tokuda, Junichi; Tuncali, Kemal; Iordachita, Iulian; Song, Sang-Eun; Fedorov, Andriy; Oguro, Sota; Lasso, Andras; Fennessy, Fiona M; Tempany, Clare M; Hata, Nobuhiko

    2012-01-01

    MRI-guided prostate biopsy in conventional closed-bore scanners requires transferring the patient outside the bore during needle insertion due to the constrained in-bore space, causing a safety hazard and limiting image feedback. To address this issue, we present our custom-made in-bore setup and software to support MRI-guided transperineal prostate biopsy in a wide-bore 3 Tesla (T) MRI scanner. The setup consists of a specially designed tabletop and a needle-guiding template with Z-frame that give a physician access to the perineum of the patient at the imaging position and allow performance of MRI-guided transperineal biopsy without moving the patient out of the scanner. The software and Z-frame allow registration of the template, target planning, and biopsy guidance. Initially, we performed phantom experiments to assess the accuracy of template registration and needle placement in a controlled environment. Subsequently, we embarked on our clinical trial (N = 10). The phantom experiments showed that the translational errors of the template registration along the right-left (RP) and anterior-posterior (AP) axes were 1.1 ± 0.8 mm and 1.4 ± 1.1 mm respectively, while the rotational errors around the RL, AP, and superior-inferior axes were 0.8 ± 1.0 degrees, 1.7 ± 1.6 degrees, and 0.0 ± 0.0 degrees respectively. The 2D root-mean-square (RMS) needle placement error was 3.0 mm. The clinical biopsy procedures were safely carried out in all ten clinical cases with a needle placement error of 5.4 mm (2D RMS). In conclusion, transperineal prostate biopsy in a wide-bore 3T scanner is feasible using our custom-made tabletop set up and software, which supports manual needle placement without moving the patient out of the magnet. PMID:22951350

  14. Repeated biopsies in patients with prostate cancer on active surveillance

    DEFF Research Database (Denmark)

    Thomsen, Frederik B; Marcussen, Niels; Berg, Kasper D;

    2015-01-01

    were included. The International Society of Urological Pathology 2005 Gleason scoring system was used for the histopathological assessment of all biopsies. Three different definitions of histopathological progression were applied. Unweighted and linear weighted Kappa (κ) statistics were used to compare...... the interobserver agreement. RESULTS: The overall Gleason score agreement was 68.8% with a weighted κ of 0.670. The interobserver agreement was 79.6% for meeting the AS selection criteria. According to the three progression definitions applied, overall agreement was between 80.7% and 89.0% with weighted κ values...

  15. Evaluation of a robotic technique for transrectal MRI-guided prostate biopsies

    Energy Technology Data Exchange (ETDEWEB)

    Schouten, Martijn G. [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); University Medical Centre Nijmegen, Department of Radiology, Nijmegen (Netherlands); Bomers, Joyce G.R.; Yakar, Derya; Huisman, Henkjan; Bosboom, Dennis; Scheenen, Tom W.J.; Fuetterer, Jurgen J. [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); Rothgang, Eva [Pattern Recognition Lab, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen (Germany); Center for Applied Medical Imaging, Siemens Corporate Research (Germany); Center for Applied Medical Imaging, Siemens Corporate Research, Baltimore, MD (United States); Misra, Sarthak [University of Twente, MIRA-Institute of Biomedical Technology and Technical Medicine, Enschede (Netherlands)

    2012-02-15

    To evaluate the accuracy and speed of a novel robotic technique as an aid to perform magnetic resonance image (MRI)-guided prostate biopsies on patients with cancer suspicious regions. A pneumatic controlled MR-compatible manipulator with 5 degrees of freedom was developed in-house to guide biopsies under real-time imaging. From 13 consecutive biopsy procedures, the targeting error, biopsy error and target displacement were calculated to evaluate the accuracy. The time was recorded to evaluate manipulation and procedure time. The robotic and manual techniques demonstrated comparable results regarding mean targeting error (5.7 vs 5.8 mm, respectively) and mean target displacement (6.6 vs 6.0 mm, respectively). The mean biopsy error was larger (6.5 vs 4.4 mm) when using the robotic technique, although not significant. Mean procedure and manipulation time were 76 min and 6 min, respectively using the robotic technique and 61 and 8 min with the manual technique. Although comparable results regarding accuracy and speed were found, the extended technical effort of the robotic technique make the manual technique - currently - more suitable to perform MRI-guided biopsies. Furthermore, this study provided a better insight in displacement of the target during in vivo biopsy procedures. (orig.)

  16. Increased fatty acid synthase expression in prostate biopsy cores predicts higher Gleason score in radical prostatectomy specimen

    OpenAIRE

    HAMADA, SHINSUKE; Horiguchi, Akio; Kuroda, Kenji; Ito, Keiichi; ASANO, TOMOHIKO; Miyai, Kosuke; Iwaya, Keiichi

    2014-01-01

    Background Fatty acid synthase (FAS) is highly expressed in various types of cancer, and elevated expression of FAS has been suggested to be a predictor of tumor aggressiveness and poor prognosis. We examined whether FAS expression in prostate biopsy cores could predict the pathological characteristics of radical prostatectomy (RP) specimens. Methods Paraffin-embedded prostate biopsy cores, obtained from 102 patients who subsequently underwent RP, were immunostained with polyclonal anti-FAS a...

  17. Incidence of sepsis following transrectal ultrasound guided prostate biopsy at a tertiary-care medical center in Lebanon

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    Mohammed Shahait

    2016-02-01

    Full Text Available ABSTRACT Background Urosepsis is a rare but life-threatening complication following transrectal ultrasound (TRUS guided needle prostate biopsy. Despite the technological and pharmacological improvements, the problem of bacterial urosepsis after prostate biopsy remains. A strategy for preventing urosepsis following TRUS prostate biopsy in areas with high prevalence of resistant strains or patients presenting risk factors is lacking. Objectives The aim of this study was to assess the prevalence of urosepsis, as well its predictors, following TRUS guided needle biopsy of the prostate in a tertiary care medical center in Lebanon. Materials and Methods We carried out a retrospective study on all patients who underwent TRUS prostate biopsy at the American University of Beirut Medical Center between January 1, 2011 and June 31, 2013. Patients’ hospital charts were reviewed. Data collected included demographic information, pre-procedure disease specific information, as well as post-procedure information. Predictors of urosepsis following TRUS were assessed. Results In total, 265 patients were included in this study, where the prevalence of urosepsis following TRUS prostate biopsy was found to be 9.4%. The significant independent predictors of urosepsis were found to be: age with an OR=0.93 (95% CI: 0.88–1.00, p-value=0.03, and hypertension comorbidity with an OR=3.25 (95% CI: 1.19–8.85, p-value=0.02. Conclusion We found a high prevalence of urosepsis among patients who have undergone TRUS prostate biopsy, and identified two significant risk factors. The results of this study highlight the importance of implementing strategies for prevention of urosepsis following TRUS prostate biopsy.

  18. A panel of kallikrein markers can reduce unnecessary biopsy for prostate cancer: data from the European Randomized Study of Prostate Cancer Screening in Göteborg, Sweden

    Directory of Open Access Journals (Sweden)

    Scardino Peter T

    2008-07-01

    Full Text Available Abstract Background Prostate-specific antigen (PSA is widely used to detect prostate cancer. The low positive predictive value of elevated PSA results in large numbers of unnecessary prostate biopsies. We set out to determine whether a multivariable model including four kallikrein forms (total, free, and intact PSA, and human kallikrein 2 (hK2 could predict prostate biopsy outcome in previously unscreened men with elevated total PSA. Methods The study cohort comprised 740 men in Göteborg, Sweden, undergoing biopsy during the first round of the European Randomized study of Screening for Prostate Cancer. We calculated the area-under-the-curve (AUC for predicting prostate cancer at biopsy. AUCs for a model including age and PSA (the 'laboratory' model and age, PSA and digital rectal exam (the 'clinical' model were compared with those for models that also included additional kallikreins. Results Addition of free and intact PSA and hK2 improved AUC from 0.68 to 0.83 and from 0.72 to 0.84, for the laboratory and clinical models respectively. Using a 20% risk of prostate cancer as the threshold for biopsy would have reduced the number of biopsies by 424 (57% and missed only 31 out of 152 low-grade and 3 out of 40 high-grade cancers. Conclusion Multiple kallikrein forms measured in blood can predict the result of biopsy in previously unscreened men with elevated PSA. A multivariable model can determine which men should be advised to undergo biopsy and which might be advised to continue screening, but defer biopsy until there was stronger evidence of malignancy.

  19. Comparison of 3 different methods of anesthesia before transrectal prostate biopsy: a prospective randomized trial

    Energy Technology Data Exchange (ETDEWEB)

    Oebek, C.; Oezkan, B.; Tunc, B.; Can, G.; Yalcin, V.; Solok, V. [University of Istanbul (Turkey). Cerrahpasa School of Medicine. Depts. of Urology and Public Health (GC)

    2004-09-15

    Purpose: Periprostatic nerve block (PNB) is the most common anesthesia technique used before prostate biopsy. However, needle punctures for anesthetic infiltration may be painful and cause higher infectious complications. We assessed whether addition of rectal lidocaine gel would improve its efficacy. We also investigated the efficacy and safety of tramadol, a codeine derivative, as a noninvasive method. Materials and Methods: A total of 300 patients who underwent prostate biopsies were randomized into 4 groups of controls, PNB, perianal/intrarectal lidocaine gel plus PNB and tramadol. Pain was assessed with a numeric analog scale. Results: Each group consisted of 75 patients, and there was a statistically significant difference among pain scores (p = 0.001). Mean pain scores were 4.63 for controls, 2.57 for PNB, 2.03 for infiltration plus gel group and 3.11 for tramadol. Pain and discomfort were least in PNB plus gel arm. The difference of pain score between PNB alone and tramadol group did not reach statistical significance. Infectious complications were higher in the combination group, whereas there were no complications with tramadol. Conclusions: Any form of analgesia/anesthesia was superior to none. The combination of PNB plus gel provided significantly better analgesia compared to PNB alone or tramadol. If this can be duplicated in other trials, the combination may be accepted as the new gold standard of anesthesia for prostate biopsy. The efficacy of tramadol was similar to that of PNB, and was free of complications. Therefore, tramadol may have a role before prostate biopsy, which needs to be explored. (author)

  20. A fully actuated robotic assistant for MRI-guided prostate biopsy and brachytherapy

    Science.gov (United States)

    Li, Gang; Su, Hao; Shang, Weijian; Tokuda, Junichi; Hata, Nobuhiko; Tempany, Clare M.; Fischer, Gregory S.

    2013-03-01

    Intra-operative medical imaging enables incorporation of human experience and intelligence in a controlled, closed-loop fashion. Magnetic resonance imaging (MRI) is an ideal modality for surgical guidance of diagnostic and therapeutic procedures, with its ability to perform high resolution, real-time, high soft tissue contrast imaging without ionizing radiation. However, for most current image-guided approaches only static pre-operative images are accessible for guidance, which are unable to provide updated information during a surgical procedure. The high magnetic field, electrical interference, and limited access of closed-bore MRI render great challenges to developing robotic systems that can perform inside a diagnostic high-field MRI while obtaining interactively updated MR images. To overcome these limitations, we are developing a piezoelectrically actuated robotic assistant for actuated percutaneous prostate interventions under real-time MRI guidance. Utilizing a modular design, the system enables coherent and straight forward workflow for various percutaneous interventions, including prostate biopsy sampling and brachytherapy seed placement, using various needle driver configurations. The unified workflow compromises: 1) system hardware and software initialization, 2) fiducial frame registration, 3) target selection and motion planning, 4) moving to the target and performing the intervention (e.g. taking a biopsy sample) under live imaging, and 5) visualization and verification. Phantom experiments of prostate biopsy and brachytherapy were executed under MRI-guidance to evaluate the feasibility of the workflow. The robot successfully performed fully actuated biopsy sampling and delivery of simulated brachytherapy seeds under live MR imaging, as well as precise delivery of a prostate brachytherapy seed distribution with an RMS accuracy of 0.98mm.

  1. The effectivity of periprostatic nerve blockade for the pain control during transrectal ultrasound guided prostate biopsy

    Directory of Open Access Journals (Sweden)

    Alper Otunctemur

    2013-06-01

    Full Text Available Aim: Transrectal ultrasound (TRUS guided prostete biopsy is accepted as a standard procedure in the diagnosis of prostate cancer. Many different protocoles are applied to reduce the pain during the process. In this study we aimed to the comparison of two procedure with intrarectal lidocaine gel and periprostatice nerve blockade respective- ly in addition to perianal intrarectal lidocaine gel on the pain control in prostate biop- sy by TRUS. Methods: 473 patients who underwent prostate biopsy guided TRUS between 2008-2012 were included in the study. 10-point linear visual analog pain scale(VAS was used to evaluate the pain during biopsy. The patients were divided into two groups according to anesthesia procedure. In Group 1, there were 159 patients who had perianal-intrarectal lidocaine gel, in Group 2 there were 314 patients who had periprostatic nerve blockade in addition to intrarectal lidocain gel. The pain about probe manipulation was aseesed by VAS-1 and during the biopsy needle entries was evalu- ated by VAS-2. Results were compared with Mann-Whitney U and Pearson chi-square test. Results: Mean VAS-2 scores in Group 1 and Group 2 were 4.54 ± 1.02 and 2.06 ± 0.79 respectively. The pain score was determined significantly lower in the Group 2 (p = 0.001. In both groups there was no significant difference in VAS-1 scores, patient’s age, prostate volume, complication rate and PSA level. Conclusion: The combination of periprostatic nerve blockade and intrarectal lidocain gel provides a more meaningful pain relief compared to group of patients undergoing intrarectal lidocaine gel.

  2. Dissemination of tuberculosis after biopsy of primary tubercular prostate: a case report

    OpenAIRE

    Onkar Jha; Vidya Nair; Deepak Talwar

    2015-01-01

    Only 15-20% of extrapulmonary tuberculosis (TB) has been attributed to TB of the urogenital system and often Results from haematogenous spread from an active site of infection. Isolated involvement of prostate by TB is relatively less common. The incidence of primary prostatic TB is unknown and in its truest sense is a very rare entity. Here, we report the case of a patient with primary prostatic TB who was misdiagnosed as nonspecific granulomatous inflammation on transrectal ultrasound-guid...

  3. Raising cut-off value of prostate specific antigen (PSA for biopsy in symptomatic men in India to reduce unnecessary biopsy

    Directory of Open Access Journals (Sweden)

    Shalini Agnihotri

    2014-01-01

    Full Text Available Background & objectives: The characteristics of prostate specific antigen (PSA for trans-rectal ultrasonography guided prostate biopsy in men with lower urinary tract symptoms (LUTS are not well defined. This study was carried out to analyse the threshold of PSA for biopsy in symptomatic men in India. Methods: From January 2000 to June 2011, consecutive patients who had digital rectal examination (DRE and PSA testing done for LUTS were included in this study. PSA was done with ELISA technique. Patients with acute or chronic prostatitis, prostatic abscess, history of surgery on prostate within the previous three months and patients on 5α-reductase inhibitors or on urethral catheter were excluded. Results: Of the 4702 patients evaluated, 70.9 per cent had PSA of less than 4 ng/ml and 29.1 per cent had PSA of more than 4 ng/ml. Of these, 875 men with a mean age of 65.72±7.4 (range 50-75 yr had trans rectal ultrasonography (TRUS guided biopsy. Twenty five men had biopsy at PSA level of 20 ng/ml. Positive predictive value of PSA in ranges of 4.1-10, 10.1-20, >20 ng/ml was 15.2, 24 and 62.6 per cent, respectively with negative DRE. PSA cut-off to do biopsy was derived by ROC curve as 5.82 ng/ml for all the men. When the subjects were further stratified on the basis of DRE findings, a cut-off of 5.4 ng/ml was derived in men with normal DRE. Interpretation & conclusions: A cut-off for biopsy in symptomatic men with negative DRE could safely be raised to 5.4 ng/ml, which could avoid subjecting 10 per cent of men to undergo unnecessary biopsy.

  4. Prostate biopsies guided by three-dimensional real-time (4-D) transrectal ultrasonography on a phantom: comparative study versus two-dimensional transrectal ultrasound-guided biopsies

    CERN Document Server

    Long, Jean-Alexandre; Moreau-Gaudry, Alexandre; Troccaz, Jocelyne; Rambeaud, Jean-Jacques; Descotes, Jean-Luc

    2007-01-01

    OBJECTIVE: This study evaluated the accuracy in localisation and distribution of real-time three-dimensional (4-D) ultrasound-guided biopsies on a prostate phantom. METHODS: A prostate phantom was created. A three-dimensional real-time ultrasound system with a 5.9MHz probe was used, making it possible to see several reconstructed orthogonal viewing planes in real time. Fourteen operators performed biopsies first under 2-D then 4-D transurethral ultrasound (TRUS) guidance (336 biopsies). The biopsy path was modelled using segmentation in a 3-D ultrasonographic volume. Special software was used to visualise the biopsy paths in a reference prostate and assess the sampled area. A comparative study was performed to examine the accuracy of the entry points and target of the needle. Distribution was assessed by measuring the volume sampled and a redundancy ratio of the sampled prostate. RESULTS: A significant increase in accuracy in hitting the target zone was identified using 4-D ultrasonography as compared to 2-D....

  5. Transrectal ultrasound-guided biopsy of the prostate: aspirin increases the incidence of minor bleeding complications

    Energy Technology Data Exchange (ETDEWEB)

    Halliwell, O.T. [Department of Radiology, Southampton General Hospital, Southampton (United Kingdom)], E-mail: hallo99@doctors.org.uk; Yadegafar, G. [Public Health Sciences and Medical Statistics Division, School of Medicine, Southampton General Hospital, Southampton University, Southampton (United Kingdom); Lane, C.; Dewbury, K.C. [Department of Radiology, Southampton General Hospital, Southampton (United Kingdom)

    2008-05-15

    Aim: To assess whether patients taking aspirin were more likely to experience bleeding complications after transrectal ultrasound (TRUS)-guided prostate biopsy. Materials and methods: Three hundred and eighty-seven patients taking aspirin who underwent prostate biopsy over a 3.5 year period and 731 patients not taking aspirin over a 2 year period returned a questionnaire assessing the incidence and severity of bleeding complications. Results: Patients taking aspirin had a significantly higher cumulative incidence of haematuria and rectal bleeding, but not of haemospermia. They also had a longer mean duration of bleeding, but no increase in bleeding severity. Severe bleeding was very uncommon in both groups and no patients required intervention for bleeding complications. Conclusion: Aspirin exacerbates minor bleeding complications in patients undergoing TRUS guided biopsy of the prostate, but in this large group of aspirin-taking patients no dangerous bleeding complications were encountered. It may be that the risks associated with aspirin cessation outweigh the risks of haemorrhagic complications.

  6. Is There a Concordance Between the Gleason Scores of Needle Biopsy and Radical Prostatectomy Specimens in Prostatic Carsinoma?

    Directory of Open Access Journals (Sweden)

    Faruk Özgör

    2016-03-01

    Full Text Available Aim: To evaluate the concordance between the Gleason Scores (GS of prostate biopsy and radical prostatectomy specimens. Methods: Prostate biopsy was performed in 1135 patients with the suspicion of prostate cancer in our clinic between 2008 and 2012. A total of 366 patients were diagnosed with prostate cancer. Radical prostatectomy was performed in 73 of these patients and GS of pathology specimens were included in this study for comparison. The patients were divided into three groups (low intermediate- and high-risk patients according to the D’amico risk classification for prostate cancer. Results: The median age of the patients was 64.2±6.1 years (54- 73. The mean prostate specific antigen level was 20.34 ng/mL and the mean biopsy core number was 12±0.58. A statistically significant concordance was detected between the GS of biopsy specimens and radical prostatectomy materials in 65.7% of patients (p<0.01. There were 40 patients in the low-risk group, however, 8 (20% of them were identified to be intermediate-risk patients and one (2.5% was found to be a high-risk patient after radical prostatectomy. Conclusion: Concordance between the GS of prostate biopsy and radical prostatectomy materials are important for selection of the appropriate treatment

  7. Evaluation of T2-weighted and dynamic contrast-enhanced MRI in localizing prostate cancer before repeat biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Cheikh, Alexandre Ben; Girouin, Nicolas [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Lyon (France)]|[Universite de Lyon, Lyon (France)]|[Universite de Lyon 1, faculte de medecine Lyon Nord, Lyon (France); Colombel, Marc; Marechal, Jean-Marie [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urology, Lyon (France); Gelet, Albert [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urology, Lyon (France)]|[Inserm, U556, Lyon (France); Bissery, Alvine; Rabilloud, Muriel [Hospices Civils de Lyon, Department of Biostatistics, Lyon (France)]|[Universite de Lyon 1, UMR CNRS 5558, Laboratoire Biostatistiques-Sante, Pierre-Benite (France); Lyonnet, Denis [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Lyon (France)]|[Universite de Lyon, Lyon (France)]|[Universite de Lyon 1, faculte de medecine Lyon Nord, Lyon (France)]|[Inserm, U556, Lyon (France); Rouviere, Olivier [Hopital Edouard Herriot, Hospices Civils de Lyon, Department of Urinary and Vascular Radiology, Lyon (France)]|[Universite de Lyon, Lyon (France)]|[Universite de Lyon 1, faculte de medecine Lyon Nord, Lyon (France)]|[Inserm, U556, Lyon (France)]|[Hopital Edouard Herriot, Department of Urinary and Vascular Radiology, Pavillon P Radio, Lyon Cedex 03 (France)

    2009-03-15

    We assessed the accuracy of T2-weighted (T2w) and dynamic contrast-enhanced (DCE) 1.5-T magnetic resonance imaging (MRI) in localizing prostate cancer before transrectal ultrasound-guided repeat biopsy. Ninety-three patients with abnormal PSA level and negative prostate biopsy underwent T2w and DCE prostate MRI using pelvic coil before repeat biopsy. T2w and DCE images were interpreted using visual criteria only. MR results were correlated with repeat biopsy findings in ten prostate sectors. Repeat biopsy found prostate cancer in 23 patients (24.7%) and 44 sectors (6.6%). At per patient analysis, the sensitivity, specificity, positive and negative predictive values were 47.8%, 44.3%, 20.4% and 79.5% for T2w imaging and 82.6%, 20%, 24.4% and 93.3% for DCE imaging. When all suspicious areas (on T2w or DCE imaging) were taken into account, a sensitivity of 82.6% and a negative predictive value of 100% could be achieved. At per sector analysis, DCE imaging was significantly less specific (83.5% vs. 89.7%, p < 0.002) than T2w imaging; it was more sensitive (52.4% vs. 32.1%), but the difference was hardly significant (p = 0.09). T2w and DCE MRI using pelvic coil and visual diagnostic criteria can guide prostate repeat biopsy, with a good sensitivity and NPV. (orig.)

  8. Is effective a prior multiparametric magnetic resonance scan in patients candidates to prostate biopsy? CAT Study.

    Science.gov (United States)

    Ramos Rodríguez, J R; Molinero Pérez, M; Herrera Imbroda, B; Domínguez Pinos, M D

    2016-01-01

    We carried out a critically appraised topic (CAT)-type study to determine whether the relevant scientific evidence supports the recommendation of doing a multiparametric magnetic resonance imaging study of the prostate in all patients who are candidates for prostate biopsy with the aim of improving the detection of clinically significant prostate cancer and stratifying patients to receive active surveillance or treatment. After a formal literature search and an analysis of the two most relevant articles it found, we reached the conclusion that, despite promising results that point to the potential usefulness of this approach, there is still not enough clear scientific evidence to endorse it categorically. Before this approach can be endorsed, we need evidence from well-designed prospective randomized trials using widely agreed upon criteria and including large numbers of patients at multiple centers.

  9. Differentiation of prostatitis and prostate cancer by using diffusion-weighted MR imaging and MR-guided biopsy at 3 T

    NARCIS (Netherlands)

    Nagel, Klaas N.A.; Schouten, Martijn G.; Hambrock, Thomas; Litjens, Geert J.S.; Hoeks, Caroline; Haken, ten Bennie; Barentsz, Jelle O.; Fütterer, Jurgen J.

    2013-01-01

    Purpose To determine if prostatitis and prostate cancer (PCa) can be distinguished by using apparent diffusion coefficients (ADCs) on magnetic resonance (MR) images, with specimens obtained at MR-guided biopsy as the standard of reference. Materials and Methods The need for institutional review boa

  10. Differentiation of Prostatitis and Prostate Cancer by Using Diffusion-weighted MR Imaging and MR-guided Biopsy at 3 T

    NARCIS (Netherlands)

    Nagel, K.N.A.; Schouten, M.G.; Hambrock, T.; Litjens, G.J.S.; Hoeks, C.M.A.; Haken, B.T.; Barentsz, J.O.; Futterer, J.J.

    2013-01-01

    Purpose: To determine if prostatitis and prostate cancer (PCa) can be distinguished by using apparent diffusion coefficients (ADCs) on magnetic resonance (MR) images, with specimens obtained at MR-guided biopsy as the standard of reference. Materials and Methods: The need for institutional review bo

  11. Optoacoustic imaging of the prostate: development toward image-guided biopsy.

    Science.gov (United States)

    Yaseen, Mohammad A; Ermilov, Sergey A; Brecht, Hans-Peter; Su, Richard; Conjusteau, André; Fronheiser, Matthew; Bell, Brent A; Motamedi, Massoud; Oraevsky, Alexander A

    2010-01-01

    Optoacoustic (OA) tomography has demonstrated utility in identifying blood-rich malignancies in breast tissue. We describe the development and characterization of a laser OA imaging system for the prostate (LOIS-P). The system consists of a fiber-coupled Q-switched laser operating at 757 nm, a commercial 128-channel ultrasonic probe, a digital signal processor, and software that uses the filtered radial back-projection algorithm for image reconstruction. The system is used to reconstruct OA images of a blood-rich lesion induced in vivo in a canine prostate. OA images obtained in vivo are compared to images acquired using ultrasound, the current gold standard for guiding biopsy of the prostate. Although key structural features such as the urethra could be identified with both imaging techniques, a bloody lesion representing a highly vascularized tumor could only be clearly identified in OA images. The advantages and limitations of both forward and backward illumination modes are also evaluated by collecting OA images of phantoms simulating blood vessels within tissue. System resolution is estimated to be 0.2 mm in the radial direction of the acoustic array. The minimum detectable pressure signal is 1.83 Pa. Our results encourage further development toward a dual-modality OA/ultrasonic system for prostate imaging and image-guided biopsy.

  12. Design of a predictive targeting error simulator for MRI-guided prostate biopsy.

    Science.gov (United States)

    Avni, Shachar; Vikal, Siddharth; Fichtinger, Gabor

    2010-02-23

    Multi-parametric MRI is a new imaging modality superior in quality to Ultrasound (US) which is currently used in standard prostate biopsy procedures. Surface-based registration of the pre-operative and intra-operative prostate volumes is a simple alternative to side-step the challenges involved with deformable registration. However, segmentation errors inevitably introduced during prostate contouring spoil the registration and biopsy targeting accuracies. For the crucial purpose of validating this procedure, we introduce a fully interactive and customizable simulator which determines the resulting targeting errors of simulated registrations between prostate volumes given user-provided parameters for organ deformation, segmentation, and targeting. We present the workflow executed by the simulator in detail and discuss the parameters involved. We also present a segmentation error introduction algorithm, based on polar curves and natural cubic spline interpolation, which introduces statistically realistic contouring errors. One simulation, including all I/O and preparation for rendering, takes approximately 1 minute and 40 seconds to complete on a system with 3 GB of RAM and four Intel Core 2 Quad CPUs each with a speed of 2.40 GHz. Preliminary results of our simulation suggest the maximum tolerable segmentation error given the presence of a 5.0 mm wide small tumor is between 4-5 mm. We intend to validate these results via clinical trials as part of our ongoing work.

  13. Detection of bone marrow metastases in prostate cancer: Role of trephine biopsy and Immunohistochemistry

    Directory of Open Access Journals (Sweden)

    Manish Kumar Singh

    2013-01-01

    Full Text Available Context: Bone marrow (BM metastases are an integral part of tumor dissemination in many malignancies. Prostate carcinoma, which has high tendency to metastasize to bone, shown to have affinity for endosteal niche as well as tendency to compete with hematopoietic cells to home in BM. This marrow dissemination can be confidently proved by histopathological examination of BM. Aims: In this study, we are trying to detect the presence of metastases and micrometastases in BM of prostate carcinoma patients with the help of immunohistochemical markers prostate-specific antigen (PSA and prostate-specific acid phosphatase and correlate the findings with American Joint Committee on Cancer Tumor, Node and Metastasis 7 th (2010 classification, serum PSA, and biopsy Gleason′s score. Materials and Methods: We performed BM examination and hematological workup of 11 known prostate carcinoma patients including metastatic cases also, during our study period of 1 year. The BM biopsy sections and clot sections were used to carry out immunohistochemistry. The data were analyzed by using SPSS (Statistical Package for Social Sciences version 15.0 statistical analysis software. Results: We found that two patients were positive for metastases in BM out of the 11. Both of these patients already had metastases to other site with very high serum PSA levels. Anemia was common hematological alteration in both of them and one of them showed increased osteoblasts in the aspirate film. Conclusion: Taking into account our small sample size and short study duration, we conclude that further large sized future studies with long-term follow-up in to this BM dissemination by prostate cancer cells could open new horizons to understand the biology of metastasis of this common malignancy and also provide more effective therapeutic options as well as prognostic implications in these patients.

  14. Usefulness of transrectal ultrasound-guided 12 core biopsy method in patients with clinically suspected prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Se Hwan; Lim, Joo Won; Park, Seong Jin; Ko, Young Tae; Kim, Yoon Wha [Kyung Hee University Hospital, Seoul (Korea, Republic of)

    2000-06-15

    To evaluate the improvement of prostate cancer detection provided by transrectal ultrasound (TRUS)-guided 12 core biopsy method compared with sextant biopsy method. Between June 1997 and February 1999, 29 patients with pathologically proven prostate cancer in 124 patients who underwent TRUS-guided 12 core biopsy method were evaluated. They had abnormal findings in prostate specific antigen (PSA), digital rectal examination (DRE) or TRUS findings. The prostate was diffusely enlarged in all patients on DRE findings and in 15 cases (15/29, 52%), hard nodule was palpated. The average of PSA and prostate specific antigen density (PSAD) is 229.33 ng/ml (1-2280) and 9.14 ng/ml/cm{sup 3} (0.048-142.5), respectively, 12 transrectal biopsy, including 2 transition zones, was performed in both lobe, 6 biopsies were located in both base, middle and apex. Then 2 biopsies were inserted between 3 biopsies in both peripheral zone and 2 biopsies were performed in both transition zone. Each specimen was pathologically examined. The results of pathology were compared with method 1 and 2, respectively. We defined the method 1 and 2 as different sextant biopsy method. The method 1 is that cores are taken from both base, middle and apex and method 2 is that cores are taken from both base, apex and transition zone. TRUS findings were analyzed by two radiologists. Of the 29 patients with prostate cancer, 3 (10%) had carcinomas only in the additional regions as compared with method. When compared with method 2,2 (7.0%) had carcinomas only in the additional regions. 2 patients were same in both cases. TRUS findings were abnormal in 21 cases in all patients whose 12 biopsy method was not helpful. 12 biopsy method was helpful in 2/8 (25%) whose TRUS findings were non-specific and 1/21 (4.8%) whose TRUS findings were abnormal. Small low echoic lesion was seen in one patients whose 12 biopsy method was helpful, but cancer was found in other area. TRUS-guided 12 core biopsy method may be superior

  15. Predicting Prostate Biopsy Results Using a Panel of Plasma and Urine Biomarkers Combined in a Scoring System

    DEFF Research Database (Denmark)

    Albitar, Maher; Ma, Wanlong; Lund, Lars;

    2016-01-01

    , and PTEN in plasma and urine. Patient age, serum prostate-specific antigen (sPSA) level, and biomarkers data were used to develop two independent algorithms, one for predicting the presence of PCa and the other for predicting high-grade PCa (Gleason score [GS] ≥7). RESULTS: Using training and validation...... a scoring system to predict prostate biopsy results and the presence of high grade PCa. METHODS: Urine and plasma specimens were collected from 319 patients recommended for prostate biopsies. We measured the gene expression levels of UAP1, PDLIM5, IMPDH2, HSPD1, PCA3, PSA, TMPRSS2, ERG, GAPDH, B2M, AR...

  16. In vivo testing of laser optoacoustic system for image-guided biopsy of prostate

    Science.gov (United States)

    Oraevsky, Alexander; Ermilov, Sergey; Mehta, Ketan; Miller, Tom; Bell, Brent; Orihuela, Eduardo; Motamedi, Massoud

    2006-02-01

    We have developed and used a laser optoacoustic imaging system with transrectal probe (LOIS-P) for detection of mechanical lesions in canine prostates in vivo. LOIS images have been acquired with a 128-channel transrectal probe and a 32-channel data acquisition system. Optoacoustic images showed a strong contrast enhancement for a blood containing lesion, when compared with ultrasound images. Our studies demonstrated that sufficient optoacoustic contrast exists between blood containing lesion and prostate tissue, although the lesion has been undetectable with ultrasound. The imaging results have been compared with visual examination of surgically excised prostates. Although axial resolution of the wide-band transducers employed in the transrectal probe provides good axial resolution of 0.5 mm, the convex arc geometry of the this array of transducers provides lateral resolution degrading with depth in tissue. A two step algorithm has been developed to improve the lateral resolution of deeply located objects. This algorithm employs optoacoustic image reconstruction based on radial back-projection to determine location and shape of the target object, then a procedure, we call Maximum Angular Amplitude Probability (MAAP), to determine true brightness of the object and simultaneously remove arc-shaped artifacts associated with radial back-projection. A laser optoacoustic imaging system (LOIS-P) with transrectal probe operating in backward detection mode empowered with the new image reconstruction algorithm seems promising as a modality for detection of prostate cancer and guiding prostate biopsy.

  17. Lymphatic drainage from the treated versus untreated prostate: feasibility of sentinel node biopsy in recurrent cancer

    Energy Technology Data Exchange (ETDEWEB)

    Vermeeren, Lenka; Valdes Olmos, Renato A. [Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Meinhardt, Willem; Poel, Henk G. van der [Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Urology, Amsterdam (Netherlands)

    2010-11-15

    The goal of this study was to establish the feasibility of sentinel node biopsy in patients with recurrent prostate cancer after initial local treatment and to compare lymphatic drainage patterns of the treated versus untreated prostate. In ten patients with a proven local recurrence after initial local treatment (four external beam radiation, four brachytherapy and two high-intensity focused ultrasound), the radiotracer ({sup 99m}Tc-nanocolloid, GE Healthcare) was injected into the prostate. Planar images after 15 min and 2 h were followed by SPECT/CT (Symbia T, Siemens) to visualize lymphatic drainage. Laparoscopic sentinel lymphadenectomy was assisted by a gamma probe (Europrobe, EuroMedical Instruments) and a portable gamma camera (Sentinella, S102, Oncovision). Sentinel node identification and lymphatic drainage patterns were compared to a consecutive series of 70 untreated prostate carcinoma patients from our institute. Lymphatic drainage was visualized in all treated patients, with a median of 3.5 sentinel nodes per patient. Most sentinel nodes were localized in the pelvic area, although the percentage of patients with a sentinel node outside the pelvic para-iliac region (para-aortic, presacral, inguinal or near the ventral abdominal wall) was high compared to the untreated patients (80 versus 34%, p = 0.01). In patients with recurrent prostate cancer, 95% of the sentinel nodes could be harvested and half of the patients had at least one positive sentinel node on pathological examination. Lymphatic mapping of the treated prostate appears feasible, although sentinel nodes are more frequently found in an aberrant location. Larger trials are needed to assess the sensitivity and therapeutic value of lymphatic mapping in recurrent prostate cancer. (orig.)

  18. Quantification of tumor extension in prostate biopsies: importance in the identification of confined tumors

    Directory of Open Access Journals (Sweden)

    Leite Kátia R.M.

    2003-01-01

    Full Text Available OBJECTIVE: To assess the importance of quantifying the adenocarcinoma in prostate biopsies when determining the tumor's final stage in patients who undergo radical prostatectomy. To identify the best methodology for obtaining such data. PATIENTS AND METHODS: Prostate biopsies from 132 patients were examined, with determination of Gleason histological grade and tumor volume in number of involved fragments, tumor extent of the fragment mostly affected by the tumor and the total percentage of tumor in the specimen. Theses parameters were statistically correlated with the neoplasia's final stage following the evaluation of radical prostatectomy specimens. RESULTS: An average of 12 and a median of 14 biopsy fragments were evaluated per patient. In the univariate analysis the Gleason histological grade, the largest tumor extent in one fragment and the total percentage of tumor in the specimen were correlated with tumor stage of the surgical specimen. In the multivariate analysis, the Gleason histological grade and the total percentage of tumor were strongly correlated with the neoplasia's final stage. The risk of the tumor not being confined was 3 for Gleason 7 tumors and 10.6 for Gleason 8 tumors or above. In cases where the tumor involved more than 60% of the specimen, the risk of non-confined disease was 4.4 times. Among 19 patients with unfavorable histological parameters, Gleason > 7 and extension greater than 60% the tumor final stage was pT3 in 95%. CONCLUSION: When associated to the Gleason histological grade, tumor quantification in prostate biopsies is an important factor for determining organ-confined disease, and among the methods, total percentage of tumor is the most informative one. Such data should be included in the pathological report and must be incorporated in future nomograms.

  19. Probability of Extraprostatic Disease According to the Percentage of Positive Biopsy Cores in Clinically Localized Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Thiago N. Valette

    2015-06-01

    Full Text Available ABSTRACTObjectivePrediction of extraprostatic disease in clinically localized prostate cancer is relevant for treatment planning of the disease. The purpose of this study was to explore the usefulness of the percentage of positive biopsy cores to predict the chance of extraprostatic cancer.Materials and MethodsWe evaluated 1787 patients with localized prostate cancer submitted to radical prostatectomy. The percentage of positive cores in prostate biopsy was correlated with the pathologic outcome of the surgical specimen. In the final analysis, a correlation was made between categorical ranges of positive cores (10% intervals and the risk of extraprostatic extension and/or bladder neck invasion, seminal vesicles involvement or metastasis to iliac lymph nodes. Student's t test was used for statistical analysis.ResultsFor each 10% of positive cores we observed a progressive higher prevalence of extraprostatic disease. The risk of cancer beyond the prostate capsule for ConclusionThe percentage of positive cores in prostate biopsy can predict the risk of cancer outside the prostate. Our study shows that the percentage of positive prostate biopsy fragments helps predict the chance of extraprostatic cancer and may have a relevant role in the patient's management.

  20. Comparison of Two Local Anesthesia Injection Methods During a Transrectal Ultrasonography-guided Prostate Biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Song Ee; Oh, Young Taik [Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Jang Hwan; Rha, Koon Ho; Hong, Sung Joon; Yang, Seung Choul [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2010-09-15

    To compare the effectiveness of 2 injection methods of lidocaine during a transrectal ultrasound (TRUS)-guided prostate biopsy for pain control and complication rates. We retrospectively evaluated patients who underwent a TRUS-guided prostate biopsy from March 2005 to March 2006. One hundred patients were categorized into two groups based on injection method. For group 1, 10 mL of 1% lidocaine was injected bilaterally at the junction of the seminal vesicle and prostate and for group 2, into Denonvilliers' fascia. Pain scores using a visual analog scale (VAS) as well as immediate and delayed complication rates were evaluated. The mean VAS score showed no significant differences between the groups (group 1, 3.4{+-}1.78: group 2, 2.8{+-}1.3: p = 0.062). The difference in delayed complication rates and incidence of hematuria, hemospermia, and blood via the rectum was not significant between groups. However, two patients in group 1 complained of symptoms immediately after local anesthesia: one of tinnitus and the other of mild dizziness. There were no significant differences between pain control and complication rates between the 2 lidocaine injection methods. However, injection into Denonvilliers' fascia is thought to have less potential risk

  1. Prostatic biopsy in the prostate specific antigen gray zone; La biopsia prostatica multipla nalla zona grigia dei valori dell'antigene prostatico specifico

    Energy Technology Data Exchange (ETDEWEB)

    Drudi, F. M.; Ricci, P.; Iannicelli, E.; Di Nardo, R.; Novelli, L.; Laghi, A.; Passariello, R. [Rome Univ. La Sapienza, Rome (Italy). Ist. di Radiologia II Cattedra; Perugia, G. [Rome Univ. La Sapienza, Rome (Italy). Dipt. di Urologia U. Bracci

    2000-02-01

    The main purpose of this study was to identify cases of undetected prostatic cancer in patients with normal findings at digital examination and transrectal US, and prostate specific antigen (PSA) values ranging 4-10 ng/mL. 290 patients were submitted to transrectal US and random bilateral prostatic biopsy; 3 samples were collected from each side of the gland using 16-Gauge thru-cut needles. Of the 290 patients who gave full informed consent, 34 people were selected whose age range was between 56 to 76 years (mean: 64). Inclusion criteria were PSA 4-10 ng/mL, PSAD cut-off 0.15, free/total PSA ratio 15-25%, and normal findings at digital examination and transrectal US. PSA velocity was calculated collecting 3 blood samples every 30 days for 2 months. 5 of the 34 selected patients (15%) had prostatic cancer, and 2 (6%) Pin (1 Pin 1 and 1 Pin 2). As for the other 27 patients, biopsy demonstrated 4 (12%) cases of prostatitis and 23 (62%) cases of BPH. PSA values increased in all patients with positive histology, versus only 6 (22%) of those with negative histology. Our findings confirm that prostatic biopsy can detect tumors also in areas which appear normal at transrectal US and digital examination, and that PSA rate increases in patients with positive histology. Finally, the actual clinical role of prostatic biopsy relative to all other diagnostic imaging techniques remains to be defined. [Italian] Si intende qui dimostrare la percentuale di neoplasie prostatiche sfuggite all'esplorazione rettale e all'ecografia transrettale nei pazienti convalori di antigene prostatico specifico tra 4 e 10 ng/ml. 290 pazienti sono stati sottoposti a ecografia transrettale e biopsia multipla (6 prelievi, ago da 16 Gauge) dopo consenso informato. Di questi sono stati selezionati 34: eta' tra 56 e 76 anni, eta' media 64 anni. Parametri di selezione: antigene prostatico specifico con valori tra 4 e 10ng/ml; densita' dell'antigene prostatico specifico con

  2. Outbreak of Achromobacter xylosoxidans and Ochrobactrum anthropi Infections after Prostate Biopsies, France, 2014

    Science.gov (United States)

    Cassier, Pierre; Dananché, Cédric; Hulin, Monique; Dauwalder, Olivier; Rouvière, Olivier; Bertrand, Xavier; Perraud, Michel; Bénet, Thomas; Vanhems, Philippe

    2016-01-01

    We report an outbreak of healthcare-associated prostatitis involving rare environmental pathogens in immunocompetent patients undergoing transrectal prostate biopsies at Hôpital Édouard Herriot (Lyon, France) during August 13–October 10, 2014. Despite a fluoroquinolone-based prophylaxis, 5 patients were infected with Achromobacter xylosoxidans and 3 with Ochrobactrum anthropi, which has not been reported as pathogenic in nonimmunocompromised persons. All patients recovered fully. Analysis of the outbreak included case investigation, case–control study, biopsy procedure review, microbiologic testing of environmental and clinical samples, and retrospective review of hospital records for 4 years before the outbreak. The cases resulted from asepsis errors during preparation of materials for the biopsies. A low-level outbreak involving environmental bacteria was likely present for years, masked by antimicrobial drug prophylaxis and a low number of cases. Healthcare personnel should promptly report unusual pathogens in immunocompetent patients to infection control units, and guidelines should explicitly mention asepsis during materials preparation. PMID:27434277

  3. The Rectal Administration of Lignocaine Gel and Periprostatic Lignocaine Infiltration During Transrectal Ultrasound-Guided Prostate Biopsy Provides Effective Analgesia

    Science.gov (United States)

    Siddiqui, EJ; Ali, S; Koneru, S

    2006-01-01

    INTRODUCTION Transrectal ultrasound guided prostate needle biopsy (TRUS) is the standard procedure to diagnose or exclude prostate cancer. This procedure can be associated with significant discomfort, both on insertion of the ultrasound probe as well as on taking the biopsy. We evaluated a new technique for pain relief during TRUS biopsy. PATIENTS AND METHODS In Group 1 (n = 60), the biopsies were taken without any analgesia. In Group 2 (n = 60), 11 ml of Instillagel (2% lignocaine) was administered rectally prior to probe insertion and 5 ml of 1% lignocaine periprostatic injection was administered before taking the biopsy. The discomfort encountered during the procedure was graded by the patient on a scale ranging from no discomfort to mild, moderate and severe pain. RESULTS In Group 2, there was a marked reduction in the pain experienced during the procedure. The Chi-squared test for trend showed a significant association between the rectal administration of local anaesthetic gel and reduction in pain on probe insertion (P = 0.0001). There was also a significant association between the use of periprostatic lignocaine injection and reduction in pain on taking the biopsy (P < 0.0001). CONCLUSIONS The use of lignocaine gel prior to probe insertion and periprostatic infiltration of lignocaine before taking the needle biopsy significantly reduces the pain experienced by the patient during TRUS-guided prostate biopsy. PMID:16551424

  4. Histopathological findings in extended prostate biopsy with PSA ≤ 4 ng/mL

    Directory of Open Access Journals (Sweden)

    Katia R. Leite

    2008-06-01

    Full Text Available OBJECTIVE: Cancer detection has been reported in up to 27% of patients when lowering the PSA cutoff to 2.5 ng/mL. Although this practice could increase the number of biopsies performed, it also could lead to more frequent detection of significant prostate cancers at an organ-confined stage and/or a less aggressive state. This study describes the incidence of malignancy and tumor characteristics in extended prostate biopsies with PSA ≤ 4 ng/mL. MATERIALS AND METHODS: Prostate biopsies from 1081 patients where examined, 275 (25.4% patients had PSA level ≤ 4 ng/mL. RESULTS: Cancer was diagnosed in 32.0% and 35.7% of patients with PSA ≤ 4 ng/mL and > 4 ng/mL, respectively (p = 0.906. The median Gleason score was 7 independent of PSA > or ≤ 4 ng/mL (p = 0.078. The median number of cores positive for tumor was 4 and 3, respectively, for PSA > 4 ng/mL and PSA ≤ 4 ng/mL (p = 0.627. There was a difference in the total percent of tumors involving all cores, 11% and 7% for PSA > or ≤ 4 ng/mL (p = 0.042. Fifty-six patients underwent radical prostatectomy, 12 had PSA ≤ 4 ng/mL. In both groups, a diagnosis of cancer was accurate with no differences in Gleason score, tumor volume or staging for both groups. CONCLUSION: When PSA is below 4 ng/mL, cancer is detected in a proportion equal to the proportion diagnosed with a PSA > 4 ng/mL, and tumor characteristics are similar between the two groups. Only clinically significant tumors were diagnosed following radical prostatectomy.

  5. DNA Ploidy Measured on Archived Pretreatment Biopsy Material May Correlate With Prostate-Specific Antigen Recurrence After Prostate Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Keyes, Mira, E-mail: mkeyes@bccancer.bc.ca [Radiation Oncology, Provincial Prostate Brachytherapy Program, Vancouver Cancer Centre, British Columbia Cancer Agency, Vancouver, British Columbia (Canada); MacAulay, Calum [Department of Integrative Oncology, British Columbia Cancer Research Centre, British Columbia Cancer Agency, Vancouver, British Columbia (Canada); Hayes, Malcolm [Department of Pathology, Vancouver Cancer Centre, British Columbia Cancer Agency, Vancouver, British Columbia (Canada); Korbelik, Jagoda [Department of Integrative Oncology, British Columbia Cancer Research Centre, British Columbia Cancer Agency, Vancouver, British Columbia (Canada); Morris, W. James [Radiation Oncology, Provincial Prostate Brachytherapy Program, Vancouver Cancer Centre, British Columbia Cancer Agency, Vancouver, British Columbia (Canada); Palcic, Branko [Department of Integrative Oncology, British Columbia Cancer Research Centre, British Columbia Cancer Agency, Vancouver, British Columbia (Canada)

    2013-08-01

    Purpose: To explore whether DNA ploidy of prostate cancer cells determined from archived transrectal ultrasound-guided biopsy specimens correlates with disease-free survival. Methods and Materials: Forty-seven failures and 47 controls were selected from 1006 consecutive low- and intermediate-risk patients treated with prostate {sup 125}I brachytherapy (July 1998-October 2003). Median follow-up was 7.5 years. Ten-year actuarial disease-free survival was 94.1%. Controls were matched using age, initial prostate-specific antigen level, clinical stage, Gleason score, use of hormone therapy, and follow-up (all P nonsignificant). Seventy-eight specimens were successfully processed; 27 control and 20 failure specimens contained more than 100 tumor cells were used for the final analysis. The Feulgen-Thionin stained cytology samples from archived paraffin blocks were used to determine the DNA ploidy of each tumor by measuring integrated optical densities. Results: The samples were divided into diploid and aneuploid tumors. Aneuploid tumors were found in 16 of 20 of the failures (80%) and 8 of 27 controls (30%). Diploid DNA patients had a significantly lower rate of disease recurrence (P=.0086) (hazard ratio [HR] 0.256). On multivariable analysis, patients with aneuploid tumors had a higher prostate-specific antigen failure rate (HR 5.13). Additionally, those with “excellent” dosimetry (V100 >90%; D90 >144 Gy) had a significantly lower recurrence rate (HR 0.25). All patients with aneuploid tumors and dosimetry classified as “nonexcellent” (V100 <90%; D90 <144 Gy) (5 of 5) had disease recurrence, compared with 40% of patients with aneuploid tumors and “excellent” dosimetry (8 of 15). In contrast, dosimetry did not affect the outcome for diploid patients. Conclusions: Using core biopsy material from archived paraffin blocks, DNA ploidy correctly classified the majority of failures and nonfailures in this study. The results suggest that DNA ploidy can be used as a

  6. 3D-2D ultrasound feature-based registration for navigated prostate biopsy: A feasibility study

    OpenAIRE

    Selmi, Sonia,; Promayon, Emmanuel; Troccaz, Jocelyne

    2016-01-01

    International audience; The aim of this paper is to describe a 3D-2D ultrasound feature-based registration method for navigated prostate biopsy and its first results obtained on patient data. A system combining a low-cost tracking system and a 3D-2D registration algorithm was designed. The proposed 3D-2D registration method combines geometric and image-based distances. After extracting features from ultrasound images, 3D and 2D features within a defined distance are matched using an intensity...

  7. 3D-2D ultrasound feature-based registration for navigated prostate biopsy: a feasibility study.

    Science.gov (United States)

    Selmi, Sonia Y; Promayon, Emmanuel; Troccaz, Jocelyne

    2016-08-01

    The aim of this paper is to describe a 3D-2D ultrasound feature-based registration method for navigated prostate biopsy and its first results obtained on patient data. A system combining a low-cost tracking system and a 3D-2D registration algorithm was designed. The proposed 3D-2D registration method combines geometric and image-based distances. After extracting features from ultrasound images, 3D and 2D features within a defined distance are matched using an intensity-based function. The results are encouraging and show acceptable errors with simulated transforms applied on ultrasound volumes from real patients.

  8. Prostate cancer: 1.5 T endo-coil dynamic contrast-enhanced MRI and MR spectroscopy-correlation with prostate biopsy and prostatectomy histopathological data

    Energy Technology Data Exchange (ETDEWEB)

    Chabanova, Elizaveta, E-mail: elcha@heh.regionh.dk [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Balslev, Ingegerd [Department of Pathology, Copenhagen University Hospital at Herlev (Denmark); Logager, Vibeke [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark); Hansen, Alastair [Department of Pathology, Copenhagen University Hospital at Herlev (Denmark); Jakobsen, Henrik; Kromann-Andersen, Bjarne; Norgaard, Nis [Department of Urology, Copenhagen University Hospital at Herlev, (Denmark); Horn, Thomas [Department of Pathology, Copenhagen University Hospital at Herlev (Denmark); Thomsen, Henrik S. [Department of Diagnostic Radiology, Copenhagen University Hospital at Herlev (Denmark)

    2011-11-15

    Purpose: To investigate diagnostic accuracy of detection of prostate cancer by magnetic resonance: to evaluate the performance of T2WI, DCEMRI and CSI and to correlate the results with biopsy and radical prostatectomy histopathological data. Materials and methods: 43 patients, scheduled for radical prostatectomy, underwent prostate MR examination. Prostate cancer was identified by transrectal ultrasonographically (TRUS) guided sextant biopsy. MR examination was performed at 1.5T with an endorectal MR coil. Cancer localisation was performed on sextant-basis - for comparison between TRUS biopsy, MR techniques and histopathological findings on prostatectomy specimens. Results: Prostate cancer was identified in all 43 patients by combination of the three MR techniques. The detection of prostate cancer on sextant-basis showed sensitivity and specificity: 50% and 91% for TRUS, 72% and 55% for T2WI, 49% and 69% for DCEMRI, and 46% and 78% for CSI. Conclusion: T2WI, DCEMRI and CSI in combination can identify prostate cancer. Further development of MR technologies for these MR methods is necessary to improve the detection of the prostate cancer.

  9. Telomerase activity in needle biopsies from prostate cancer and benign prostates

    NARCIS (Netherlands)

    Wymenga, LFA; Wisman, GBA; Ruiters, MHJ; Mensink, HJA; Veenstra, R.

    2000-01-01

    Background Telomerase activation is thought to be essential for the immortality of cancer cells. It may be a prognostic factor in small volume well differentiated prostate cancers and hence a guide for the aggressiveness of the approach. The length of the chromosome tips (telomeres) are maintained b

  10. Randomized controlled trial of antibiotic prophylaxis regimens for transrectai ultrasound-guided prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    CHAN Eddie Shu-yin; LO Ka-lun; NG Chi-fai; HOU See-ming; YIP Sidney Kam-hung

    2012-01-01

    Background A prior study showed significant antibioti resistance to quinotone in our poputation.In this study we aimed to evaluate and compare the efficacy of a single versus a combined prophylactic antibiotic regimen before transrectal ultrasound-guided prostate biopsy(TRUGPB).Methods A prospective randomized study was conducted at a university hospital.Patients undergoing TRUGPB were randomized into an amoicillin-clavulanate alone(1mg;one dose before and two doses after biopsy)or an amoxicllin-clavulanate+ciprofloxacin group(250mg;one dose before and two doses after biopsy).Patients were surveyed for infection symptoms by phine on days 3 and 30 after TRUGPB.We defined an infective complication as the iccurrence of symptoms including fever,chills or rigor within 30 days after prostate biopsy,requiring medical treatment or hospitalization,aided by a tertiory-wide etectronic medical record system.Results Between November 2007 and July 2009,367 patients were randomized to either amoxicillin-clavulanate alone or amoxicillin-caavulanate+ciprofloxacin group.The infection rates after TRUGPB were 3.9%in the former group(7 out of 179 patoents)versus 0.53%(1 out of 188 patients)in the latter.Sixty-three percent(5/8)of patients with infective complications needed hospitalization.There was no intensive care unit admission or mortality during the study period.Conclusions Combining prophylactic antibiotics with amoxicllin-clavulanate+soprofloxacin significantly reduced the in cidence of infective complications after TRUGPB.We recommended a combination regimen,especially in centre with high incidence of post-TRUGPB infection.

  11. Early experience with multiparametric magnetic resonance imaging-targeted biopsies under visual transrectal ultrasound guidance in patients suspicious for prostate cancer undergoing repeated biopsy

    DEFF Research Database (Denmark)

    Boesen, Lars; Noergaard, Nis; Chabanova, Elizaveta;

    2015-01-01

    in all 39 patients. Both PI-RADS and Likert scoring showed a high correlation between suspicion of malignancy and biopsy results (p Gleason score....... MATERIAL AND METHODS: Eighty-three patients with prior negative TRUS-bx scheduled for repeated biopsies due to persistent suspicion of PCa were prospectively enrolled. mp-MRI was performed before biopsy and all lesions were scored according to the Prostate Imaging Reporting and Data System (PI...... upgrade of at least one grade based on the mp-MRI-bx. Secondary PCa lesions not visible on mp-MRI were detected by TRUS-bx in six out of 39 PCa patients. The secondary foci were all Gleason 6 (3 + 3) in 5-10% of the biopsy core. According to the Epstein criteria, 37 out of 39 cancer patients were...

  12. The Accuracy of Prostate Cancer Localization Diagnosed on Transrectal Ultrasound-Guided Biopsy Compared to 3-Dimensional Transperineal Approach

    Directory of Open Access Journals (Sweden)

    Kevin Krughoff

    2013-01-01

    Full Text Available Background. Prostate cancer is often understaged following 12-core transrectal ultrasound- (TRUS- guided biopsies. Our goal is to understand where cancers are typically missed by this method. Methods. Transperineal 3-dimensional mapping biopsy (3DMB provides a more accurate depiction of disease status than transrectal ultrasound- (TRUS- guided biopsy. We compared 3DMB findings in men with prior TRUS-guided biopsies to determine grade and location of missed cancer. Results were evaluated for 161 men with low-risk organ confined prostate cancer. Results. The number of cancer-positive biopsy zones per patient with TRUS was 1.38 ± 1.21 compared to 3.33 ± 4.06 with 3DMB, with most newly discovered cancers originating from the middle lobe and apex. Approximately half of all newly discovered cancerous zones resulted from anterior 3DMB sampling. Gleason upgrade was recognized in 56 patients using 3DMB. When both biopsy methods found positive cores in a given zone, Gleason upgrades occurred most frequently in the middle left and right zones. TRUS cancer-positive zones not confirmed by 3DMB were most often the basal zones. Conclusion. Most cancer upgrades and cancers missed from TRUS biopsy originated in the middle left zone of the prostate, specifically in anterior regions. Anterior sampling may lead to more accurate diagnosis and appropriate followup.

  13. Predicting Prostate Biopsy Results Using a Panel of Plasma and Urine Biomarkers Combined in a Scoring System

    DEFF Research Database (Denmark)

    Albitar, Maher; Ma, Wanlong; Lund, Lars;

    2016-01-01

    a scoring system to predict prostate biopsy results and the presence of high grade PCa. METHODS: Urine and plasma specimens were collected from 319 patients recommended for prostate biopsies. We measured the gene expression levels of UAP1, PDLIM5, IMPDH2, HSPD1, PCA3, PSA, TMPRSS2, ERG, GAPDH, B2M, AR......, and PTEN in plasma and urine. Patient age, serum prostate-specific antigen (sPSA) level, and biomarkers data were used to develop two independent algorithms, one for predicting the presence of PCa and the other for predicting high-grade PCa (Gleason score [GS] ≥7). RESULTS: Using training and validation...... data sets, a model for predicting the outcome of PCa biopsy was developed with an area under receiver operating characteristic curve (AUROC) of 0.87. The positive and negative predictive values (PPV and NPV) were 87% and 63%, respectively. We then developed a second algorithm to identify patients...

  14. Percentage of Cancer Volume in Biopsy Cores Is Prognostic for Prostate Cancer Death and Overall Survival in Patients Treated With Dose-Escalated External Beam Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Vance, Sean M.; Stenmark, Matthew H.; Blas, Kevin; Halverson, Schulyer [Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Hamstra, Daniel A., E-mail: dhamm@umich.edu [Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Feng, Felix Y. [Department of Radiation Oncology, University of Michigan Medical Center, Ann Arbor, Michigan (United States); Department of Radiation Oncology, Veterans Affairs Medical Center, Ann Arbor, Michigan (United States)

    2012-07-01

    Purpose: To investigate the prognostic utility of the percentage of cancer volume (PCV) in needle biopsy specimens for prostate cancer patients treated with dose-escalated external beam radiotherapy. Methods and Materials: The outcomes were analyzed for 599 men treated for localized prostate cancer with external beam radiotherapy to a minimal planning target volume dose of 75 Gy (range, 75-79.2). We assessed the effect of PCV and the pretreatment and treatment-related factors on the freedom from biochemical failure, freedom from metastasis, cause-specific survival, and overall survival. Results: The median number of biopsy cores was 7 (interquartile range, 6-12), median PCV was 10% (interquartile range, 2.5-25%), and median follow-up was 62 months. The PCV correlated with the National Comprehensive Cancer Network risk group and individual risk features, including T stage, prostate-specific antigen level, Gleason score, and percentage of positive biopsy cores. On log-rank analysis, the PCV stratified by quartile was prognostic for all endpoints, including overall survival. In addition, the PCV was a stronger prognostic factor than the percentage of positive biopsy cores when the two metrics were analyzed together. On multivariate analysis, the PCV predicted a worse outcome for all endpoints, including freedom from biochemical failure, (hazard ratio, 1.9; p = .0035), freedom from metastasis (hazard ratio, 1.7, p = .09), cause-specific survival (hazard ratio, 3.9, p = .014), and overall survival (hazard ratio, 1.8, p = .02). Conclusions: For patients treated with dose-escalated external beam radiotherapy, the volume of cancer in the biopsy specimen adds prognostic value for clinically relevant endpoints, particularly in intermediate- and high-risk patients. Although the PCV determination is more arduous than the percentage of positive biopsy cores, it provides superior risk stratification.

  15. 3D versus 2D Systematic Transrectal Ultrasound-Guided Prostate Biopsy: Higher Cancer Detection Rate in Clinical Practice

    Directory of Open Access Journals (Sweden)

    Alexandre Peltier

    2013-01-01

    Full Text Available Objectives. To compare prostate cancer detection rates of extended 2D versus 3D biopsies and to further assess the clinical impact of this method in day-to-day practice. Methods. We analyzed the data of a cohort of 220 consecutive patients with no prior history of prostate cancer who underwent an initial prostate biopsy in daily practice due to an abnormal PSA and/or DRE using, respectively, the classical 2D and the new 3D systems. All the biopsies were done by a single experienced operator using the same standardized protocol. Results. There was no significant difference in terms of age, total PSA, or prostate volume between the two groups. However, cancer detection rate was significantly higher using the 3D versus the 2D system, 50% versus 34% (P<0.05. There was no statistically significant difference while comparing the 2 groups in term of nonsignificant cancer detection. Conclusion. There is reasonable evidence demonstrating the superiority of the 3D-guided biopsies in detecting prostate cancers that would have been missed using the 2D extended protocol.

  16. Can perineural invasion detected in prostate needle biopsy specimens predict surgical margin positivity in D’Amico low risk patients?

    Directory of Open Access Journals (Sweden)

    Ozgur Haki Yuksel

    2016-07-01

    Full Text Available Objectives: In this study, our aim was to estimate the value of perineural invasion (PNI in prostate needle biopsy (PNB specimens in the prediction of surgical margin positivity (SMP and its prognostic significance (upgrade Gleason Score in patients who had undergone radical retropubic prostatectomy (RRP with low risk prostate cancer according to D’Amico risk assessment. Materials and Methods: We retrospectively analyzed the data of 65 patients who were diagnosed as clinical stage T1c prostate cancer (PC and underwent RRP between January 2010 and June 2013. Pathological specimens of PNB and RRP were separately examined for the parameters of PNI, vascular invasion (VI, Gleason Score (GS and SMP. Results: The patients’ mean age was 63.65 ± 4.93 (range 47- 75 years. PNI in PNB specimens were identified in 12 of 65 patients and 11 of 12 patients showed SMP on RRP specimens. While 53 of 65 patients had not PNI on PNB, only 11 of them demonstrated SMP on RRP specimens. SMP was 30.64-fold more frequently encountered in PNB specimens obtained from PNI-positive patients relative to PNI-negative patients. In our study, PNI detected in PNB specimens was statistically significantly associated with SMP on RRP specimens (P = 0.0001. Conclusion: It is well known that higher PSA values and GS were independent predictors of SMP in clinically localized prostate cancer (CLPC. We think that PNI in PNB specimens may be a useful prognostic factor for predicting SMP in cases with CLPC.

  17. CLINICAL STAGING OF CANCER OF THE PROSTATE DURING ITS PRIMARY BIOPSY

    Directory of Open Access Journals (Sweden)

    S. B. Petrov

    2010-01-01

    Full Text Available Clinical staging of cancer is the important element of a diagnostic process that determines the nature and scope of therapeutic measures required for a patient. Objective: to assess the role of clinical, clinical laboratory, and morphological findings in the diagnosis of prostate cancer (PC and to analyze the pattern of its clinical stages in patients having different levels of serum prostate-specific antigen (PSA and the results of digital rectal examination (DRE and ultrasound study (USS of the gland. Subjects and methods. The examination and follow-up records were analyzed in 2579 males aged 38-88 years who had indications for primary puncture biopsy of the prostate. Results. PC was detected in 997 (38.66% patients. Clinically localized adenocarcinoma was diagnosed in 50.85% of cases, locally advanced one being in 49.15%, including that with its invasion into the seminal vesicles in 8.73%. The findings of DRE and transrectal USS and serum PSA values allow one to substantially define the likely extent of cancer.

  18. Preoperative determination of prostate cancer tumor volume: analysis through biopsy fragments

    Directory of Open Access Journals (Sweden)

    Alberto A. Antunes

    2007-08-01

    Full Text Available OBJECTIVE: Preoperative determination of prostate cancer (PCa tumor volume (TV is still a big challenge. We have assessed variables obtained in prostatic biopsy aiming at determining which is the best method to predict the TV in radical prostatectomy (RP specimens. MATERIALS AND METHODS: Biopsy findings of 162 men with PCa submitted to radical prostatectomy were revised. Preoperative characteristics, such as PSA, the percentage of positive fragments (PPF, the total percentage of cancer in the biopsy (TPC, the maximum percentage of cancer in a fragment (MPC, the presence of perineural invasion (PNI and the Gleason score were correlated with postoperative surgical findings through an univariate analysis of a linear regression model. RESULTS: The TV correlated significantly to the PPF, TPC, MPC, PSA and to the presence of PNI (p < 0.001. However, the Pearson correlation analysis test showed an R2 of only 24%, 12%, 17% and 9% for the PPF, TPC, MPC, and PSA respectively. The combination of the PPF with the PSA and the PNI analysis showed to be a better model to predict the TV (R2 of 32.3%. The TV could be determined through the formula: Volume = 1.108 + 0.203 x PSA + 0.066 x PPF + 2.193 x PNI. CONCLUSIONS: The PPF seems to be better than the TPC and the MPC to predict the TV in the surgical specimen. Due to the weak correlation between those variables and the TV, the PSA and the presence of PNI should be used together.

  19. Prospective study of antibiotic prophylaxis for prostate biopsy involving >1100 men.

    LENUS (Irish Health Repository)

    Manecksha, Rustom P

    2012-01-01

    We aimed to compare infection rates for two 3-day antibiotic prophylaxis regimens for transrectal ultrasound-guided prostate biopsy (TRUSgbp) and demonstrate local microbiological trends. In 2008, 558 men and, in 2009, 625 men had TRUSgpb. Regimen 1 (2008) comprised 400 mg Ofloxacin immediately before biopsy and 200 mg 12-hourly for 3 days. Regimen 2 (2009) comprised Ofloxacin 200 mg 12-hourly for 3 days commencing 24 hours before biopsy. 20\\/558 (3.6%) men had febrile episodes with regimen 1 and 10\\/625 (1.6%) men with regimen 2 (P = 0.03). E. coli was the most frequently isolated organism. Overall, 7\\/13 (54%) of positive urine cultures were quinolone resistant and (5\\/13) 40% were multidrug resistant. Overall, 5\\/9 (56%) patients with septicaemia were quinolone resistant. All patients were sensitive to Meropenem. There was 1 (0.2%) death with regimen 1. Commencing Ofloxacin 24 hours before TRUSgpb reduced the incidence of febrile episodes significantly. We observed the emergence of quinolone and multidrug-resistant E. coli. Meropenem should be considered for unresolving sepsis.

  20. Prediction of pathological and oncological outcomes based on extended prostate biopsy results in patients with prostate cancer receiving radical prostatectomy: a single institution study

    Directory of Open Access Journals (Sweden)

    Ishizaki Fumio

    2012-06-01

    Full Text Available Abstract Background The prediction of pathological outcomes prior to surgery remains a challenging problem for the appropriate surgical indication of prostate cancer. This study was performed to identify preoperative values predictive of pathological and oncological outcomes based on standardized extended prostate biopsies with core histological results diagrammed/mapped in patients receiving radical prostatectomy for prostate cancer clinically diagnosed as localized or locally advanced disease. Methods In 124 patients with clinically localized or locally advanced prostate cancer (cT1c–cT3a without prior treatment, pathological outcomes on the surgical specimen including seminal vesicle involvement (SVI, positive surgical margin (PSM, and perineural invasion (PNI were studied in comparison with clinical parameters based on the results of 14-core prostate biopsies comprising sextant, laterally-directed sextant, and bilateral transition zone (TZ sampling. Results Concerning the association of pathological outcomes with oncological outcomes, patients with PSM and PNI on surgical specimens had poorer biochemical-progression-free survival than those without PSM (logrank p = 0.002 and PNI (p = 0.003; it was also poorer concerning SVI, although the difference was not significant (p = 0.120. Concerning the impact of clinical parameters on these pathological outcomes, positive TZ and multiple positive biopsy cores in the prostatic middle were independent values predictive of SVI with multivariate analyses (p = 0.020 and p = 0.025, respectively; both positive TZ and multiple positive prostatic middle biopsies were associated with larger tumor volume (p  Conclusions %positive cores and Gleason score in extended biopsies were independent values predictive of PSM and PNI in prostate cancer clinically diagnosed as localized or locally advanced disease, respectively, which were associated with poorer oncological outcomes. When

  1. Optimized high-throughput microRNA expression profiling provides novel biomarker assessment of clinical prostate and breast cancer biopsies

    Directory of Open Access Journals (Sweden)

    Fedele Vita

    2006-06-01

    Full Text Available Abstract Background Recent studies indicate that microRNAs (miRNAs are mechanistically involved in the development of various human malignancies, suggesting that they represent a promising new class of cancer biomarkers. However, previously reported methods for measuring miRNA expression consume large amounts of tissue, prohibiting high-throughput miRNA profiling from typically small clinical samples such as excision or core needle biopsies of breast or prostate cancer. Here we describe a novel combination of linear amplification and labeling of miRNA for highly sensitive expression microarray profiling requiring only picogram quantities of purified microRNA. Results Comparison of microarray and qRT-PCR measured miRNA levels from two different prostate cancer cell lines showed concordance between the two platforms (Pearson correlation R2 = 0.81; and extension of the amplification, labeling and microarray platform was successfully demonstrated using clinical core and excision biopsy samples from breast and prostate cancer patients. Unsupervised clustering analysis of the prostate biopsy microarrays separated advanced and metastatic prostate cancers from pooled normal prostatic samples and from a non-malignant precursor lesion. Unsupervised clustering of the breast cancer microarrays significantly distinguished ErbB2-positive/ER-negative, ErbB2-positive/ER-positive, and ErbB2-negative/ER-positive breast cancer phenotypes (Fisher exact test, p = 0.03; as well, supervised analysis of these microarray profiles identified distinct miRNA subsets distinguishing ErbB2-positive from ErbB2-negative and ER-positive from ER-negative breast cancers, independent of other clinically important parameters (patient age; tumor size, node status and proliferation index. Conclusion In sum, these findings demonstrate that optimized high-throughput microRNA expression profiling offers novel biomarker identification from typically small clinical samples such as breast

  2. MR-guided transgluteal biopsies with an open low-field system in patients with clinically suspected prostate cancer: technique and preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Zangos, Stephan [Johann Wolfgang Goethe-University, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt/Main (Germany); Johann Wolfgang Goethe-University, Institute for Diagnostic and Interventional Radiology, Frankfurt/Main (Germany); Eichler, Katrin; Engelmann, Kerstin; Ahmed, Mukhtiar; Dettmer, Sebastian; Herzog, Christopher; Pegios, Wasilios; Wetter, A.; Lehnert, Thomas; Mack, Martin G.; Vogl, Thomas J. [Johann Wolfgang Goethe-University, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt/Main (Germany)

    2005-01-01

    The purpose of this study was to examine the feasibility and safety of MR-guided biopsies with a transgluteal approach in patients with uncertain or suspicious prostate lesions. Twenty-five patients with uncertain or suspicious focal prostate lesions detected by high-field MR imaging of the prostate gland using endorectal coil imaging were biopsied with a transgluteal approach in a low-field MRI system (0.2 T, Concerto, Siemens). The procedures were guided using T1-weighted FLASH sequences. The prostate gland was biopsied repeatedly with a coaxial technique through a 15-gauge pencil tip with a 16-gauge biopsy handy (median 3.8 samples per patient). Complications and biopsy findings were documented retrospectively. Using T1-weighted sequences biopsy procedures were performed successfully with MR guidance in all cases without any side effects or complications. The median intervention time was 11.3 min. Pathological findings revealed ten cases of hyperplasia or atrophy, three cases of prostatitis, ten cases of carcinoma and two cases of normal tissue. The clinical follow-up showed that in two patients prostate cancer was missed at MR-guided biopsy. Transgluteal MR-guided biopsy of the prostate gland is a safe and promising approach for histological clarification of uncertain or suspicious lesions. (orig.)

  3. The accuracy and safety aspects of a novel robotic needle guide manipulator to perform transrectal prostate biopsies.

    NARCIS (Netherlands)

    Schouten, M.G.; Ansems, J.; Renema, W.K.J.; Bosboom, D.G.H.; Scheenen, T.W.J.; Futterer, J.J.

    2010-01-01

    PURPOSE: To introduce a new in-house developed pneumatically controlled magnetic field compatible manipulator as an aid to perform magnetic resonance (MR)-guided biopsies of the prostate. METHODS: A pneumatic controlled manipulator with five degrees of freedom constructed of plastic to achieve magne

  4. Can a Gleason 6 or Less Microfocus of Prostate Cancer in One Biopsy and Prostate-Specific Antigen Level Archetype of Low-Risk Prostate Disease?

    Science.gov (United States)

    Taverna, Gianluigi; Benecchi, Luigi; Grizzi, Fabio; Seveso, Mauro; Giusti, Guido; Piccinelli, Alessandro; Benetti, Alessio; Colombo, Piergiuseppe; Minuti, Francesco; Graziotti, Pierpaolo

    2012-01-01

    Prostate cancer (PC) remains a cause of death worldwide. Here we investigate whether a single microfocus of PC at the biopsy (graded as Gleason 6 or less, ≤5% occupancy) and the PSA archetype of low-risk prostate disease. 4500 consecutive patients were enrolled. Among them, 134 patients with a single micro-focus of PC were followed up, and the parameters influencing the biochemical relapse (BR) were analysed. Out of 134 patients, 94 had clinically significant disease, specifically in 74.26% of the patients with PSA <10 ng/mL. Positive surgical margins and the extracapsular invasion were found in 29.1% and 51.4% patients, respectively. BR was observed in 29.6% of the patients. Cox regression evidenced a correlation between the BR and Gleason grade at the retropubic radical prostatectomy (RRP), capsular invasion, and the presence of positive surgical margins. Multivariate regression analysis showed a statistically significant correlation between the presence of surgical margins at the RRP and BR. Considering a single micro-focus of PC at the biopsy and PSA serum level <10 ng/mL, clinically significant disease was found in 74.26% patients and only positive surgical margins are useful for predicting the BR.

  5. Association between Seminal Vesicle Invasion and Prostate Cancer Detection Location after Transrectal Systemic Biopsy among Men Who Underwent Radical Prostatectomy.

    Directory of Open Access Journals (Sweden)

    Young Ik Lee

    Full Text Available Our hypothesis is that the location of the seminal vesicles near the base of the prostate, the more positive cores are detected in the base, the greater the risk of seminal vesicle invasion. Therefore we investigate the clinical outcomes of base dominant prostate cancer (BDPC in transrectal ultrasound (TRUS -guided biopsies compared with anteromiddle dominant prostate cancer (AMPC.From November 2003 to June 2014, a total of 990 intermediate and high risk prostate cancer (PCa patients who underwent radical prostatectomy (RP were enrolled and stratified into two groups according to proportion of positive cores-BDPC group had ≥ 33.3% ratio of positive cores from the prostate base among all positive cores and AMPC group < 33.3% in systemic biopsy. Between two groups, we compared the rate of pathologic outcomes and biochemical recurrence (BCR. We performed multivariate logistic regression model to confirm the significance of BDPC to seminal vesicle invasion (SVI and Cox proportional hazard analysis to BCR.Among these 990 PCa patients, the 487 patients in BDPC group had more advanced clinical stage (p<0.001, a higher biopsy GS (p = 0.002, and a higher rate of extracapsular extension (ECE, SVI and BCR (all p<0.001 than AMPC group. The patients in BDPC group had poor BCR free survival rate via Kaplan-meier analysis (p<0.001. The ratio of the base positive cores was a significant predictor to SVI in multivariate analysis (p < 0.001 and significant predictor of BCR in multivariate Cox proportional analysis (hazard ratio: 1.466, p = 0.004.BDPC in TRUS-guided prostate biopsies was significantly associated with SVI and BCR after adjusting for other clinical factors. Therefore, BDPC should be considered to be a more aggressive tumor despite an otherwise similar cancer profile.

  6. Ultrasound guided transrectal prostate biopsy:11-year experience%B超引导下经直肠前列腺穿刺临床分析

    Institute of Scientific and Technical Information of China (English)

    朱刚; 芦志华; 马宏; 闫伟; 万奔; 王建业

    2009-01-01

    Objective To summarize the experience in ultrasound guided transrectal prostate biopsy and analyze the influeneing factors of the biopsy results.Methods 687 patients with prostate specific antigen(PSA)>4μg,tubemles in prostate detected by digital rectal examination and/or prostate abnormality detected by magnetic resonance imaging,aged(70±8),underwent ultrasound guided transrectal 6-12 core prostate biopsy 1996-2007.Since 2006 the criteria for biopsy ineluded PSA of 4-10μg/ml,free PSA/total PSA ratio(F/T ratio)≤0.16,and PSA density>0.15.Results 269 of the 687 cases.witll the mean age of(72±8),were diagnosed as wlth pmstate cancer.294 and 121 of the 687patients(42.8%and 17.6%respectively)accepted prostate biopsy beeanse of elevated PSA or abnormality of DRE.The number of patients accepting prostate biopsy increased yearly(10 cases in 1996 to 98 cases in 2007).The positive biopsy rate was 39.8%.with the highest rate of 60.0%in 1999 and lowest rate of 30.4%in 2005.The highest number of prostate cancer diagnosed was the highest(42 cases)in 2007 and the lowest(4 cases)in 1996.PSA level was positively co-related with positive biopsy rate.The application of F/T ratio improved the positive biopsy rate in the patient with the PSA of 4-10μg/ml.The incidence rates of the main complications hematuria,bloody stool,and fever were 46.3%,8.7%,and 1.9%respectively.Conclusion Elevated PSA has become the most common resson for prostate biopsy.The combination with PSA.F/T ratio.and increased biopsy core number improve the positive biopsy rate.The ultrasound guided transrectal prostate biopsy is efficient and safe in the diagnosis of prostate cancer.%目的 总结B超引导下经直肠前列腺穿刺的经验并分析影响前列腺穿刺结果的因素.方法 统计卫生部北京医院1996-2007年行B超引导下经直肠前列腺穿刺病例.患者入选条件为前列腺特异抗原(PSA)>4μg/L,和(或)直肠指检发现前列腺结节,和(或)B超或磁共振成像(MRI)检

  7. Fluid biopsy in patients with metastatic prostate, pancreatic and breast cancers

    Science.gov (United States)

    Marrinucci, Dena; Bethel, Kelly; Kolatkar, Anand; Luttgen, Madelyn S.; Malchiodi, Michael; Baehring, Franziska; Voigt, Katharina; Lazar, Daniel; Nieva, Jorge; Bazhenova, Lyudmila; Ko, Andrew H.; Korn, W. Michael; Schram, Ethan; Coward, Michael; Yang, Xing; Metzner, Thomas; Lamy, Rachelle; Honnatti, Meghana; Yoshioka, Craig; Kunken, Joshua; Petrova, Yelena; Sok, Devin; Nelson, David; Kuhn, Peter

    2012-02-01

    Hematologic spread of carcinoma results in incurable metastasis; yet, the basic characteristics and travel mechanisms of cancer cells in the bloodstream are unknown. We have established a fluid phase biopsy approach that identifies circulating tumor cells (CTCs) without using surface protein-based enrichment and presents them in sufficiently high definition (HD) to satisfy diagnostic pathology image quality requirements. This 'HD-CTC' assay finds >5 HD-CTCs mL-1 of blood in 80% of patients with metastatic prostate cancer (n = 20), in 70% of patients with metastatic breast cancer (n = 30), in 50% of patients with metastatic pancreatic cancer (n = 18), and in 0% of normal controls (n = 15). Additionally, it finds HD-CTC clusters ranging from 2 HD-CTCs to greater than 30 HD-CTCs in the majority of these cancer patients. This initial validation of an enrichment-free assay demonstrates our ability to identify significant numbers of HD-CTCs in a majority of patients with prostate, breast and pancreatic cancers.

  8. Intravascular Large B-Cell Lymphoma Diagnosed on Prostate Biopsy: A Case Report

    Directory of Open Access Journals (Sweden)

    Nazan Özsan

    2014-12-01

    Full Text Available Intravascular large B-cell lymphoma (IVLBCL is a very rare type of non-Hodgkin lymphoma, usually affecting elderly patients and characterized by selective infiltration of neoplastic cells within blood vessels’ lumina. IVLBCL diagnosed with prostatic involvement is extremely rare. We report a patient of 65 years old, having mostly neurological complaints but diagnosed with IVLBCL upon histopathological examination of transurethral prostate resection material, which revealed large neoplastic cell infiltration totally limited within the lumens of small vessels. By immunohistochemistry, neoplastic cell infiltration was positive with MUM1, bcl-6, and bcl-2 and negative with ALK1, CD10, and CD30, with a high Ki-67 proliferation index. CD34 and CD31 staining showed expression in endothelial cells, highlighting the intravascular nature of neoplastic infiltrate. The patient unfortunately refused to receive treatment and died of the disease 8 months after the diagnosis. IVLBCL, though very rare, should be considered in differential diagnosis of all organ biopsies with intravascular infiltration. Further improvements in the understanding of the pathogenesis and biology of this rare type of lymphoma are mandatory.

  9. 经直肠超声引导下的前列腺活检术后感染相关并发症的研究进展%Research Progress in Postoperative Infection Related Complications after Prostate Biopsy Guided by Transrectal Ultrasound

    Institute of Scientific and Technical Information of China (English)

    王娟霞(综述); 王志平(审校)

    2016-01-01

    With the improvement of living standards,the extension of human life,and the growth of age-ing population,the incidence of prostate cancer is an uptrend .However,there is no obvious symptom of early prostate cancer, most patients miss the best treatment timinge when diagnosed at middle-late stage,so early diagnosis of prostate cancer is critical.Prostate biopsy is the gold standard in the diagnosis of prostate cancer. Here is to make a review of the epidemiology,risk factors,prevention and treatment of the infection caused by prostate biopsy guided by transrectal ultrasound.%随着生活水平的提高、人类寿命的延长,人口老龄化增长,前列腺癌的发病率呈上升趋势。但由于前列腺癌早期无明显症状,大部分患者就诊时已属于中晚期,往往失去了最佳的治疗时机,因此早期诊断前列腺癌十分关键。前列腺穿刺活检术是诊断前列腺癌的金标准,该文对经直肠超声引导下的前列腺活检术后引发的感染相关并发症的流行病学,危险因素,预防及治疗进行综述。

  10. Comparison between needle biopsy and radical prostatectomy samples in assessing Gleason score and modified Gleason score in prostatic adenocarcinomas

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    Banu DOĞAN GÜN

    2007-01-01

    Full Text Available Histologic grading is an important predictor of prostatic disease stage and prognosis. We aimed to assess the degree of concordance between pathologic characteristics of the specimens obtained from biopsy and radical prostatectomy materials.Gleason scores and modified Gleason scores calculated for 25 cases of prostatic adenocarcinoma from both needle biopsy and radical prostatectomy specimens were analyzed.Mean Gleason scores for biopsy and radical specimens were 6.4 (SD:±0.7 and 6.64 (SD:±1.3; and corresponding modified Gleason scores were 7.32 (SD:±1.43 and 7.32 (SD:±0.98, respectively. The Gleason scores of biopsy and radical prostatectomy specimens were identical in 48% (12/25 of the cases, while 32% (8/25 of the biopsy specimens were over-and 20% (5/25 of them were undergraded. While assessing modified Gleason scores, the exact degree of concordance of biopsy specimens with radical prostatectomy materials was 56% (14/25 and of the 11 (44% cases not correlated exactly, 6 (24% were over- and 5 (20% were undergraded. When the exact, over- and underestimated scores of Gleason and modified Gleason grading systems were compared statistically, no difference between two groups was seen (p>0.05. Overgrading errors were found to be more than undergrading errors for both of the scoring systems. Using either the modified Gleason or traditional Gleason scoring

  11. 重复穿刺活检中高级别上皮内瘤对前列腺癌的预测价值%Prediction value of high-grade prostatic intraepithelial neoplasia for prostate cancer on repeat biopsies

    Institute of Scientific and Technical Information of China (English)

    Huilian Hou; Xuebin Zhang; Xu Li; Xingfa Chen; Chunbao Wang; Guanjun Zhang; Honghan Wang; Huilin Gong; Yuan Deng; Min Wang

    2011-01-01

    Objective: The significance of isolated high-grade prostatic intraepithelial neoplasia in initial biopsy as an predictor for prostate cancer has been extensively research, and the true relationship remnant is no clear till now. The aim of this study is to evaluate prediction value of cancer on repeat biopsy in patients with high-grade prostatic intraepithelial neoplasia,using multivariate analysis. Methods: Thirty-eight men with a diagnosis of isolated high-grade prostatic intraepithelial neoplasia in initial needle biopsy were studies, in the Fist Affiliated Hospital of Medical School of Xi'an Jiaotong University, from January 2003 to March 2009. These samples were using immunostaining of p63 and 34βE12 and P504s, with a median follow-up of 525 (range, 7 to 1650) days, and to researched the incidence of subsequent prostate cancer, and to predicted the risk of prostate cancer in clinicopathological parameters of isolated high-grade prostatic intraepithelial neoplasia on repeat biopsies by logistic regression analysis. Results: There were 10 of 38 (26.3%) men with prostate cancer on repeat biopsies after diagnosis isolated high-grade prostatic intraepithelial neoplasia in initial biopsy, of the rates of prostate cancer were 80% for micropapillary and 75% for cribriform high-grade prostatic intraepithelial neoplasia (P < 0.05), respectively. The positive cores of isolated high-grade prostatic intraepithelial neoplasia was the important for the risk of prostate cancer using Multifactor logistic regression analysis. The time range in 30 to 690 days was stronger risk for prostate cancer detection after diagnosis isolated HGPIN in initial biopsy. p63 and 34βE12 were disrupted positive expression, and P504S was weak positive expression in the 61% isolated high-grade prostatic intraepithelial neoplasia. Conclusion: Isolated high-grade prostatic intraepithelial neoplasia on repeat biopsy conferred a 26.3% risk of prostate cancer, and this risk level is lower than the

  12. Comparative Effectiveness of Single versus Combination Antibiotic Prophylaxis for Infections after Transrectal Prostate Biopsy.

    Science.gov (United States)

    Marino, Kaylee; Parlee, Anne; Orlando, Ralph; Lerner, Lori; Strymish, Judith; Gupta, Kalpana

    2015-12-01

    An increase in fluoroquinolone resistance and transrectal ultrasound-guided prostate (TRUS) biopsy infections has prompted the need for alternative effective antibiotic prophylaxis. We aimed to compare ciprofloxacin and other single-agent therapies to combination therapy for efficacy and adverse effects. Men who underwent a TRUS biopsy within the VA Boston health care system with documented receipt of prophylactic antibiotics periprocedure were eligible for inclusion. Postprocedure infections within 30 days were ascertained by chart review from electronic records, including any inpatient, outpatient, or urgent-care visits. Among 455 evaluable men over a 3-year period, there were 25 infections (5.49%), with sepsis occurring in 2.4%, urinary tract infections (UTI) in 1.54%, and bacteremia in 0.44% of patients. Escherichia coli was the most common urine (89%) and blood (92%) pathogen, with fluoroquinolone resistance rates of 88% and 91%, respectively. Ciprofloxacin alone was associated with significantly more infections than ciprofloxacin plus an additional agent (P = 0.014). Intramuscular gentamicin alone was also significantly associated with a higher infection rate obtained with all other regimens (P = 0.004). Any single-agent regimen, including ciprofloxacin, ceftriaxone, or gentamicin, was associated with significantly higher infection rates than any combination regimen (odds ratio [OR], 4; 95% confidence interval [CI], 1.47, 10.85; P = 0.004). Diabetes, immunosuppressive condition or medication, hospitalization within the previous year, and UTI within the previous 6 months were not associated with infection risk. Clostridium difficile infections were similar. These findings suggest that ciprofloxacin, ceftriaxone, and gentamicin alone are inferior to a combination regimen. Institutions with high failure rates of prophylaxis for TRUS biopsies should consider combination regimens derived from their local data.

  13. Prostate needle biopsies: interobserver variation and clinical consequences of histopathological re-evaluation

    DEFF Research Database (Denmark)

    Berg, Kasper Drimer; Toft, Birgitte Grønkaer; Røder, Martin Andreas;

    2011-01-01

    pathology reports and with histopathology of the radical prostatectomy specimen. The consequences of re-evaluation for clinical workup and treatment of patients according to local algorithms were determined. For Gleason score (GS), complete agreement between primary report and re-evaluation was found in 76......-evaluations in 19.7% and 13.1% of patients, respectively. Gleason scoring based on the radical prostatectomy specimen was higher than in both primary reports and re-evaluation of biopsies. Although a relatively high degree of concordance was found between biopsy assessments, the significant trend towards higher...... Gleason scoring at re-evaluation, leading to frequent changes in clinical assessments and surgical strategy, justifies re-evaluation of PCa biopsies in patients with primary GS ≤ 6....

  14. Prostate needle biopsies: interobserver variation and clinical consequences of histopathological re-evaluation

    DEFF Research Database (Denmark)

    Berg, Kasper Drimer; Toft, Birgitte Grønkaer; Brasso, Klaus;

    2011-01-01

    pathology reports and with histopathology of the radical prostatectomy specimen. The consequences of re-evaluation for clinical workup and treatment of patients according to local algorithms were determined. For Gleason score (GS), complete agreement between primary report and re-evaluation was found in 76......-evaluations in 19.7% and 13.1% of patients, respectively. Gleason scoring based on the radical prostatectomy specimen was higher than in both primary reports and re-evaluation of biopsies. Although a relatively high degree of concordance was found between biopsy assessments, the significant trend towards higher...... Gleason scoring at re-evaluation, leading to frequent changes in clinical assessments and surgical strategy, justifies re-evaluation of PCa biopsies in patients with primary GS = 6....

  15. Patient information leaflets for Transrectal Ultrasound guided prostate biopsy: Results of North Thames deanery survey

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    Phipps Claire

    2010-01-01

    Full Text Available Abstract Background We evaluated the quality of patient information leaflets for Trans-Rectal Ultrasound guided prostate biopsies (TRUS-Bx in North Thames region. TRUS-Bx information leaflets were requested from 24 hospitals in the region. All hospitals were contacted by telephone, and non-responders were followed-up by postal survey. Leaflets received were evaluated for a clear description of the procedure, directions to TRUS-Bx location, a clear description of the procedure, contact for queries/concerns, information about preparation prior to procedure, information about regular medication, information on how to obtain results, instructions for follow-up arrangements, analgesia used and risk of morbidity/mortality. Additionally, the leaflets were evaluated for diagrams to clarify the procedure and the anatomy, and sources of additional information, such as reference to published articles or prostate cancer patient support groups/internet websites. Findings In summary, a total of 17 leaflets (77% were received. Of these, the majority (94% had a clear description of the procedure, contact for queries/concerns (82%, information about preparation prior to TRUS-Bx (71%. Directions to TRUS-Bx location (29%, and analgesia used (35%, was very poorly described, and information on obtaining results and follow-up arrangements were described in only 12 (71% leaflets. Complications such as risks of infection, haematuria, haematospermia and rectal bleeding, were generally explained (71%-76% of leaflets, urinary retention was mentioned in only 5 (29% leaflets and mortality in only 1 case. Descriptive diagrams of the procedure and prostate anatomy were very rarely used, and sources of additional information were limited to 1 published article and reference to 1 prostate cancer support group. Conclusions This study demonstrates that there is large variation in the information supplied in TRUS-Bx patient information leaflets in the North Thames region, with

  16. Extending the validity of the Memorial Anxiety Scale for Prostate Cancer (MAX-PC) at the time of prostate biopsy in a racially-mixed population.

    Science.gov (United States)

    Dale, William; Hemmerich, Joshua; Meltzer, David

    2007-05-01

    The Memorial Anxiety Scale for Prostate Cancer (MAX-PC) has been validated for assessing men with prostate cancer for cancer-specific anxiety. It was originally validated in a predominantly white population. The MAX-PC Prostate Cancer Anxiety Subscale (MAX-PC-PCAS) may be relevant for measuring cancer-specific anxiety in undiagnosed men at risk for prostate cancer. We assess the validity of the MAX-PC-PCAS at the time of prostate biopsy (n = 178). Questions assessed socio-demographic information, health status, patient-estimated risk of cancer, the Hospital Anxiety and Depression Scale--Anxiety Subscale (HADS-A), and the MAX-PC-PCAS. The patients' most recent PSA was recorded. Cronbach's alpha, inter-item correlations, and Pearson correlations with both the HADS-A and clinical variables were compared with the original validation sample. Our sample was younger (63.1 vs 71.1 years), had a larger fraction of African-Americans (43 vs 10%), and had higher PSAs. Cronbach's alpha was equivalent (0.91 vs 0.90), median inter-item correlation was equivalent (0.63 vs 0.61), and Pearson correlation with HADS-A was higher (0.71 vs 0.57). Anxiety levels were not correlated with PSA levels, and there were minor differences in the validation findings by race. The validity of the MAX-PC-PCAS extends to men without cancer undergoing biopsy and to African-Americans.

  17. 2D-3D rigid registration to compensate for prostate motion during 3D TRUS-guided biopsy

    Science.gov (United States)

    De Silva, Tharindu; Fenster, Aaron; Bax, Jeffrey; Gardi, Lori; Romagnoli, Cesare; Samarabandu, Jagath; Ward, Aaron D.

    2012-02-01

    Prostate biopsy is the clinical standard for prostate cancer diagnosis. To improve the accuracy of targeting suspicious locations, systems have been developed that can plan and record biopsy locations in a 3D TRUS image acquired at the beginning of the procedure. Some systems are designed for maximum compatibility with existing ultrasound equipment and are thus designed around the use of a conventional 2D TRUS probe, using controlled axial rotation of this probe to acquire a 3D TRUS reference image at the start of the biopsy procedure. Prostate motion during the biopsy procedure causes misalignments between the prostate in the live 2D TRUS images and the pre-acquired 3D TRUS image. We present an image-based rigid registration technique that aligns live 2D TRUS images, acquired immediately prior to biopsy needle insertion, with the pre-acquired 3D TRUS image to compensate for this motion. Our method was validated using 33 manually identified intrinsic fiducials in eight subjects and the target registration error was found to be 1.89 mm. We analysed the suitability of two image similarity metrics (normalized cross correlation and mutual information) for this task by plotting these metrics as a function of varying parameters in the six degree-of-freedom transformation space, with the ground truth plane obtained from registration as the starting point for the parameter exploration. We observed a generally convex behaviour of the similarity metrics. This encourages their use for this registration problem, and could assist in the design of a tool for the detection of misalignment, which could trigger the execution of a non-real-time registration, when needed during the procedure.

  18. Steroid-responsive IgG4-related disease with isolated prostatic involvement: An unusual presentation with elevated serum PSA

    Directory of Open Access Journals (Sweden)

    Vikas Jain

    2016-01-01

    Full Text Available Autoimmune prostatitis is known to occur as a part of multisystem fibro-inflammatory disorder known as IgG4 related disease (IgG4 RD. The usual presentation is with symptoms of gastro-intestinal disease with prostatic involvement presenting as lower urinary tract symptoms. The disease responds to corticosteroids. We report an asymptomatic young man who was diagnosed to have IgG4 related prostatitis on TRUS-guided prostate biopsy done for elevated serum PSA, in the absence of any other systemic involvement. The treatment with steroid resulted in normalization of S PSA levels.

  19. Elevated levels of Dickkopf-related protein 3 in seminal plasma of prostate cancer patients

    Directory of Open Access Journals (Sweden)

    Zenzmaier Christoph

    2011-11-01

    Full Text Available Abstract Background Expression of Dkk-3, a secreted putative tumor suppressor, is altered in age-related proliferative disorders of the human prostate. We now investigated the suitability of Dkk-3 as a diagnostic biomarker for prostate cancer (PCa in seminal plasma (SP. Methods SP samples were obtained from 81 patients prior to TRUS-guided prostate biopsies on the basis of elevated serum prostate-specific antigen (PSA; > 4 ng/mL levels and/or abnormal digital rectal examination. A sensitive indirect immunoenzymometric assay for Dkk-3 was developed and characterized in detail. SP Dkk-3 and PSA levels were determined and normalized to total SP protein. The diagnostic accuracies of single markers including serum PSA and multivariate models to discriminate patients with positive (N = 40 and negative (N = 41 biopsy findings were investigated. Results Biopsy-confirmed PCa showed significantly higher SP Dkk-3 levels (100.9 ± 12.3 vs. 69.2 ± 9.4 fmol/mg; p = 0.026. Diagnostic accuracy (AUC of SP Dkk-3 levels (0.633 was enhanced in multivariate models by including serum PSA (model A; AUC 0.658 or both, serum and SP PSA levels (model B; AUC 0.710. In a subpopulation with clinical follow-up > 3 years post-biopsy to ensure veracity of negative biopsy status (positive biopsy N = 21; negative biopsy N = 25 AUCs for SP Dkk-3, model A and B increased to 0.667, 0.724 and 0.777, respectively. Conclusions In multivariate models to detect PCa, inclusion of SP Dkk-3 levels, which were significantly elevated in biopsy-confirmed PCa patients, improved the diagnostic performance compared with serum PSA only.

  20. P504S/alpha-methylacyl-CoA racemase: a useful marker for diagnosis of small foci of prostatic carcinoma on needle biopsy.

    Science.gov (United States)

    Jiang, Zhong; Wu, Chin-Lee; Woda, Bruce A; Dresser, Karen; Xu, Jiangchun; Fanger, Gary R; Yang, Ximing J

    2002-09-01

    Establishing a definitive diagnosis of malignancy in prostate needle biopsies with very small foci of adenocarcinoma is a major diagnostic challenge for surgical pathologists. A positive diagnostic marker specific for prostatic adenocarcinoma may enhance our ability to detect limited prostate cancer and reduce errors in diagnosis. P504S, also known as alpha-methylacyl-CoA racemase, recently identified by cDNA subtraction and microarray technology, might serve as such a specific marker because it has been demonstrated to be highly expressed in prostatic adenocarcinoma, but not in benign prostatic glands. However, whether small foci of carcinoma can be reliably detected by this marker is a crucial question for its clinical application. The aim of this study was to assess the utility of P504S immunohistochemistry in detecting small amounts of prostate cancer in prostate needle biopsies. A total of 142 prostate needle biopsies, including 73 cases with a small focus of prostatic adenocarcinoma (prostates, were examined by using immunohistochemistry for P504S and high molecular weight cytokeratin (34betaE12). P504S immunoreactivity was found in 69 of 73 cases (94.5%) of carcinoma but not in any benign prostates (0 of 69) or benign glands adjacent to malignant glands. The 34betaE12 immunostaining confirmed the absence of basal cells in the focus of carcinoma in all 73 cases. The high specificity and sensitivity of P504S in the detection of minimal prostatic adenocarcinoma indicated its potential diagnostic value in clinical practice. Using a combination of P504S and 34betaE12 can help the diagnosis of limited prostatic adenocarcinoma on needle biopsy.

  1. Clinical Characteristics and Outcome of Gleason Score 10 Prostate Cancer on Core Biopsy Treated by External Radiotherapy and Hormone Therapy

    Institute of Scientific and Technical Information of China (English)

    Zhi-peng Mai; Wei-gang Yan; Han-zhong Li; Zhi-gang Ji; Fu-quan Zhang; Ke Hu; Yu Xiao

    2015-01-01

    Objective To evaluate the clinical characteristics and outcomes of patients with Gleason score 10 prostate cancer treated by external radiotherapy and hormone therapy. Methods From January 2003 to March 2014, 1832 patients with prostate cancer were treated, among which 9 patients (represented 0.49%) were identified as Gleason score 10 disease on prostate core biopsy without distant metastases when first diagnosed. All 9 patients were treated by whole pelvic external radiotherapy (The whole pelvic dose was 50.0 Gy and the boost dose ranged from 76.2 to 78.0 Gy) and long-term hormone therapy. We assessed the clinical characteristics, treatment outcomes and treatment toxicities. Survival curves were calculated using the Kaplan-Meier method. Results The median follow-up was 4.8 years. Six patients’ pre-treatment prostate-specific antigen (PSA) levels were lower than 20.0μg/L and three patients’ pre-treatment PSA levels were higher than 70.0μg/L. The median percentage of positive biopsy cores was 91%. Three, four and two cases were classified as T2c, T3a and T3b stage, respectively. Three cases were assessed as N1 stage. The 5-year biochemical failure-free survival, distant metastasis-free survival, cancer specific survival and overall survival rates were 28.6%, 57.1%, 66.7%and 57.1%, respectively. Five patients experienced grade 1-2 acute gastrointestinal toxicities and six patients complained of grade 1-2 acute genitourinary toxicities. No bone fracture or cardiovascular disease was detected. Conclusions Gleason score 10 prostate cancer on core biopsy is usually combined with other high risk factors. The pre-treatment PSA levels lie in two extremes. Timely and active treatments are urgent needed because unfavourable oncological outcomes are often presented.

  2. Can Single Positive Core Prostate Cancer at biopsy be Considered a Low-Risk Disease after Radical Prostatectomy?

    Directory of Open Access Journals (Sweden)

    Ricardo Kupka da Silva

    2013-12-01

    Full Text Available Purpose Single positive core in a prostate biopsy is usually associated with indolent prostate cancer (PCa and is one of the active surveillance (AS inclusion criteria. We investigated whether single positive core PCa at biopsy could define an archetype of low-risk disease. Materials and Methods A total of 1320 consecutive patients were enrolled. Among them, 249 patients with single positive core PCa were followed up, and the clinical and pathological parameters influencing prognosis were analyzed. Results Out of the 249 patients, 172 (69.0% had pathological findings ≥ pT2c and 87 (34.9% had an undergraded Gleason Score (GS based on the biopsy. Positive surgical margins (PSMs, extraprostatic extension (EPE and seminal vesicle invasion (SVI were found in 20.8%, 10.0% and 6.0% of patients, respectively. In a comparative analysis, we found that the PSA level, prostate weight and number of cores at biopsy are essential to correctly predict an indolent PCa. A total of 125 patients (67.3% with nonpalpable tumors became high-risk tumors (pT2c-T3. Analyzing only nonpalpable tumors with a GS of 6 at biopsy (156 patients, we noted that 106 (67.9% of cT1 progressed from cT1c to pT2c-pT3. Conclusions Single core PCa have clinically significant disease in the Radical Prostatectomy specimens, with considerable rates of overgrading for the GS, pT2c-pT3, PSMs, EPE and SVI. The treatment plan must be evaluated individually for patients with single core PCa and must take into account other prognostic factors when determining whether a patient should be managed with AS.

  3. The diagnostic accuracy and cost-effectiveness of magnetic resonance spectroscopy and enhanced magnetic resonance imaging techniques in aiding the localisation of prostate abnormalities for biopsy: a systematic review and economic evaluation

    NARCIS (Netherlands)

    Mowatt, G.; Scotland, G.; Boachie, C.; Cruickshank, M.; Ford, J.A.; Fraser, C.; Kurban, L.; Lam, T.B.; Padhani, A.R.; Royle, J.; Scheenen, T.W.J.; Tassie, E.

    2013-01-01

    In the UK, prostate cancer (PC) is the most common cancer in men. A diagnosis can be confirmed only following a prostate biopsy. Many men find themselves with an elevated prostate-specific antigen (PSA) level and a negative biopsy. The best way to manage these men remains uncertain.To assess the dia

  4. Magnetic resonance imaging-guided prostate biopsy. Institutional analysis and systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Polanec, S.H.; Helbich, T.H.; Kubin, K.; Pinker-Domenig, K.; Brader, P. [Medical Univ. of Vienna (Austria). Dept. of Biomedical Imaging and Image-Guided Therapy; Margreiter, M.; Klingler, H.C. [Medical Univ. of Vienna (Austria). Dept. of Urology; Susani, M. [Medical Univ. of Vienna (Austria). Dept. of Pathology

    2014-05-15

    Objectives: To evaluate the detection rate of prostate cancer (PCa) after magnetic resonance-guided biopsy (MRGB); to monitor the patient cohort with negative MRGB results and to compare our own results with other reports in the current literature. Materials and Methods: A group of 41 patients was included in this IRB-approved study and subjected to combined MRI and MRGB. MRGB was performed in a closed 1.5 T MR unit and the needle was inserted rectally. The follow-up period ranged between 12 and 62 months (mean 3.1 years). To compare the results with the literature, a systematic literature search was performed. Eighteen publications were evaluated. Results: The cancer-suspicious regions were punctured successfully in all cases. PCa was detected in eleven patients (26.9 %) who were all clinically significant. MRGB showed a benign histology in the remaining 30 patients. In the follow-up (mean 3.1 years) of patients with benign histology, no new PCa was diagnosed. The missed cancer rate during follow-up was 0.0 % in our study. Conclusion: MRGB is effective for the detection of clinically significant cancer, and this is in accordance with the recent literature. In the follow-up of patients with benign histology, no new PCa was discovered. Although the probability of developing PCa after negative MRGB is very low, active surveillance is reasonable. (orig.)

  5. Stereotactic large-core needle breast biopsy: analysis of pain and discomfort related to the biopsy procedure

    Energy Technology Data Exchange (ETDEWEB)

    Hemmer, Judith M.; Heesewijk, Hans P.M. van [St. Antonius Hospital, Department of Radiology, Nieuwegein (Netherlands); Kelder, Johannes C. [St. Antonius Hospital, Department of Statistics, Nieuwegein (Netherlands)

    2008-02-15

    The purpose of this study was to determine the significance of variables such as duration of the procedure, type of breast tissue, number of passes, depth of the biopsies, underlying pathology, the operator performing the procedure, and their effect on women's perception of pain and discomfort during stereotactic large-core needle breast biopsy. One hundred and fifty consecutive patients with a non-palpable suspicious mammographic lesions were included. Between three and nine 14-gauge breast passes were taken using a prone stereotactic table. Following the biopsy procedure, patients were asked to complete a questionnaire. There was no discomfort in lying on the prone table. There is no relation between type of breast lesion and pain, underlying pathology and pain and performing operator and pain. The type of breast tissue is correlated with pain experienced from biopsy (P = 0.0001). We found out that patients with dense breast tissue complain of more pain from biopsy than patients with more involution of breast tissue. The depth of the biopsy correlates with pain from biopsy (P = 0.0028). Deep lesions are more painful than superficial ones. There is a correlation between the number of passes and pain in the neck (P = 0.0188) and shoulder (P = 0.0366). The duration of the procedure is correlated with pain experienced in the neck (P = 0.0116) but not with pain experienced from biopsy. (orig.)

  6. Post-prostate biopsy infection with Escherichia coli ST131 leading to epididymo-orchitis and meningitis caused by Gram-negative bacilli.

    Science.gov (United States)

    Assimacopoulos, Aris; Johnston, Brian; Clabots, Connie; Johnson, James R

    2012-12-01

    A 57-year-old man who had recently undergone a transrectal prostate biopsy for a rising prostate-specific antigen level developed postbiopsy necrotizing epididymo-orchitis (requiring orchiectomy) and then Gram-negative meningitis, despite fluoroquinolone administration for periprocedural prophylaxis and subsequent therapy. The causative organism proved to be a fluoroquinolone-resistant Escherichia coli strain from sequence type ST131.

  7. Higher body mass index increases the risk for biopsy-mediated detection of prostate cancer in Chinese men.

    Directory of Open Access Journals (Sweden)

    Meng-Bo Hu

    Full Text Available To investigate the relationship between body mass index (BMI and prostate cancer (PCa risk at biopsy in Chinese men.We retrospectively reviewed the records of 1,807 consecutive men who underwent initial multicore (≥10 prostate biopsy under transrectal ultrasound guidance between Dec 2004 and Feb 2014. BMI was categorised based on the Asian classification of obesity as follows: <18.5 (underweight, 18.5-22.9 (normal weight, 23-24.9 (overweight, 25-29.9 (moderately obese, and ≥30 kg/m2 (severely obese. The odds ratios (OR of each BMI category for risk of PCa and high-grade prostate cancer (HGPCa, Gleason score ≥4+3 detection were estimated in crude, age-adjusted and multivariate-adjusted models. Prevalence ratios and accuracies of PSA predicted PCa were also estimated across BMI groups.In total, PCa was detected by biopsy in 750 (45.4% men, and HGPCa was detected in 419 (25.4% men. Compared with men of normal weight, underweight men and obese men were older and had higher prostate specific antigen levels. The risk of overall PCa detection via biopsy presented an obvious U-shaped relationship with BMI in crude analysis. Overall, 50.0%, 37.4%, 45.6% 54.4% and 74.1% of the men in the underweight, normal weight, overweight, moderately obese and severely obese groups, respectively, were diagnosed with PCa via biopsy. In multivariate analysis, obesity was significantly correlated with a higher risk of PCa detection (OR = 1.17, 95%CI 1.10-1.25, P<0.001. However, higher BMI was not correlated with HGPCa detection (OR = 1.03, 95%CI 0.97-1.09, P = 0.29. There were no significant differences in the accuracy of using PSA to predict PCa or HGPCa detection across different BMI categories.Obesity was associated with higher risk of PCa detection in the present Chinese biopsy population. No significant association was detected between obesity and HGPCa.

  8. Multi-drug resistant E.coli urosepsis in physicians following transrectal ultrasound guided prostate biopsies--three cases including one death.

    Science.gov (United States)

    Carlson, William H; Bell, David G; Lawen, Joseph G; Rendon, Ricardo A

    2010-04-01

    Three male physicians underwent transrectal ultrasound guided prostate biopsies for elevated prostate-specific antigen levels or irregular digital rectal exam findings. All three of these patients developed urosepsis secondary to multi-drug resistant organisms despite antibiotic prophylaxis. There are increasing reports of infectious complications following prostate biopsy caused by multi-drug resistant organisms. These cases highlight the potentially lethal risks to healthcare workers who are more likely to harbor multi-drug resistant organisms than the general population. Further research into preoperative assessment and appropriate antibiotic prophylaxis in all potentially high risk patients is warranted.

  9. SU-E-T-448: Heightened Apical Positivity of 2-Year Post-Radiotherapy Biopsies Is Not Related to Suboptimal Dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Studenski, M; Stoyanova, R; Abramowitz, M; Dogan, N; Pollack, A [University of Miami, Miami, FL (United States)

    2015-06-15

    Purpose: Previous research has demonstrated that following radiation therapy for prostate cancer, there is a relative increase in positive biopsies in the apex versus the rest of the prostate. The increase could be due to: 1) Inter-fraction apex motion or deformation, 2) Intra-fraction apex motion or deformation, 3) Suboptimal dose coverage in the apex, 4) Tissue composition in the apex and/or 5) Prostate size. In this initial study, the potential for suboptimal dose coverage in the apex was assessed by splitting the prostate planning target volume into the apex (inferior third) and remainder. Methods: 69 patients were selected from 303 patients treated on a clinical radiotherapy trial for prostate cancer. These patients were selected as they had both a localized (sextant template) 2-year post-treatment biopsy and 3D dose information. Of these patients, 10 had positive biopsies in the apex, 8 in the remainder and 11 in both locations. For all patients, the following dosimetric data was acquired from the apex dose volume histogram: Dmean, Dmax, Dmin, D95% and V100%. Unpaired, one-tailed t-tests were used to test for statistical significance (p < 0.05) between all dosimetric parameters for patients with positive versus negative apical biopsies. Additionally, D95% for the apex was plotted against D95% of the remainder. Results: There was no statistical difference for the selected apical dosimetric parameters for patients with positive versus negative biopsies (p-values > 0.05). No correlation was found between D95% (normalized to the prescription dose) for the apex and remainder (R{sup 2} = 0.0116). Conclusion: No correlation was found between positive apical biopsy and suboptimal dosimetric coverage. Current research is looking into inter-fraction apex motion and deformation as a potential source of the increased apical failure using daily CBCT images.

  10. Interobserver agreement of gleason score and modified gleason score in needle biopsy and in surgical specimen of prostate cancer

    Directory of Open Access Journals (Sweden)

    Sergio G. Veloso

    2007-10-01

    Full Text Available INTRODUCTION: Gleason score, which has a high interobserver variability, is used to classify prostate cancer. The most recent consensus valued the tertiary Gleason pattern and recommended its use in the final score of needle biopsies (modified Gleason score. This pattern is considered to be of high prognostic value in surgical specimens. This study emphasized the evaluation of the modified score agreement in needle biopsies and in surgical specimen, as well as the interobserver variability of this score MATERIALS AND METHODS: Three pathologists evaluated the slides of needle biopsies and surgical specimens of 110 patients, reporting primary, secondary and tertiary Gleason patterns and after that, traditional and modified Gleason scores were calculated. Kappa test (K assessed the interobserver agreement and the agreement between the traditional and modified scores of the biopsy and of the surgical specimen RESULTS: Interobserver agreement in the biopsy was K = 0.36 and K = 0.35, and in the surgical specimen it was K = 0.46 and K = 0.36, for the traditional and modified scores, respectively. The tertiary Gleason grade was found in 8%, 0% and 2% of the biopsies and in 8%, 0% and 13% of the surgical specimens, according to observers 1, 2 and 3, respectively. When evaluating the agreement of the traditional and modified Gleason scores in needle biopsy with both scores of the surgical specimen, a similar agreement was found through Kappa CONCLUSION: Contrary to what was expected, the modified Gleason score was not superior in the agreement between the biopsy score and the specimen, or in interobserver reproducibility, in this study.

  11. Clinical outcome following a low-suspicion multiparametric prostate MRI or benign MRI-guided biopsy to detect prostate cancer

    DEFF Research Database (Denmark)

    Boesen, Lars; Nørgaard, Nis; Løgager, Vibeke;

    2017-01-01

    predictive values of MRI in ruling out any prostate cancer and significant prostate cancer defined as: a) any core with Gleason score (GS) > 6 or b) > 2 positive cores/cancerous core ≥ 50%. RESULTS: Prostate cancer was detected in 38/194 (20%) patients during the median study period of 47 months...... (interquartile range 43-52). The overall negative predictive value of MRI in ruling out any and significant prostate cancer was 80% (156/194) and 95% (184/194), respectively. No patient with a low-suspicion MRI had intermediate/high grade cancer (Gleason score > 6). The majority of patients with no cancer during...

  12. Importance of prostate-specific antigen (PSA as a predictive factor for concordance between the Gleason scores of prostate biopsies and RADICAL prostatectomy specimens

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    Nelson Gianni de Lima

    2013-06-01

    Full Text Available OBJECTIVE: To evaluate the concordance between the Gleason scores of prostate biopsies and radical prostatectomy specimens, thereby highlighting the importance of the prostate-specific antigen (PSA level as a predictive factor of concordance. METHODS: We retrospectively analyzed 253 radical prostatectomy cases performed between 2006 and 2011. The patients were divided into 4 groups for the data analysis and dichotomized according to the preoperative PSA, <10 ng/mL and ≥10 ng/mL. A p-score <0.05 was considered significant. RESULTS: The average patient age was 63.3±7.8 years. The median PSA level was 9.3±4.9 ng/mL. The overall concordance between the Gleason scores was 52%. Patients presented preoperative PSA levels <10 ng/mL in 153 of 235 cases (65% and ≥10 ng/mL in 82 of 235 cases (35%. The Gleason scores were identical in 86 of 153 cases (56% in the <10 ng/mL group and 36 of 82 (44% cases in the ≥10 ng/mL group (p = 0.017. The biopsy underestimated the Gleason score in 45 (30% patients in the <10 ng/mL group and 38 (46% patients in the ≥10 ng/mL (p = 0.243. Specifically, the patients with Gleason 3 + 3 scores according to the biopsies demonstrated global concordance in 56 of 110 cases (51%. In this group, the patients with preoperative PSA levels <10 ng/dL had higher concordance than those with preoperative PSA levels ≥10 ng/dL (61% x 23%, p = 0.023, which resulted in 77% upgrading after surgery in those patients with PSA levels ≥10 ng/dl. CONCLUSION: The Gleason scores of needle prostate biopsies and those of the surgical specimens were concordant in approximately half of the global sample. The preoperative PSA level was a strong predictor of discrepancy and might improve the identification of those patients who tended to be upgraded after surgery, particularly in patients with Gleason scores of 3 + 3 in the prostate biopsy and preoperative PSA levels ≥10 ng/mL.

  13. Prostate biopsy and radical prostatectomy Gleason score correlation in heterogenous tumors: proposal for a composite Gleason score.

    Science.gov (United States)

    Arias-Stella, Javier A; Shah, Alpa B; Montoya-Cerrillo, Diego; Williamson, Sean R; Gupta, Nilesh S

    2015-09-01

    When prostate biopsy cores are separately identified in multiple containers, current recommendations are to grade each specimen individually. For treatment algorithms, the highest Gleason score (HGS) is typically used as the overall score, even if a lower score predominates. This practice has the potential to misrepresent the overall cancer in the entire gland for some patients and place them in a higher-grade group. We compare a novel composite Gleason score (CGS), integrating grade patterns from contiguous positive biopsy sites, with HGS to determine correlation with the radical prostatectomy (RP) Gleason score (GS). One hundred needle biopsy cases from 2008 to 2012 with >2 GSs in a biopsy set (eg, 3+3=6, 3+4=7, and 4+3=7) or more than a 1-step difference in GS (eg, 3+4=7 and 4+4=8 without 4+3=7) were analyzed. Grades were assigned using both methods (HGS and CGS) and compared with RPGS. Grade groups I to V were used to define downgrade and upgrade. Comparing HGS with RPGS, 31% remained the same and 69% had a change in GS (87% downgraded and 13% upgraded). Comparing CGS with RPGS, 59% remained the same and 41% had a change in GS (10% downgraded and 90% upgraded). Of the 2 methods, the CGS showed better overall correlation with RP (P2 grades are present in a biopsy set. CGS has a significantly lower rate of downgrade and predicts the RPGS more accurately than HGS.

  14. Comparison of Transperineal Mapping Biopsy Results with Whole-Mount Radical Prostatectomy Pathology in Patients with Localized Prostate Cancer

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    Darren J. Katz

    2014-01-01

    Full Text Available Objective. We sought to evaluate the accuracy of transperineal mapping biopsy (TMB by comparing it to the pathology specimen of patients who underwent radical prostatectomy (RP for localized prostate cancer. Methods. From March 2007 to September 2009, 78 men at a single center underwent TMB; 17 of 78 subsequently underwent RP. TMB cores were grouped into four quadrants and matched to data from RP whole-mount slides. Gleason score, tumor location and volume, cross-sectional area, and maximal diameter were measured; sensitivity and specificity were assessed. Results. For the 17 patients who underwent RP, TMB revealed 12 (71% had biopsy Gleason grades ≥ 3 + 4 and 13 (76% had bilateral disease. RP specimens showed 14 (82% had Gleason scores ≥ 3 + 4 and 13 (76% had bilateral disease. Sensitivity and specificity of TMB for prostate cancer detection were 86% (95% confidence interval [CI] 72%–94% and 83% (95% CI 62%–95%, respectively. Four quadrants negative for cancer on TMB were positive on prostatectomy, and six positive on TMB were negative on prostatectomy. Conclusion. TMB is a highly invasive procedure that can accurately detect and localize prostate cancer. These findings help establish baseline performance characteristics for TMB and its utility for organ-sparing strategies.

  15. Contemporary outcomes in the detection of prostate cancer using transrectal ultrasound-guided 12-core biopsy in Singaporean men with elevated prostate specific antigen and/or abnormal digital rectal examination

    Directory of Open Access Journals (Sweden)

    Alvin Lee

    2015-10-01

    Conclusion: In conclusion, using contemporary 12-core biopsy methods, the local prostate cancer detection rate based on serum PSA and DRE findings has increased over the past decade presumably due to multiple genetic and environmental factors. Post-biopsy sepsis remains an important complication worldwide.

  16. Usual and unusual histologic patterns of high Gleason score 8 to 10 adenocarcinoma of the prostate in needle biopsy tissue.

    Science.gov (United States)

    Gottipati, Srinivas; Warncke, Jason; Vollmer, Robin; Humphrey, Peter A

    2012-06-01

    High Gleason score 8 to 10 adenocarcinoma is the most aggressive and potentially lethal form of prostate cancer. The 2005 International Society of Urological Pathology (ISUP)-modified Gleason grading scheme defines several gland arrangements of high Gleason grade patterns 4 and 5. The aim of this investigation was to quantitate the frequency of the ISUP-defined high Gleason grade patterns in needle biopsy tissue, to determine the common admixtures and to characterize patterns not presented in the 2005 ISUP report. For patients who underwent radical prostatectomy, we analyzed for association of specific high-grade patterns in needle biopsy with extraprostatic extension in radical prostatectomy tissues. A total of 268 prostate needle biopsy cases with Gleason score of 8 to 10 were examined. A mean of 3.6 patterns (range, 1 to 8) were identified per case and only 12% of cases had a pure single pattern. Ill-defined glands with poorly formed lumina (at 57%) and fused microacinar glands (at 53%) comprised the predominant and most frequently admixed patterns. Single cells and single signet ring cells were present in 53% and 31% of cases, respectively. Additional patterns in order of frequency included cords (35%), cribriform glands (25%), sheets of cells (19%), chains (4%), glomeruloid (3%), comedonecrosis (2%), and hypernephromatoid (1 case=0.3%). Gleason score 8 to 10 carcinomas are typically extensive in needle core tissue, with a mean of 4.4 positive cores (range, 1 to 15 cores) per case. Only 14 cases (5%) had high-grade minimal carcinoma measuring ISUP report include single file growth, solid cylinders, and nested patterns. The single file pattern was present in 40% of cases, and the small solid nested pattern was detected in 24% of cases. One case displayed solid cylinders. Only the single file pattern was associated with extraprostatic extension at radical prostatectomy (P=0.005). These results show that the 2005 ISUP-defined patterns of high Gleason score 8 to 10

  17. Percent free prostate-specific antigen is effective to predict prostate biopsy outcome in Chinese men with prostate-specific antigen between 10.1 and 20.0 ng ml(-1).

    Science.gov (United States)

    Chen, Rui; Zhou, Li-Qun; Cai, Xiao-Bing; Xie, Li-Ping; Huang, Yi-Ran; He, Da-Lin; Gao, Xu; Xu, Chuan-Liang; Ding, Qiang; Wei, Qiang; Yin, Chang-Jun; Ren, Shan-Cheng; Wang, Fu-Bo; Tian, Ye; Sun, Zhong-Quan; Fu, Qiang; Ma, Lu-Lin; Zheng, Jun-Hua; Ye, Zhang-Qun; Ye, Ding-Wei; Xu, Dan-Feng; Hou, Jian-Quan; Xu, Ke-Xin; Yuan, Jian-Lin; Gao, Xin; Liu, Chun-Xiao; Pan, Tie-Jun; Sun, Ying-Hao

    2015-01-01

    Percent free prostatic-specific antigen (%fPSA) has been introduced as a tool to avoid unnecessary biopsies in patients with a serum PSA level of 4.0-10.0 ng ml-1 , however, it remains controversial whether %fPSA is effective in PSA range of 10.1-20.0 ng ml-1 in both Chinese and Western population. In this study, the diagnostic performance of %fPSA and serum PSA in predicting prostate cancer (PCa) and high-grade PCa (HGPCa) was analyzed in a multi-center biopsy cohort of 5915 consecutive Chinese patients who underwent prostate biopsy in 22 hospitals across China from January 1, 2010 to December 31, 2013. The indication for biopsy was PSA>4.0 ng ml-1 or/and suspicious digital rectal examination. Total and free serum PSA determinations were performed by three types of electrochemiluminescence immunoassays with recalibration to the World Health Organization standards. The diagnostics accuracy of PSA, %fPSA and %fPSA in combination with PSA (%fPSA + PSA) was determined by the area under the receivers operating characteristic curve (AUC). %fPSA was more effective than PSA in men aged ≥60 years old. The AUC was 0.584 and 0.635 in men aged ≥60 years old with a PSA of 4.0-10.0 ng ml-1 and 10.1-20.0 ng ml-1 , respectively. The AUC of %fPSA was superior to that of PSA in predicting HGPCa in patients ≥60 years old in these two PSA range. Our results indicated that %fPSA is both statistically effective and clinical applicable to predict prostate biopsy outcome in Chinese patients aged ≥60 years old with a PSA of 4.0-10.0 ng ml-1 and 10.1-20.0 ng ml-1 .

  18. Application of transrectal ultrasound-guided repeat needle biopsy in the diagnosis of prostate cancer in Chinese population: A retrospective study

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    Yi Wang

    2016-01-01

    Full Text Available Background: Transrectal ultrasound-guided repeat needle biopsy (TUGRNB is widely used for diagnosis of prostate cancer (PCa. However, significance of TUGRNB in Chinese population was rarely reported. A retrospective study was conducted to evaluate the significance of TUGRNB applied in prediction of PCa in Chinese population. Materials and Methods: A total of 960 from January 2009 to December 2012 were included. Repeat needle biopsy rate and PCa positive detection rate were evaluated. Relationship between prostate specific antigen (PSA levels and PCa positive rates was analyzed. Results: PCa positive detection rate after initial needle biopsy was 28.4%, which was lower than the rate of repeat needle biopsy (40%. The rate for immediate transurethral resection (TUR, surgery after initial needle biopsy, was 27.1%, however with a low PCa positive detection rate (0.66%. The repeat needle biopsy rate was lower compared with the initial biopsy rate (P 20 ng/ml, PCa positive rate was significantly higher than those with PSA < 20 ng/ml (P < 0.05. Conclusion: PCa positive detection rate following repeat needle biopsy in Chinese population was higher, although the repeated needle biopsy rate was still in a low level. TUGRNB should attract more attention in the diagnosis of PCa.

  19. 中国前列腺癌联盟成员医院前列腺穿刺活检现状的调查报告%Current status of prostate biopsy in Chinese Prostate Cancer Consortium member hospitals

    Institute of Scientific and Technical Information of China (English)

    陈锐; 谢立平; 周利群; 黄翼然; 傅强; 贺大林; 魏强; 丁强; 叶章群

    2015-01-01

    applied biopsy scheme in CPCC hospitals is transrectal ultrasound-guided biopsy.The PSA level of patients in CPCC hospitals is relatively high.The relationship between PSA level and PCa detection rate in Chinese population is different from reports in Western population.%目的 调查中国前列腺癌联盟(Chinese Prostate Cancer Consortium,CPCC)成员医院开展前列腺穿刺活检的情况,探讨不同PSA值患者的前列腺癌检出率.方法 回顾性收集2010年1月至2013年12月33家CPCC成员医院行前列腺穿刺活检患者的临床资料,包括患者血清PSA、前列腺体积、穿刺方式、穿刺针数等,所有信息采用EpiData Entry 3.1软件进行登记,分析行前列腺穿刺活检患者的临床特征及前列腺癌的检出率.结果 共收集19 292例患者信息,其中22家医院的17 296例为连续收集病例,排除影响PSA的因素后,共13 904例纳入统计分析.前列腺体积为31.1~65.5ml,中位值44.0 ml.PSA <4.0、4.0~10.0、10.1~20.0、20.1~50.0、>50.0 μg/L的患者分别为701例(5%)、4 124例(30%)、4 014例(29%)、2 587例(19%)、2 478例(18%).游离PSA比值9.0%~20.6%,中位值14.0%.采用超声引导下经直肠穿刺10 808例(78%),经会阴穿刺3 087例(22%).接受6、8、10、12针及饱和穿刺的患者分别为1 436例(10%)、2 640例(19%)、3 920例(28%)、4 989例(36%)和607例(4%),312例(2%)接受<6针的非系统穿刺.本组13 904例的穿刺阳性率为44%(6 123/13 904),其中PSA4.1~10.0、10.1~20.0 μg/L患者的穿刺阳性率分别为26%和35%.阳性患者中,Gleason评分<7分1 295例(21%),(3+4)分1 164例(19%),(4+3)分1 155例(19%),≥8分2 371例(39%),未记录评分138例(2%).结论 目前CPCC成员医院开展前列腺穿刺活检的主要方式是超声引导下经直肠穿刺,行前列腺穿刺活检患者具有年龄大、PSA高、前列腺体积小、Gleason评分高的特点.

  20. [Imaging of cancer prostate].

    Science.gov (United States)

    Ghouadni, Mehdi; Sandoz, Catherine; Eiss, David; Cornud, François; Thiounn, Nicolas; Hélénon, Olivier

    2003-12-31

    Imaging of prostate cancer relies mainly on ultrasonography (US) and magnetic resonance imaging (MRI). It plays a diagnostic role in detecting and staging prostate carcinomas. Prostate biopsies are performed under endorectal US guidance at best with additional colour Doppler information. US also may provide useful information regarding the significance of an abnormal digital rectal examination sometimes related to some benign prostate alterations that can mimic a neoplastic nodule. In all cases imaging studies need to be interpreted in light of clinical and biological data including the results of biopsy especially in staging carcinoma with MR. Finally, CT and scintigraphy are helpful in screening for distant metastases.

  1. The role of imaging based prostate biopsy morphology in a data fusion paradigm for transducing prognostic predictions

    Science.gov (United States)

    Khan, Faisal M.; Kulikowski, Casimir A.

    2016-03-01

    A major focus area for precision medicine is in managing the treatment of newly diagnosed prostate cancer patients. For patients with a positive biopsy, clinicians aim to develop an individualized treatment plan based on a mechanistic understanding of the disease factors unique to each patient. Recently, there has been a movement towards a multi-modal view of the cancer through the fusion of quantitative information from multiple sources, imaging and otherwise. Simultaneously, there have been significant advances in machine learning methods for medical prognostics which integrate a multitude of predictive factors to develop an individualized risk assessment and prognosis for patients. An emerging area of research is in semi-supervised approaches which transduce the appropriate survival time for censored patients. In this work, we apply a novel semi-supervised approach for support vector regression to predict the prognosis for newly diagnosed prostate cancer patients. We integrate clinical characteristics of a patient's disease with imaging derived metrics for biomarker expression as well as glandular and nuclear morphology. In particular, our goal was to explore the performance of nuclear and glandular architecture within the transduction algorithm and assess their predictive power when compared with the Gleason score manually assigned by a pathologist. Our analysis in a multi-institutional cohort of 1027 patients indicates that not only do glandular and morphometric characteristics improve the predictive power of the semi-supervised transduction algorithm; they perform better when the pathological Gleason is absent. This work represents one of the first assessments of quantitative prostate biopsy architecture versus the Gleason grade in the context of a data fusion paradigm which leverages a semi-supervised approach for risk prognosis.

  2. Droplet Digital PCR Based Androgen Receptor Variant 7 (AR-V7 Detection from Prostate Cancer Patient Blood Biopsies

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    Yafeng Ma

    2016-08-01

    Full Text Available Androgen receptor splice variant V7 (AR-V7 was recently identified as a valuable predictive biomarker in metastatic castrate-resistant prostate cancer. Here, we report a new, sensitive and accurate screen for AR-V7 mRNA expression directly from circulating tumor cells (CTCs: We combined EpCAM-based immunomagnetic CTC isolation using the IsoFlux microfluidic platform with droplet digital polymerase chain reaction (ddPCR to analyze total AR and AR-V7 expression from prostate cancer patients CTCs. We demonstrate that AR-V7 is reliably detectable in enriched CTC samples with as little as five CTCs, even considering tumor heterogeneity, and confirm detection of AR-V7 in CTC samples from advanced prostate cancer (PCa patients with AR-V7 detection limited to castrate resistant disease status in our sample set. Sensitive molecular analyses of circulating tumor cells (CTCs or circulating tumor nucleic acids present exciting strategies to detect biomarkers, such as AR-V7 from non-invasive blood samples, so-called blood biopsies.

  3. 3D non-rigid registration using surface and local salient features for transrectal ultrasound image-guided prostate biopsy

    Science.gov (United States)

    Yang, Xiaofeng; Akbari, Hamed; Halig, Luma; Fei, Baowei

    2011-03-01

    We present a 3D non-rigid registration algorithm for the potential use in combining PET/CT and transrectal ultrasound (TRUS) images for targeted prostate biopsy. Our registration is a hybrid approach that simultaneously optimizes the similarities from point-based registration and volume matching methods. The 3D registration is obtained by minimizing the distances of corresponding points at the surface and within the prostate and by maximizing the overlap ratio of the bladder neck on both images. The hybrid approach not only capture deformation at the prostate surface and internal landmarks but also the deformation at the bladder neck regions. The registration uses a soft assignment and deterministic annealing process. The correspondences are iteratively established in a fuzzy-to-deterministic approach. B-splines are used to generate a smooth non-rigid spatial transformation. In this study, we tested our registration with pre- and postbiopsy TRUS images of the same patients. Registration accuracy is evaluated using manual defined anatomic landmarks, i.e. calcification. The root-mean-squared (RMS) of the difference image between the reference and floating images was decreased by 62.6+/-9.1% after registration. The mean target registration error (TRE) was 0.88+/-0.16 mm, i.e. less than 3 voxels with a voxel size of 0.38×0.38×0.38 mm3 for all five patients. The experimental results demonstrate the robustness and accuracy of the 3D non-rigid registration algorithm.

  4. The value of touch imprint cytology of prostate core needle biopsy specimens – Kuwait experience

    Directory of Open Access Journals (Sweden)

    S. Hussein

    2015-12-01

    Conclusions: The routine use of TIC complements CNB reports and helps to provide an immediate and reliable cytological diagnosis of prostate lesions. TIC and serial sectioning of CNB specimens significantly improve the diagnostic accuracy.

  5. A novel equation and nomogram including body weight for estimating prostate volumes in men with biopsy-proven benign prostatic hyperplasia

    Institute of Scientific and Technical Information of China (English)

    Yasukazu Nakanishi; Iwao Fukui; Kazunori Kihara; Hitoshi Masuda; Satoru Kawakami; Mizuaki Sakura; Yasuhisa Fujii; Kazutaka Saito; Fumitaka Koga; Masaya Ito; Junji Yonese

    2012-01-01

    Anthropometric measurements,e.g.,body weight (BW),body mass index (BMI),as well as serum prostate-specific antigen (PSA) and percent-free PSA (%fPSA) have been shown to have positive correlations with total prostate volume (TPV).We developed an equation and nomegram for estimating TPV,incorporating these predictors in men with benign prostatic hyperplasia (BPH).A total of 1852 men,including 1113 at Tokyo Medical and Dental University (TMDU) Hospital as a training set and 739 at Cancer Institute Hospital (CIH) as a validation set,with PSA levels of up to 20 ng ml-1,who underwent extended prostate biopsy and were proved to have BPH,were enrolled in this study.We developed an equation for continuously coded TPV and a logistic regression-based nomngram for estimating a TPV greater than 40 ml.Predictive accuracy and performance characteristics were assessed using an area under the receiver operating characteristics curve (AUC) and calibration plots.The final linear regression model indicated age,PSA,%fPSA and BW as independent predictors of continuously coded TPV.For predictions in the training set,the multiple correlation coefficient was increased from 0.38 for PSA alone to 0.60 in the final model.We developed a novel nomogram incorporating age,PSA,%fPSA and BW for estimating TPV greater than 40 ml.External validation confirmed its predictive accuracy,with AUC value of 0.764.Calibration plots showed good agreement between predicted probability and observed proportion.In conclusion,TPV can be easily estimated using these four independent predictors.

  6. PSA levels of 4.0 - 10 ng/ml and negative digital rectal examination: antibiotic therapy versus immediate prostate biopsy

    Directory of Open Access Journals (Sweden)

    Avraham Shtricker

    2009-10-01

    Full Text Available Purpose: The management of mildly elevated (4.0-10.0 ng/ml prostate specific antigen (PSA is uncertain. Immediate prostate biopsy, antibiotic treatment, or short term monitoring PSA level for 1-3 months is still in controversy. Material and Methods: We conducted a retrospective chart review of patients in a large community practice (2003 - 2007 who had PSA levels between 4.0-10 ng/mL without any further evidence of infection. Data was gathered regarding patient's age, whether standard antibiotic therapy (10-14 days of ofloxacin or ciprofloxacin had been administered before the second PSA measurement, results of a second PSA test performed at 1- to 2-month intervals, whether a prostate biopsy was performed and its result. Results: One-hundred and thirty-five men met the study inclusion criteria with 65 (48.1% having received antibiotics (group 1; the PSA levels decreased in 39 (60% of which, sixteen underwent a biopsy which demonstrated prostate cancer in 4 (25%. Twenty-six (40% patients of group 1 exhibited no decrease in PSA levels; seventeen of them underwent a biopsy that demonstrated cancer in 2 (12%. The other 70 (51.9% patients were not treated with antibiotics (group 2; the PSA levels decreased in 42 (60% of which, thirteen underwent a biopsy which demonstrated prostate cancer in 4 (31%. In the other 28 (40% patients of group 2 there was no demonstrated decrease in PSA, nineteen of these subjects underwent a biopsy that demonstrated cancer in 8 (42%. Conclusions: There appears to be no advantage for administration of antibacterial therapy with initial PSA levels between 4-10 ng/mL without overt evidence of inflammation.

  7. 影响二次经直肠前列腺穿刺活检阳性率的因素分析%To investigate the factors on affectting the positive prostate cancer in the secondary transrectal prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    曾健文; 蒋重和; 莫鉴锋; 周理林; 潘楚灶; 贺沂; 邵琳

    2015-01-01

    Objectives To Explore postive factors on suspicous prostate cancer in the secondary transrectal prostate biopsy.Methods From January 2008-February 2014,55 cases in our hospital had been recevied transrectal secondary prostate biopsy,retrospectively.According to the results of biopsy,the patients were divided into control groups and prostate cancer group.Differences between prostate-specific antigen(PSA) parameters and pathological findings were compared during the first puncture and to analyze the influenced factors in the second biopsy.Results There was significant difference in Family history of prostate cancer,prostate-specific antigen velocity (PSAV),prostate specific antigen density (PSAD),HGPIN,ASAP,chronic prostatitis between two groups (P < 0.05).Family history,PSAV,PSAD,HGPIN,ASAP were risk factorsn in secondary needle prostate biopsy.Results There was significant difference in Family history of prostate cancer,prostate-specific antigen velocity (PSAV),prostate specific antigen density(PSAD),HGPIN,ASAP,chronic prostatitis between two groups(P < 0.05).Family history,PSAV,PSAD,HGPIN,ASAP were risk factorsn in secondary needle prostate biopsy.Conclusions To avoid misdiagnosis and unnecessary repeat biopies,combined with the patient's family history,the first biopsy pathology results (HGPIN,ASAP) and PSAV,PSAD parameters can improve the positive rate of secondary prostate biopsy.%目的 探讨在二次经直肠前列腺穿刺活检中影响阳性率的因素.方法 回顾性分析2008年1月~2014年2月本院55例首次经直肠前列腺穿刺活检阴性并行二次经直肠前列腺穿刺活检的患者临床资料,依第二次穿刺活检结果分为前列腺癌组与非前列腺癌组.比较两组前列腺特异性抗原(PSA)相关参数及首次穿刺时病理结果的差异,并分析影响第二次穿刺活检阳性率的相关因素.结果 前列腺癌组家族史、前列腺特异性抗原速率(PSAV)、前列腺特异性抗原密度(PSAD)水平

  8. Thirty-two-channel coil 3T magnetic resonance-guided biopsies of prostate tumor suspicious regions identified on multimodality 3T magnetic resonance imaging: technique and feasibility.

    NARCIS (Netherlands)

    Hambrock, T.; Futterer, J.J.; Huisman, H.J.; Hulsbergen- van de Kaa, C.A.; Basten, JP van; Oort, I van; Witjes, J.A.; Barentsz, J.O.

    2008-01-01

    OBJECTIVES: To test the technique and feasibility of translating tumor suspicious region maps in the prostate, obtained by multimodality, anatomic, and functional 3T magnetic resonance imaging (MRI) data to 32-channel coil, T2-weighted (T2-w), 3T MR images, for directing MR-guided biopsies. Furtherm

  9. Impact of preoperative screening for rectal colonization with fluoroquinolone-resistant enteric bacteria on the incidence of sepsis following transrectal ultrasound guided prostate biopsy

    Science.gov (United States)

    Farrell, John J; Hicks, Jennifer L; Wallace, Stephanie E; Seftel, Allen D

    2017-01-01

    With the universal adoption of antibiotic prophylaxis prior to prostate biopsy, the current risk of post-biopsy infection (including sepsis) is study of preoperative rectal cultures to screen for rectal colonization with fluoroquinolone-resistant bacteria using ciprofloxacin-supplemented MacConkey agar culture media. To evaluate the feasibility and practicality of this test, one provider used the results of rectal swab cultures collected during the preoperative outpatient evaluation to adjust each patient’s preoperative antibiotic prophylaxis when fluoroquinolone-resistant enteric bacteria were detected, whereas two other providers continued usual preoperative care and empiric antimicrobial prophylaxis. Rectal colonization with fluoroquinolone-resistant bacteria was detected in 19/152 (12.5%) of patients. In our intention-to-treat analysis (N=268), the rate of post-biopsy sepsis was 3.6% lower in the group that was screened for rectal colonization with fluoroquinolone-resistant bacteria prior to transrectal prostate biopsy. The observed risk reduction in the rectal screening group trended toward, but did not achieve, statistical significance. We suggest that preoperative screening for rectal colonization with fluoroquinolone-resistant enteric bacteria may be a useful step toward mitigating post-prostate biopsy sepsis. PMID:28280717

  10. Prolonged antibiotic therapy increases risk of infection after transrectal prostate biopsy: A case report after pancreasectomy and review of the literature

    Directory of Open Access Journals (Sweden)

    Guevar Maselli

    2014-12-01

    Full Text Available Infection due to prostate biopsy afflicted more than 5% of patients and is the most common reason for hospitalization. A large series from US SEER-Medicare reported that men undergoing biopsy were 2.26 times more likely to be hospitalized for infectious complications within 30 days compared with randomly selected controls. The factors predicting a higher susceptibility to infection remain largely unknown but some authors have higlighted in the etiopathogenesis the importance of the augmented prevalence of ciprofloxacin resistant variant of bacteria in the rectum flora. We present one case of sepsis after transrectal prostate biopsy in a patient with history of pancreatic surgery. Based on our experience patients candidated to prostate biopsy with transrectal technique with history of recent major surgery represent an high risk category for infective complication. Also major pancreatic surgery should be consider an high risk category for infection. A transperineal approach and preventive measures (such as rectal swab should be adopted to reduce biopsy driven infection.

  11. Prostate Cancer Screening: the role of biopsy, PSA, PSA dynamics and isoforms

    NARCIS (Netherlands)

    P.F.J. Raaijmakers (René)

    2009-01-01

    textabstractIn the beginning of the past century, A. Astraldi urologist from Buenos Aires, Argentina, recognized the importance of early detection of prostate cancer and was unsatisfied with the available diagnostic tools he had to his disposal. The only diagnostic means for the urologist at that ti

  12. Magnetic resonance imaging-targeted, 3D transrectal ultrasound-guided fusion biopsy for prostate cancer: Quantifying the impact of needle delivery error on diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Martin, Peter R., E-mail: pmarti46@uwo.ca [Department of Medical Biophysics, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Cool, Derek W. [Department of Medical Imaging, The University of Western Ontario, London, Ontario N6A 3K7, Canada and Robarts Research Institute, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Romagnoli, Cesare [Department of Medical Imaging, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Fenster, Aaron [Department of Medical Biophysics, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Department of Medical Imaging, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Robarts Research Institute, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Ward, Aaron D. [Department of Medical Biophysics, The University of Western Ontario, London, Ontario N6A 3K7 (Canada); Department of Oncology, The University of Western Ontario, London, Ontario N6A 3K7 (Canada)

    2014-07-15

    Purpose: Magnetic resonance imaging (MRI)-targeted, 3D transrectal ultrasound (TRUS)-guided “fusion” prostate biopsy intends to reduce the ∼23% false negative rate of clinical two-dimensional TRUS-guided sextant biopsy. Although it has been reported to double the positive yield, MRI-targeted biopsies continue to yield false negatives. Therefore, the authors propose to investigate how biopsy system needle delivery error affects the probability of sampling each tumor, by accounting for uncertainties due to guidance system error, image registration error, and irregular tumor shapes. Methods: T2-weighted, dynamic contrast-enhanced T1-weighted, and diffusion-weighted prostate MRI and 3D TRUS images were obtained from 49 patients. A radiologist and radiology resident contoured 81 suspicious regions, yielding 3D tumor surfaces that were registered to the 3D TRUS images using an iterative closest point prostate surface-based method to yield 3D binary images of the suspicious regions in the TRUS context. The probabilityP of obtaining a sample of tumor tissue in one biopsy core was calculated by integrating a 3D Gaussian distribution over each suspicious region domain. Next, the authors performed an exhaustive search to determine the maximum root mean squared error (RMSE, in mm) of a biopsy system that gives P ≥ 95% for each tumor sample, and then repeated this procedure for equal-volume spheres corresponding to each tumor sample. Finally, the authors investigated the effect of probe-axis-direction error on measured tumor burden by studying the relationship between the error and estimated percentage of core involvement. Results: Given a 3.5 mm RMSE for contemporary fusion biopsy systems,P ≥ 95% for 21 out of 81 tumors. The authors determined that for a biopsy system with 3.5 mm RMSE, one cannot expect to sample tumors of approximately 1 cm{sup 3} or smaller with 95% probability with only one biopsy core. The predicted maximum RMSE giving P ≥ 95% for each

  13. Development and preliminary evaluation of a motorized needle guide template for MRI-guided targeted prostate biopsy.

    Science.gov (United States)

    Song, Sang-Eun; Tokuda, Junichi; Tuncali, Kemal; Tempany, Clare M; Zhang, Elizabeth; Hata, Nobuhiko

    2013-11-01

    To overcome the problems of limited needle insertion accuracy and human error in the use of a conventional needle guide template in magnetic resonance imaging (MRI)-guided prostate intervention, we developed a motorized MRI-compatible needle guide template that resembles a transrectal ultrasound-guided prostate template. The motorized template allows automated, gapless needle guidance in a 3T MRI scanner with minimal changes in the current clinical procedure. To evaluate the impact of the motorized template on MRI, signal-to-noise ratio and distortion were measured under various system configurations. A maximum of 44% signal-to-noise ratio decrease was found when the ultrasonic motors were running, and a maximum of 0.4% image distortion was observed due to the presence of the motorized template. To measure needle insertion accuracy, we performed four sets of five random target needle insertions mimicking four biopsy procedures, which resulted in an average in-plane targeting error of 0.94 mm with a standard deviation of 0.34 mm. The evaluation studies indicated that the presence and operation of the motorized template in the MRI bore create insignificant image degradation, and provide submillimeter targeting accuracy. The automated needle guide that is directly controlled by navigation software eliminates human error so that the safety of the procedure can be improved.

  14. Laparoscopic Sentinel Lymph Node Biopsy for Prostate Cancer: The Relevance of Locations Outside the Extended Dissection Area

    Directory of Open Access Journals (Sweden)

    W. Meinhardt

    2012-01-01

    Full Text Available Objective. To assess the relevance of sentinel lymph nodes (SNs outside the extended pelvic lymph node dissection area (e-PLND. Patients and Methods. Evaluation of our laparoscopic SN procedures for prostate cancer patients of intermediate prognosis. Retrospective data collection on the exact location of the excised SNs and the pathology results were analyzed. Results and Limitations. Of the 121 patients, 49 had positive lymph nodes. 37 patients (31% had SNs outside the e-PLND template. Five of these nodes were tumor bearing but only twice exclusively so. Of the 14 patients considered for salvage treatment, 6 were node positive. 7 of these 14 patients (50% had SNs outside the extended dissection area, yet none of these nodes were tumor positive. Limitations are those of a retrospective study. Conclusions. Laparoscopic SN biopsy may show SNs outside the e-PLND template in 31% of the patients. However, nodes that are exclusively positive in one of these areas are rare. For the dichotomy positive or negative nodes, the locations outside the e-PLND area are not often relevant. Nevertheless, when all positive nodes are to be treated by resection or radiotherapy, these locations are relevant. When considering salvage treatment for prostate cancer, the method is feasible.

  15. Importance of Local Control in Early-Stage Prostate Cancer: Outcomes of Patients With Positive Post-Radiation Therapy Biopsy Results Treated in RTOG 9408

    Energy Technology Data Exchange (ETDEWEB)

    Krauss, Daniel J., E-mail: dkrauss@beaumont.edu [Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan (United States); Hu, Chen [NRG Statistics and Data Management Center, Philadelphia, Pennsylvania (United States); Bahary, Jean-Paul [Centre Hospitalier de l' Université de Montréal-Notre Dame, Montreal, Quebec (Canada); Souhami, Luis [McGill University, Montreal, Quebec (Canada); Gore, Elizabeth M. [Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Chafe, Susan Maria Jacinta [Cross Cancer Institute, Edmonton, Alberta (Canada); Leibenhaut, Mark H. [Sutter General Hospital, Sacramento, California (United States); Narayan, Samir [Michigan Cancer Research Consortium CCOP (United States); Torres-Roca, Javier [H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida (United States); Michalski, Jeff [Washington University, St. Louis, Missouri (United States); Zeitzer, Kenneth L. [Albert Einstein Medical Center, Bronx, New York, New York (United States); Donavanik, Viroon [Christiana Care Health Services Inc CCOP, Newark, Delaware (United States); Sandler, Howard [Cedars-Sinai Medical Center, Los Angeles, California (United States); McGowan, David G. [Cross Cancer Institute, Edmonton, Alberta (Canada); Jones, Christopher U. [Sutter General Hospital, Sacramento, California (United States); Shipley, William U. [Dana-Farber Cancer Institute, Boston, Massachusetts (United States)

    2015-07-15

    Purpose: The purpose of this study was to assess the association between positive post-radiation therapy (RT) biopsy results and subsequent clinical outcomes in males with localized prostate cancer. Methods and Materials: Radiation Therapy Oncology Group study 94-08 analyzed 1979 males with prostate cancer, stage T1b-T2b and prostate-specific antigen concentrations of ≤20 ng/dL, to investigate whether 4 months of total androgen suppression (TAS) added to RT improved survival compared to RT alone. Patients randomized to receive TAS received flutamide with luteinizing hormone releasing hormone (LHRH) agonist. According to protocol, patients without evidence of clinical recurrence or initiation of additional endocrine therapy underwent repeat prostate biopsy 2 years after RT completion. Statistical analysis was performed to evaluate the impact of positive post-RT biopsy results on clinical outcomes. Results: A total of 831 patients underwent post-RT biopsy, 398 were treated with RT alone and 433 with RT plus TAS. Patients with positive post-RT biopsy results had higher rates of biochemical failure (hazard ratio [HR] = 1.7; 95% confidence interval [CI] = 1.3-2.1) and distant metastasis (HR = 2.4; 95% CI = 1.3-4.4) and inferior disease-specific survival (HR = 3.8; 95% CI = 1.9-7.5). Positive biopsy results remained predictive of such outcomes after correction for potential confounders such as Gleason score, tumor stage, and TAS administration. Prior TAS therapy did not prevent elevated risk of adverse outcome in the setting of post-RT positive biopsy results. Patients with Gleason score ≥7 with a positive biopsy result additionally had inferior overall survival compared to those with a negative biopsy result (HR = 1.56; 95% CI = 1.04-2.35). Conclusions: Positive post-RT biopsy is associated with increased rates of distant metastases and inferior disease-specific survival in patients treated with definitive RT and was associated with inferior overall

  16. 丁卡因胶浆在经直肠前列腺穿刺活检中的临床应用价值%Tetracaine Hydrochloride Jelly for clinical value during Transrectal Ultrasound guided biopsy of the prostate

    Institute of Scientific and Technical Information of China (English)

    邓晓俊; 刘辉; 刘峰; 王伟峰; 郝继东; 万建省; 刘波

    2014-01-01

    taking biopsy were 5.5 ± 1.7and 3.3 ± 1.5 (P =0.211 > 0.05),respectively.Conclusions TRUS-guided prostate biopsy of the prostate can be safely whether or not anaesthesia in patients.But used 1% Tetracaine Hydrochloride Jelly in the rectal and perianal before TURS-guided prostate biopsy is an effective method for relieving biopsy-relate pain during the procedure.

  17. Accuracy of 3 Tesla pelvic phased-array multiparametric MRI in diagnosing prostate cancer at repeat biopsy

    Directory of Open Access Journals (Sweden)

    Pietro Pepe

    2014-12-01

    Full Text Available Introduction. Multiparametric pelvic magnetic resonance imaging (mpMRI accuracy in prostate cancer (PCa diagnosis was evaluated. Materials and Methods. From June 2011 to December 2013, 168 patients (median 65 years with negative digital rectal examination underwent repeat transperineal saturation biopsy (SPBx; median 28 cores for persistently high or increasing PSA values, PSA >10 ng/ml or PSA values between 4.1-10 o r 2.6-4 ng/ml with free/total PSA < 25% and < 20%, respectively. All patients underwent mpMRI using a 3.0 Tesla scanner equipped with surface 16 channels phased-array coil and lesions suspicious for PCa were submitted to additional targeted biopsies. Results. A T1c PCa was found in 66 (39% cases; SPBx and mpMRI-suspicious targeted biopsy diagnosed 60 (91% and 52 (78.8% cancers missing 6 (all of the anterior zone and 14 cancers (12 and 2 of the lateral margins and anterior zone, respectively; in detail, mpMRI missed 12 (18.1% PCa charaterized by microfocal (1 positive core with greatest percentage of cancer and Gleason score equal to 5% and 6, respectively disease at risk for insignificant cancer. The diameter of the suspicious mpMRI lesion was directly correlated to the diagnosis of PCa with poor Gleason score (p < 0.05; detection rate of cancer for each suspicious mpMRI core was 35.3%. Diagnostic accuracy, sensitivity, specificity, positive and negative predictive value of mpMRI in diagnosing PCa was 75.7%, 82.5%, 71.8%, 78.9%, 87.9%, respectively. Conclusion. Multiparametric pMRI improved SPBx accuracy in diagnosing significant anterior PCa; the diameter of mpMRI suspicious lesion resulted significantly predictive of aggressive cancers.

  18. Possible relations between oxidative damage and apoptosis in benign prostate hyperplasia and prostate cancer patients.

    Science.gov (United States)

    Kosova, Funda; Temeltaş, Gökhan; Arı, Zeki; Lekili, Murat

    2014-05-01

    Cancer has been described as the twentieth century plague, and is a very common health problem. It has been reported that ROS and ROS products play a key role in cancer and that oxidative damage is effective in apoptosis initiation. In this study we aimed to evaluate the relationship between MDA (malondialdehyde), DNA damage (8-hydroxyguanine, 8-OH-dG), and caspase-3 in BHP and prostate cancer patients. Twenty male patients with prostate cancer and 20 male patients with benign prostate hyperplasia were included into this study. The MDA (nanomole), DNA damage (nanograms per millilitre), and caspase-3 (nanograms per millilitre) levels were measured in prostate cancer and benign prostate hyperplasia using Elisa kits (Millipore Corporation, Billerica, MA, USA). In the prostate cancer group, serum MDA (30.96 ± 9.25) and DNA damage (4.42 ± 0.36) levels were significantly raised (p benign prostate hyperplasia group (24.05 ± 8.06, 3.99 ± 0.54). However, in the prostate cancer group, serum caspase-3 (2.36 ± 0.82) levels were statistically significantly lowered (p benign prostate hyperplasia group (3.15 ± 1.04). We observed that altered prooxidant, DNA damage levels may lead to an increase in oxidative damage and may consequently play an important role in prostate carcinogenesis. These findings indicate that, although the triggering of these changes is unknown, changes in the levels of MDA, DNA damage, and caspase-3 in the blood are related to prostatic carcinoma development. In addition, it would be appropriate to conduct new studies with a large number of patients at different stages.

  19. Molecular Markers for Prostate Cancer Risk Stratification from Multiple Ultrasound-Guided Biopsies

    Science.gov (United States)

    2014-12-01

    2.1 Months 1-2: Sort nuclei, amplify DNA , create sequencing libraries for cells from first 12 cores. Sequence 12-24 cells from each core sample...cells per biopsy. 2.1 Months 10-12: Sort nuclei, amplify DNA , create sequencing libraries for cells from first 12 cores. Sequence 12-24 cells from...that this line of investigation should be extended to deeper DNA sequencing on a clinically relevant number of cases in order to establish prognostic

  20. Risk of Pathologic Upgrading or Locally Advanced Disease in Early Prostate Cancer Patients Based on Biopsy Gleason Score and PSA: A Population-Based Study of Modern Patients

    Energy Technology Data Exchange (ETDEWEB)

    Caster, Joseph M.; Falchook, Aaron D. [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Hendrix, Laura H. [Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Chen, Ronald C., E-mail: Ronald_chen@med.unc.edu [Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States); Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (United States)

    2015-06-01

    Purpose: Radiation oncologists rely on available clinical information (biopsy Gleason score and prostate-specific antigen [PSA]) to determine the optimal treatment regimen for each prostate cancer patient. Existing published nomograms correlating clinical to pathologic extent of disease were based on patients treated in the 1980s and 1990s at select academic institutions. We used the Surveillance, Epidemiology, and End Results (SEER) database to examine pathologic outcomes (Gleason score and cancer stage) in early prostate cancer patients based on biopsy Gleason score and PSA concentration. Methods and Materials: This analysis included 25,858 patients whose cancer was diagnosed between 2010 and 2011, with biopsy Gleason scores of 6 to 7 and clinical stage T1 to T2 disease, who underwent radical prostatectomy. In subgroups based on biopsy Gleason score and PSA level, we report the proportion of patients with pathologically advanced disease (positive surgical margin or pT3-T4 disease) or whose Gleason score was upgraded. Logistic regression was used to examine factors associated with pathologic outcomes. Results: For patients with biopsy Gleason score 6 cancers, 84% of those with PSA <10 ng/mL had surgical T2 disease with negative margins; this decreased to 61% in patients with PSA of 20 to 29.9 ng/mL. Gleason score upgrading was seen in 43% (PSA: <10 ng/mL) to 61% (PSA: 20-29.9 ng/mL) of biopsy Gleason 6 patients. Patients with biopsy Gleason 7 cancers had a one-third (Gleason 3 + 4; PSA: <10 ng/mL) to two-thirds (Gleason 4 + 3; PSA: 20-29.9 ng/mL) probability of having pathologically advanced disease. Gleason score upgrading was seen in 11% to 19% of patients with biopsy Gleason 4 + 3 cancers. Multivariable analysis showed that higher PSA and older age were associated with Gleason score upgrading and pathologically advanced disease. Conclusions: This is the first population-based study to examine pathologic extent of disease and pathologic Gleason score

  1. Oral antibiotics in trans-rectal prostate biopsy and its efficacy to reduce infectious complications: Systematic review

    Directory of Open Access Journals (Sweden)

    Mohand Deeb Yaghi

    2015-01-01

    Full Text Available For the diagnosis of prostate cancer trans-rectal prostate biopsy (TRPB is used commonly, the procedure is associated with infective complications. There is evidence that antibiotics (ABx decrease infective events after TRPB, but different regimens are used. To systematically review different regimens of prophylactic oral ABx in TRPB. MEDLINE, EMBASE, clinical trials site, and Cochrane library were searched, experts were consulted for relevant studies. Randomized clinical trials conducted in the last 20 years, which investigated the different oral antibiotic regimens in TRPB, and compared their efficacy to reduce infectious complications were analyzed. Primary outcomes were bacteriuria, urinary tract infection (UTI, fever, bacteremia, and sepsis. Secondary outcomes were the hospitalization rate and the prevalence of ABx-resistant bacteria. Nine trials were eligible with 3012 patients. ABx prevented bacteriuria (3.5% vs. 9.88%, UTI (4.46% vs. 9.75%, and hospitalization (0.21% vs. 2.13% significantly in comparison with placebo or no treatment. No significant difference was found in all the outcomes of the review between the single dose regimen and the 3 days. The single dose regimen was as effective as the multiple doses except in bacteriuria (6.75% vs. 3.25%, and the prevalence of ABx-resistant bacteria (1.57% vs. 0.27%. Quinolones reduced only UTI significantly in comparison with other ABx (chloramphenicol, trimethoprim-sulfamethoxazol. It is essential to prescribe prophylactic ABx in TRPB. No conclusive evidence could be claimed about the superiority of the multiple or the 3 days regimens to the single dose regimen. Unexpectedly, ABx-resistant bacteria were identified more often in the single dose cohorts.

  2. Prostate cancer: performance characteristics of combined T{sub 2}W and DW-MRI scoring in the setting of template transperineal re-biopsy using MR-TRUS fusion

    Energy Technology Data Exchange (ETDEWEB)

    Lawrence, Edward M. [University of Cambridge, Department of Radiology, Cambridge (United Kingdom); Addenbrooke' s Hospital, Department of Radiology, Cambridge (United Kingdom); Albert Einstein College of Medicine, Bronx, NY (United States); Tang, Sarah Y.W.; Doble, Andrew; Kastner, Christof [University of Cambridge, Department of Urology, Addenbrooke' s Hospital, Cambridge (United Kingdom); Barrett, Tristan [University of Cambridge, Department of Radiology, Cambridge (United Kingdom); Addenbrooke' s Hospital, Department of Radiology, Cambridge (United Kingdom); Koo, Brendan [Addenbrooke' s Hospital, Department of Radiology, Cambridge (United Kingdom); Goldman, Debra A.; Sala, Evis [Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Warren, Anne Y. [Addenbrooke' s Hospital, Department of Histopathology, Cambridge (United Kingdom); Axell, Richard G. [Addenbrooke' s Hospital, Department of Medical Physics and Clinical Engineering, Cambridge (United Kingdom); Anglia Ruskin University, Postgraduate Medical Institute, Chelmsford (United Kingdom); Gallagher, Ferdia A. [University of Cambridge, Department of Radiology, Cambridge (United Kingdom); Addenbrooke' s Hospital, Department of Radiology, Cambridge (United Kingdom); CRUK Cambridge Research Institute, Cambridge (United Kingdom); Gnanapragasam, Vincent J. [University of Cambridge, Department of Urology, Addenbrooke' s Hospital, Cambridge (United Kingdom); University of Cambridge, Translational Prostate Cancer Group, Department of Oncology, Cambridge (United Kingdom)

    2014-07-15

    To measure the performance characteristics of combined T{sub 2}-weighted (T{sub 2}W) and diffusion-weighted (DW) magnetic resonance imaging (MRI) suspicion scoring prior to MR-transrectal ultrasound (TRUS) fusion template transperineal (TTP) re-biopsy. Thirty-nine patients referred for prostate re-biopsy, with prior MRI examinations, were retrospectively included. The MR images, including T{sub 2}W and DW-MRI, had been independently evaluated prospectively by two radiologists using a structured scoring system. An MR-TRUS fusion TTP re-biopsy was used for MR target and non-targeted biopsy cores. Targeting performance and correlation with disease status were evaluated on a per-patient and per-region basis. The cancer yield was 41 % (16/39 patients). MR targeting accurately detected the disease in 12/16 (75 %) cancerous patients and missed the disease in 4/16 (25 %) patients, all with Gleason 3 + 3 disease. There was a significant relationship (P < 0.01) between MR suspicion score and the significance of cancer. Reader 1 had significantly higher sensitivity in the transition zone (TZ; 0.84) compared with the peripheral zone (PZ; 0.32) (P = 0.04). Inter-reader agreement was moderate for the PZ and substantial for the TZ. MRI targeting is beneficial in the setting of TTP MR-TRUS fusion re-biopsy and MR suspicion score relates to prostate cancer clinical significance. A T{sub 2}W and DW-MRI structured scoring system results in good inter-reader agreement in this setting. (orig.)

  3. Can a Gleason 6 or Less Microfocus of Prostate Cancer in One Biopsy and Prostate-Specific Antigen Level <10 ng/mL Be Defined as the Archetype of Low-Risk Prostate Disease?

    Directory of Open Access Journals (Sweden)

    Gianluigi Taverna

    2012-01-01

    Full Text Available Prostate cancer (PC remains a cause of death worldwide. Here we investigate whether a single microfocus of PC at the biopsy (graded as Gleason 6 or less, ≤5% occupancy and the PSA <10 ng/mL can define the archetype of low-risk prostate disease. 4500 consecutive patients were enrolled. Among them, 134 patients with a single micro-focus of PC were followed up, and the parameters influencing the biochemical relapse (BR were analysed. Out of 134 patients, 94 had clinically significant disease, specifically in 74.26% of the patients with PSA <10 ng/mL. Positive surgical margins and the extracapsular invasion were found in 29.1% and 51.4% patients, respectively. BR was observed in 29.6% of the patients. Cox regression evidenced a correlation between the BR and Gleason grade at the retropubic radical prostatectomy (RRP, capsular invasion, and the presence of positive surgical margins. Multivariate regression analysis showed a statistically significant correlation between the presence of surgical margins at the RRP and BR. Considering a single micro-focus of PC at the biopsy and PSA serum level <10 ng/mL, clinically significant disease was found in 74.26% patients and only positive surgical margins are useful for predicting the BR.

  4. Automated high-throughput assessment of prostate biopsy tissue using infrared spectroscopic chemical imaging

    Science.gov (United States)

    Bassan, Paul; Sachdeva, Ashwin; Shanks, Jonathan H.; Brown, Mick D.; Clarke, Noel W.; Gardner, Peter

    2014-03-01

    Fourier transform infrared (FT-IR) chemical imaging has been demonstrated as a promising technique to complement histopathological assessment of biomedical tissue samples. Current histopathology practice involves preparing thin tissue sections and staining them using hematoxylin and eosin (H&E) after which a histopathologist manually assess the tissue architecture under a visible microscope. Studies have shown that there is disagreement between operators viewing the same tissue suggesting that a complementary technique for verification could improve the robustness of the evaluation, and improve patient care. FT-IR chemical imaging allows the spatial distribution of chemistry to be rapidly imaged at a high (diffraction-limited) spatial resolution where each pixel represents an area of 5.5 × 5.5 μm2 and contains a full infrared spectrum providing a chemical fingerprint which studies have shown contains the diagnostic potential to discriminate between different cell-types, and even the benign or malignant state of prostatic epithelial cells. We report a label-free (i.e. no chemical de-waxing, or staining) method of imaging large pieces of prostate tissue (typically 1 cm × 2 cm) in tens of minutes (at a rate of 0.704 × 0.704 mm2 every 14.5 s) yielding images containing millions of spectra. Due to refractive index matching between sample and surrounding paraffin, minimal signal processing is required to recover spectra with their natural profile as opposed to harsh baseline correction methods, paving the way for future quantitative analysis of biochemical signatures. The quality of the spectral information is demonstrated by building and testing an automated cell-type classifier based upon spectral features.

  5. 超声引导下经直肠前列腺穿刺活检术的护理%Nursing of Ultrasound-guided Transretal Prostatic Biopsy

    Institute of Scientific and Technical Information of China (English)

    康杰; 康庆; 雷志蕊; 李琰峰

    2015-01-01

    Objective: To summarize the nursing experience of the ultrasound guided percutaneous biopsy of the prostate in our hospital during the last 2 years. Method:To analyze 58 cases of PSA value of the prostate biopsy of the rectum were elevated in patients with suspected prostate cancer from March 2013-February2015. Results:58 cases of ultrasound guided by transrectal prostate biopsy in patients with targeted nursing, postoperative active prevention and use of Chinese Medicine auxiliary means in the treatment of bleeding, infection, pain etc., reduce complications occurred. Conclusion:Under the guidance of ultrasound, the prostate biopsy is safe and reliable, help improve the diagnosis of prostate cancer, to observe the changes of the disease and to do nursing timely, can prevent complications caused by prostate puncture, reduce the side effect and promote the complications as soon as possible to eliminate the obvious effect and positive significance.%目的:总结近两年来北京中医药大学东直门医院行超声引导下经直肠前列腺穿刺活检术的护理体会。方法:分析2013年3月-2015年2月经直肠前列腺穿刺活检的58例PSA值升高可疑前列腺癌患者。结果:58例超声引导下经直肠前列腺穿刺活检术的患者通过针对性护理,术后积极预防,运用中医辅助手段治疗出血、感染、疼痛等减少并发症的发生。结论:经超声引导下经直肠前列腺穿刺活检术是一种安全可靠,有助于提高前列腺癌的诊断率,术后及时有针对性的观察病情变化做好护理,对前列腺穿刺术引起并发症的预防,减轻副反应及促进并发症尽早消除有明显的效果和积极意义。

  6. MR-sequences for prostate cancer diagnostics: validation based on the PI-RADS scoring system and targeted MR-guided in-bore biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Schimmoeller, Lars; Quentin, Michael; Buchbender, Christian; Antoch, Gerald; Blondin, Dirk [University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf (Germany); Arsov, Christian; Hiester, Andreas; Rabenalt, Robert; Albers, Peter [University Dusseldorf, Medical Faculty, Department of Urology, Dusseldorf (Germany)

    2014-10-15

    This study evaluated the accuracy of MR sequences [T2-, diffusion-weighted, and dynamic contrast-enhanced (T2WI, DWI, and DCE) imaging] at 3T, based on the European Society of Urogenital Radiology (ESUR) scoring system [Prostate Imaging Reporting and Data System (PI-RADS)] using MR-guided in-bore prostate biopsies as reference standard. In 235 consecutive patients [aged 65.7 ± 7.9 years; median prostate-specific antigen (PSA) 8 ng/ml] with multiparametric prostate MRI (mp-MRI), 566 lesions were scored according to PI-RADS. Histology of all lesions was obtained by targeted MR-guided in-bore biopsy. In 200 lesions, biopsy revealed prostate cancer (PCa). The area under the curve (AUC) for cancer detection was 0.70 (T2WI), 0.80 (DWI), and 0.74 (DCE). A combination of T2WI + DWI, T2WI + DCE, and DWI + DCE achieved an AUC of 0.81, 0.78, and 0.79. A summed PI-RADS score of T2WI + DWI + DCE achieved an AUC of 0.81. For higher grade PCa (primary Gleason pattern ≥ 4), the AUC was 0.85 for T2WI + DWI, 0.84 for T2WI + DCE, 0.86 for DWI + DCE, and 0.87 for T2WI + DWI + DCE. The AUC for T2WI + DWI + DCE for transitional-zone PCa was 0.73, and for the peripheral zone 0.88. Regarding higher-grade PCa, AUC for transitional-zone PCa was 0.88, and for peripheral zone 0.96. The combination of T2WI + DWI + DCE achieved the highest test accuracy, especially in patients with higher-grade PCa. The use of ≤2 MR sequences led to lower AUC in higher-grade and peripheral-zone cancers. (orig.)

  7. Pathologic diagnosis and Gleason grading of prostatic carcinoma by transrectal ultrasound-guided prostate needle biopsy%穿刺活检前列腺癌72例病理形态学观察及Gleason分级

    Institute of Scientific and Technical Information of China (English)

    王云帆; 缪琦; 王淑芳; 饶晓松

    2013-01-01

    目的 观察经直肠超声引导的前列腺癌穿刺活检组织的病理形态学改变,进行系统的Gleason分级.方法 收集经直肠超声引导的前列腺穿刺活检诊断的前列腺癌72例,复习HE组织切片,并依据2005年国际泌尿病理学协会(ISUP)修订的前列腺癌Gleason分级系统进行分级.结果 72例前列腺癌中53例的主要及次要成分为3级结构(73.6%),59例主要及次要成分为4级结构(81.9%),12例主要及次要成分为5级结构(16.7%).结论 本组前列腺癌Gleason 4级结构与3级结构常常混合存在,而且4级结构相比3级结构更为常见.修订后的Gleason分级系统有助于对前列腺癌进行规范分级,以利于进一步研究,准确反映肿瘤的预后差异.%Objective To study the morphological diagnostic criteria and Gleason grading of prostatic carcinoma in transrectal ultrasound guided prostate needle biopsy. Methods 72 cases of prostatic needle biopsy guided by transrectal ultrasound were reviewed. Routine pathological examination was used in the study. Data with respect to Gleason grading were studied according to the refinements of the ISUP 2005 consensus conference on Gleason grading of needle biopsies. Results The results showed that Gleason pattern 3 was seen in 73. 61% ; pattern 4 in 81. 94% ; pattern 5 in 16. 67% among 72 cases of prostatic carcinoma. Conclusions Most of the tumors show at least two different patterns, and the pattern 4 is more common than pattern 3. The use of modified Gleason scoring leads to improves the prognostic value of the patients with prostate cancer and can be more accurately assessed in transrectal ultrasound guided prostate needle biopsy. Continued effort is required to refine biopsy strategies to Gleason grading of prostatic specimens.

  8. Vitamin D and Related Genes, Race, and Prostate Cancer Aggressiveness

    Science.gov (United States)

    2014-10-01

    SUBTITLE 5a. CONTRACT NUMBER Vitamin D and Related Genes, Race, and Prostate Cancer 5b. GRANT NUMBER W81XWH-11-1-0568 Aggressiveness 5c. PROGRAM...examine whether altered vitamin D status (as measured by serum metabolites and by functional polymorphisms within genes related to vitamin D...potential to provide insights into a chronically underserved population carrying an unequal burden of disease. 15. SUBJECT TERMS Vitamin D, prostate

  9. VEGF and prostatic cancer: a systematic review.

    Science.gov (United States)

    Botelho, Francisco; Pina, Francisco; Lunet, Nuno

    2010-09-01

    Elevated vascular endothelial growth factor (VEGF) blood concentration reflects its prostatic production, making this a potentially interesting tumour marker to support the decision of submitting a patient for prostatic biopsy. The objective was to review systematically the evidence on the role of VEGF blood concentration in prostate cancer detection. Published studies addressing the relation between serum or plasma VEGF levels and prostate cancer were identified by searching Pubmed, ISI Web of Knowledge, SCOPUS and LILACS up to January 2010, and reviewed following a standardized protocol. Three studies reported higher plasma VEGF (pg/ml) in patients with localized prostate cancer than in healthy controls (7.0 vs. 0.0, 9.9 vs. 2.2, and 210 vs. 26.5, Pprostate cancer patients than in patients with benign prostate hypertrophy (518.9 vs. 267.9, Pbenign prostate hypertrophy, localized or metastatic prostate cancer. The three studies that used controls with previous suspicion of prostatic cancer but a negative biopsy reported non-statistically significant difference in VEGF serum levels (pg/ml) between controls and localized prostate cancer patients (241 vs. 206; 69.5 vs. 55; 215.2 vs. 266.4). Higher VEGF plasma levels are observed in prostatic cancer patients compared with healthy controls, but serum levels do not appear to be useful in differentiating benign from malignant prostatic disease using, as controls, individuals with high risk of prostate cancer and negative biopsy.

  10. The predictability of T3 disease in staging MRI following prostate biopsy decreases in patients with high initial PSA and Gleason score

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    Young Hwii Ko; Deuk Jae Sung; Sung Gu Kang; Seok Ho Kang; Jeong Gu Lee; Je Jong Kim; Jun Cheon

    2011-01-01

    To obtain improved accuracy in predicting extracapsular extension (ECE) and seminal vesicle invasion (SVI), we evaluated the variables affecting the predictability of staging magnetic resonance imaging (MRI, phased-array coil) and estimated their impact on accuracy between preoperative MRI staging and histological outcome. A total of 121 patients with localized or locally advanced prostate cancer who underwent robotic radical prostatectomy (RALP) were included. Following transrectal biopsy, all enrolled patients had undergone MRI for staging work-up. After RALP, only 43.8% (53/121) of the patients were matched with the MRI predicted stage. Compared to the matched group in the prediction of ECE, the unmatched group had significantly higher initial prostate-specific antigen (PSA, 12.8 ng ml-1 versus 8.1 ng ml-1, P=0.048). In the prediction of SVI, initial PSA (8.1 ng ml-1 versus 17.3 ng ml-1, P=0.009) and biopsy Gleason score (6.5 versus 7.6, P=0.035) were significantly higher in the unmatched group. When applying clinical cutoffs of initial PSA of 10 and 20 ng ml-1, the accuracy of MRI in the prediction of ECE was decreased in the group with PSA over 20 ng ml-1 (75.6,64.5 and 37.5%, P=0.01), and this group had significantly decreased accuracy of MRI in the prediction of SVI (91.5,77.4 and 37.5%, P<0.01). Applying the clinical cutoff of a Gleason score of 7, the accuracy of MRI in the prediction of SVI was decreased in the higher Gleason score group (93.9,82.1 and 62.9%, P=0.01). Thus, for these patient groups, to obtain margin negativity during radical prostatectomy, operative findings, rather than post-biopsy MRI images, may provide substantial information, implying a clinical advantage in conducting MRI before prostate biopsy.

  11. Occurrence of infection following prostate biopsy procedures in Japan: Japanese Research Group for Urinary Tract Infection (JRGU) - a multi-center retrospective study.

    Science.gov (United States)

    Togo, Yoshikazu; Kubo, Tatsuhiko; Taoka, Rikiya; Hiyama, Yoshiki; Uehara, Teruhisa; Hashimoto, Jiroh; Kurimura, Yuichiro; Takahashi, Satoshi; Tsukamoto, Taiji; Miyazaki, Jun; Nishiyama, Hiroyuki; Kira, Shinichiro; Kiyota, Hiroshi; Yazawa, Satoshi; Niwa, Naoya; Hongo, Hiroshi; Oya, Mototsugu; Kato, Taku; Yasuda, Mitsuru; Deguchi, Takashi; Ishikawa, Kiyohito; Hoshinaga, Kiyotaka; Matsumoto, Minori; Shigemura, Katsumi; Tanaka, Kazushi; Arakawa, Soichi; Fujisawa, Masato; Wada, Koichiro; Uehara, Shinya; Watanabe, Toyohiko; Kumon, Hiromi; Kobayashi, Kanao; Matsubara, Akio; Matsumoto, Masahiro; Sho, Takehiko; Hamasuna, Ryoichi; Matsumoto, Tetsuro; Hayami, Hiroshi; Nakagawa, Masayuki; Yamamoto, Shingo

    2014-04-01

    We retrospectively investigated the incidence of genitourinary tract infection in 5895 patients who underwent transrectal and/or transperineal prostate biopsy procedure between January and December 2011 at 46 institutions belonging to Japanese Research Group for Urinary Tract Infection (JRGU). The total rate of genitourinary tract infection after prostate biopsy was 0.76%, while that following transrectal procedure was 0.83% and following transperineal procedure was 0.57%, which were not significantly different. In contrast, febrile infection associated with a fever (≥38 °C) occurred significantly more frequently after transrectal (0.71%) than transperineal (0.16%) approach (P = 0.04). Notably, in infectious cases, Escherichia coli was most frequently isolated. Of the 9 E. coli strains isolated by urine culture, 6 (66.7%) produced extended spectrum β-lactamase (ESBL) and 7 (77.8%) showed levofloxacin resistance. Similarly, of 6 E. coli strains isolated by blood culture, 4 (66.7%) produced ESBL and 6 (100%) showed levofloxacin resistance. When the efficacy of antimicrobial prophylaxis (AMP) with levofloxacin for the patients undergoing transrectal or transperineal biopsy was compared between a single dose (500 mg) and that given for 2 or more days, no significant difference was observed for the rate of infection (transrectal: 0.82% vs. 1.04%, p = 0.94; transperineal: 0.30% vs. 0.46%, p = 0.68). Although a single dose of levofloxacin for AMP is sufficient to prevent genitourinary infection after transrectal or transperineal prostate biopsy, and recommended in this era of increased multi-drug resistant pathogens, the increase in fluoroquinolone-resistant E. coli and ESBL-producing E. coli has emerged as a profound problem for surveillance.

  12. Diagnostic Accuracy of Mucosal Biopsy versus Endoscopic Mucosal Resection in Barrett's Esophagus and Related Superficial Lesions.

    Science.gov (United States)

    Elsadek, Hany M; Radwan, Mamdouh M

    2015-01-01

    Background. Endoscopic surveillance for early detection of dysplastic or neoplastic changes in patients with Barrett's esophagus (BE) depends usually on biopsy. The diagnostic and therapeutic role of endoscopic mucosal resection (EMR) in BE is rapidly growing. Objective. The aim of this study was to check the accuracy of biopsy for precise histopathologic diagnosis of dysplasia and neoplasia, compared to EMR in patients having BE and related superficial esophageal lesions. Methods. A total of 48 patients with previously diagnosed BE (36 men, 12 women, mean age 49.75 ± 13.3 years) underwent routine surveillance endoscopic examination. Biopsies were taken from superficial lesions, if present, and otherwise from BE segments. Then, EMR was performed within three weeks. Results. Biopsy based histopathologic diagnoses were nondysplastic BE (NDBE), 22 cases; low-grade dysplasia (LGD), 14 cases; high-grade dysplasia (HGD), 8 cases; intramucosal carcinoma (IMC), two cases; and invasive adenocarcinoma (IAC), two cases. EMR based diagnosis differed from biopsy based diagnosis (either upgrading or downgrading) in 20 cases (41.67%), (Kappa = 0.43, 95% CI: 0.170-0.69). Conclusions. Biopsy is not a satisfactory method for accurate diagnosis of dysplastic or neoplastic changes in BE patients with or without suspicious superficial lesions. EMR should therefore be the preferred diagnostic method in such patients.

  13. A Retrospective Study on Pathologic Features and Racial Disparities in Prostate Cancer

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    Steven A. Bigler

    2011-01-01

    Full Text Available We reviewed more than 3,000 pathology reports on prostate cancer-related surgical specimens and analyzed racial disparities in histological and clinical features at the time of initial biopsy, diagnosis of prostate cancer, and prostatectomy, as well as in characteristics of tumor evolution between African American and Caucasian patients. As compared to Caucasians, African American patients had younger age, higher cancer detection rate, higher Gleason score of prostate cancer, and more bilateral involvement of the prostate. African Americans also had larger prostates, greater volume of tumor, and more positive margins. The diagnosis of HGPIN or ASAP in prostate biopsies and African American race conferred an increased risk of diagnosis of prostate cancer. The interval between prior noncancerous biopsy and the subsequent biopsy with diagnosis of prostate cancer was shorter in men with HGPIN, with ASAP, or of African American race.

  14. The PCA3 test for guiding repeat biopsy of prostate cancer and its cut-off score: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Yong Luo

    2014-06-01

    Full Text Available The specificity of prostate-specific antigen (PSA for early intervention in repeat biopsy is unsatisfactory. Prostate cancer antigen 3 (PCA3 may be more accurate in outcome prediction than other methods for the early detection of prostate cancer (PCa. However, the results were inconsistent in repeated biopsies. Therefore, we performed a systematic review and meta-analysis to evaluate the role of PCA3 in outcome prediction. A systematic bibliographic search was conducted for articles published before April 2013, using PubMed, Medline, Web of Science, Embase and other databases from health technology assessment agencies. The quality of the studies was assessed on the basis of QUADAS criteria. Eleven studies of diagnostic tests with moderate to high quality were selected. A meta-analysis was carried out to synthesize the results. The results of the meta-analyses were heterogeneous among studies. We performed a subgroup analysis (with or without inclusion of high-grade prostatic intraepithelial neoplasia (HGPIN and atypical small acinar proliferation (ASAP. Using a PCA3 cutoff of 20 or 35, in the two sub-groups, the global sensitivity values were 0.93 or 0.80 and 0.79 or 0.75, specificities were 0.65 or 0.44 and 0.78 or 0.70, positive likelihood ratios were 1.86 or 1.58 and 2.49 or 1.78, negative likelihood ratios were 0.81 or 0.43 and 0.91 or 0.82 and diagnostic odd ratios (ORs were 5.73 or 3.45 and 7.13 or 4.11, respectively. The areas under the curve (AUCs of the summary receiver operating characteristic curve were 0.85 or 0.72 and 0.81 or 0.69, respectively. PCA3 can be used for repeat biopsy of the prostate to improve accuracy of PCa detection. Unnecessary biopsies can be avoided by using a PCa cutoff score of 20.

  15. The PCA3 test for guiding repeat biopsy of prostate cancer and its cut-off score:a systematic review and meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Yong Luo; Xin Gou; Peng Huang; Chan Mou

    2014-01-01

    The speciifcity of prostate-speciifc antigen (PSA) for early intervention in repeat biopsy is unsatisfactory. Prostate cancer antigen 3 (PCA3) may be more accurate in outcome prediction than other methods for the early detection of prostate cancer (PCa). However, the results were inconsistent in repeated biopsies. Therefore, we performed a systematic review and meta-analysis to evaluate the role of PCA3 in outcome prediction. A systematic bibliographic search was conducted for articles published before April 2013, using PubMed, Medline, Web of Science, Embase and other databases from health technology assessment agencies. The quality of the studies was assessed on the basis of QUADAS criteria. Eleven studies of diagnostic tests with moderate to high quality were selected. A meta-analysis was carried out to synthesize the results. The results of the meta-analyses were heterogeneous among studies. We performed a subgroup analysis (with or without inclusion of high-grade prostatic intraepithelial neoplasia (HGPIN) and atypical small acinar proliferation (ASAP)). Using a PCA3 cutoff of 20 or 35, in the two sub-groups, the global sensitivity values were 0.93 or 0.80 and 0.79 or 0.75, speciifcities were 0.65 or 0.44 and 0.78 or 0.70, positive likelihood ratios were 1.86 or 1.58 and 2.49 or 1.78, negative likelihood ratios were 0.81 or 0.43 and 0.91 or 0.82 and diagnostic odd ratios (ORs) were 5.73 or 3.45 and 7.13 or 4.11, respectively. The areas under the curve (AUCs) of the summary receiver operating characteristic curve were 0.85 or 0.72 and 0.81 or 0.69, respectively. PCA3 can be used for repeat biopsy of the prostate to improve accuracy of PCa detection. Unnecessary biopsies can be avoided by using a PCa cutoff score of 20.

  16. Prostatitis

    OpenAIRE

    Domingue, Gerald J.; Hellstrom, Wayne J.G.

    1998-01-01

    The laboratory diagnosis of acute bacterial prostatitis is straightforward and easily accomplished in clinical laboratories. Chronic bacterial prostatitis, and especially chronic idiopathic prostatitis (most often referred to as abacterial prostatitis), presents a real challenge to the clinician and clinical microbiologist. Clinically, the diagnosis of chronic idiopathic prostatitis is differentiated from that of acute prostatitis by a lack of prostatic inflammation and no “significant” (cont...

  17. IgG4-related prostatitis progressed from localized IgG4-related lymphadenopathy

    Science.gov (United States)

    Li, Dujuan; Kan, Yunzhen; Fu, Fangfang; Wang, Shuhuan; Shi, Ligang; Liu, Jie; Kong, Lingfei

    2015-01-01

    Immunoglobulin G4-related disease (IgG4-RD) is a recently described inflammatory disease involving multiple organs. Prostate involvement with IgG4-RD is very rare. In this report, we describe a case of IgG4-related prostatitis progressed from localized IgG4-related lymphadenopathy. This patient was present with urine retention symptoms. MRI and CT examination revealed the prostatic enlargement and the multiple lymphadenopathy. Serum IgG4 levels were elevated. Prostatic tissue samples resected both this time and less than 1 year earlier showed the same histological type of prostatitis with histopathologic and immunohistochemical findings characteristic of IgG4-RD. The right submandibular lymph nodes excised 2 years earlier were eventually proven to be follicular hyperplasia-type IgG4-related lymphadenopathy. This is the first case of IgG4-RD that began as localized IgG4-related lymphadenopathy and progressed into a systemic disease involving prostate and multiple lymph nodes. This patient showed a good response to steroid therapy. This leads us to advocate a novel pathogenesis of prostatitis, and a novel therapeutic approach against prostatitis. Pathologists and urologists should consider this disease entity in the patients with elevated serum IgG4 levels and the symptoms of prostatic hyperplasia to avoid ineffective medical or unnecessary surgical treatment. PMID:26617921

  18. Prostatic and dietary omega-3 fatty acids and prostate cancer progression during active surveillance.

    Science.gov (United States)

    Moreel, Xavier; Allaire, Janie; Léger, Caroline; Caron, André; Labonté, Marie-Ève; Lamarche, Benoît; Julien, Pierre; Desmeules, Patrice; Têtu, Bernard; Fradet, Vincent

    2014-07-01

    The association between omega-3 (ω-3) fatty acids and prostate cancer has been widely studied. However, little is known about the impact of prostate tissue fatty acid content on prostate cancer progression. We hypothesized that compared with the estimated dietary ω-3 fatty acids intake and the ω-3 fatty acids levels measured in red blood cells (RBC), the prostate tissue ω-3 fatty acid content is more strongly related to prostate cancer progression. We present the initial observations from baseline data of a phase II clinical trial conducted in a cohort of 48 untreated men affected with low-risk prostate cancer, managed under active surveillance. These men underwent a first repeat biopsy session within 6 months after the initial diagnosis of low-risk prostate cancer, at which time 29% of the men had progressed from a Gleason score of 6 to a Gleason score of 7. At the first repeat biopsy session, fatty acid levels were assessed with a food-frequency questionnaire, and determined in the RBC and in the prostate tissue biopsy. We found that eicosapentaenoic acid (EPA) was associated with a reduced risk of prostate cancer progression when measured directly in the prostate tissue. Thus, this initial interim study analysis suggests that prostate tissue ω-3 fatty acids, especially EPA, may be protective against prostate cancer progression in men with low-risk prostate cancer.

  19. Prognostic Importance of Gleason 7 Disease Among Patients Treated With External Beam Radiation Therapy for Prostate Cancer: Results of a Detailed Biopsy Core Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Spratt, Daniel E.; Zumsteg, Zach; Ghadjar, Pirus; Pangasa, Misha; Pei, Xin [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Fine, Samson W. [Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Yamada, Yoshiya; Kollmeier, Marisa [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Zelefsky, Michael J., E-mail: zelefskm@mskcc.org [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

    2013-04-01

    Purpose: To analyze the effect of primary Gleason (pG) grade among a large cohort of Gleason 7 prostate cancer patients treated with external beam radiation therapy (EBRT). Methods and Materials: From May 1989 to January 2011, 1190 Gleason 7 patients with localized prostate cancer were treated with EBRT at a single institution. Of these patients, 613 had a Gleason 7 with a minimum of a sextant biopsy with nonfragmented cores and full biopsy core details available, including number of cores of cancer involved, percentage individual core involvement, location of disease, bilaterality, and presence of perineural invasion. Median follow-up was 6 years (range, 1-16 years). The prognostic implication for the following outcomes was analyzed: biochemical recurrence-free survival (bRFS), distant metastasis-free survival (DMFS), and prostate cancer-specific mortality (PCSM). Results: The 8-year bRFS rate for pG3 versus pG4 was 77.6% versus 61.3% (P<.0001), DMFS was 96.8% versus 84.3% (P<.0001), and PCSM was 3.7% versus 8.1% (P=.002). On multivariate analysis, pG4 predicted for significantly worse outcome in all parameters. Location of disease (apex, base, mid-gland), perineural involvement, maximum individual core involvement, and the number of Gleason 3+3, 3+4, or 4+3 cores did not predict for distant metastases. Conclusions: Primary Gleason grade 4 independently predicts for worse bRFS, DMFS, and PCSM among Gleason 7 patients. Using complete core information can allow clinicians to utilize pG grade as a prognostic factor, despite not having the full pathologic details from a prostatectomy specimen. Future staging and risk grouping should investigate the incorporation of primary Gleason grade when complete biopsy core information is used.

  20. Urinary Biomarker Panel to Improve Accuracy in Predicting Prostate Biopsy Result in Chinese Men with PSA 4–10 ng/mL

    Science.gov (United States)

    Zhou, Yongqiang; Li, Yun; Li, Xiangnan

    2017-01-01

    This study aims to evaluate the effectiveness and clinical performance of a panel of urinary biomarkers to diagnose prostate cancer (PCa) in Chinese men with PSA levels between 4 and 10 ng/mL. A total of 122 patients with PSA levels between 4 and 10 ng/mL who underwent consecutive prostate biopsy at three hospitals in China were recruited. First-catch urine samples were collected after an attentive prostate massage. Urinary mRNA levels were measured by quantitative real-time polymerase chain reaction (qRT-PCR). The predictive accuracy of these biomarkers and prediction models was assessed by the area under the curve (AUC) of the receiver-operating characteristic (ROC) curve. The diagnostic accuracy of PCA3, PSGR, and MALAT-1 was superior to that of PSA. PCA3 performed best, with an AUC of 0.734 (95% CI: 0.641, 0.828) followed by MALAT-1 with an AUC of 0.727 (95% CI: 0.625, 0.829) and PSGR with an AUC of 0.666 (95% CI: 0.575, 0.749). The diagnostic panel with age, prostate volume, % fPSA, PCA3 score, PSGR score, and MALAT-1 score yielded an AUC of 0.857 (95% CI: 0.780, 0.933). At a threshold probability of 20%, 47.2% of unnecessary biopsies may be avoided whereas only 6.2% of PCa cases may be missed. This urinary panel may improve the current diagnostic modality in Chinese men with PSA levels between 4 and 10 ng/mL.

  1. Urinary Biomarker Panel to Improve Accuracy in Predicting Prostate Biopsy Result in Chinese Men with PSA 4–10 ng/mL

    Directory of Open Access Journals (Sweden)

    Yongqiang Zhou

    2017-01-01

    Full Text Available This study aims to evaluate the effectiveness and clinical performance of a panel of urinary biomarkers to diagnose prostate cancer (PCa in Chinese men with PSA levels between 4 and 10 ng/mL. A total of 122 patients with PSA levels between 4 and 10 ng/mL who underwent consecutive prostate biopsy at three hospitals in China were recruited. First-catch urine samples were collected after an attentive prostate massage. Urinary mRNA levels were measured by quantitative real-time polymerase chain reaction (qRT-PCR. The predictive accuracy of these biomarkers and prediction models was assessed by the area under the curve (AUC of the receiver-operating characteristic (ROC curve. The diagnostic accuracy of PCA3, PSGR, and MALAT-1 was superior to that of PSA. PCA3 performed best, with an AUC of 0.734 (95% CI: 0.641, 0.828 followed by MALAT-1 with an AUC of 0.727 (95% CI: 0.625, 0.829 and PSGR with an AUC of 0.666 (95% CI: 0.575, 0.749. The diagnostic panel with age, prostate volume, % fPSA, PCA3 score, PSGR score, and MALAT-1 score yielded an AUC of 0.857 (95% CI: 0.780, 0.933. At a threshold probability of 20%, 47.2% of unnecessary biopsies may be avoided whereas only 6.2% of PCa cases may be missed. This urinary panel may improve the current diagnostic modality in Chinese men with PSA levels between 4 and 10 ng/mL.

  2. Does needle calibre affect pain and complication rates in patients undergoing transperineal prostate biopsy? A prospective, randomized trial%前瞻性随机试验:活检针口径大小对经会阴前列腺活检患者的疼痛和并发症发生率的影响

    Institute of Scientific and Technical Information of China (English)

    Saredi Giovanni; Maria Chiara Sighinolfi; Fidanza Francesco; De Stefani Stefano; Micali Salvatore; Maurizio Paterlini; Roberto D'Amico; Bianchi Giampaolo

    2009-01-01

    Transperineal prostate biopsy is a procedure that can be used to obtain histological samples from the prostate. To improve both the quality of the biopsy core samples and prostate cancer detection, we are currently performing a prospective, randomized trial comparing prostate biopsy samples obtained using an 18 G-needle to those obtained using a 16 G-needle. The aim of this preliminary study was to evaluate pain and complication rates in both groups in order to assess whether performing a prostate biopsy with a larger calibre needle is a feasible procedure. One hundred and eighty-seven patients undergoing transperineal prostate biopsy were prospectively evaluated and divided into two groups. The first group (94 patients, Group A) received a transperineal prostate biopsy using a 16 G-needle and the second group (93 patients, Group B) underwent transperineal prostate biopsy with an 18 G-needle. Anaesthesia was obtained with a single perineal injection at the prostatic apex in all subjects. A visual analogue scale (VAS) and facial expression scale (FES) were used to assess pain during multiple steps of the procedure in each group. A detailed questionnaire was used to obtain information about drug use because it could potentially influence the pain and complications that patients experienced. Two weeks after the procedure, early and late complications were evaluated. Statistical analysis was carried out using non-parametric tests. Prostate Specific Antigen (PSA) and drug use were similar at baseline between the two groups. Pain during prostate biopsy, which was measured with both the VAS and FES instruments, did not differ significantly between the 18- and 16 G-needle groups, and no significant differences were found in early or late complication rates between the groups. Transperineal prostate biopsy with a 16 G-needle is a feasible procedure in terms of pain and complication rates. Further studies with larger patient populations are required to assess whether or not

  3. Prostate Cancer Patients-Negative Biopsy Controls Discrimination by Untargeted Metabolomics Analysis of Urine by LC-QTOF: Upstream Information on Other Omics

    Science.gov (United States)

    Fernández-Peralbo, M. A.; Gómez-Gómez, E.; Calderón-Santiago, M.; Carrasco-Valiente, J.; Ruiz-García, J.; Requena-Tapia, M. J.; Luque de Castro, M. D.; Priego-Capote, F.

    2016-12-01

    The existing clinical biomarkers for prostate cancer (PCa) diagnosis are far from ideal (e.g., the prostate specific antigen (PSA) serum level suffers from lack of specificity, providing frequent false positives leading to over-diagnosis). A key step in the search for minimum invasive tests to complement or replace PSA should be supported on the changes experienced by the biochemical pathways in PCa patients as compared to negative biopsy control individuals. In this research a comprehensive global analysis by LC-QTOF was applied to urine from 62 patients with a clinically significant PCa and 42 healthy individuals, both groups confirmed by biopsy. An unpaired t-test (p-value < 0.05) provided 28 significant metabolites tentatively identified in urine, used to develop a partial least squares discriminant analysis (PLS-DA) model characterized by 88.4 and 92.9% of sensitivity and specificity, respectively. Among the 28 significant metabolites 27 were present at lower concentrations in PCa patients than in control individuals, while only one reported higher concentrations in PCa patients. The connection among the biochemical pathways in which they are involved (DNA methylation, epigenetic marks on histones and RNA cap methylation) could explain the concentration changes with PCa and supports, once again, the role of metabolomics in upstream processes.

  4. Pretreatment biopsy analysis of DAB2IP identifies subpopulation of high-risk prostate cancer patients with worse survival following radiation therapy.

    Science.gov (United States)

    Jacobs, Corbin; Tumati, Vasu; Kapur, Payal; Yan, Jingsheng; Xie, Xian-Jin; Hannan, Raquibul; Hsieh, Jer-Tsong; Kim, Dong Wook Nathan; Saha, Debabrata

    2015-12-01

    Decreased expression of tumor suppressor DAB2IP is linked to aggressive cancer and radiation resistance in several malignancies, but clinical survival data is largely unknown. We hypothesized that pretreatment DAB2IP reduction would predict worse prostate cancer-specific survival (PCSS). Immunohistochemistry of pretreatment biopsies was scored by an expert genitourinary pathologist. Other endpoints analyzed include freedom from biochemical failure (FFBF), castration resistance-free survival (CRFS), and distant metastasis-free survival (DMFS). Seventy-nine patients with NCCN-defined high-risk prostate cancer treated with radiotherapy from 2005 to 2012 at our institution were evaluated. Twenty-eight percent (22/79) of pretreatment biopsies revealed DAB2IP-reduction. The median follow up times were 4.8 years and 5.3 years for patients in the DAB2IP-reduced group and DAB2IP-retained group, respectively. Patients with reduced DAB2IP demonstrated worse outcome compared to patients retaining DAB2IP, including FFBF (4-year: 34 vs. 92%; P cancer have decreased tumor expression of DAB2IP. This subpopulation with reduced DAB2IP has a suboptimal response and worse malignancy-specific survival following radiation therapy and androgen deprivation. DAB2IP loss may be a genetic explanation for the observed differences in aggressive tumor characteristics and radiation resistance. Further study into improving treatment response and survival in this subpopulation is warranted.

  5. Morbidade da biópsia da próstata transretal guiada por ultrassonografia Morbidity of transrectal ultrasound guided prostate biopsy

    Directory of Open Access Journals (Sweden)

    Raphael Sandes Solha

    2013-04-01

    Full Text Available OBJETIVO: Avaliar a incidência de complicações pós-procedimento nos pacientes submetidos a biópsia prostática transretal guiada por ultrassom no setor de intervenção do Departamento de Diagnóstico por Imagem da Escola Paulista de Medicina - Universidade Federal de São Paulo. MATERIAIS E MÉTODOS: Foram avaliados, via contato telefônico, 132 pacientes submetidos a biópsia de próstata transretal guiada por ultrassom no período de abril/2011 a junho/2011, seguindo o protocolo padrão do nosso setor. RESULTADOS: As complicações pós-biópsia foram categorizadas em maiores e menores de acordo com a necessidade de avaliação médica adicional. Cinquenta e nove pacientes (61,8% apresentaram complicações, e desses, grande parte (86,4% apresentou sintomas leves e autolimitados, considerados menores. Oito pacientes (8,2% apresentaram complicações maiores, sendo que apenas um deles necessitou de tratamento sob regime de internação hospitalar. A retenção urinária foi a complicação maior mais incidente no nosso estudo. CONCLUSÃO: Corroborando outros estudos da literatura, nosso trabalho demonstrou baixa prevalência de complicações maiores após a biópsia prostática transretal.OBJECTIVE: To evaluate the incidence of postprocedural complications in patients submitted to transrectal ultrasound-guided prostate biopsy at the Unit of Intervention, Department of Imaging Diagnosis of Escola Paulista de Medicina - Universidade Federal de São Paulo. MATERIALS AND METHODS: Telephone interviews were conducted with 132 patients who had undergone transrectal ultrasound-guided prostate biopsy in the period from April 2011 to June 2011, according to the institution's protocol. RESULTS: Post-biopsy complications were categorized into two groups - minor and major complications, according to their need for further clinical evaluation. Complications were reported by 59 patients (61.8%, most of them (86.4% with mild and self-limited symptoms

  6. Electron microscopic examination on 50 cases of prostatic needle biopsies%前列腺穿刺组织的电镜观察

    Institute of Scientific and Technical Information of China (English)

    张惠箴; 蒋智铭; 郭慕依; 郑莉

    2010-01-01

    Objective To study the differences in ultrastructural findings between prostatic carcinoma and benign prostatic hypertrophy, and the various ultrastructural features seen in moderately to poorly differentiated prostatic carcinoma. Methods Utrasound-guided needle biopsies were carried out in 50 clinically suspicious cases of prostatic carcinoma. For each case, one additional core was sampled from the most suspicious area, fixed in glutaraldehyde and examined under electron microscopy. Results In the 50 cases of prostatic needle biopsies studied, there were a total of 42 cases with histologic findings of prostatic carcinoma. Thirty-one cases showed features corresponding to Gleason's score 3 to 5. In contrast to that seen in benign prostatic hypertrophy, the ultrastructural findings of the tumor cells commonly seen in prostatic carcinoma included the centrally located giant nucleoli, a direct contact with stroma, and formation of cytoplasmic microcyst. Occasionaly, there were mitotic figures seen, accompanying with fibromyxoid change of the peritumoural stroma. Amongst the 31 cases of Gleason's score 3 to 5 prostatic carcinoma, 29cases (93. 5%) demonstrated cytoplasmic prostasomes and storage vesicles. Similar to their counterparts in benign prostatic cells, prostasomes and storage vesicles in prostatic carcinoma cells were formed in the Golgi apparatus and released into the lumen by apocrine excretion and exocytosis. Conclusions Electron microscopy is helpful in distinguishing between benign and malignant prostatic lesions. Because of the high yield of prostasomes in moderately to poorly differentiated prostatic carcinoma, prostasomes may become a potential target for cancer immunotherapy and one of the useful diagnostic indices for delineating the prostatic origin of metastatic carcinoma.%目的 探讨前列腺癌与良性前列腺增生的超微结构差异,以及中-低分化前列腺癌中前列腺小体和储存空泡的超微结构特征、形成和分泌

  7. ERG rearrangement is associated with prostate cancer-related death in Chinese prostate cancer patients.

    Directory of Open Access Journals (Sweden)

    Mei Qi

    Full Text Available Recently, ETS-related gene (ERG gene rearrangements, phosphatase tensin homologue (PTEN deletions and EGFR family aberrations were characterized as potential biomarkers for prostate cancer (PCa patient management. Although ERG gene rearrangement has been identified in approximately 50% of localized prostate cancers in western countries, the prognostic significance of this critical molecular event remains unknown in Chinese patients. Using fluorescence in situ hybridization (FISH and immunohistochemistry, we evaluated ERG, PTEN and EGFR family aberrations in a cohort of 224 Chinese prostate cancer patients diagnosed in transurethral resection of the prostate (TUR-P. Overall, ERG rearrangement was detected in 23.2% (44/190 cases, of which 54.5% (24/44 showed deletion of the 5'end of ERG. PTEN deletion was identified in 10.8% (19/176 cases. Amplification of EGFR and HER2 genes was present in 1.1% (2/178 and 5.8% (10/173 of cases, respectively. Significant correlation between ERG rearrangement and PTEN deletion was identified in this cohort. EGFR and HER2 aberrations occurred more frequently in PCas without ERG rearrangement than in those with ERG rearrangement, although this did not reach statistical significance. Overall, ERG rearrangement was associated with pre-operative PSA values (P = 0.038 and cancer-related death (P = 0.02, but not with the age, clinical T stage, Gleason score, or Ki-67 labeling index (LI. Notably, multivariate analysis including known prognostic markers revealed ERG rearrangement was an independent prognostic factor (P = 0.022. Additionally, ERG rearrangement status was helpful to identify patients with poor prognosis from PCa group with low Ki-67 LI. In summary, we reported that ERG rearrangement was associated with cancer-related death in Chinese PCa patients. Determination of ERG rearrangement status allows stratification of PCa patients into different survival categories.

  8. Bone Biopsy

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Bone Biopsy Bone biopsy uses a needle and imaging ... the limitations of Bone Biopsy? What is a Bone Biopsy? A bone biopsy is an image-guided ...

  9. A hypothesis to relate salivary tumors with mammary and prostate neoplasias.

    Science.gov (United States)

    Actis, Adriana B

    2005-04-21

    Salivary, mammary and prostate glands are sex hormone-dependent organs sharing common aspects in structure, hormonal responsiveness and tumor histopathology. Salivary tumors (especially the malignant types) are not as frequent as mammary and prostate neoplasias. Hence, prognosis of some salivary tumors is not always efficient. Here, we review the oncology of salivary gland and its putative relation to breast/prostate tumors.

  10. Comparisons of the incidence and pathological characteristics of prostate cancer between Chinese and Portuguese in Macau

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Background Aging of population in Macau has become a serious problem and we are diagnosing more and more Patients with prostate cancer.To investigate the effect of ethnicity and environment on incidence of prostate carcinoma,We compared the difference of biopsy and postoperative pathology of prostate between indigenous Chinese(Chinese)and Chinese of Portuguese descent(Portuguese)with elevated serologic prostate specific antigen(PSA)and incidence of prostate carcinoma in Macau.Methods Between 1999 and 2006,prostate biopsy was performed in a random sample of 462 patients with elevated serologic PSA who,on followup,were diagnosed in this hospital with benign prostate hyperplasia.Of these,416 were indigenous Chinese,46 Portuguese.Based on demographic statistics by Macau government for 2005,we compared differences in incidences of prostate carcinoma,positive rate of random prostate biopsy in patients with elevated serologic PSA,factors related to serological PSA and pathological grade and stage between both ethnic groups.Results Prostate carcinoma was diagnosed on biopsy in 178 cases.Positive biopsies of prostate carcinoma were Present in 160 Chinese with positive rate of 38.5% and in 18 Portuguese with 39.1%.For patients diagnosed with prostate carcinoma,there was no significant difference in age,incidence,grade of cancerous cells,stage of the disease,incidence of inflammation of prostatic tissues or prostatic intraepithelial neoplasia(PIN)related to elevated PSA between the groups(All P>0.05).Conclusions There was no significant difference in incidence or characteristics of prostate carcinoma between people of Portuguese and Chinese descent in Macau based on our limited data.Long term residence in the same environment may be associated with the incidence and progression of prostate carcinoma in Portuguese living in Macau,but further rigorous epidemiological investigation and analysis of risk factors about prostate carcinoma are needed to corroborate this conclusion.

  11. Diffusion-weighted magnetic resonance imaging in the prostate transition zone: histopathological validation using magnetic resonance-guided biopsy specimens

    NARCIS (Netherlands)

    Hoeks, C.M.A.; Vos, E.K.; Bomers, J.G.R.; Barentsz, J.O.; Kaa, C.A. van de; Scheenen, T.W.J.

    2013-01-01

    OBJECTIVES: The objective of this study was to evaluate the apparent diffusion coefficient (ADC) of diffusion-weighted magnetic resonance (MR) imaging for the differentiation of transition zone cancer from non-cancerous transition zone with and without prostatitis and for the differentiation of tran

  12. 初步建立中国人前列腺癌预测的数学模型%Development of a Nomogram for Predicting Positive Initial Prostate Biopsy Among Chinese Patients

    Institute of Scientific and Technical Information of China (English)

    李秋洋; 唐杰; 李岩密; 费翔; 张艳; 何恩辉

    2011-01-01

    目的 建立中国人前列腺癌预测模型.方法 对556例疑似前列腺癌患者行前列腺穿刺活检,收集建立模型的变量:患者年龄、前列腺体积、前列腺特异性抗原(PSA)、游离PSA(f-PSA)/总PSA(t-PSA).将变量通过逐步回归建立回归方程,在此基础上建立穿刺活检阳性的危险评分数学模型,并通过受试者工作曲线下面积来评估该模型的预测价值.结果 556例患者中,205例(36.87%)经前列腺穿刺活检证实为前列腺癌.单因素分析结果显示,患者的年龄、前列腺体积、血清PSA、f-PSA/t-PSA均为建立数学模型的影响因素.对受试者工作曲线的分析结果显示,所建模型的曲线下面积为0.8767,大于患者年龄、前列腺体积、PSA、f-PSA/t-PSA等单因素的0.6397、0.7255、0.7111、0.6973.结论 初步建立具有较高预测价值的前列腺癌预测模型.%Objective To develop a predictive nomogram for predicting the prostate carcinoma among Chinese population. Methods Totally 356 Chinese male patients who had undergone an initial prostate biopsy in our hospital from July 2004 to February 2009 were enrolled in this study. Variables including age, volume, prostate specific antigen (PSA) level, and free PSA ( f-PSA) /total PSA (t-PSA) were collected. Logistic regression analysis was performed to estimate the relative risk. Regression equation was established for variables via stepwise regression, via which a nomogram for assessing the positive biopsy results was established, and then the predictive value of this nomogram was evaluated using receiver area under curve ( ROC) analysis. Results Of these 556 patients, cancer was detected in 205 patients (36. 87% ) via biopsies. Univariate analysis showed that age, prostate volume, PSA levels, and f-PSA/t-PSA were the influencing factors of the nomogram. The risk model performed well in an independent sample, with an AUCROC of 0. 8767, which was significantly larger than that of the prediction

  13. [Bacterial prostatitis and prostatic fibrosis: modern view on the treatment and prophylaxis].

    Science.gov (United States)

    Zaitsev, A V; Pushkar, D Yu; Khodyreva, L A; Dudareva, A A

    2016-08-01

    Treatments of chronic bacterial prostatitis (CP) remain difficult problem. Bacterial prostatitis is a disease entity diagnosed clinically and by evidence of inflammation and infection localized to the prostate. Risk factors for UTI in men include urological interventions, such as transrectal prostate biopsy. Ensuing infections after prostate biopsy, such as UTI and bacterial prostatitis, are increasing due to increasing rates of fluoroquinolone resistance. The increasing global antibiotic resistance also significantly affects management of UTI in men, and therefore calls for alternative strategies. Prostatic inflammation has been suggested to contribute to the etiology of lower urinary tract symptoms (LUTS) by inducing fibrosis. Several studies have shown that prostatic fibrosis is strongly associated with impaired urethral function and LUTS severity. Fibrosis resulting from excessive deposition of collagen is traditionally recognized as a progressive irreversible condition and an end stage of inflammatory diseases; however, there is compelling evidence in both animal and human studies to support that the development of fibrosis could potentially be a reversible process. Prostate inflammation may induce fibrotic changes in periurethral prostatic tissues, promote urethral stiffness and LUTS. Patients experiencing CP and prostate-related LUTS could benefit from anti-inflammatory therapies, especially used in combination with the currently prescribed enzyme treatment with Longidase. Treatment results showed that longidase is highly effective in bacterial and abacterial CP. Longidase addition to standard therapeutic methods significantly reduced the disease symptoms and regression of inflammatory-proliferative alterations in the prostate.

  14. 经会阴前列腺穿刺活检漏诊原因分析(附4例报告)%Analysis of the cause of missed diagnosis in transperineal prostate biopsy with 4 cases report

    Institute of Scientific and Technical Information of China (English)

    齐小康; 丁雪飞; 周广臣; 顾晓; 卢圣铭

    2016-01-01

    Objective To investigate the causes of missed diagnosis in transrectal ultrasound-guided transperineal prostate biopsy.Methods The biopsy results of total 278 patients who received transrectal ultrasound-guided transperineal prostate biopsy from January 2012 to December 2014 in Subei People's Hospital were retrospectively analyzed,using 11 systemic divisions.Results One hundred and twenty-nine patients were diagnosed with prostate cancer,and 149 patients were hyperplasia of prostate.Fifty-six patients with biopsy-negativeand obvious symptoms of lower urinary tract obstruction were underwent transurethral resection of the prostate.Four of which were found to be prostate cancer.Conclusion Early-stage prostate cancer,special prostate tumor location,inadequate biopsy tissue,special patients in limited position,and dissatisfied anesthesia may increase the risk of missed diagnosis.Targeted and individualized puncture may improve the effectiveness.%目的 探讨直肠超声引导下经会阴前列腺穿刺活检漏诊的原因.方法 回顾性分析2012年1月至2014年12月苏北人民医院行直肠超声引导下经会阴前列腺穿刺活检的患者共278例,采用前列腺11分区法系统穿刺.结果 穿刺活检病理诊断前列腺癌129例,前列腺增生149例.穿刺阴性患者中56例合并明显下尿路梗阻症状,行经尿道前列腺电切术(TURP),术后发现前列腺癌4例,其中2例行前列腺癌根治术,2例选择内分泌治疗.4例患者随访复查前列腺特异抗原(PSA)水平下降且控制满意,1例患者随访9个月后出现PSA升高,随访过程中无死亡病例.结论 早期前列腺癌,肿瘤位置特殊,穿刺组织不足,特殊患者体位受限,麻醉不满意等因素可能增加漏诊风险,可寻求靶向及个体化穿刺以提高穿刺效力.

  15. Development of a nomogram for predicting the risk of positive prostate biopsy%预测前列腺穿刺阳性风险的列线图模型的建立

    Institute of Scientific and Technical Information of China (English)

    李方龙; 李德维; 张一琰; 崔亮; 殷小涛; 殷昭阳; 齐思勇; 许勇; 郭刚

    2016-01-01

    Objective We develop a nomogram for predicting the risk of positive prostate biopsy based on clinic indexes of patients.Methods We retrospectively analyzed the clinical data of patients who underwent prostate biopsy for prostate cancer in our hospital from July 2009 to March 2015.Variables including age,prostate volume,free PSA (fPSA) and total PSA (tPSA) were collected.958 patients with integrity data,which PSA was under 100 ng/ml,were enrolled in this study.Of these patients,we randomly selected 20% as validation group (191),and the other 80% as development group (767).We performed Logistic regression analysis to identify the independent risk factors related to positive prostate biopsy in development group.Then we constructed a prediction model according to regression equation to predict the result of prostate biopsy.Receiver operating characteristic (ROC) analysis was performed to verify the diagnostic value of the novel prediction model,which was furtherly compared with the diagnostic values of PSA alone,f/t PSA,PSAD respectively.Result The age of benign prostatic hyperplasia was (67.3 ± 9.7) years,tPSA (12.4 ± 8.8) ng/ml,the prostate volume (69.2 ± 50.6) cm3.The age of prostate cancer was(71.6 ± 9.7) years,tPSA (24.3 ± 21.3) ng/ml,the prostate volume was (46.0 ± 34.0) cm3.The fPSA,tPSA,PSAD,f/tPSA,age and prostate volume were independent risk factors by Logistic regression analysis,the ORs were 1.094,1.551,0.958,0,13.647 and 0.985 respectively (P < 0.05).The nomogram based on all variables was established.The area under the ROC curve of the model (0.854) was greater than those of tPSA (0.709),f/tPSA (0.667) and PSAD (0.807) (P < 0.05).Conclusions The nomogram established in this study has better diagnostic value for prostate cancer compared with PSA and other PSA related parameters,which is a simple and convenient method without additional medical spending.%目的 基于单中心数据资料建立预测前列腺穿刺阳性风险的列线图模

  16. Multiparametric 3T MRI for the prediction of pathological downgrading after radical prostatectomy in patients with biopsy-proven Gleason score 3 + 4 prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gondo, Tatsuo [Memorial Sloan-Kettering Cancer Center, Urology Service, Department of Surgery, New York, NY (United States); Tokyo Medical University, Department of Urology, Tokyo (Japan); Hricak, Hedvig; Sala, Evis; Vargas, Hebert Alberto [Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States); Zheng, Junting; Moskowitz, Chaya S. [Memorial Sloan-Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY (United States); Bernstein, Melanie; Eastham, James A. [Memorial Sloan-Kettering Cancer Center, Urology Service, Department of Surgery, New York, NY (United States)

    2014-12-15

    The aim of this study was to assess the diagnostic performance of pre-treatment 3-Tesla (3T) multiparametric magnetic resonance imaging (mpMRI) for predicting Gleason score (GS) downgrading after radical prostatectomy (RP) in patients with GS 3 + 4 prostate cancer (PCa) on biopsy. We retrospectively reviewed 304 patients with biopsy-proven GS 3 + 4 PCa who underwent mpMRI before RP. On T2-weighted imaging and three mpMRI combinations (T2-weighted imaging + diffusion-weighted imaging [DWI], T2-weighted imaging + dynamic contrast-enhanced-MRI [DCE-MRI], and T2-weighted imaging + DWI + DCE-MRI), two radiologists (R1/R2) scored the presence of a dominant tumour using a 5-point Likert scale (1 = definitely absent to 5 = definitely present). Diagnostic performance in identifying downgrading was evaluated via areas under the curves (AUCs). Predictive accuracies of multivariate models were calculated. In predicting downgrading, T2-weighted imaging + DWI (AUC = 0.89/0.85 for R1/R2) performed significantly better than T2-weighted imaging alone (AUC = 0.72/0.73; p < 0.001/p = 0.02 for R1/R2), while T2-weighted imaging + DWI + DCE-MRI (AUC = 0.89/0.84 for R1/R2) performed no better than T2-weighted imaging + DWI (p = 0.48/p > 0.99 for R1/R2). On multivariate analysis, the clinical + mpMRI model incorporating T2-weighted imaging + DWI (AUC = 0.92/0.88 for R1/R2) predicted downgrading significantly better than the clinical model (AUC = 0.73; p < 0.001 for R1/R2). mpMRI improves the ability to identify a subgroup of patients with Gleason 3 + 4 PCa on biopsy who are candidates for active surveillance. DCE-MRI (compared to T2 + DWI) offered no additional benefit to the prediction of downgrading. (orig.)

  17. Gene expression in skeletal muscle biopsies from people with type 2 diabetes and relatives

    DEFF Research Database (Denmark)

    Palsgaard, Jane; Brøns, Charlotte; Friedrichsen, Martin

    2009-01-01

    BACKGROUND: Gene expression alterations have previously been associated with type 2 diabetes, however whether these changes are primary causes or secondary effects of type 2 diabetes is not known. As healthy first degree relatives of people with type 2 diabetes have an increased risk of developing...... type 2 diabetes, they provide a good model in the search for primary causes of the disease. METHODS/PRINCIPAL FINDINGS: We determined gene expression profiles in skeletal muscle biopsies from Caucasian males with type 2 diabetes, healthy first degree relatives, and healthy controls. Gene expression...... downregulated in people with type 2 diabetes. On the individual gene level, 11 genes showed altered expression levels in first degree relatives compared to controls, among others KIF1B and GDF8 (myostatin). LDHB was found to have a decreased expression in both groups compared to controls. CONCLUSIONS...

  18. Gum biopsy

    Science.gov (United States)

    Biopsy - gingiva (gums) ... used to close the opening created for the biopsy. ... to eat for a few hours before the biopsy. ... Risks for this procedure include: Bleeding from the biopsy site Infection of the gums Soreness

  19. Prostate Ultrasound

    Medline Plus

    Full Text Available ... physician during a routine physical exam or prostate cancer screening exam. an elevated blood test result. difficulty ... if a patient is at high risk for cancer. In this case, a biopsy is performed and ...

  20. The Impact of Free/Total PSA Ratio on Prostate Cancer Diagnosis in Patients with PSA Level Between 2,5-10 mg/dl Undergoing Transrectal Prostate Biopsy

    Directory of Open Access Journals (Sweden)

    Nevzat Sener

    2014-02-01

    Full Text Available Aim:  In this study, we aimed to compare the outcomes of pathologic results of patients underwent transrectal prostate biopsy (TRIB with free/total PSA ratio. Material and Method: Patients having a PSA level between 2.5-10 ng/ml and underwent TRIB were retrospectively analyzed. Patients were divided into two groups as having a free/total PSA ratio below and over 20%. The ratio below 20% was in Group 1 and over 20% were in Group 2. Results: There were 60 patients in Group 1 and 82 patients in Group 2. PSA levels were 7,45 ± 2,14 and 6,31 ± 1,89 for groups 1 and 2, respectively (p=0.067. Fourteen patients in Group 1 (23% and 15 patients in Group 2 (18% were diagnosed with prostate cancer. Sensitivity was 100% and specificity was 23% when PSA level was between 2.5 and 10. Discussion: Free/Total PSA ratio can be applied to PSA levels between 2.5 and 10. Even though it has a low specificity, with high sensitivity, it can be used in urologic practice.

  1. Prostate cancer

    DEFF Research Database (Denmark)

    Chabanova, Elizaveta; Balslev, Ingegerd; Logager, Vibeke

    2011-01-01

    To investigate diagnostic accuracy of detection of prostate cancer by magnetic resonance: to evaluate the performance of T2WI, DCEMRI and CSI and to correlate the results with biopsy and radical prostatectomy histopathological data.......To investigate diagnostic accuracy of detection of prostate cancer by magnetic resonance: to evaluate the performance of T2WI, DCEMRI and CSI and to correlate the results with biopsy and radical prostatectomy histopathological data....

  2. Cancer related gene expression in the human prostate zones

    NARCIS (Netherlands)

    L. Heul-Nieuwenhuijsen (Leonie)

    2009-01-01

    textabstractThe normal prostate: The prostate is the largest accessory gland of the male reproductive system. (Figure 1) The healthy adult prostate is about the size of a chestnut and conical in shape. In general, it measures 20 ml in volume, though it can become five or six time that size with incr

  3. Utility of Ultrasound in the Diagnosis, Treatment, and Follow-up of Prostate Cancer: State of the Art.

    Science.gov (United States)

    Chen, Frank K; de Castro Abreu, Andre Luis; Palmer, Suzanne L

    2016-10-01

    Prostate cancer screening currently consists of serum prostate-specific antigen and digital rectal examination, followed by transrectal ultrasound-guided biopsy for diagnostic confirmation. Although the current paradigm of prostate cancer screening has led to a decrease in advanced disease and cancer-related mortality, these techniques have limitations in terms of sensitivity and specificity, resulting in missed cancers that are clinically significant and the overdetection of clinically insignificant cancers. New imaging techniques and technologies are required to improve the detection of prostate cancer. This article summarizes the use of novel ultrasound techniques and technologies in the detection, biopsy, and treatment of prostate cancer.

  4. The value of transperineal ultrasound-guided prostate biopsy in the diagnosis of prostate cancer%超声引导下经会阴部前列腺穿刺活组织检查术在前列腺癌诊断中的意义

    Institute of Scientific and Technical Information of China (English)

    姚明华; 郭乐航; 王帅; 谢娟; 吴蓉

    2012-01-01

    目的 探讨超声引导下经会阴部前列腺穿刺活组织检查术在前列腺癌诊断中的作用和意义,以及影响前列腺癌诊断的各种相关因素.方法 回顾性总结268例在超声引导下经会阴部前列腺穿刺活组织检查患者的超声显像结果及病理资料,并对影响前列腺癌诊断的各种相关因素进行分析.结果 268例患者的前列腺癌检出率为38.1%(102/268).将患者分为≤60岁组(41例)、>60岁且≤70岁组(76例)、>70岁且≤80岁组(107例)及>80岁组(44例),4组的前列腺癌检出率分别为17.1%(7/41)、26.3%(20/76)、50.5%(54/107)及47.7%(21/44),各组间差异均有统计学意义(P值均<0.01).230例检测前列腺特异性抗原(PSA)水平患者的前列腺癌检出率为32.6%(75/230).根据PSA水平将患者分为PSA≤4 ng/mL组(13例)、>4 ng/mL且≤10 ng/mL组(122例)、>10 ng/mL且≤20 ng/mL组(56例)、>20 ng/mL且≤30 ng/mL组(10例)及>30 ng/mL组(29例),5组的前列腺癌检出率分别为0、24.6%(30/122)、30.4%(17/56)、40.0%(4/10)、82.8%(24/29),各组间差异均有统计学意义(P值均<0.01).232例通过经直肠超声检查或磁共振成像测量前列腺体积患者的前列腺癌检出率为37.5%(87/232).根据前列腺体积将患者分为前列腺体积≤50mL组(155例)及>50 mL组(77例),两组的前列腺癌检出率分别为45.8%(71/155)及20.8%(16/77),两组间差异有统计学意义(P<0.01).结论 超声引导下经会阴部前列腺穿刺活组织检查在前列腺癌的诊断中具有重要意义.%Objective To evaluate the value of transperineal ultrasound-guided prostate biopsy in the diagnosis of prostate cancer and analyze the prostate-cancer-related factors. Methods Transperineal ultrasound-guided prostate biopsy was performed in 268 subjects in this study. The pathologic results and ultrasonic data were compared and the prostate-cancer-related factors were retrospectively analyzed. Results The

  5. Immunohistochemical expression of Ets-related gene-transcriptional factor in adenocarcinoma prostate and its correlation with Gleason score

    Directory of Open Access Journals (Sweden)

    Rahul Mannan

    2016-01-01

    Full Text Available Background: Prostate carcinoma is the second leading cause of cancer-related deaths in males worldwide. The burden is expected to grow 1.7 million new cases and 499,000 new deaths by 2030. In developing countries such as India, prostate carcinoma will show an increase by 140% in the next few years. Although the diagnosis of prostate carcinoma can usually be made on histological features, now a days many immunohistochemical (IHC markers are used to distinguish it from benign mimickers as well as in predicting prognosis and treatment. Out of these markers, Ets-related gene (ERG product is a proto-oncogene which participates in chromosomal translocations and is frequently over expressed in prostate carcinoma which harbors ERG-transmembrane protease, serine 2 fusion. Materials and Methods: Fifty cases of carcinoma prostate diagnosed in needle biopsies and prostatic chips, in the Department of Pathology of a tertiary care teaching hospital in Punjab, India, were included in the present study. The slides were observed under the light microscope, and Gleason scoring was done using the 2005 International Society of Urological Pathology modified Gleason system. IHC study for ERG expression was done on all the cases, for which anti-ERG monoclonal rabbit clone antibody EP111 (Dako, Denmark was used. Lymphocytes and endothelial cells were taken as in built positive controls for staining. The intensity of ERG positivity was scored as no staining (0, weak staining (+1, moderate staining (+2 and intense staining (+3. The H score was then calculated by multiplying the intensity of the stain with the percentage (0-100 of the cells showing that staining intensity. The H-score has a range of 0-300. The relationship between IHC expression and clinico-pathological parameters was compared and analyzed using Chi-square test. P < 0.05 was considered statistically significant. Results: Majority of patients included in the study were in the age group of 61-80 (84% of the

  6. Predictive power of the ESUR scoring system for prostate cancer diagnosis verified with targeted MR-guided in-bore biopsy

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    Schimmöller, L., E-mail: Lars.Schimmoeller@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Quentin, M., E-mail: Michael.Quentin@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Arsov, C., E-mail: Cristian.Arsov@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Urology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Hiester, A., E-mail: Andreas.Hiester@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Urology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Kröpil, P., E-mail: Patric.Kroepil@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Rabenalt, R., E-mail: Robert.Rabenalt@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Urology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Albers, P., E-mail: urologie@uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Urology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Antoch, G., E-mail: Antoch@med.uni-duesseldorf.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany); Blondin, D., E-mail: Dirk.Blondin@sk-mg.de [Univ Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Moorenstr. 5, D-40225 Dusseldorf (Germany)

    2014-12-15

    Highlights: • The PI-RADS summed score (PS{sub sum}) demonstrated very good diagnostic values, especially for higher grade PCa. • Lesions with PS{sub sum} ≥13 represented prostate cancer in 88% and higher grade prostate cancer in 42%. • Sensitivity and NPV was nearly 100% for higher grade PCa detection using a cut-off limit of PS{sub sum} 10. • Peripheral zone lesions demonstrated better diagnostic value with the PS{sub sum} compared to transitional zone lesions. • Further improvement of the PI-RADS score is required to prevent unnecessary overdiagnosis. - Abstract: Purpose: This study evaluates the diagnostic value of the ESUR scoring system (PI-RADS) regarding prostate cancer detection using MR-guided in-bore biopsies (IB-GB) as the reference standard. Methods: 566 lesions in 235 consecutive patients (65.7 ± 7.9 years, PSA 9.9 ± 8.5 ng/ml) with a multiparametric (mp)-MRI (T2WI, DWI, DCE) of the prostate at 3 T were scored using the PI-RADS scoring system. PI-RADS single (PS{sub single}), summed (PS{sub sum}), and overall (PS{sub overall}) scores were determined. All lesions were histologically verified by IB-GB. Results: Lesions with a PS{sub sum} below 9 contained no prostate cancer (PCa) with Gleason score (GS) ≥ 4 + 3 = 7. A PS{sub sum} of 13–15 (PS{sub overall} V) resulted in 87.8% (n = 108) in PCa and in 42.3% (n = 52) in GS ≥ 4 + 3 = 7. Transition zone (TZ) lesions with a PS{sub sum} of 13–15 (PS{sub overall} V) resulted in 76.3% (n = 36) in PCa and in 26.3% (n = 10) in GS ≥ 4 + 3 = 7, whereas for peripheral zone (PZ) lesions cancer detection rate at this score was 92.9% (n = 79) and 49.4% (n = 42) for GS ≥ 4 + 3 = 7. Using a threshold of PS{sub sum} ≥ 10, sensitivity was 86.0%, and negative predictive value (NPV) was 86.2%. For higher grade PCa sensitivity was 98.6%, and NPV was 99.5%. Conclusion: A PS{sub sum} below 9 excluded a higher grade PCa, whereas lesions with a PS{sub sum} ≥ 13 (PS{sub overall} V) represented in 88

  7. Improving the Prediction of Prostate Cancer Overall Survival by Supplementing Readily Available Clinical Data with Gene Expression Levels of IGFBP3 and F3 in Formalin-Fixed Paraffin Embedded Core Needle Biopsy Material.

    Directory of Open Access Journals (Sweden)

    Zhuochun Peng

    Full Text Available A previously reported expression signature of three genes (IGFBP3, F3 and VGLL3 was shown to have potential prognostic value in estimating overall and cancer-specific survivals at diagnosis of prostate cancer in a pilot cohort study using freshly frozen Fine Needle Aspiration (FNA samples.We carried out a new cohort study with 241 prostate cancer patients diagnosed from 2004-2007 with a follow-up exceeding 6 years in order to verify the prognostic value of gene expression signature in formalin fixed paraffin embedded (FFPE prostate core needle biopsy tissue samples. The cohort consisted of four patient groups with different survival times and death causes. A four multiplex one-step RT-qPCR test kit, designed and optimized for measuring the expression signature in FFPE core needle biopsy samples, was used. In archive FFPE biopsy samples the expression differences of two genes (IGFBP3 and F3 were measured. The survival time predictions using the current clinical parameters only, such as age at diagnosis, Gleason score, PSA value and tumor stage, and clinical parameters supplemented with the expression levels of IGFBP3 and F3, were compared.When combined with currently used clinical parameters, the gene expression levels of IGFBP3 and F3 are improving the prediction of survival time as compared to using clinical parameters alone.The assessment of IGFBP3 and F3 gene expression levels in FFPE prostate cancer tissue would provide an improved survival prediction for prostate cancer patients at the time of diagnosis.

  8. Immunoglobulin G4-related prostatitis: A case-control study focusing on clinical and pathologic characteristics

    NARCIS (Netherlands)

    J. Buijs (Jorie); L. Maillette De Buy Wenniger (Lucas); G.J.H.L. Leenders (Geert); J. Verheij (Joanne); I. van Onna (Ilze); B.E. Hansen (Bettina); M. van Heerde (Marianne); N.C. Krak (Nanda); U. Beuers (Ulrich); M.J. Bruno (Marco); H.R. van Buuren (Henk)

    2014-01-01

    markdownabstractOBJECTIVE To evaluate the occurrence and histopathologic characteristics of immunoglobulin G4 (IgG4)- related prostatic involvement in patients diagnosed with autoimmune pancreatitis. METHODS Nine cases of IgG4-related prostatitis were identified among 117 men in the autoimmune pan

  9. 55岁以内患者前列腺穿刺临床病理特征分析%Prostate biopsy results and clinicopathological characteristics of the 55 years or younger patients

    Institute of Scientific and Technical Information of China (English)

    宋刚; 方冬; 纪光杰; 虞巍; 赵承琳; 李学松; 山刚志; 李淑清; 何群

    2016-01-01

    目的 了解55岁以下行前列腺穿刺活检患者的临床病理特征,为青年前列腺穿刺活检患者提供诊疗决策.方法 回顾性分析北京大学第一医院泌尿外科自2011年1月至2013年11月间行前列腺穿刺活检年龄≤55岁的患者,收集患者的前列腺特异抗原(PSA)、直肠指诊、超声、磁共振等临床信息,以及穿刺病理结果确定是否存在前列腺腺癌或高级别前列腺腺癌(Gleason评分≥7分).结果 共82例患者顺利完成穿刺,中位年龄51岁,中位PSA 8.62 μg/L.其中71例(86.6%)穿刺前行前列腺磁共振检查,25例阳性(35.2%),28例阴性(39.4%),18例可疑(25.4%).穿刺活检病理确诊前列腺腺癌共26例(31.7%),其中23例(28.0%)为高级别前列腺腺癌.较高的PSA值、阳性的超声检查结果以及阳性的磁共振检查结果为病理诊断前列腺癌或高级别前列腺癌的危险因素.其中对于PSA值在4~10μg/L之间的患者,穿刺阳性率为15.0%,超声及磁共振检查对于穿刺结果有提示意义.结论 PSA升高或存在前列腺结节的青年(≤55岁)患者前列腺穿刺阳性率为31.7%,PSA处于灰区(4~ 10 μg/L)穿刺阳性率为15%.不可忽视该年龄段人群罹患前列腺癌的风险.PSA值、超声检查和磁共振检查为穿刺阳性的危险因素.%Objective To explore the clinical features,biopsy results and risk factors of patients underwent prostate biopsy with age ≤ 55,and to help make the proper treatment strategies of this cohort of patients.Methods The data of patients with age ≤55 underwent prostate biopsy between Jan 2011 and Nov 2013 was retrospectively reviewed.Clinical factors including prostate-specific antigen,digital rectal examination,ultrasonography and magnetic resonance imaging were recorded.Biopsy positive results were defined as the presence of prostate cancer and high-grade prostate cancer (Gleason score ≥ 7).Results There were all together 82 patients in this cohort

  10. The incidence and risk factors of resistant E. coli infections after prostate biopsy under fluoroquinolone prophylaxis: a single-centre experience with 2215 patients.

    Science.gov (United States)

    Kandemir, Özlem; Bozlu, Murat; Efesoy, Ozan; Güntekin, Onur; Tek, Mesut; Akbay, Erdem

    2016-08-01

    We evaluated the incidence and risk factors of resistant Escherichia coli infections after the prostate biopsy under flouroquinolone prophylaxis. From January 2003 to December 2012, we retrospectively evaluated the records of 2215 patients. The risk factors were described for infective complications and resistant E. coli in positive cultures was calculated. Of 2215 patients, 153 had positive urine cultures, such as 129 (84·3%) E. coli, 8 (5·2%) Enterococcus spp., 6 (3·9%) Enterobacter spp., 5 (3·2%) Pseudomonas spp., 3 (1·9%) MRCNS, and 2 (1·3%) Klebsiella spp. Of the positive urine cultures which yielded E. coli, 99 (76·7%) were evaluated for fluoroquinolone resistance. Of those, 83 (83·8%) were fluoroquinolone-resistant and composed of 51 (61·4%) extended-spectrum beta-lactamase (ESBL)-positive. Fluoroquinolone-resistant E. coli ratios were 73·4 and 95·9% before 2008 and after 2008, respectively (P = 0·002). The most sensitive antibiotics for fluoroquinolone-resistant E. coli strains were imipenem (100%), amikacin (84%) and cefoperazone (83%). The use of quinolones in the last 6 months and a history of hospitalization in the last 30 days were found to be significant risk factors. We found that resistant E. coli strains might be a common microorganism in patients with this kind of complication. The risk factors for development of infection with these resistant strains were history of the use of fluoroquinolones and hospitalization.

  11. Validation of International Society of Urological Pathology (ISUP) grading for prostatic adenocarcinoma in thin core biopsies using TROG 03.04 'RADAR' trial clinical data.

    Science.gov (United States)

    Delahunt, B; Egevad, L; Srigley, J R; Steigler, A; Murray, J D; Atkinson, C; Matthews, J; Duchesne, G; Spry, N A; Christie, D; Joseph, D; Attia, J; Denham, J W

    2015-10-01

    In 2014 a consensus conference convened by the International Society of Urological Pathology (ISUP) adopted amendments to the criteria for Gleason grading and scoring (GS) for prostatic adenocarcinoma. The meeting defined a modified grading system based on 5 grading categories (grade 1, GS 3+3; grade 2, GS 3+4; grade 3, GS 4+3; grade 4, GS 8; grade 5, GS 9-10). In this study we have evaluated the prognostic significance of ISUP grading in 496 patients enrolled in the TROG 03.04 RADAR Trial. There were 19 grade 1, 118 grade 2, 193 grade 3, 88 grade 4 and 79 grade 5 tumours in the series, with follow-up for a minimum of 6.5 years. On follow-up 76 patients experienced distant progression of disease, 171 prostate specific antigen (PSA) progression and 39 prostate cancer deaths. In contrast to the 2005 modified Gleason system (MGS), the hazards of the distant and PSA progression endpoints, relative to grade 2, were significantly greater for grades 3, 4 and 5 of the 2014 ISUP grading scheme. Comparison of predictive ability utilising Harrell's concordance index, showed 2014 ISUP grading to significantly out-perform 2005 MGS grading for each of the three clinical endpoints.

  12. Individualized regimen for transperineal prostate biopsy: an experience with 1044 cases%建立经会阴前列腺穿刺活组织检查的个体化方案(1044例资料总结)

    Institute of Scientific and Technical Information of China (English)

    汪东亚; 戴文斌; 苗华栋; 詹佳; 钱伟庆; 孙忠全; 宋建达

    2011-01-01

    Objective To establish an individualized regimen for transperineal prostate biopsy. Methods The techenology of prostate biopsy in our unit have evolved from finger guided, transrectal ultrasound (TRUS) guided,and magnetic resonance diffusion weighted imaging (MRD) and TRUS jointly guided transperineal prostate biopsy. The clinical data of 1,044 patients with suspected prostate cancer, who underwent transperineal prostate biopsy in our hospital between Jan. 2005 and Dec. 2010, were retrospectively analyzed. We began to use individualized prostate biopsy protocol in 2009, in which we determined the biopsy cores and position of transperineal prostate biopsy according to the following factors: digital rectal examination(DRE), TRUS, magnetic resonance diffusion weighted imaging, MRD, total prostate specific antigen (PSA), adjusted PSA, age-specific PSA, F/T (≤0.2 or >0.16), PSAdensity(≤ or >0. 15 ng ? mL-1 ? mL-1), PSA speed (≤ or >0.75 ? mL-1 ? Year-1), thickness of prostate peripheral zone (≤ or >0. 5 cm). We also compared the total detective rates of Pca between the individualized puncture regimen and traditional regimen and the rates in patients with PSA≤20 μg/L. Results The detective rate of Pea in 1,641 cases receiving prostate biopsy during Jan. 2000 to Dec. 2010 was 52.1 %. Among them 1,044 patients received TRUS-guided transperineal prostate biopsy from Jan. 2005, with the detective rate for Pca being 52. 0% (543/1,044). A further modified individualized regimen for transperineal prostate biopsy was used during Jan. 2009 to Dec. 2010, which achieved a Pca detective rate of 60.7% and an early Pca detective rate of 44.1 % in patients with PSA≤20 μg/L; the rates were significantly higher than those ofthe 3 above-mentioned periods (P<0.05). Conclusions The individualized regimen with emphasized-puncture for suspected lesions plus systemic 8-14 cores puncture is a feasible regimen, which is based on total PSA, DRE, MRD and existence of suspected

  13. Liver biopsy

    Science.gov (United States)

    Biopsy - liver; Percutaneous biopsy ... the biopsy needle to be inserted into the liver. This is often done by using ultrasound. The ... the chance of damage to the lung or liver. The needle is removed quickly. Pressure will be ...

  14. Synovial biopsy

    Science.gov (United States)

    Biopsy - synovial membrane ... fluid in and out of the area. A biopsy grasper is inserted through the trocar and turned ... Synovial biopsy helps diagnose gout and bacterial infections, or rule out other infections. It can be used to diagnose ...

  15. Nerve biopsy

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    Biopsy - nerve ... A nerve biopsy is most often done on a nerve in the ankle, forearm, or along a rib. The health care ... feel a prick and a mild sting. The biopsy site may be sore for a few days ...

  16. Bladder biopsy

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    Biopsy - bladder ... A bladder biopsy can be done as part of a cystoscopy . Cystoscopy is a telescopic examination of the inside of the ... informed consent form before you have a bladder biopsy. In most cases, you are asked to urinate ...

  17. Biopsy - polyps

    Science.gov (United States)

    Polyp biopsy ... are treated is the colon. How a polyp biopsy is done depends on the location: Colonoscopy or flexible sigmoidoscopy explores the large bowel Colposcopy-directed biopsy examines the vagina and cervix Esophagogastroduodenoscopy (EGD) or ...

  18. Androgen regulated genes in human prostate xenografts in mice: relation to BPH and prostate cancer.

    Directory of Open Access Journals (Sweden)

    Harold D Love

    Full Text Available Benign prostatic hyperplasia (BPH and prostate carcinoma (CaP are linked to aging and the presence of androgens, suggesting that androgen regulated genes play a major role in these common diseases. Androgen regulation of prostate growth and development depends on the presence of intact epithelial-stromal interactions. Further, the prostatic stroma is implicated in BPH. This suggests that epithelial cell lines are inadequate to identify androgen regulated genes that could contribute to BPH and CaP and which could serve as potential clinical biomarkers. In this study, we used a human prostate xenograft model to define a profile of genes regulated in vivo by androgens, with an emphasis on identifying candidate biomarkers. Benign transition zone (TZ human prostate tissue from radical prostatectomies was grafted to the sub-renal capsule site of intact or castrated male immunodeficient mice, followed by the removal or addition of androgens, respectively. Microarray analysis of RNA from these tissues was used to identify genes that were; 1 highly expressed in prostate, 2 had significant expression changes in response to androgens, and, 3 encode extracellular proteins. A total of 95 genes meeting these criteria were selected for analysis and validation of expression in patient prostate tissues using quantitative real-time PCR. Expression levels of these genes were measured in pooled RNAs from human prostate tissues with varying severity of BPH pathologic changes and CaP of varying Gleason score. A number of androgen regulated genes were identified. Additionally, a subset of these genes were over-expressed in RNA from clinical BPH tissues, and the levels of many were found to correlate with disease status. Our results demonstrate the feasibility, and some of the problems, of using a mouse xenograft model to characterize the androgen regulated expression profiles of intact human prostate tissues.

  19. Androgen regulated genes in human prostate xenografts in mice: relation to BPH and prostate cancer.

    Science.gov (United States)

    Love, Harold D; Booton, S Erin; Boone, Braden E; Breyer, Joan P; Koyama, Tatsuki; Revelo, Monica P; Shappell, Scott B; Smith, Jeffrey R; Hayward, Simon W

    2009-12-21

    Benign prostatic hyperplasia (BPH) and prostate carcinoma (CaP) are linked to aging and the presence of androgens, suggesting that androgen regulated genes play a major role in these common diseases. Androgen regulation of prostate growth and development depends on the presence of intact epithelial-stromal interactions. Further, the prostatic stroma is implicated in BPH. This suggests that epithelial cell lines are inadequate to identify androgen regulated genes that could contribute to BPH and CaP and which could serve as potential clinical biomarkers. In this study, we used a human prostate xenograft model to define a profile of genes regulated in vivo by androgens, with an emphasis on identifying candidate biomarkers. Benign transition zone (TZ) human prostate tissue from radical prostatectomies was grafted to the sub-renal capsule site of intact or castrated male immunodeficient mice, followed by the removal or addition of androgens, respectively. Microarray analysis of RNA from these tissues was used to identify genes that were; 1) highly expressed in prostate, 2) had significant expression changes in response to androgens, and, 3) encode extracellular proteins. A total of 95 genes meeting these criteria were selected for analysis and validation of expression in patient prostate tissues using quantitative real-time PCR. Expression levels of these genes were measured in pooled RNAs from human prostate tissues with varying severity of BPH pathologic changes and CaP of varying Gleason score. A number of androgen regulated genes were identified. Additionally, a subset of these genes were over-expressed in RNA from clinical BPH tissues, and the levels of many were found to correlate with disease status. Our results demonstrate the feasibility, and some of the problems, of using a mouse xenograft model to characterize the androgen regulated expression profiles of intact human prostate tissues.

  20. 超声引导下前列腺10点加定点穿刺活检术诊断前列腺癌%Transrectal ultrasound-guided 10 cores plus fixed-point prostate biopsy for diagnosing prostate cancer

    Institute of Scientific and Technical Information of China (English)

    张利; 韩雪冰; 米振国; 郭荣荣

    2008-01-01

    目的 探讨经直肠彩色多普勒超声引导下前列腺穿刺活组织检查在前列腺癌诊断中的应用.方法 181例疑诊前列腺癌的患者进行血清总前列腺特异性抗原(T-PSA)检测,采用10点加前列腺癌可疑灶定点穿刺活检术.结果 181例中检出前列腺癌80例(44.2%),前列腺增生63例(34.8%).前列腺炎36例(19.9%),前列腺结核1例(0.6%),前列腺平滑肌瘤1例(0.6%).T-PSA水平>20μg/L组的前列腺癌发生率高于其他各组.随着T-PSA水平的升高,Gleason评分增加(P<0.001).结论 超声引导下10点加定点穿刺活检术诊断前列腺癌的阳性率高,对T-PSA>20μg/L的疑诊前列腺癌患者活检意义较大.%Objective To evaluate the clinical value of transrectal ultrasound-guided 10 cores plus fixed-point prostate biopsy for diagnosing prostate cancer.Methods The serum PSA level of 181 patients were determined with ELISA.AU the patients underwent 10 cores plus fixed-point prostate biopsy under the guidance of transrectal ultrasound.Resuits 80 cases with prostate cancer(44.2%),63 cases with benign prostatic hypertrophy (34.8%),36 cases with prostatitis(19.9%),1 cage with tuberculosis(0.6%),and 1 cage with prostate leiomyoma(0.6%).When PSA WaS more than 20 μg/L,the incidence rate of prostate cancer was significantly higher than other PSA levels.Meanwhile,Gleason scores were increased with the advance of PSA levels (P<0.001).Conclusion Transrectal ultrasound-guided systematic 10 cores plus fixed-point prostate biopsy could significantly enhance the prostate cancer detection rate, and it was important in diagnosing prostate cancer for patients,especially when PsA was more than 20 μg/L.

  1. Evaluation of PCA3 and multiparametric MRI’s: collective benefits before deciding initial prostate biopsy for patients with PSA level between 3-10ng/mL

    Science.gov (United States)

    Okcelik, Sezgin; Soydan, Hasan; Ates, Ferhat; Berber, Ufuk; Saygin, Hasan; Sönmez, Güner; Karademir, Kenan

    2016-01-01

    ABSTRACT Objective To analyze the contribution of multiparametric MRI and PCA3 assay, pre- decision of initial biopsy in PSA level between 3-10 ng/mL patients with normal digital rectal examination(DRE). Materials and Methods PSA level 3-10 ng/mL ,patients, with normal DRE results and no previous prostate biopsy history, were included in this study. Each patient underwent multiparametric MRI one week before biopsy. Urine sample taking for PCA3 examination preceded the biopsy. Systematic and targeted biopsies were conducted. Patients with high PSA levels were seperated into two groups as: high PCA3 scored and low PCA3 scored. Then each group was divided into two sub-groups as: MRI lesion positive and negative. Tumor incidence, positive predictive values(PPV) and negative predictive values(NPV) were calculated. Results 53 patients were included between February 2013 and March 2014.Mean age 61.22 ± 1.06. Mean PSA value 5.13 ± 0.19 ng / mL. Mean PCA3 score 98.01 ± 23.13 and mean prostate size was 48.96 ± 2.67 grams. Fourty nine patients had both PCA3 score and multiparametric MRI. The PCA3’s PPV value was 58.33%. If multiparametric MRI lesions are added to high PCA3 scores , the PPV appears to elevate to 91.66%. NPV of PCA3 was 96%. NPV was 95% when there was no lesion in the multiparametric MRI with low PCA3 scores. Sensitivity was 91.66% , specificity was 95% respectively. Conclusion Adding multimetric MRI can also support biopsy decision for patients with high PCA3 value. When PCA3 value is low, patients can be survailled without any need to take a MRI. PMID:27286106

  2. Natural course of keratoacanthoma and related lesions after partial biopsy: clinical analysis of 66 lesions.

    Science.gov (United States)

    Takai, Toshihiro; Misago, Noriyuki; Murata, Yozo

    2015-04-01

    There is some confusion regarding the classification of keratoacanthoma (KA) and related lesions that have crateriform architecture. We examined the clinical courses of 66 KA lesions and related lesions after a partial biopsy to clarify the nosological concept of KA. We histopathologically classified these lesions into five types: (i) KA at various stages (53 lesions); (ii) KA-like squamous cell carcinoma (SCC) (3 lesions); (iii) KA with malignant transformation (3 lesions); (iv) infundibular SCC (5 lesions); and (v) crateriform SCC arising from solar keratosis (2 lesions). We analyzed the clinical course in each group. The regression rate of KA was 98.1% and that of KA-like SCC/KA with malignant transformation was 33.3%. No regression was observed in either infundibular SCC or crateriform SCC arising from solar keratosis. Thus, KA is a distinct entity that should be distinguished from other types of SCC with crateriform architecture based on the high frequency of regression. The regression rate of 33.3% in KA-like SCC/KA with malignant transformation indicated that KA lesions with an SCC component still have the potential for regression. However, this result also indicated that KA is biologically unstable, and some KA tend to evolve into conventional SCC with a gradual loss of the capacity for the spontaneous regression. Infundibular SCC and crateriform SCC arising from solar keratosis are fundamentally different from KA, not only according to the histopathological findings but also based on the biological properties.

  3. Correlation between benign prostate hyperplasia and the related indicators of atherosclerosis

    Institute of Scientific and Technical Information of China (English)

    张瑞华

    2012-01-01

    Objective To investigate the correlation between benign prostate hyperplasia (BPH) and atherosclerotic related indicators. Methods Totally 125 patients were divided into two groups based on prostate volume(PV):50 cases without BPH(PV≤30 ml) and 75 cases with BPH (PV>30ml)

  4. Relationship of body mass index and blood lipid level with cancer detection on prostate biopsy%体质指数、血脂水平与前列腺穿刺活检阳性间的关系

    Institute of Scientific and Technical Information of China (English)

    张浩宇; 吕广霖; 袁和兴; 魏雪栋; 胡林昆; 张学锋; 侯建全

    2015-01-01

    Objective To investigate the relationship between body mass index (BMI), blood lipid level and cancer de⁃tection in prostate biopsy. Methods A total of 214 patients undergoing a prostate biopsy during 2013.2—2014.8 were re⁃viewed retrospectively. They were divided into prostate cancer and non-cancer groups by biopsy results. The differences of age, prostate-specific antigen (PSA) level, prostate volume (PV), blood lipid level and BMI were analyzed between two groups. Risk factors for cancer detection of biopsy were also analyzed. Results Compared with non-cancer patients, pros⁃tate cancer patients were older, had higher level of PSA and BMI, but smaller PV and lower level of HDL-C ( P<0.05). Lo⁃gistic regression analysis showed that older, higher level of PSA and BMI were risk factors for prostate biopsy positive, but larger PV and higher level of HDL-C were protective factors (P<0.05). Conclusion Comprehensive assessment of BMI and blood lipid levels can provide important reference for prostate cancer screening at early time and establishment of pros⁃tate biopsy scheme, which also provide significant evidence for the prevention, diagnosis and treatment of prostate cancer at early stage for high risk population.%目的:探讨体质指数(BMI)、血脂水平与前列腺穿刺活检阳性之间的关系。方法回顾性分析2013年2月—2014年8月间在我院行前列腺穿刺活检患者214例,根据穿刺病理结果分为前列腺癌组和非癌组,比较2组间年龄、前列腺特异性抗原(PSA)、前列腺体积(PV)、血脂水平、体质指数(BMI)等指标,并分析前列腺穿刺阳性的危险因素。结果前列腺癌组年龄、PSA、BMI高于非癌组,而PV、高密度脂蛋白胆固醇(HDL-C)则低于非癌组(均P<0.05)。Logistic回归分析提示年龄大,PSA、BMI升高是前列腺穿刺活检阳性的危险因素,而PV、HDL-C升高则为保护因素(均P<0.05)。结论综合评估患者BMI

  5. Granulomatous prostatitis - an infrequent diagnosis

    Directory of Open Access Journals (Sweden)

    RPS Punia

    2002-01-01

    Full Text Available Granulomatous prostatitis is a rare disorder of pros-tate. We encountered 10 cases of′grmudomatous prosta-titis consisting of 5 cases of non-specific granulomatous prostatitis, 2 cases of xanthogranulomatous prostatitis, I case of tuberculous prostatitis, I case of malakoplakia prostate and I case of granulomatous prostatitis associ-ated with adenocarcinoma prostate. The diagnosis was made by histopathologic examination of trucut biopsy, TURP chips or retropubic prostatectomy specimen. In all the cases, granulomatous prostatitis was an incidental find-ing.

  6. Application of transrectal ultrasound-guided transperineal prostate puncture biopsy in diagnosis of prostate cancer%基于直肠超声图像分析引导下的经会阴前列腺穿刺活检在前列腺癌诊断中应用

    Institute of Scientific and Technical Information of China (English)

    张进

    2014-01-01

    目的:探讨经直肠超声引导下经会阴前列腺穿刺活检对于前列腺癌诊断的价值。方法:通过9+X穿刺方法,对82例临床拟诊前列腺癌的患者进行经直肠超声引导下经会阴前列腺穿刺活检,对穿刺结果进行分析。结果:全部患者均活检成功,前列腺癌的阳性率为25.6%(21/82),穿刺并发症轻微。结论:经直肠超声引导下经会阴前列腺穿刺活检相对阳性率更高,并发症相对较少、较轻,适应范围更广,必将有更广阔的应用前景。%Objective:To investigate the value of the transrectal ultrasound-guided transperineal prostate puncture biopsy in diagnosis of prostate cancer. Methods:Transperineal prostate puncture biopsy was performed under tran-srectal guidance in 82 patients suspected of suffering from prostate cancer with 9+X method. Results:All the patients were completed the biopsy successfully. 21 patients were positive for cancer in 82 patients (25.6%).There were few-er and lighter complications. Conclusion:Transperineal prostate puncture biopsy would be gotten extensive usage be-cause of the higher positive rate, fewer and lighter complications and wider extent of application.

  7. Management of benign prostatic hypertrophy-related urinary retention: current trends and perspectives.

    Science.gov (United States)

    Stamatiou, Konstantinos

    2009-01-01

    The failure of prostate-directed treatment modalities to help all men or all symptoms has questioned the longstanding assumption that the prostate is at the root of all male urinary symptoms, and a correlation between urinary bladder function and prostate pathology has been recognized. Now, it is widely recognized that bladder dysfunction plays a role in some, if not most, of the benign prostatic hyperplasia-related symptoms and signs, and recent studies have suggested that pharmacotherapies that target the bladder, such as antimuscarinics, may improve storage urinary symptoms. Indeed, the current mainstays of overactive bladder syndrome pharmacotherapy are antimuscarinic agents with mixed actions, including musculotropic (calcium antagonistic) activity. Moreover, the combination therapy with alpha blocker and antimuscarinic agents is now suggested when bladder outlet obstruction related to benign prostatic hyperplasia coexists with overactive bladder symptoms. Combinational treatment, targeting to both decrease resistance to urine outflow through the prostatic urethra and increase bladder smooth muscle, may improve the bladder outlet surgery success rate, and perhaps it might reinforce the need to offer an additional trial without catheter in patients with benign prostatic hyperplasia who are likely to suffer from detrusor hypocontractivity. Currently, no clinical trial supporting the use of parasympathomimetic drugs in those with poor voiding and longstanding symptomatic benign prostatic hyperplasia exists in the literature; however, experimental studies present promising results.

  8. Occupational physical activity in relation with prostate cancer and benign prostatic hyperplasia.

    Science.gov (United States)

    Lagiou, Areti; Samoli, Evi; Georgila, Christina; Minaki, Ploumi; Barbouni, Anastasia; Tzonou, Anastasia; Trichopoulos, Dimitrios; Lagiou, Pagona

    2008-08-01

    Using data from two case-control studies undertaken in Athens, Greece from 1994 to 1997, we have examined the association of occupational physical activity with the risk of prostate cancer and benign prostatic hyperplasia (BPH). Cases consisted of 320 patients with histologically confirmed incident prostate cancer and 184 patients with surgically treated BPH. Controls were 246 patients hospitalized for minor conditions. Occupations before retirement were classified, independently and blindly as to case-control status, into high, medium, and low physical activity levels. After fine controlling for years of schooling, there was a suggestive inverse association of physical activity with prostate cancer (P for trend 0.12) and a significant one with BPH (P for trend 0.04). The odds ratio (95% confidence interval) for high versus low activity was 0.69 (0.40-1.22) for prostate cancer and 0.59 (0.31-1.11) for BPH. The association of physical activity with both conditions tended to be more pronounced among men 65 years old or younger. Given the high frequency of occurrence of the examined conditions in the male population and our limited knowledge about other modifiable risk factors, preventive measures may have to focus on increasing physical activity.

  9. 经直肠超声定位下前列腺穿刺活检术的探讨%Transrectal Ultrasounography Guided Prostate Biopsy and its Influencing Factors

    Institute of Scientific and Technical Information of China (English)

    杜科霖; 欧阳骏; 丁翔; 温端改

    2011-01-01

    目的 探讨理想的前列腺穿刺活检方案.方法 回顾性分析127例疑诊为前列腺癌患者的年龄、直肠指检(DRE)或经直肠超声(TRUS)情况、血清前列腺特异性抗原(PSA)水平、前列腺体积大小、穿刺针数等,与穿刺活检阳性率的关系.结果 127例穿刺活检结果显示:前列腺增生症(BPH)80例,前列腺癌(Pca)47例,Pca活检阳性率为37.9%;随着患者年龄的增长及PSA水平的增高,Pca检出率明显增高,差异有统计学意义(P<0.05),对前列腺体积不同患者,采用不同穿刺活检方案,其Pca活检阳性率不等,小体积前列腺患者,系统6针、10针、12针穿刺活检三组阳性率比较差异无统计学意义(P>0.05),大体积前列腺患者,12针穿刺活检阳性率明显高于系统6针的.直肠指检阳性组穿刺活检阳性率与阴性组比较有统计学意义(P<0.05).结论 对不同的初次前列腺活检患者,应当根据患者的个体情况选择不同的穿刺活检方案.%Objective To investigate the impaction of different prostate biopsy strategies on the prostate cancer detection. Methods 127 men who were highly suspected as prostate cancer were included in this study. Retrospective analysis the relationship hetween the patient ' s age , DRE or TRUS conditions . PSA levels , prostate volume size , the numher of needle and the biopsy positive rate. Results Of the 127 patients, prostate cancers were detected in 47 ( 37.9% ). The positive rate of prostate cancer was positively correlated with the age of the patients and the PSA levels ( P < 0. 05 ). In the patients with small prostate volume, there was no significant difference in the dete.ction rate of prostate cancer between 6-, 10-, and 12-core protocols ( P >0. 05 ). But In the patients with large prostate volume, the detection rate by 12-core protocol was significantly higher than that hy 6-core protocol ( 36. 9% vs. 12. 8% , P > 0. 05 ). The detection rate of the prostate canc:er was

  10. Age-related changes in the prostate and testes of the Beagle dog

    Energy Technology Data Exchange (ETDEWEB)

    Lowseth, L.A.; Gerlach, R.F.; Gillett, N.A.; Muggenburg, B.A. (Lovelace Biomedical and Environmental Research Inst., Albuquerque, NM (United States))

    1990-01-01

    Age-related changes in the histologic morphology of the Beagle dog prostate have been used as a model for similar changes that occur in human beings. Previous studies of the aging changes in Beagle dogs have been limited to animals less than 10 years of age. In this study, the prostate, testes, and serum testosterone levels were evaluated in healthy Beagle dogs that were grouped by age to provide five groups of dogs that ranged from 3 to 14 years of age. Tissue sections from the prostate and testes were examined qualitatively and quantitatively by light microscopy. All animals 6 years of age and older had histologic characteristics of complex benign prostatic hyperplasia. A mean statistically significant increase in prostatic weight with increased age was noted. Morphometric analysis of the prostatic tissue suggested that similar to the change observed in human males, the increase in size was primarily due to an increase in the absolute volume of interstitial tissues. The epithelial component did not contribute to the increase noted, with the exception that the percentage of glandular lumen did increase with age, indicating progressive cystic dilatation of the glands. Stereologic analysis of the testes showed a decrease in the relative percentage of germ cells with increasing age. No distinct age-related trend was detected in serum testosterone concentrations. These findings indicate that the progression of benign prostatic hyperplasia occurs throughout the entire life span of the dog; an association with changes in the testes was not identified.

  11. Occupation related pesticide exposure and cancer of the prostate: a meta-analysis

    OpenAIRE

    Van Maele-Fabry, G; Willems, J

    2003-01-01

    Aims: To summarise recent literature on the risk of prostate cancer in pesticide related occupations, to calculate the meta-rate ratio, and to compare it to data from meta-analyses previously published.

  12. Absorption fever characteristics due to percutaneous renal biopsy-related hematoma.

    Science.gov (United States)

    Hu, Tingyang; Liu, Qingquan; Xu, Qin; Liu, Hui; Feng, Yan; Qiu, Wenhui; Huang, Fei; Lv, Yongman

    2016-09-01

    This study aims to describe the unique characteristics of absorption fever in patients with a hematoma after percutaneous renal biopsy (PRB) and distinguish it from secondary infection of hematoma.We retrospectively studied 2639 percutaneous renal biopsies of native kidneys. We compared the clinical characteristics between 2 groups: complication group (gross hematuria and/or perirenal hematoma) and no complication group. The axillary temperature of patients with a hematoma who presented with fever was measured at 06:00, 10:00, 14:00, and 18:00. The onset and duration of fever and the highest body temperature were recorded. Thereafter, we described the time distribution of absorption fever and obtained the curve of fever pattern.Of 2639 patients, PRB complications were observed in 154 (5.8%) patients. Perirenal hematoma was the most common complication, which occurred in 118 (4.5%) of biopsies, including 74 small hematoma cases (thickness ≤3 cm) and 44 large hematoma cases (thickness >3 cm). Major complications were observed in only 6 (0.2%) cases resulting from a large hematoma. Of 118 patients with a perirenal hematoma, absorption fever was observed in 48 cases. Furthermore, large hematomas had a 5.23-fold higher risk for absorption fever than the small ones.Blood pressure, renal insufficiency, and prothrombin time could be risk factors for complications. Fever is common in patients with hematoma because of renal biopsy and is usually noninfectious. Evaluation of patients with post-biopsy fever is necessary to identify any obvious infection sources. If no focus is identified, empiric antibiotic therapy should not be initiated nor should prophylactic antibiotics be extended for prolonged durations. Absorption fevers will resolve in time without specific therapeutic interventions.

  13. Tongue biopsy

    Science.gov (United States)

    Biopsy - tongue ... A tongue biopsy can be done using a needle. You will get numbing medicine at the place where the ... provider will gently stick the needle into the tongue and remove a tiny piece of tissue. Some ...

  14. Clonal Evaluation of Prostate Cancer by ERG/SPINK1 Status to Improve Prognosis Prediction

    Science.gov (United States)

    2015-10-01

    SUBJECT TERMS Multiclonality, ERG, SPINK1, immunohistochemistry, active surveillance, prostate biopsy, prostatectomy 16. SECURITY CLASSIFICATION OF: 17...and in doing so, will increase the number of men eligible for active surveillance, enhancing the well-being of men with prostate cancer through...minimizing over- treatment and treatment-related side effects. KEYWORDS: Multiclonality, ERG, SPINK1, immunohistochemistry, active surveillance

  15. Computational imaging reveals shape differences between normal and malignant prostates on MRI

    Science.gov (United States)

    Rusu, Mirabela; Purysko, Andrei S.; Verma, Sadhna; Kiechle, Jonathan; Gollamudi, Jay; Ghose, Soumya; Herrmann, Karin; Gulani, Vikas; Paspulati, Raj; Ponsky, Lee; Böhm, Maret; Haynes, Anne-Maree; Moses, Daniel; Shnier, Ron; Delprado, Warick; Thompson, James; Stricker, Phillip; Madabhushi, Anant

    2017-01-01

    We seek to characterize differences in the shape of the prostate and the central gland (combined central and transitional zones) between men with biopsy confirmed prostate cancer and men who were identified as not having prostate cancer either on account of a negative biopsy or had pelvic imaging done for a non-prostate malignancy. T2w MRI from 70 men were acquired at three institutions. The cancer positive group (PCa+) comprised 35 biopsy positive (Bx+) subjects from three institutions (Gleason scores: 6–9, Stage: T1–T3). The negative group (PCa−) combined 24 biopsy negative (Bx−) from two institutions and 11 subjects diagnosed with rectal cancer but with no clinical or MRI indications of prostate cancer (Cl−). The boundaries of the prostate and central gland were delineated on T2w MRI by two expert raters and were used to construct statistical shape atlases for the PCa+, Bx− and Cl− prostates. An atlas comparison was performed via per-voxel statistical tests to localize shape differences (significance assessed at p < 0.05). The atlas comparison revealed central gland hypertrophy in the Bx− subpopulation, resulting in significant volume and posterior side shape differences relative to PCa+ group. Significant differences in the corresponding prostate shapes were noted at the apex when comparing the Cl− and PCa+ prostates. PMID:28145532

  16. Benign prostatic hyperplasia: age-related tissue-remodeling.

    Science.gov (United States)

    Untergasser, Gerold; Madersbacher, Stephan; Berger, Peter

    2005-03-01

    Aging and androgens are the two established risk factors for the development of benign prostatic hyperplasia (BPH) and benign prostatic enlargement (BPE), which can lead to lower urinary tract symptoms (LUTS) in elderly men. BPH, consisting of a nodular overgrowth of the epithelium and fibromuscular tissue within transition zone and periurethral areas, is first detectable around the fourth decade of life and affects nearly all men by the ninth decade. The pathogenesis of BPH is still largely unresolved, but multiple partially overlapping and complementary theories have been proposed, all of which seem to be operative at least to some extent. In addition to nerve-, endocrine- and immune system, local para- and luminocrine pleiotrope mechanisms/factors are implicated in the prostatic tissue-remodeling process. Prostate tissue-remodeling in the transition zone is characterized by: (i) hypertrophic basal cells, (ii) altered secretions of luminal cells leading to calcification, clogged ducts and inflammation, (iii) lymphocytic infiltration with production of proinflammatory cytokines, (iv) increased radical oxygen species (ROS) production that damages epithelial and stromal cells, (v) increased basic fibroblast (bFGF) and transforming growth factor beta (TGF-beta 1) production leading to stromal proliferation, transdifferentiation and extracellular matrix production, (vi) altered autonomous innervation that decreases relaxation and leads to a high adrenergic tonus, (vii) and altered neuroendocine cell function and release of neuroendocrine peptides (NEP). This review summarizes the multifactorial nature of prostate tissue remodeling in elderly men with symptomatic BPH with a particular focus on changes of cell-cell interactions and cell functions in the human aging prostate.

  17. Discoidin domain receptor 2 facilitates prostate cancer bone metastasis via regulating parathyroid hormone-related protein.

    Science.gov (United States)

    Yan, Zhang; Jin, Su; Wei, Zhang; Huilian, Hou; Zhanhai, Yin; Yue, Teng; Juan, Li; Jing, Li; Libo, Yao; Xu, Li

    2014-09-01

    Prostate cancer frequently metastasizes to the skeleton but the underlying mechanism remains largely undefined. Discoidin domain receptor 2 (DDR2) is a member of receptor tyrosine kinase (RTK) family and is activated by collagen binding. This study aimed to investigate the function and detailed mechanism of DDR2 in prostate cancer bone dissemination. Herein we found that DDR2 was strongly expressed in bone-metastatic prostate cancer cells and tissues compared to that in normal controls. Enhanced expression of constitutively activated DDR2 led to elevation in motility and invasiveness of prostate cancer cells, whereas knockdown of DDR2 through specific shRNA caused a dramatic repression. Knockdown of DDR2 in prostate cancer cells resulted in significant decrease in the proliferation, differentiation and function of osteoblast. Over-expression of DDR2 in prostate cancer cells resulted in notable acceleration of osteoclast differentiation and bone resorption, whereas knockdown of DDR2 exhibited the opposite effects. An intrabone injection bone metastasis animal model demonstrated that DDR2 promoted osteolytic metastasis in vivo. Molecular evidence demonstrated that DDR2 regulated the expression, secretion, and promoter activity of parathyroid hormone-related protein (PTHrP), via modulating Runx2 phosphorylation and transactivity. DDR2 was responsive to TGF-β and involved in TGF-β-mediated osteoclast activation and bone resorption. In addition, DDR2 facilitated prostate cancer cells adhere to type I collagen. This study reveals for the first time that DDR2 plays an essential role in prostate cancer bone metastasis. The mechanism disclosure may provide therapeutic targets for the treatment of prostate cancer.

  18. Gender relations and couple negotiations of British men's food practice changes after prostate cancer.

    Science.gov (United States)

    Mróz, Lawrence W; Robertson, Steven

    2015-01-01

    Nutrition plays an important role in the health of men diagnosed with prostate cancer and dietary interventions can therefore be a significant part of prostate cancer survivorship supportive care. Family food provision, however, involves complex social interactions, which shape how men engage with their diets and dietary interventions. The role that gender plays in shaping prostate cancer couples' food practices and men's diets after a prostate cancer diagnosis is thought to be important but is little understood. This study explored couples' accounts of nutrition information seeking and diet change to gain a better understanding of how gender relations shaped men's food practices after prostate cancer diagnosis. Qualitative health interviews with men and their partners were conducted and analysed using interpretive descriptive methods. Findings demonstrated how couples navigated food change journeys that involved seeking information, deciding what changes were warranted and implementing and regulating diet changes. Two overarching themes that illustrated couples' food negotiations were called 'Seeking information and deciding on food changes' and 'Monitoring food changes'. Additional sub-themes described who led food changes, women's filtering of information, and moderation or 'treats'. Throughout these food change journeys, interactions between men and women were at play, demonstrating how gender relations and dynamics acted to shape couples' food negotiations and men's food practices. Findings reveal that attention to gender relations and the men's family food dynamics should inform diet interventions for men with prostate cancer in order to improve uptake.

  19. Advanced prostate cancer risk in relation to toenail selenium levels

    NARCIS (Netherlands)

    Geybels, M.S.; Verhage, B.A.J.; Schooten, F.J. van; Goldbohm, A.; Brandt, P.A. van den

    2013-01-01

    BACKGROUND: Selenium may prevent advanced prostate cancer (PCa), but most studies on this topic were conducted in populations with moderate to high selenium status. We investigated the association of toenail selenium, reflecting long-term selenium exposure, and advanced PCa risk in a population from

  20. Impact of Comorbidity, Race, and Marital Status in Men Referred for Prostate Biopsy with PSA >20 ng/mL: A Pilot Study in High-Risk Patients.

    Science.gov (United States)

    Klaassen, Zachary; Muller, Roberto; Li, Qiang; Tatem, Alexander J; King, Sherita A; Freedland, Stephen J; Madi, Rabii; Terris, Martha K; Moses, Kelvin A

    2014-01-01

    Objective. To assess the impact of comorbidity, race, and marital status on overall survival (OS) among men presenting for prostate biopsy with PSA >20 ng/mL. Methods. Data were reviewed from 2000 to 2012 and 78 patients were included in the cohort. We analyzed predictors of OS using a Cox proportional hazards model and the association between Charlson Comorbidity Index (CCI) score and PCa diagnosis or high-grade cancer using logistic regression and multinomial regression models, respectively. Results. The median age of patients was 62.5 (IQR 57-73) years. Median CCI was 3 (IQR 2-4), 69% of patients were African American men, 56% of patients were married, and 85% of patients had a positive biopsy. CCI (HR 1.52, 95% CI 1.19, 1.94), PSA (HR 1.62, 95% CI 1.09, 2.42), and Gleason sum (HR 2.04, 95% CI 1.17, 3.56) were associated with OS. CCI was associated with Gleason sum 7 (OR 4.06, 95% CI 1.04, 15.89) and Gleason sum 8-10 (OR 4.52, 95% CI 1.16, 17.54) PCa. Conclusions. CCI is an independent predictor of high-grade disease and worse OS among men with PCa. Race and marital status were not significantly associated with survival in this cohort. Patient comorbidity is an important component of determining the optimal approach to management of prostate cancer.

  1. Complications and risk factors in transrectal prostate biopsies%经直肠前列腺穿刺活检术后并发症的原因分析

    Institute of Scientific and Technical Information of China (English)

    庄红雨; 彭涛; 许学敏

    2013-01-01

    目的 分析经直肠前列腺穿刺活检术后并发症发生的原因,提高诊治水平.方法 收集2002年1月至2012年6月北京安贞医院经直肠前列腺穿刺活检术1127例患者的病历资料进行回顾性分析.分析年龄、前列腺体积、总前列腺特异抗原(tPSA)、穿刺针数、口服抗凝药及病理结果等与并发症的关系.结果 1127例经直肠前列腺穿刺活检术患者发生并发症81例.1127例患者中,因感染中毒性休克死亡1例,发生血尿40例(3.5%),直肠出血8例(0.7%),其中5例较严重直肠出血,可于直肠镜下见直肠前壁黏膜点状缺损伴活动性出血;尿潴留21例(1.9%),发热10例(0.9%),迷走性晕厥2例(0.2%).并发症组平均年龄[(65±5)岁]高于无并发症组[(64±6)岁],差异有统计学意义(P =0.048).2组患者的平均前列腺体积、tPSA水平相近,组间差异均无统计学意义(均P>0.05).不同穿刺针数(6、8~12、>12针)及是否口服抗凝药者血尿、直肠出血、尿潴留、发热和迷走性晕厥发生率的差异均无统计学意义(均P>0.05).前列腺增生患者经直肠前列腺穿刺活检术后直肠出血发生率[0.5% (5/997)]低于前列腺癌者[2.3% (3/130)],差异有统计学意义(P=0.021);血尿、尿潴留、发热和迷走性晕厥发生率的差异无统计学意义(均P>0.05).结论 经直肠前列腺穿刺活检术是安全的,但对于高龄患者、高度怀疑前列腺癌者应警惕术后并发症的发生.%Objective To analyze the causes of the following complications after the trans-rectal prostate biopsy.Methods Transrectal prostate biopsy medical records of 1127 patients from January 2002 to June 2012 in Beijing Anzhen hospital were analyzed retrospectively,including age,prostate volume,tPSA level,biopsy needles,oral anticoagulants and pathological characters.Results 1 of 1127 patients died of septic shock.Major complications showed hematuria in 40 patients (3.5%),rectal bleeding in 8

  2. The Chances of Subsequent Cancer Detection in Patients with a PSA > 20 ng/ml and an Initial Negative Biopsy

    Directory of Open Access Journals (Sweden)

    Nadeem Shaida

    2009-01-01

    Full Text Available Transrectal ultrasound (TRUS–guided prostate biopsy is known to carry a significant false-negative rate, leading some patients to have multiple biopsies. We investigated cancer detection rates in patients with a PSA >20 ng/ml and a negative initial biopsy. We reviewed our database of 2396 TRUS-guided biopsies done between 1997 and 2002 in order to give a follow-up of at least 6 years. PSA, PSA density (PSAD, PSA velocity (PSAV, prostate volume, and DRE findings were analysed in relation to cancer status. Of the patients, 388 (16% had a PSA >20 ng/ml, including 99 (26% with benign biopsies. Of those, 67 were rebiopsied, including 19 (28% with cancer on the first rebiopsy and four (6% on further biopsies. PSAD, DRE, and volume significantly differed between rebiopsied patients with and without cancer (p 20 ng/ml and have an initial negative biopsy have a high chance of malignancy being detected on a second biopsy. However, if a second biopsy is also negative, then the chances of subsequent biopsies showing signs of cancer are very low if the DRE is normal and particularly if the PSAD is >0.35 ng/ml/cm3.

  3. Relation between serological data at the time of biopsy and renal histology in lupus nephritis.

    Science.gov (United States)

    Nossent, J C; Henzen-Logmans, S C; Vroom, T M; Huysen, V; Berden, J H; Swaak, A J

    1991-01-01

    As autoantibodies are thought to participate in the pathogenesis of renal inflammation in systemic lupus erythematosis (SLE) we investigated associations between serological markers of disease activity in SLE and the activity of renal histopathological lesions in thirty-five patients with lupus nephritis (LN). We found the following prevalence of serum auto-antibodies in LN: IgG antinuclear antibodies (ANA) 100%, IgM ANA 69%, IgA ANA 60%, IgG anti-dsDNA 60%, IgM anti-dsDNA 71%, IgA anti-dsDNA 60%, anti-RNP 20%, anti-Sm 14%, anti-SSA 31%, anti-SSB 14%, anti-histone 37%, anti-cardiolipin 80% and antibody to ribosomal protein (anti-P) 6%. No correlation was found between serological parameters and the WHO-classification of biopsies. The activity-index of histological lesion, assessed according to the NIH-renal histology scoring system, correlated with IgM ANA and IgM anti-dsDNA titers. Of all the specific features of histological renal inflammation, glomerular proliferation showed the best overall correlation with serological parameters of disease activity. Anticardiolipin antibodies were correlated with overall disease activity, but not with renal histological activity. Thus, serological markers of disease activity did not adequately reflect the amount of renal inflammation in LN and cannot replace renal biopsy as a diagnostic tool.

  4. 经直肠前列腺穿刺活检术后直肠活动性出血的临床分析%Reactive Proctorrhagia after Transrectal Prostate Biopsy

    Institute of Scientific and Technical Information of China (English)

    彭涛; 庄红雨; 许学敏

    2011-01-01

    目的 探讨影响经直肠前列腺穿刺活检术后直肠活动性出血并发症的相关因素,为提高诊治水平提供依据.方法 回顾性分析1 127例经直肠前列腺穿刺患者的年龄、前列腺体积、前列腺特异抗原(PSA)、穿刺活检前是否应用抗凝药、穿刺针数、病理结果.经直肠前列腺穿刺活检术后发生直肠活动性出血8例,分析活动性出血部位、程度、处理方法、治疗转归.结果 1 127例经直肠前列腺穿刺活检术后发生直肠活动性直肠出血8例,发生率为0.71%,其中997例前列腺增生患者发生直肠活动性出血5例,130例前列腺癌患者发生直肠活动性出血3例.8例直肠活动性出血患者中有2例前列腺平面以上直肠活动性出血点1个,出血量300~400 ml,直肠镜下缝扎一针止血成功;4例直肠前列腺部活动性出血点1个、2例前列腺外侧直肠活动性出血点1个,出血量100~200 ml,均在直肠镜下采用双极电凝(功率20 W)止血加肛管压迫止血成功.直肠活动性出血与直肠无活动性出血患者的年龄、前列腺体积、PSA水平比较,差异均无统计学意义(P>0.05).直肠活动性出血的影响因素分析显示,经直肠前列腺穿刺活检前是否口服抗凝药、穿刺针数均与术后直肠活动性出血无关,而患者前列腺疾病的性质与术后直肠活动性出血有关(P<0.05).结论 经直肠前列腺穿刺患者的年龄、前列腺体积、PSA、穿刺活检前是否应用抗凝药、穿刺针数与穿刺活检术后直肠活动性出血均无关,前列腺癌较前列腺增生患者易发生直肠活动性出血.正确处理术后直肠活动性出血就不会产生严重后果.%Objective To determine whether reactive proctorrhagia after transrectal prostate biopsy is affected by potential correlation factors and to improve our quality of diagnosis and treatment. Methods A total of 1 127 transrectal prostate biopsy cases were retrospectively evaluated

  5. Hemorrhagic complications and risk factors in transrectal ultrasound-guided prostate biopsies%经直肠超声引导前列腺穿刺引起出血并发症的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    李岩密; 唐杰; 徐丽; 杨敬春; 张舜欣; 费翔

    2008-01-01

    目的 探讨经直肠超声(TRUS)引导前列腺穿刺的出血性并发症及其有关的可能危险因素.方法 对252例行TRUS引导前列腺穿刺活检者进行病例对照研究,对比分析穿刺后出现出血事件者和非出血组的相关因素(年龄、病理诊断、前列腺体积、高血压、糖尿病、服用抑制血小板聚集及抗凝药物、穿刺针数),采用非条件Logistic回归进行多因素分析.结果 血尿是最常见的穿刺后出血事件(19.1%).特征分析年龄和前列腺体积在两组的构成情况有差异.多因素分析出血事件具有统计学意义的相关因素包括年龄(OR=0.97,95% CI:0.942 1.000)和前列腺的体积(OR=0.989,95% CI:0.979~0.999).穿刺后血尿具有统计学意义的相关因素有3个:前列腺癌患者(OR=0.479,95% CI:0.236~0.975)、前列腺体积(OR=0.987,95% CI:0.976~0.999)、穿刺前服用抑制血小板聚集及抗凝药物者(OR=3.589,95% CI:1.133~11.366).结论 TRUS引导前列腺穿刺活检是安全、有效的.年龄和前列腺体积与出血事件的发生率有关;前列腺癌患者及前列腺体积是穿刺后出现血尿的相关因素;服用抑制血小板聚集及抗凝药物是穿刺后出现血尿的危险因素.%Objective To determine the rate of hemorrhagic complications and the possible risk factors in transrectal ultrasound(TRUS)guided prostate biopsies.Methods TRUS guided prostate biopsies were carried out in 252 patients.Chi-aquare test,t test,conditional Logistic regression were used to comparatively analyze the risk factors(age,presence of prostate cancer,the volume of prostate,arterial hypertension,diabetes mellitus,use of acetylsalicylic acid and anticoagulant,number of samples)between hemorrhagic patients and non-hemorrhagic groups.Results Hematuria was the most frequent sing in all complications,corresponding to 19.1% of the cases.According to the general feature analysis between two groups,age and the volume of the prostate were significant

  6. PI-RADS version 2 for prediction of pathological downgrading after radical prostatectomy: a preliminary study in patients with biopsy-proven Gleason Score 7 (3+4) prostate cancer

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    Woo, Sungmin; Kim, Sang Youn [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Lee, Joongyub [Seoul National University College of Medicine, Seoul National University Hospital, Division of Clinical Epidemiology, Medical Research Collaborating Center, Biomedical Research Institution, Seoul (Korea, Republic of); Kim, Seung Hyup; Cho, Jeong Yeon [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine and Kidney Research Institute, Seoul (Korea, Republic of)

    2016-10-15

    To evaluate PI-RADSv2 for predicting pathological downgrading after radical prostatectomy (RP) in patients with biopsy-proven Gleason score (GS) 7(3+4) PC. A total of 105 patients with biopsy-proven GS 7(3+4) PC who underwent multiparametric prostate MRI followed by RP were included. Two radiologists assigned PI-RADSv2 scores for each patient. Preoperative clinicopathological variables and PI-RADSv2 scores were compared between patients with and without downgrading after RP using the Wilcoxon rank sum test or Fisher's exact test. Logistic regression analyses with Firth's bias correction were performed to assess their association with downgrading. Pathological downgrading was identified in ten (9.5 %) patients. Prostate-specific antigen (PSA), PSA density, percentage of cores with GS 7(3+4), and greatest percentage of core length (GPCL) with GS 7(3+4) were significantly lower in patients with downgrading (p = 0.002-0.037). There was no significant difference in age and clinical stage (p = 0.537-0.755). PI-RADSv2 scores were significantly lower in patients with downgrading (3.8 versus 4.4, p = 0.012). At univariate logistic regression analysis, PSA, PSA density, and PI-RADSv2 scores were significant predictors of downgrading (p = 0.003-0.022). Multivariate analysis revealed only PSA density and PI-RADSv2 scores as independent predictors of downgrading (p = 0.014-0.042). The PI-RADSv2 scoring system was an independent predictor of pathological downgrading after RP in patients with biopsy-proven GS 7(3+4) PC. (orig.)

  7. Tuberculous prostatitis: mimicking a cancer.

    Science.gov (United States)

    Aziz, El Majdoub; Abdelhak, Khallouk; Hassan, Farih Moulay

    2016-01-01

    Genitourinary tuberculosis is a common type of extra-pulmonary tuberculosis . The kidneys, ureter, bladder or genital organs are usually involved. Tuberculosis of the prostate has mainly been described in immune-compromised patients. However, it can exceptionally be found as an isolated lesion in immune-competent patients. Tuberculosis of the prostate may be difficult to differentiate from carcinoma of the prostate and the chronic prostatitis when the prostate is hard and nodular on digital rectal examination and the urine is negative for tuberculosis bacilli. In many cases, a diagnosis of tuberculous prostatitis is made by the pathologist, or the disease is found incidentally after transurethral resection. Therefore, suspicion of tuberculous prostatitis requires a confirmatory biopsy of the prostate. We report the case of 60-year-old man who presented a low urinary tract syndrome. After clinical and biological examination, and imaging, prostate cancer was highly suspected. Transrectal needle biopsy of the prostate was performed and histological examination showed tuberculosis lesions.

  8. 体重指数对前列腺癌检出率及 G leaso n评分的影响%Effect of boby mass index on positive rate of prostate cancer and Gleason score in the patients undergoing transrectal prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    周峰; 浦金贤; 欧阳骏; 李纲; 平季根; 裴昌松; 黄玉华; 侯建全

    2016-01-01

    Objective To investigate the effect of body mass index (BMI) on the positive rate of prostate cancer and Gleason score in the patients undergoing transrectal prostate biopsy .Methods A total of 290 patients underwent prostatic biopsy for the first time was assigned into two groups of A(with BMI≥25 kg/m2 ,143 cases) and B(with BMI0 .05) .The percentage of patients with high Gleason score (Gleason score ≥ 7 points ) was higher in group A than that in group B (44.76% vs .38.10% ) (P0 .05);高BMI组的高Gleason评分(≥7分)比例高于正常BMI组(44.76% vs .38.10% )(P<0 .05).结论 前列腺穿刺活检患者的BM I对前列腺癌检出率没有显著影响 ,但BM I是影响前列腺穿刺活检Gleason评分的重要因素.

  9. Avaliação da extensão da neoplasia em câncer da próstata: valor do PSA, da percentagem de fragmentos positivos e da escala de Gleason Extraprostatic disease prediction in patients with carcinoma of the prostate: role of PSA, prostatic biopsy fragments percentage and Gleason score

    Directory of Open Access Journals (Sweden)

    Antonio Carlos Calvete

    2003-09-01

    ática, verificamos que o PSA pré-operatório foi o mais discriminante (p = 0,000000, seguido pela escala de Gleason da biópsia prostática (p = 0,000003 e pela percentagem de biópsias positivas (p = 0,000574.OBJECTIVE: To valuate the behavior of the prostatic biopsy fragments percentage, guided by transrectal ultrasonography in extraprostatic disease prediction in patients with localized adenocarcinoma of the prostate gland and, also, to compare the efficiency of this pattern with them got by the valuation of PSA and preoperative Gleason score. METHODS: This retrospective non-controlled study consisted of 522 patients with adenocarcinoma located in the prostate. They were submitted to surgical treatment through retropubic radical prostatectomy. The ages of the patients ranged from 42 to 76 years with a mean of 62.44 years. All of them were submitted to transrectal ultrasonography with prostatic biopsy (direct of the lesion and/or suspected area and sextant previous to the radical surgical treatment. The 522 patients were divided in groups according to the positive fragments found by the biopsy, what was correlated with the anatomicpathologic findings of intraprostatic disease (limited to the gland and extraprostatic (invasion periprostatic adiposity and/or the bladder neck and/or the seminal vesicles and/or positive pelvic lymph nodes of the surgical specimen. RESULTS: Regarding the analysis of the positive fragments percentage, the groups G1 (0-25%, G2 (20-50% and G3 (51-75% showed an incidence of the intraprostatic disease two and three times greater than the extraprostatic one. However, when more than 75% of the biopsy fragments were positive (G4, 76-100%, the relation inverted occurring a predominance of the extraprostatic disease over the intraprostatic. In this group 56.98% of the patients showed extraprostatic disease. There was a statistically significant difference of the extraprostatic disease between the groups G3 and G4 (p 0.0068. CONCLUSION: When we compared the

  10. Expression of kallikrein-related peptidase 7 is decreased in prostate cancer

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    Chong-Yu Zhang

    2015-02-01

    Full Text Available Recent evidence suggests that the human kallikrein 7 (KLK7 is differentially regulated in a variety of tumors. The aim of this study was to determine the expression of kallikrein-related peptidase 7 and KLK7 in our large collection of prostate samples. Between August 2000 and December 2012, 116 patients with histologically confirmed prostate cancer (PCa and 92 with benign prostate hyperplasia (BPH were recruited into the study. Using immunohistochemistry, quantitative reverse transcription polymerase chain reaction (RT-PCR and western blot, kallikrein-related peptidase 7 expression in BPH and PCa tissues was determined at the mRNA and protein levels. The relationships between kallikrein-related peptidase 7 mRNA expression and clinicopathological features were analyzed. A total of 64 of 92 (69.57% benign cases showed positive staining for KLK7 and 23 of 116 (19.83% malignant cases showed positive, the difference of KLK7 expression between PCa and BPH was statistically significant (P < 0.001. The expression level of kallikrein-related peptidase 7 mRNA was significantly decreased in PCa tissues compared with that in BPH tissues and normal prostate tissue. Kallikrein-related peptidase 7 mRNA exhibited different expression patterns in terms of localization depending on pathological category of PCa. Similarly, our western immunoblot analyses demonstrated that the protein expression levels of KLK7 was lower in PCa than in BPH tissues and normal prostate tissue. Kallikrein-related peptidase 7 and KLK7 expression are down-regulated in PCa and lower expression of kallikrein-related peptidase 7 closely correlates with higher Gleason score and higher prostate-specific antigen level.

  11. IgG4-Related Autoimmune Prostatitis: Is It an Unusual or Underdiagnosed Manifestation of IgG4-Related Disease?

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    María T. Bourlon

    2013-01-01

    Full Text Available IgG4-related disease (IgG4-RD encompasses a wide range of extrapancreatic manifestations. Albeit some are relatively well known, others such as autoimmune prostatitis remain poorly described. We present a 61-year-old Latin-American male with autoimmune pancreatitis (AIP who presented with lower urinary tract symptoms (LUTS, normal prostate specific antigen (PSA test, and prostate enlargement attributed to benign prostatic hyperplasia (BPH. He underwent a transurethral resection of the prostate (TURP after which symptoms were resolved. On histopathology, prostatic stroma had a dense inflammatory infiltrate rich in plasma cells and lymphocytes; immunohistochemical morphometric assessment showed >10 IgG4-positive plasma cells/high power field (HPF. The diagnosis of IgG4-related prostatitis was postoperatively. We compared the patient characteristics with those of previous reports on Asian patients. Shared findings included prostate enlargement, LUTS (symptoms that can be confused with BPH, and PSA within normal limits or mild elevations. IgG4-related prostatitis is rarely considered as a preprocedural diagnosis, even in patients with evidence of IgG4-RD. Involved prostate zones include mainly central and transitional zones and less frequently the peripheral. Currently, there is insufficient data about the natural history and outcome. Whether steroids, transurethral resection, or both are the treatment of choice needs to be elucidated.

  12. Age-related changes in the innervation of the prostate gland: implications for prostate cancer initiation and progression.

    Science.gov (United States)

    White, Carl W; Xie, Jin Han; Ventura, Sabatino

    2013-01-01

    The adult prostate gland grows and develops under hormonal control while its physiological functions are controlled by the autonomic nervous system. The prostate gland receives sympathetic input via the hypogastric nerve and parasympathetic input via the pelvic nerve. In addition, the hypogastric and pelvic nerves also provide sensory inputs to the gland. This review provides a summary of the innervation of the adult prostate gland and describes the changes which occur with age and disease. Growth and development of the prostate gland is age dependent as is the occurrence of both benign prostate disease and prostate cancer. In parallel, the activity and influence of both the sympathetic and parasympathetic nervous system changes with age. The influence of the sympathetic nervous system on benign prostatic hyperplasia is well documented and this review considers the possibility of a link between changes in autonomic innervation and prostate cancer progression.

  13. Does Leaving the Biopsy Needle in Povidone-Iodine Solution Reduce Infective Complications after Biopsy?

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    Erdal Benli

    2016-01-01

    Full Text Available Aim. The aim of this study is to evaluate whether leaving the biopsy needle used during prostate needle biopsy in 10% povidone-iodine (betadine solution affects the infectious complications forming after biopsy. Material and Method. This study retrospectively evaluated the data of 176 patients with prostate biopsy performed between December 2012 and April 2014. Patients in Group 1 (n=89 were given ofloxacin as a prophylactic antibiotic before biopsy. Patients in Group 2 (n=87 had the biopsy needle left in povidone-iodine solution for 1 minute before each use, in addition to antibiotic prophylaxis. The two groups were compared in terms of infective complications developing after biopsy. Results were analyzed using the Mann–Whitney U test and Fisher’s exact test. Results. The distribution of infective complications after biopsy according to group was as follows. Group 1, not using betadine, had 15.7% fever, 13.5% hospital stay, 12.4% urinary retention, 10.1% prostatitis, and 5.6% sepsis. The distribution of the same complications in Group 2 using betadine was identified as 5.7% fever, 4.6% hospital stay, 3.4% urinary retention, 2.3% prostatitis, and 0% sepsis. The use of betadine was found to significantly reduce the infectious complications after biopsy compared to the control group (p<0.05. Conclusion. At the end of this study leaving the prostate needle in povidone-iodine solution before each use during prostate biopsy was found to reduce the infective complications and hospital stay after biopsy.

  14. Analysis on Causes and Prevention of Septic Shock Caused by Puncture Biopsy in Patients with Prostate Cancer%前列腺癌穿刺活检导致感染性休克的原因及预防

    Institute of Scientific and Technical Information of China (English)

    李娟; 郭广亚; 周莉

    2015-01-01

    Objective To explore the causes and preventive measures of septic shock caused by puncture biopsy in pa-tients with prostate cancer.Methods 84 cases of patients with prostate cancer who received puncture biopsy were divided into shock group and non-shock group,the pathogenic biological characteristics of patients with septic shock was observed,the single factor and multivariate logistic regression were used to analyse the factors affecting septic shock.Results The incidence of septic shock was 8.33%,and its occurrence time was 12-37 h after operation.11 strains of pathogenic bacteria were detected in 7 pa-tients with septic shock including gram negative bacteria accounting for 72.73% and gram positive bacteria accounting for 27.27%.There were significant difference in age,diabetes plus,prostate infection plus,urinary tract infection plus,APACHEⅡscore and repeated puncture between the 2 groups (P<0.05).Combined prostate infection or urinary tract infection,lower score of APACHEⅡand age≥55 were risk factors leading to septic shock of patients with prostate cancer using biopsy raised.Conclu-sion Septic shock is mainly caused by gram negative bacteria and occurs 12~37 h after operation.Patients with elder age,lower score of APACHE II,prostate infections or urinary tract infection should be given prevention and treatment to reduce the incidence of septic shock.%目的:探讨前列腺癌患者穿刺活检引发感染性休克的原因及预防措施。方法选择行穿刺活检术的前列腺癌患者84例,按照是否发生感染性休克分为休克组和非休克组,观察感染性休克患者病原菌生物学特征,采用单因素和多因素logistic回归分析影响感染性休克的因素。结果感染性休克发生率为8.33%,发生时间为术后12~37 h。7例感染性休克患者共检出病原菌11株,其中革兰氏阴性菌占72.73%,革兰氏阳性菌占27.27%。两组患者在年龄、合并糖尿病、合并前列腺

  15. Diabetes mellitus and health-related quality of life in prostate cancer: 5-year results from the Prostate Cancer Outcomes Study.

    Science.gov (United States)

    Thong, Melissa S Y; van de Poll-Franse, Lonneke; Hoffman, Richard M; Albertsen, Peter C; Hamilton, Ann S; Stanford, Janet L; Penson, David F

    2011-04-01

    Study Type--Therapy (outcomes research) Level of Evidence 2b. What's known on the subject? and What does the study add? Comorbid diabetes can affect prostate cancer treatment decision-making and outcomes. Few longitudinal studies have investigated the effect of comorbid diabetes on general and cancer-specific health-related quality of life (HRQL) in prostate cancer. Our study found that men with prevalent diabetes (pre-prostate cancer diagnosis) generally had the poorest general HRQL, urinary control and sexual function scores over time, independent of treatment. Non-diabetic men had the best scores and men with incident diabetes (post-prostate cancer diagnosis) reported intermediate scores. OBJECTIVE • To investigate the association between prostate cancer, diabetes, and long-term general and cancer-specific health-related quality of life (HRQL) in a cohort of men with non-metastatic prostate cancer. PATIENTS AND METHODS • We used data from self-administered surveys to assess the HRQL of men with localized or locally advanced disease at 6 (baseline), 12, 24, and 60 months after initial diagnosis. • We examined changes in general and cancer-specific HRQL with repeated measures analyses using a mixed-model approach. RESULTS • In total, we evaluated 1811 men, including 13% with prevalent (pre-prostate cancer diagnosis) diabetes, 12% with incident (post-prostate cancer diagnosis) diabetes, and 75% who never reported being diagnosed with diabetes. • Generally, men with prevalent diabetes had the poorest scores on general HRQL and non-diabetic men the best scores, independent of treatment. • Similarly, men with prevalent diabetes had the lowest urinary control and sexual function scores over time, while men without diabetes had the highest scores. Men with incident diabetes reported intermediate scores. CONCLUSION • Prostate cancer survivors with comorbid diabetes have poorer general and cancer-specific HRQL than those without diabetes.

  16. Identifying New Candidate Genes and Chemicals Related to Prostate Cancer Using a Hybrid Network and Shortest Path Approach

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    Yuan, Fei; Zhou, You; Wang, Meng; Yang, Jing; Wu, Kai; Lu, Changhong; Kong, Xiangyin; Cai, Yu-Dong

    2015-01-01

    Prostate cancer is a type of cancer that occurs in the male prostate, a gland in the male reproductive system. Because prostate cancer cells may spread to other parts of the body and can influence human reproduction, understanding the mechanisms underlying this disease is critical for designing effective treatments. The identification of as many genes and chemicals related to prostate cancer as possible will enhance our understanding of this disease. In this study, we proposed a computational method to identify new candidate genes and chemicals based on currently known genes and chemicals related to prostate cancer by applying a shortest path approach in a hybrid network. The hybrid network was constructed according to information concerning chemical-chemical interactions, chemical-protein interactions, and protein-protein interactions. Many of the obtained genes and chemicals are associated with prostate cancer. PMID:26504486

  17. Factors analysis about predicting the probability of positive initial prostate biopsy%前列腺初次穿刺活检阳性的预测因素分析

    Institute of Scientific and Technical Information of China (English)

    王艳青; 董柏君; 黄吉炜; 潘家骅; 沙建军; 谢少伟; 薛蔚; 黄翼然

    2016-01-01

    Objective To investigate the value of clinical and laboratory factors in predicting the probability of positive initial prostate biopsy.Methods Data were retrospectively reviewed from 658 Chinese patients, who underwent initial prostate biopsies from January 2010 and December 2013.The medians(interquartiles) of age, PV, tPSA, fPSA/tPSA and PSAD were 69(64,75) years, 44.8(30.9, 65.8)ml, 15.1 (9.0,30.8) μg/L, 0.14(0.10,0.23) and 0.33(0.18,0.80).The positive rates of DRE, TRUS and MFI were 49% (324/658), 59% (387/658) and 59% (385/658) ,respectively.Univariate and multivariate Logistic regression analysis the value of factors, including age, tPSA, fPSA/tPSA, PV, PSAD, DRE, TRUS and MFI, in predicting the probability of positive initial prostate biopsy.The area under the receiver-operating characteristic (ROC)curve was evaluated.A stepwise discriminant function analysis was to examine the role of factors above in predicting probability of positive initial prostate biopsy.Results The percentage of positive initial prostate biopsy in our study was 48% (314/658).Univariate analysis showed that age, tPSA, f/t ratio, PV, PSAD, positive DRE, abnormal TRUS echogenicity and aberrant MFI findings had statistically significant relationships with prostate cancer (P <0.05).The areas under the ROC curve for age, tPSA, f/t ratio, PV, PSAD, DRE, TRUS echogenicity and MFI findings were 0.667、0.758、 0.270、0.335、0.837、0.809、0.720、0.802,respectively,which indicated that MFI was a significantly better predictor than TRUS (P < 0.05.The predicting accuracy of PSAD was highest among those factors.Multivariate analysis revealed that age, tPSA, f/t ratio, PV, positive DRE, aberrant MFI findings were predictive independently of positive prostate biopsy (P < 0.05).A cross-validation discriminant analysis was conducted and 87.8% correct classification rate was obtained.Conclusions Age, tPSA, f/t ratio, PV, positive DRE and aberrant MFI findings are predictive

  18. Association between prostate histologic inflammation classification and prostate cancer in needle biopsy specimens with serum PSA under 20 μg/L%血清前列腺特异性抗原小于20μg/L患者前列腺穿刺标本中炎症分级与前列腺癌的相关性分析

    Institute of Scientific and Technical Information of China (English)

    张大磊; 何磊; 张伟; 刘明; 万奔; 王建业; 金滨

    2015-01-01

    目的 研究血清前列腺特异性抗原(PSA) <20 μg/L患者前列腺穿刺活检标本中前列腺组织学炎症分级与前列腺癌(prostate cancer,PCa)之间的关系.方法 回顾性分析2011年1月至2013年12月前列腺穿刺活检患者的资料.患者入组标准:①主诉血清总PSA(total PSA,tPSA)升高入院,行前列腺穿刺;②血清tPSA<20 μg/L;③无盆腔放疗史.对前列腺穿刺标本组织学炎症的位置、范围以及程度进行评估并分级,探讨组织学炎症分级与PCa之间的相关性.结果 入组病例226例,前列腺穿刺活检诊断PCa 84例(37.2%),良性前列腺疾病(benign prostatic disease,BPD) 142例(62.8%).PCa和BPD患者前列腺组织学炎症的位置(P<0.001)、范围(P<0.001)以及程度(P=0.004)分级比较差异均有统计学意义.多因素Logistic回归分析发现,组织学炎症位置(P=0.001,OR=0.114,95%CI 0.032~ 0.405)以及炎症范围(P=0.021,OR=0.232,95%CI 0.067~ 0.804)与PCa风险呈负相关,炎症程度与PCa无相关性(P=0.223,OR=1.805,95% CI0.698 ~ 4.667).在前列腺穿刺标本中运用炎症位置和炎症范围来区分PCa和BPD的敏感性、特异性、阳性预测值和阴性预测值分别为91.7%、50.7%、52.4%和91.1%.结论 前列腺组织学炎症位置和炎症范围分级与PCa呈负相关.%Objective To investigate the relationship between prostate histologic inflammation classification and prostate cancer (PCa) in needle biopsy specimens with serum prostatic specific antigen (PSA) under 20 μg/L.Methods The clinical records of patients who underwent prostate biopsy were retrospectively analyzed in Beijing Hospital Urological Department from January 2011 to December 2013.The patients underwent prostate biopsy because of PSA raised and without pelvic radiotherapy.The needle biopsy specimen was evaluated by the pathohistologic criteria of location,extent and grade classification of prostate inflammation.Results PCa was detected in 84 (37.2

  19. Rectal Culture-Guided Targeted Antimicrobial Prophylaxis Reduces the Incidence of Post-Operative Infectious Complications in Men at High Risk for Infections Submitted to Transrectal Ultrasound Prostate Biopsy - Results of a Cross-Sectional Study.

    Science.gov (United States)

    Boeri, Luca; Fontana, Matteo; Gallioli, Andrea; Zanetti, Stefano Paolo; Catellani, Michele; Longo, Fabrizio; Mangiarotti, Barbara; Montanari, Emanuele

    2017-01-01

    The role of rectal culture-guided antimicrobial prophylaxis (TAP) in reducing infectious complications (IC) after transrectal-ultrasound prostate biopsy (TRUSPBx) is conflicting. We assessed the prevalence of IC in a cohort of men at high risk for IC submitted to TRUSPBx and treated with either TAP or empirical prophylaxis (EAP). Data from 53 patients at high risk for IC undergoing TRUSPBx were collected. Patients who did not receive a rectal swab (RS) were treated with EAP with fluoroquinolones (FQs). Of those who received the RS, patients with FQ-susceptible organisms received ciprofloxacin while those with FQ-resistant organisms received TAP. Office visits were scheduled to investigate the rate of complication at day 7 and 30 after TRUSPBx. Comorbidities were scored with the Charlson Comorbidity Index (CCI). Descriptive statistics and logistic regression models detailed the association between clinical parameters and IC rate. Out of 53 men, 17 (32.1%) had RS while 36 (67.9%) did not. All RS cultures were positive for E. Coli and 4 (23.5%) reported FQ-resistant pathogens. Considering risk factors for IC, no difference was found in terms of CCI, rate of diabetes, UTIs or recent antibiotic utilization between groups. Overall, 12 (22.6%) men reported IC, with a greater proportion of them belonging to the group treated with EAP (30.6% vs 5.9%; p = 0.045). Of these, 9 (25.0%) patients, all treated with EAP, developed post biopsy UTIs. E. Coli sustained all UTIs and 7 (77.7%) were FQ resistant. At multivariable analysis, CCI≥1, a history of UTIs/prostatitis and recent antibiotic utilization (all p<0.04) were the most powerful predictors for ICs. In conclusion, we found that compared to EAP, TAP significantly reduces ICs, in men at high risk for post TRUSPBx IC. Patients at risk for IC, especially those with recent antibiotic utilization, CCI≥1 and a history of UTIs/prostatitis before biopsy, could benefit from TAP.

  20. Rectal Culture-Guided Targeted Antimicrobial Prophylaxis Reduces the Incidence of Post-Operative Infectious Complications in Men at High Risk for Infections Submitted to Transrectal Ultrasound Prostate Biopsy – Results of a Cross-Sectional Study

    Science.gov (United States)

    Boeri, Luca; Fontana, Matteo; Gallioli, Andrea; Zanetti, Stefano Paolo; Catellani, Michele; Longo, Fabrizio; Mangiarotti, Barbara; Montanari, Emanuele

    2017-01-01

    The role of rectal culture-guided antimicrobial prophylaxis (TAP) in reducing infectious complications (IC) after transrectal-ultrasound prostate biopsy (TRUSPBx) is conflicting. We assessed the prevalence of IC in a cohort of men at high risk for IC submitted to TRUSPBx and treated with either TAP or empirical prophylaxis (EAP). Data from 53 patients at high risk for IC undergoing TRUSPBx were collected. Patients who did not receive a rectal swab (RS) were treated with EAP with fluoroquinolones (FQs). Of those who received the RS, patients with FQ-susceptible organisms received ciprofloxacin while those with FQ-resistant organisms received TAP. Office visits were scheduled to investigate the rate of complication at day 7 and 30 after TRUSPBx. Comorbidities were scored with the Charlson Comorbidity Index (CCI). Descriptive statistics and logistic regression models detailed the association between clinical parameters and IC rate. Out of 53 men, 17 (32.1%) had RS while 36 (67.9%) did not. All RS cultures were positive for E. Coli and 4 (23.5%) reported FQ-resistant pathogens. Considering risk factors for IC, no difference was found in terms of CCI, rate of diabetes, UTIs or recent antibiotic utilization between groups. Overall, 12 (22.6%) men reported IC, with a greater proportion of them belonging to the group treated with EAP (30.6% vs 5.9%; p = 0.045). Of these, 9 (25.0%) patients, all treated with EAP, developed post biopsy UTIs. E. Coli sustained all UTIs and 7 (77.7%) were FQ resistant. At multivariable analysis, CCI≥1, a history of UTIs/prostatitis and recent antibiotic utilization (all p<0.04) were the most powerful predictors for ICs. In conclusion, we found that compared to EAP, TAP significantly reduces ICs, in men at high risk for post TRUSPBx IC. Patients at risk for IC, especially those with recent antibiotic utilization, CCI≥1 and a history of UTIs/prostatitis before biopsy, could benefit from TAP. PMID:28122053

  1. ALKBH7 Variant Related to Prostate Cancer Exhibits Altered Substrate Binding

    Science.gov (United States)

    Müller, Tina A.; Podolsky, Robert H.; Dyson, Gregory; Cisneros, Gerardo Andrés

    2017-01-01

    The search for prostate cancer biomarkers has received increased attention and several DNA repair related enzymes have been linked to this dysfunction. Here we report a targeted search for single nucleotide polymorphisms (SNPs) and functional impact characterization of human ALKBH family dioxygenases related to prostate cancer. Our results uncovered a SNP of ALKBH7, rs7540, which is associated with prostate cancer disease in a statistically significantly manner in two separate cohorts, and maintained in African American men. Comparisons of molecular dynamics (MD) simulations on the wild-type and variant protein structures indicate that the resulting alteration in the enzyme induces a significant structural change that reduces ALKBH7’s ability to bind its cosubstrate. Experimental spectroscopy studies with purified proteins validate our MD predictions and corroborate the conclusion that this cancer-associated mutation affects productive cosubstrate binding in ALKBH7. PMID:28231280

  2. Vitamin D and Related Genes, Race and Prostate Cancer Aggressiveness

    Science.gov (United States)

    2015-12-29

    analysis reported in- verse associations with overall cancer mortality for supplementation trials of vitamin D3 but not D2 , and no substantial...Primary Specific Aim #1, associations between plasma vitamin D metabolites [25(OH) D3 and 1,25(OH)2D] and aggressive prostate cancer have been...ratio of 1,25(OH)2D to 25(OH) D3 and categorized research subjects into quartiles of the vitamin D metabolite index. As shown in Table 2 below, higher

  3. Protocol liver biopsies in long-term management of patients transplanted for hepatitis B-related liver disease

    Institute of Scientific and Technical Information of China (English)

    Stefano Targhetta; Patrizia Burra; Federico Villamil; Paolo Inturri; Patrizia Pontisso; Stefano Fagiuoli; Umberto Cillo; Attilio Cecchetto; Simona Gianni; Remo Naccarato

    2006-01-01

    AIM:To evaluate the long-term histological outcome of patients transplanted for HBV-related liver disease and given HBIg prophylaxis indefinitely after LT.METHODS: Forty-two consecutive patients transplanted for hepatitis B were prospectively studied. HBsAg, HBV-DNA and liver function tests were evaluated in the serum 3, 6 and 12 mo after LT and then yearly. LB was obtained 6 and 12 mo after LT and yearly thereafter. Chronic hepatitis (CH) B after LT was classified as minimal, mild,moderate or severe.RESULTS: HBV recurred in 7/42 (16.6%) patients after 6-96 mo of follow-up. A hundred and eightyseven LB were evaluated. Four of 7 patients with graft reinfection, all with unknown HBV DNA status before LT, developed cirrhosis at 12-36 mo of follow-up. Of the 122 LB obtained from 28 HBsAg+/HCV- recipients with no HBV recurrence after LT, all biopsies were completely normal in only 2 patients (7.1%), minimal/non-specific changes were observed in 18 (64.2%), and at least 1 biopsy showed CH in the remaining 8 (28.5%). Twentynine LB obtained from 7 patients transplanted for HBV-HCV cirrhosis and remaining HBsAg- after LT revealed recurrent CH-C. Actuarial survival was similar in patients with HBsAg+ or HBsAg- liver diseases.CONCLUSION: Though protocol biopsies may enablethe detection of graft dysfunction at an early stage, the risk of progression and the clinical significance of these findings remains to be determined.

  4. Ultrasonographic Findings of the Prostatic Disease : Comparative Analysis of the Benign and Malignant Nodules

    Energy Technology Data Exchange (ETDEWEB)

    Song, Yun Gyu; Kim, Ji Yang; Lee, Su Han; Kong, Su Jin; Sung, Young Soon; Kwon, Jae Soo [Masan Samsung General Hospital, Masan (Korea, Republic of)

    1996-06-15

    We evaluated the characteristics of the benign and malignant nodules on transrectal ultrasound in diagnosis of prostatic disease. Histologic examination of the trans perineal prostatic biopsy of the total 47 cases resulted in 19 cases of BPH, 8 cases of prostatic cancer, and 20 cases of normal prostatic tissue group. The hypoechoic mass in peripheral zone on TRUS had high possibility of prostatic carcinoma and the isoechoic or mixed echogenic mass in central gland had high possibility of benign lesion. Hypoechoic haloes around nodules and cysts were noted in BPH and normal prostatic tissue group, that were compatible with benign lesion. The mean value of PSA was 12.0 ng/ ml in BPH, 8.5 ng / ml in normal prostatic tissue group, and 65.6 ng / ml in prostatic cancer, which was very high in prostatic cancer. Between BPH and normal prostatic tissue group, there was no demonstrable difference in location of nodule, pattern of calcification, and echogenicity of the nodules on TRUS. The size of prostatic gland was relatively smaller and mean value of PSA was lower in normal prostatic tissue group, compared with in BPH. In conclusion, the location of the nodules and PSA value are considered to be important in differentiation of the benign and malignant prostatic nodules

  5. Kidney Biopsy

    Science.gov (United States)

    ... Care Provider People should talk with their health care provider about medical conditions they have and all prescribed and over- ... biopsy, a person should talk with their health care provider about medical conditions and allergies they have and all medications ...

  6. The experience of using sonoelastography of prostate in prostatic diseases

    Directory of Open Access Journals (Sweden)

    P. S. Zubeev

    2014-11-01

    Full Text Available Objective. To assess sonoelastography opportunities in differential diagnosis of prostatic diseases; to place sonoelastography in general algorithm of prostatic diseases diagnostics.Materials and methods. 91 patients under examination were divided into three groups. The first group included 21 patients (23.1 % with suspected prostate carcinoma, later they underwent puncture multifocal biopsy of prostate with morphological verification of prostate carcinoma. The second group consisted of 51 patients (56.0 % with benign prostatic hyperplasia, and in the third group there were 19 patients (20.9 % with acute and chronic prostatitis.Results. 91 patients with different prostatic diseases were examined. There were defined PSA (prostate specific antigen level, and performed TRUS (transrectal ultrasound, biopsy and sonoelastography of prostate. In 72 patients SEG (sonoelastography-picture of prostate was compared to morphological diagnosis. According to SEG findings, 43 (81.1 % patients were revealed to have the areas of reduced compliance due to what malignancy in prostate gland (PG was excluded. Morphological diagnosis of prostate carcinoma was confirmed in 21 patients. In 51 patients SEG-picture corresponded to benign process confirmed by histology.Conclusion. Sonoelastography is a modern diagnostic technique of prostatic diseases, seminal vesicles, paraprostatic space. The distinguished mapping types enable to make differential diagnosis of different prostatic pathological processes. Sonoelastography improves prostate carcinoma diagnostics and staging, and also has economic significance value when compared to MRP (magnetic resonance tomography with bolus contrast.

  7. Genetic Variation in the Vitamin D Pathway in Relation to Risk of Prostate Cancer – Results from Breast and Prostate Cancer Cohort Consortium (BPC3)

    Science.gov (United States)

    Mondul, Alison M.; Shui, Irene M.; Yu, Kai; Travis, Ruth C.; Stevens, Victoria L.; Campa, Daniele; Schumacher, Frederick R.; Ziegler, Regina G.; Bueno-de-Mesquita, H. Bas; Berndt, Sonja; Crawford, E. D.; Gapstur, Susan M.; Gaziano, J. Michael; Giovannucci, Edward; Haiman, Christopher A.; Henderson, Brian E.; Hunter, David J.; Johansson, Mattias; Key, Timothy J.; Le Marchand, Loic; Lindström, Sara; McCullough, Marjorie L.; Navarro, Carmen; Overvad, Kim; Palli, Domenico; Purdue, Mark; Stampfer, Meir J.; Weinstein, Stephanie J.; Willett, Walter C.; Yeager, Meredith; Chanock, Stephen J.; Trichopoulos, Dimitrios; Kolonel, Laurence N.; Kraft, Peter; Albanes, Demetrius

    2013-01-01

    Background Studies suggest that vitamin D status may be associated with prostate cancer risk, although the direction and strength of this association differs between experimental and observational studies. Genome-wide association studies have identified genetic variants associated with 25-hydroxyvitamin D (25(OH)D) status. We examined prostate cancer risk in relation to SNPs in four genes shown to predict circulating levels of 25(OH)D. Methods SNP markers localized to each of four genes (GC, CYP24A1, CYP2R1, and DHCR7) previously associated with 25(OH)D were genotyped in 10,018 cases and 11,052 controls from the NCI Breast and Prostate Cancer Cohort Consortium. Logistic regression was used to estimate the individual and cumulative association between genetic variants and risk of overall and aggressive prostate cancer. Results We observed a decreased risk of aggressive prostate cancer among men with the allele in rs6013897 near CYP24A1 associated with lower serum 25(OH)D (per A allele, OR=0.86, 95%CI=0.80–0.93, p-trend=0.0002), but an increased risk for non-aggressive disease (per a allele: OR=1.10, 95%CI=1.04–1.17, p-trend=0.002). Examination of a polygenic score of the four SNPs revealed statistically significantly lower risk of aggressive prostate cancer among men with a greater number of low vitamin D alleles (OR for 6–8 vs. 0–1 alleles = 0.66, 95% CI = 0.44 – 0.98; p-trend=0.003). Conclusions In this large, pooled analysis, genetic variants related to lower 25(OH)D were associated with a decreased risk of aggressive prostate cancer. Impact Our genetic findings do not support a protective association between loci known to influence vitamin D levels and prostate cancer risk. PMID:23377224

  8. Expression of kallikrein-related peptidase 7 is decreased in prostate cancer

    Institute of Scientific and Technical Information of China (English)

    Chong-Yu Zhang; Yu Zhu; Wen-Bin Rui; Jun Dai; Zhou-Jun Shen

    2015-01-01

    Recent evidence suggests that the human kallikrein 7 (KLK7) is differentially regulated in a variety of tumors. The aim of this study was to determine the expression of kallikrein‑related peptidase 7 and KLK7 in our large collection of prostate samples. Between August 2000 and December 2012, 116 patients with histologically confirmed prostate cancer (PCa) and 92 with benign prostate hyperplasia (BPH) were recruited into the study. Using immunohistochemistry, quantitative reverse transcription polymerase chain reaction (RT‑PCR) and western blot, kallikrein‑related peptidase 7 expression in BPH and PCa tissues was determined at the mRNA and protein levels. The relationships between kallikrein‑related peptidase 7 mRNA expression and clinicopathological features were analyzed. A total of 64 of 92 (69.57%) benign cases showed positive staining for KLK7 and 23 of 116 (19.83%) malignant cases showed positive, the difference of KLK7 expression between PCa and BPH was statistically significant (P < 0.001). The expression level of kallikrein‑related peptidase 7 mRNA was significantly decreased in PCa tissues compared with that in BPH tissues and normal prostate tissue. Kallikrein‑related peptidase 7 mRNA exhibited different expression patterns in terms of localization depending on pathological category of PCa. Similarly, our western immunoblot analyses demonstrated that the protein expression levels of KLK7 was lower in PCa than in BPH tissues and normal prostate tissue. Kallikrein‑related peptidase 7 and KLK7 expression are down‑regulated in PCa and lower expression of kallikrein‑related peptidase 7 closely correlates with higher Gleason score and higher prostate‑specific antigen level.

  9. 经直肠前列腺活检的单中心16年回顾%Transrectal prostate biopsy:a review of 16 years experience in single center

    Institute of Scientific and Technical Information of China (English)

    潘永昇; 王增军; 华立新; 成功; 汪骏; 李潇; 张成; 吴杰; 郑雨潇; 黄源; 秦超

    2016-01-01

    的患者无明显差异(45.2% vs.43.2%,P=0.362),但其阳性患者的Gleason评分均值低于LUTS组(6.76 vs.7.25,P<0.001)。结论 TRUS引导下经直肠12+1针活检方案阳性率显著高于手指引导下6针及8针活检。随着PSA的应用,前列腺活检的阳性率逐渐增高,阳性者的年龄呈下降趋势;年龄越大,前列腺活检的阳性率越高;直肠指检阳性患者,活检的Gleason评分偏高;外周区的活检有利于前列腺癌的检出;tPSA水平越高,前列腺活检的Gleason评分越高。 TRUS引导的前列腺12+1针活检检出的低危患者有增加趋势,但多数仍为有临床意义的前列腺癌。%Objective To assess the improvement of prostate cancer detection rate ( PCDR) with the advance of prostate biopsy technologies and analyse the changing epidemiology of patients with positive prostate biopsy, especially the PCDR and classficaton of risk.Methods From March 1999 to March 2015, a total of 3 762 patients were recruited to the department of urology, the first affiliated hospital of Nanjing medical university.All patients underwent a systematic 6-, 8-or 13-core biopsy, guided by finger or TRUS. The PCDR of different prostate specific antigen ( PSA) interval was analyzed.The PCDR of 6-or 8-core biopsy guided by finger and 13-core biopsy guided by TRUS were compared.The trends of PSA level, age and Gleason score in the patients with positive biopsy were summarized.Results A total of 3 762 patients underwent prostate biopsies and PCa were detected in 1479 patients (39.3%).Finger-guided 6-core biopsy was performed on 1 106 patients, and PCa were detected in 343 cases ( 31.0%) .Finger-guided 8-core biopsy was performed on 398 patients, and PCa were diagnosed in 144 cases (36.2%).Since 2009, 2 258 patients underwent TRUS-guided 13-core biopsy, and 992 ( 43.9%) were diagnosed as PCa, higher than that of finger-guided biopsies ( 43.9% vs.32.4%, P4 ng/ml) were lower than that of positive in

  10. Health-Related Quality of Life in Dutch Men with Prostate Cancer

    NARCIS (Netherlands)

    Bensing, J.; Voerman, B.; Fischer, M.; Visser, Adriaan; Garssen, B.; Andel, G. van

    2006-01-01

    Prostate cancer is the most prevalent solid malignancy in men in the Netherlands. With regard to treatment, the focus of attention has shifted in the last decade from pure survival rates to health-related quality of life. HRQOL is affected differently by different treatments. The objective of this s

  11. Danish Prostate Cancer Registry

    DEFF Research Database (Denmark)

    Helgstrand, J Thomas; Klemann, Nina; Røder, Martin Andreas

    2016-01-01

    of the prostate (TUR-Ps), and the remaining 22,028 (13.6%) specimens were derived from radical prostatectomies, bladder interventions, etc. A total of 48,078 (42.2%) males had histopathologically verified prostate cancer, and of these, 78.8% and 16.8% were diagnosed on prostate biopsies and TUR-Ps, respectively....... FUTURE PERSPECTIVES: A validated algorithm was successfully developed to convert complex prostate SNOMED codes into clinical useful data. A unique database, including males with both normal and cancerous histopathological data, was created to form the most comprehensive national prostate database to date...

  12. Evaluating localized prostate cancer and identifying candidates for focal therapy.

    Science.gov (United States)

    Sartor, A Oliver; Hricak, Hedvig; Wheeler, Thomas M; Coleman, Jonathan; Penson, David F; Carroll, Peter R; Rubin, Mark A; Scardino, Peter T

    2008-12-01

    Can focal therapy successfully control prostate cancer? Also, if so, which patients should be considered eligible? With limited data available from relatively few patients, these questions are difficult to answer. At this writing, the most likely candidates for focal therapy are patients with low-risk, small-volume tumors, located in 1 region or sector of the prostate, who would benefit from early intervention. The difficulty lies in reliably identifying these men. The larger number of cores obtained in each needle biopsy session has increased both the detection of prostate cancer and the potential risk of overtreating many patients whose cancers pose very little risk to life or health. Urologists typically perform at least a 12-core template biopsy. Although the debate continues about the optimal template, laterally and peripherally directed biopsies have been shown to improve the diagnostic yield. However, as many as 25% of tumors arise anteriorly and can be missed with peripherally directed techniques. Prostate cancer tends to be multifocal, even in its earliest stages. However, the secondary cancers are usually smaller and less aggressive than the index cancer. They appear similar to the incidental cancers found in cystoprostatectomy specimens and appear to have little effect on prognosis in surgical series. When a single focus of cancer is found in 1 core, physicians rightly suspect that more foci of cancer are present in the prostate. Assessing the risk in these patients is challenging when determined by the biopsy data alone. To predict the presence of a very low-risk or "indolent" cancer, nomograms have been developed to incorporate clinical stage, Gleason grade, prostate-specific antigen levels, and prostate volume, along with the quantitative analysis of the biopsy results. Transperineal "mapping" or "saturation" biopsies have been advocated to detect cancers missed or underestimated by previous transrectal biopsies. This approach could provide the

  13. CYP19A1 genetic variation in relation to prostate cancer risk and circulating sex hormone concentrations in men from the Breast and Prostate Cancer Cohort Consortium

    Science.gov (United States)

    Travis, Ruth C.; Schumacher, Fredrick; Hirschhorn, Joel N.; Kraft, Peter; Allen, Naomi E.; Albanes, Demetrius; Berglund, Goran; Berndt, Sonja I.; Boeing, Heiner; Bueno-de-Mesquita, H. Bas; Calle, Eugenia E.; Chanock, Stephen; Dunning, Alison M.; Hayes, Richard; Feigelson, Heather Spencer; Gaziano, J. Michael; Giovannucci, Edward; Haiman, Christopher A.; Henderson, Brian E.; Kaaks, Rudolf; Kolonel, Laurence N.; Ma, Jing; Rodriguez, Laudina; Riboli, Elio; Stampfer, Meir; Stram, Daniel O.; Thun, Michael J.; Tjønneland, Anne; Trichopoulos, Dimitrios; Vineis, Paolo; Virtamo, Jarmo; Le Marchand, Loïc; Hunter, David J.

    2009-01-01

    Sex hormones, in particular the androgens, are important for the growth of the prostate gland and have been implicated in prostate cancer carcinogenesis, yet the determinants of endogenous steroid hormone levels remain poorly understood. Twin studies suggest a heritable component for circulating concentrations of sex hormones, although epidemiological evidence linking steroid hormone gene variants to prostate cancer is limited. Here we report on findings from a comprehensive study of genetic variation at the CYP19A1 locus in relation to prostate cancer risk and to circulating steroid hormone concentrations in men by the Breast and Prostate Cancer Cohort Consortium (BPC3), a large collaborative prospective study. The BPC3 systematically characterised variation in CYP19A1 by targeted resequencing and dense genotyping; selected haplotype-tagging single nucleotide polymorphisms (htSNPs) that efficiently predict common variants in U.S. and European whites, Latinos, Japanese Americans, and Native Hawaiians; and genotyped these htSNPs in 8,166 prostate cancer cases and 9,079 study-, age-, and ethnicity-matched controls. CYP19A1 htSNPs, two common missense variants and common haplotypes were not significantly associated with risk of prostate cancer. However, several htSNPs in linkage disequilibrium blocks 3 and 4 were significantly associated with a 5–10% difference in estradiol concentrations in men (association per copy of the two-SNP haplotype rs749292–rs727479 (A–A) versus noncarriers; P=1 × 10−5), and withinverse, although less marked changes, in free testosterone concentrations. These results suggest that although germline variation in CYP19A1 characterised by the htSNPs produces measurable differences in sex hormone concentrations in men, they do not substantially influence risk for prostate cancer. PMID:19789370

  14. 超声引导下经直肠前列腺系统12点穿刺活检术对早期前列腺癌的诊断价值%Transrectal ultrasound- guided 12- core biopsy for early diagnosis of prostate cancer: A report of 149 cases

    Institute of Scientific and Technical Information of China (English)

    李波; 宋永胜

    2011-01-01

    目的 评价经直肠超声引导下前列腺系统12点穿刺活检术的临床价值.方法 对临床高度怀疑前列腺癌149例患者进行经直肠超声引导下前列腺系统12点穿刺活检.结果 成功进行12点系统穿刺活检者149例,获取组织满意.病理诊断为前列腺癌36例,前列腺增生80例,不典型增生4例,前列腺内皮瘤4例,前列腺慢性炎症9例,鳞状上皮化生3例,结核1例.前列腺平滑肌肉瘤7例,前列腺囊肿5例.结论 经直肠超声定位下系统12点穿刺法成功率高,无严重并发症.在临床早期诊断前列腺癌很有价值.%Objective To evaluate the clinical value of 12 - core systemic prostate biopsy. Methods Prostatic puncture and biopsy guided by transrectal ultrasound was performed in 149 patients suspected of prostate cancer. Results 149 cases were under 12 cores transrectal ultrasound guided biopsy. The histologic study confirmed 36 cases with prostate cancer, 80 benign hyperplasia, 4 atypical hyperplasia, 4 endothelioma, 9 chronic inflammation, 3 squamous cellmetaplasia, 1 tu berculosiswere, 7 leiomyosarcoma and 5 cyst of prostate. Conclusion Transrectal ultrasound guided 12 - core systemic prostate biopsy can improve prostate cancer detection rate with high success. No patient had severe complications after biopsy. It is useful in the early clinical diagnosis of prostate cancer.

  15. Human papillomavirus infection is not related with prostatitis-related symptoms: results from a case-control study

    Directory of Open Access Journals (Sweden)

    Riccardo Bartoletti

    2014-04-01

    Full Text Available PurposeTo investigate the relationship between human papillomavirus (HPV infection and prostatitis-related symptoms.Materials and MethodsAll young heterosexual patients with prostatitis-related symptoms attending the same Center from January 2005 to December 2010 were eligible for this case-control study. Sexually active asymptomatic men were considered as the control group. All subjects underwent clinical examination, Meares-Stamey test and DNA-HPV test. Patients with prostatitis-related symptoms and asymptomatic men were compared in terms of HPV prevalence. Moreover, multivariable Cox proportional hazards regression analysis was performed to determine the association between HPV infection and prostatitis-related symptoms.ResultsOverall, 814 out of 2,938 patients (27.7% and 292 out of 1,081 controls (27.0% proved positive to HPV. The HPV genotype distribution was as follows: HR-HPV 478 (43.3%, PHR-HPV 77 (6.9%, LR-HPV 187 (16.9% and PNG-HPV 364 (32.9%. The most common HPV genotypes were: 6, 11, 16, 26, 51, 53 and 81. No difference was found between the two groups in terms of HPV infection (OR 1.03; 95% CI 0.88-1.22; p = 0.66. We noted a statistically significant increase in HPV infection over the period 2005 to 2010 (p < 0.001 in both groups. Moreover, we found a statistically significant increase in HPV 16 frequency from 2005 to 2010 (p = 0.002.ConclusionsThis study highlights that prostatitis-like symptoms are unrelated to HPV infection. Secondary, we highlight the high prevalence of asymptomatic HPV infection among young heterosexual men.

  16. Reason analysis and nursing of septic shock caused by biopsy among prostate cancer patients%前列腺癌患者穿刺活检引发感染性休克的原因分析及护理

    Institute of Scientific and Technical Information of China (English)

    冯瑶; 王晓微; 朱春莲

    2015-01-01

    目的:探讨前列腺癌患者穿刺活检引发感染性休克的原因和护理措施,为减少前列腺活检感染性休克提供参考依据。方法回顾性分析84例行穿刺活检术的前列腺癌患者的一般资料,采用Logistic多因素分析的方法分析感染性休克的危险因素。结果84例患者中,有7例患者出现感染性休克,发生率为8.33%;7例感染性休克共检出致病菌10株,其中革兰阴性菌8株,革兰阳性菌2株。单因素分析结果显示,两组患者在年龄、合并糖尿病、合并前列腺感染、合并尿路感染、APACHEⅡ评分、反复穿刺方面比较差异有统计学意义(P<0.05);多因素Logistic回归分析结果显示,合并前列腺感染、年龄、合并尿路感染、APACHEⅡ评分是前列腺癌患者行穿刺活检术引发感染性休克的主要危险因素( OR值分别为0.376,0.141,0.281,0.269;P<0.05)。结论前列腺癌患者穿刺活检引发感染性休克的致病菌主要是以革兰阴性菌为主,发生时间多集中在术后48 h内,对于APACHEⅡ评分较低、年龄较大、合并前列腺感染或者尿路感染的患者要采取多角度的防控措施,以减少感染性休克的发生。%Objective To explore the causes and nursing measures of septic shock caused by biopsy in patients with prostate cancer, and to provide reference for reducing infectious shock. Methods The general data of 84 prostate cancer patients, who taken puncture biopsy, were retrospectively analyzed, and the causes of Septic shock were analyzed by the Pearson univariate analysis method and multivariate logistic regression analysis method. Results All 7 patients of septic shock were detected, with the occurrence rate 8. 33%. A total of 10 strains of pathogenic bacteria were detected from those 7 patients, including 8 strains of gram negative bacteria and 2 strains of gram positive bacteria. There were significant difference between two groups on the age, diabetes complication

  17. The effect of different modes of the prostate biopsy on the Gleason score of prostate cancer%不同模式经直肠超声前列腺穿刺活检对前列腺癌Gleason评分影响的研究

    Institute of Scientific and Technical Information of China (English)

    孔艳鹏; 冯蕾; 孙琰; 林翠云; 张庶; 虞青; 夏要友; 陈坤; 陆健斐

    2015-01-01

    目的:探讨不同模式经直肠超声前列腺穿刺活检对前列腺癌(prostate cancer, PCA)Gleason评分的影响。方法对95例已确诊的PCA进行回顾性研究,不同模式的经直肠前列腺穿刺活检共4组,即系统穿刺活检组(SB组)28例,仅行对比增强靶向活检组(CEUS组)15例,仅行弹性成像靶向活检组(UE组)28例,CEUS联合UE靶向活检组(CUES+UE组)24例。将得到的Gleason评分进行组间比较。结果 SB组与CEUS组之间、CEUS组与UE组间、CEUS+UE组两两之间的差异均无统计学意义(P>0.05),而UE组、CUES+UE组与SB组的Gleason评分的差异均有统计学意义(P<0.05)。结论与经直肠超声引导下前列腺系统活检相比,经直肠超声弹性成像技术、经直肠对比增强超声联合超声弹性成像技术引导的前列腺靶向活检有助于得到较高的前列腺组织Gleason评分。%Objective To investigate the effect of different patterns of the prostate biopsy on Gleason score of prostate cancer (PCA).Methods A total of 95 patients with different biopsy patterns were randomly divided into 4 groups including sysmetic biopsy group(SB, 28 cases), contrast enhanced ultrasound group (CEUS, 15 cases), ultrasonic elastography group (UE, 28 cases), the group of CEUS combined with UE (CUES+UE, 24 cases). The Gleason scores were comparatively analyzed between groups.Results There was no significant difference in Gleason score between SB group and CEUS group, as well as CEUS group, UE group and CEUS+UE group (P>0.05), whereas there were significant differences(P<0.05) between SB group and UE group, CUES+UE group respectively.Conclusion CEUS combined with UE and UE targeted biopsy was superior to SB in obtaining higher Gleason score.

  18. Analysis of results related to the percent free prostate specific antigen among men without prostate diseases in Xi'an area

    Institute of Scientific and Technical Information of China (English)

    Peng Zhang; Ziming Wang; Tie Chong; Lihua Zhao

    2007-01-01

    Objective: To measure the percent of free prostate specific antigen (fPSA) among men without prostate diseases in Xi'an area, and to study the relationship of percent fPSA with age and pathological grade, clinical stage of prostate cancer (PCa) with percent fPSA, and to analyze the difference between the data in China and theoverseas data to determine appropriate reference range for Chinese male. Methods: A total of 713 participants were enrolled into the study, with PSA, fPSA in serum measured and the percent fPSA calculated. Out of 713 cases, 679 without prostate diseases were divided into 5 groups by age, and then the relationships of PSA, fPSA and percent fPSA with age were studied, respectively. The relationship of pathological grade and clinical stage with percent fPSA of the 34 participants with PCa was also studied. With the help of the related data of men without prostate disease, the appropriate reference range for Chinese male was established. Results: The increases in PSA or fPSA were correlated with age, while there was no significant correlation between age and percent fPSA. The percent fPSA was also correlated with pathological grade and clinical stage of PCa. The percent fPSA of men without prostate disease in Xi'an area was significantly lower than that in the related overseas data. The reference range of percent fPSA for Chinese male was≥15%. Conclusion: Percent fPSA might be more useful than PSA in the detection of prostate cancer. As the percent fPSA is decreased, the pathological grade is decreased, and the clinical stage is increased, the malignant degree is increased. The reference range of≥15% is more appropriate for Chinese male.

  19. 前列腺周围神经阻滞麻醉对缓解经直肠超声引导下前列腺穿刺活检术疼痛的效果%Efficacy of periprostatic nerve block anesthesia for pain control in transrectal ultrasound-guided systematic prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    谢毅; 周芳坚; 李永红; 蒋丽娟; 吴志明; 秦自科; 韩辉; 刘卓炜

    2016-01-01

    were recorded and evaluated immediately after and at 7 days after the biopsy. Results The mean age, prostate volume, total prostate specific antigen (tPSA), free PSA (fPSA), and abnormal DRE were comparable between the 2 groups (P>0.05). Immediately after the biopsy, no difference was found between the 2 groups in DRE pain score (1.40±0.98 vs 1.39±0.91, P=0.102) or probe insert pain score (2.07±0.96 vs 2.03±0.90, P=0.960), but the biopsy pain score was significantly lower in PPNB group than in no PPNB group (2.54±1.42 vs 3.07±1.43, P=0.033). The incidence of the procedure-related complications was similar between the 2 groups (P>0.05). Conclusion PPNB can significantly lower the biopsy pain score in PBx without increasing the incidence of complications.

  20. Lymph node biopsy

    Science.gov (United States)

    Biopsy - lymph nodes; Open lymph node biopsy; Fine needle aspiration biopsy; Sentinel lymph node biopsy ... A lymph node biopsy is done in an operating room in a hospital. Or, it is done at an outpatient surgical center. The ...

  1. The role of secreted frizzled-related protein 2 expression in prostate cancer.

    LENUS (Irish Health Repository)

    O'Hurley, Gillian

    2012-02-01

    AIMS: Improved prostate cancer (PCa)-specific biomarkers are urgently required to distinguish between indolent and aggressive disease, in order to avoid overtreatment. In this study, we investigated the prostatic tissue expression of secreted frizzled-related protein (SFRP)-2. METHODS AND RESULTS: Following immunohistochemical analysis on PCa tissue microarrays with samples from 216 patients, strong\\/moderate SFRP-2 expression was observed in epithelial cells of benign prostatic hyperplasia, and negative\\/weak SFRP-2 expression was observed in the majority of tumour epithelia. However, among Gleason grade 5 carcinomas, 40% showed strong\\/moderate SFRP-2 expression and 60% showed negative SFRP-2 expression in epithelial cells. Further microscopic evaluation of Gleason grade 5 tumours revealed different morphological patterns, corresponding with differential SFRP-2 expression. The first subgroup (referred to as Type A) appeared to have a morphologically solid growth pattern, whereas the second subgroup (referred to as Type B) appeared to have a more diffuse pattern. Furthermore, 100% (4\\/4) of Type A patients experienced biochemical recurrence, as compared with 0% (0\\/6) of Type B patients. CONCLUSIONS: These results imply: (i) that there is a loss of SFRP-2 expression from benign to malignant prostate glands; and (ii) differential SFRP-2 expression among two possible subgroups of Gleason grade 5 tumours.

  2. Renal Tumor Biopsy Technique

    Institute of Scientific and Technical Information of China (English)

    Lei Zhang; Xue-Song Li; Li-Qun Zhou

    2016-01-01

    Objective:To review hot issues and future direction of renal tumor biopsy (RTB) technique.Data Sources:The literature concerning or including RTB technique in English was collected from PubMed published from 1990 to 2015.Study Selection:We included all the relevant articles on RTB technique in English,with no limitation of study design.Results:Computed tomography and ultrasound were usually used for guiding RTB with respective advantages.Core biopsy is more preferred over fine needle aspiration because of superior accuracy.A minimum of two good-quality cores for a single renal tumor is generally accepted.The use of coaxial guide is recommended.For biopsy location,sampling different regions including central and peripheral biopsies are recommended.Conclusion:In spite of some limitations,RTB technique is relatively mature to help optimize the treatment of renal tumors.

  3. 前列腺癌穿刺标本Gleason评分及穿刺阳性针数与术后病理切缘阳性之间的相关性分析%Correlation analysis of positive margins after radical prostatectomy with Gleason score of biopsy specimens and percentage of positive biopsy cores in prostate cancer

    Institute of Scientific and Technical Information of China (English)

    张尊胜; 梁军号; 张铁龙; 钱苏波

    2014-01-01

    目的 探讨前列腺癌根治术中穿刺标本Gleason评分及穿刺阳性针数比例与术后病理切缘阳性之间的相关性.方法 130例经穿刺病理证实的局限性前列腺癌患者行前列腺癌根治术,分析其穿刺后的Gleason评分、穿刺阳性针数比例与术后病理切缘阳性率之间的关系.结果 130例穿刺标本,Gleason评分6分组50例,切缘阳性率为10.00% (5/50);Gleason评分7分组65例,切缘阳性率为21.54%(14/65);Gleason评分8分组13例,切缘阳性率为0;Gleason评分9分组2例,切缘阳性率为0,不同穿刺标本Gleason评分各组之间切缘阳性率比较差异无统计学意义(x2=5.917 5,P> 0.05).穿刺阳性针数比例统计共89例,阳性针数比例1%~ 25%组30例,切缘阳性率为3.33%(1/30);阳性针数比例26%~50%组27例,切缘阳性率为11.11%(3/27);阳性针数比例51% ~ 75%组18例,切缘阳性率为6/18;阳性针数比例76%~100%组14例,切缘阳性率为4/14,不同穿刺阳性针数比例各组之间切缘阳性率比较差异有统计学意义(x2=9.861 8,P< 0.05).结论 前列腺癌穿刺标本Gleason评分与术后病理切缘之间无相关性,而穿刺阳性针数比例与术后病理切缘之间有相关性.%Objective To investigate the correlation of positive margins after radical prostatectomy with Gleason score of biopsy specimens and percentage of positive biopsy cores in prostate cancer.Methods One hundred and thirty patients with localized prostate cancer were confirmed by biopsy underwent radical prostatectomy,the relationship between positive margins rate and Gleason scores,percentage of positive biopsy cores were analyzed.Results One hundred and thirty cases of biopsy specimens,Gleason score 6 group 50 cases,positive margins rate was 10.00% (5/50),Gleason score 7 group 65 cases,positive margins rate was 21.54%(14/65),Gleason score 8 group 13 cases,positive margins rate was 0,Gleason score 9 group 2 cases,positive margins rate

  4. MRI & MR SPECTROSCOPIC EVALUATION OF PROSTATIC CARCINOMA

    Directory of Open Access Journals (Sweden)

    Rupak

    2015-09-01

    Full Text Available BACKGROUND : Prostate cancer is the most common malignancy among men more than fifty years of age (Cancer foundation of India. Imaging may help in clarifying several important issues in localized prostate cancer. MRI provides the best depiction of the contours of the prostate as well as its internal zonal anatomy. Recent evidence suggests that multi - parametric MRI could improve the accuracy of diagnostic assessment in prostate cancer. In addition, MRI also allows functional assessment with techniques such as diffusion - weighted MRI (DWI, MR spectroscopy (MRS, and dynamic contrast enhanced MRI (DCE - MRI. Strong opinions are held about the need for endorectal coil imaging. Endorectal coils provide large gains in signal with reductions in noise, most noticeably at 1.5 T; however, endorectal coils are uncomfortable and expensive. At 3 T, the need for endorectal coils has been debated. Clearly, the highest - quality MRI results from the combined use of endorectal coils and phased array body coils at 3 T. Prostate cancer is associated with proportionately lower levels of citrate and higher levels of choline and creatine than are seen in benign prostatic hyperplasia (BPH or in normal prostate tissu e. This difference can be detected by magnetic resonance spectroscopic imaging (MRSI. MRSI uses a strong magnetic field to obtain metabolic information (spectra that identifies the relative concentrations of various metabolites in the cell cytoplasm and the extracellular space. This technique can identify metabolic differences in prostate tissue (BPH, prostate cance r, and normal prostate tissue. AIM: To evaluate the role of MRI and MR Spectroscopy in the diagnosis of prostatic carcinoma by pelvic phased array coil in the detection of prostatic carcinoma in men with Prostatomegaly & elevated PSA levels and establishing statistical analysis of the same. METHOD: A prospective study of minimum 50 consecutive cases with Prostatomegaly & raised PSA levels

  5. Concurrent AURKA and MYCN Gene Amplifications Are Harbingers of Lethal TreatmentRelated Neuroendocrine Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Juan Miguel Mosquera

    2013-01-01

    Full Text Available Neuroendocrine prostate cancer (NEPC, also referred to as anaplastic prostate cancer, is a lethal tumor that most commonly arises in late stages of prostate adenocarcinoma (PCA with predilection to metastasize to visceral organs. In the current study, we explore for evidence that Aurora kinase A (AURKA and N-myc (MYCN gene abnormalities are harbingers of treatment-related NEPC (t-NEPC. We studied primary prostate tissue from 15 hormone naïve PCAs, 51 castration-resistant prostate cancers, and 15 metastatic tumors from 72 patients at different stages of disease progression to t-NEPC, some with multiple specimens. Histologic evaluation, immunohistochemistry, and fluorescence in situ hybridization were performed and correlated with clinical variables. AURKA amplification was identified in overall 65% of PCAs (hormone naïve and treated from patients that developed t-NEPC and in 86% of metastases. Concurrent amplification of MYCN was present in 70% of primary PCAs, 69% of treated PCAs, and 83% of metastases. In contrast, in an unselected PCA cohort, AURKA and MYCN amplifications were identified in only 5% of 169 cases. When metastatic t-NEPC was compared to primary PCA from the same patients, there was 100% concordance of ERG rearrangement, 100% concordance of AURKA amplification, and 60% concordance of MYCN amplification. In tumors with mixed features, there was also 100% concordance of ERG rearrangement and 94% concordance of AURKA and MYCN co-amplification between areas of NEPC and adenocarcinoma. AURKA and MYCN amplifications may be prognostic and predictive biomarkers, as they are harbingers of tumors at risk of progressing to t-NEPC after hormonal therapy.

  6. Finasteride concentrations and prostate cancer risk: results from the Prostate Cancer Prevention Trial.

    Directory of Open Access Journals (Sweden)

    Cindy H Chau

    Full Text Available In the Prostate Cancer Prevention Trial (PCPT, finasteride reduced the risk of prostate cancer by 25%, even though high-grade prostate cancer was more common in the finasteride group. However, it remains to be determined whether finasteride concentrations may affect prostate cancer risk. In this study, we examined the association between serum finasteride concentrations and the risk of prostate cancer in the treatment arm of the PCPT and determined factors involved in modifying drug concentrations.Data for this nested case-control study are from the PCPT. Cases were drawn from men with biopsy-proven prostate cancer and matched controls. Finasteride concentrations were measured using a liquid chromatography-mass spectrometry validated assay. The association of serum finasteride concentrations with prostate cancer risk was determined by logistic regression. We also examine whether polymorphisms in the enzyme target and metabolism genes of finasteride are related to drug concentrations using linear regression.Among men with detectable finasteride concentrations, there was no association between finasteride concentrations and prostate cancer risk, low-grade or high-grade, when finasteride concentration was analyzed as a continuous variable or categorized by cutoff points. Since there was no concentration-dependent effect on prostate cancer, any exposure to finasteride intake may reduce prostate cancer risk. Of the twenty-seven SNPs assessed in the enzyme target and metabolism pathway, five SNPs in two genes, CYP3A4 (rs2242480; rs4646437; rs4986910, and CYP3A5 (rs15524; rs776746 were significantly associated with modifying finasteride concentrations. These results suggest that finasteride exposure may reduce prostate cancer risk and finasteride concentrations are affected by genetic variations in genes responsible for altering its metabolism pathway.ClinicalTrials.gov NCT00288106.

  7. Prostate Cancer

    OpenAIRE

    Eggener, Scott

    2011-01-01

    Prostate cancer continues to be a significant public health issue worldwide, particularly in countries where men have life expectancies long enough to clinically manifest the disease. In many countries, it remains one of the leading causes of cancer-related morbidity and mortality.Although significant progress has been made over the past few decades, many elements regarding the diagnosis and management of patients with prostate cancer remain enigmatic. In this Prostate Cancer special issue, o...

  8. RARE DIAGNOSIS OF IGG4-RELATED SYSTEMIC DISEASE BY LIP BIOPSY IN AN INTERNATIONAL SJÖGREN SYNDROME REGISTRY

    Science.gov (United States)

    Baer, Alan N.; Gourin, Christine; Westra, William H.; Cox, Darren; Greenspan, John; Daniels, Troy E.

    2012-01-01

    IgG4-related disease has been recently defined as a distinct clinic-pathologic entity, characterized by dense IgG-4 plasmacytic infiltration of diverse organs, fibrosis, and tumefactive lesions. Salivary and lacrimal glands are a target of this disease and, when affected, may clinically resemble Küttner tumor, Mikulicz disease, or orbital inflammatory pseudotumor. In some patients, the disease is systemic, with metachronous involvement of multiple organs, including the pancreas, aorta, kidneys, and biliary tract. We report a 66-year old man who presented with salivary gland enlargement and severe salivary hypofunction and was diagnosed with IgG4-related disease on the basis of a labial salivary gland biopsy. Additional features of his illness included a marked peripheral eosinophilia, obstructive pulmonary disease, and lymphoplasmacytic aortitis. He was evaluated in the context of a research registry for Sjögren syndrome and was the only one of 2594 registrants with minor salivary gland histopathologic findings supportive of this diagnosis. PMID:23146570

  9. A Large Study of Androgen Receptor Germline Variants and Their Relation to Sex Hormone Levels and Prostate Cancer Risk. Results from the National Cancer Institute Breast and Prostate Cancer Cohort Consortium

    Science.gov (United States)

    Lindström, Sara; Ma, Jing; Altshuler, David; Giovannucci, Edward; Riboli, Elio; Albanes, Demetrius; Allen, Naomi E.; Berndt, Sonja I.; Boeing, Heiner; Bueno-de-Mesquita, H. Bas; Chanock, Stephen J.; Dunning, Alison M.; Feigelson, Heather Spencer; Gaziano, J. Michael; Haiman, Christopher A.; Hayes, Richard B.; Henderson, Brian E.; Hunter, David J.; Kaaks, Rudolf; Kolonel, Laurence N.; Le Marchand, Loic; Martínez, Carmen; Overvad, Kim; Siddiq, Afshan; Stampfer, Meir; Stattin, Pär; Stram, Daniel O.; Thun, Michael J.; Trichopoulos, Dimitrios; Tumino, Rosario; Virtamo, Jarmo; Weinstein, Stephanie J.; Yeager, Meredith; Kraft, Peter; Freedman, Matthew L.

    2010-01-01

    Background: Androgens are key regulators of prostate gland maintenance and prostate cancer growth, and androgen deprivation therapy has been the mainstay of treatment for advanced prostate cancer for many years. A long-standing hypothesis has been that inherited variation in the androgen receptor (AR) gene plays a role in prostate cancer initiation. However, studies to date have been inconclusive and often suffered from small sample sizes. Objective and Methods: We investigated the association of AR sequence variants with circulating sex hormone levels and prostate cancer risk in 6058 prostate cancer cases and 6725 controls of Caucasian origin within the Breast and Prostate Cancer Cohort Consortium. We genotyped a highly polymorphic CAG microsatellite in exon 1 and six haplotype tagging single nucleotide polymorphisms and tested each genetic variant for association with prostate cancer risk and with sex steroid levels. Results: We observed no association between AR genetic variants and prostate cancer risk. However, there was a strong association between longer CAG repeats and higher levels of testosterone (P = 4.73 × 10−5) and estradiol (P = 0.0002), although the amount of variance explained was small (0.4 and 0.7%, respectively). Conclusions: This study is the largest to date investigating AR sequence variants, sex steroid levels, and prostate cancer risk. Although we observed no association between AR sequence variants and prostate cancer risk, our results support earlier findings of a relation between the number of CAG repeats and circulating levels of testosterone and estradiol. PMID:20534771

  10. The frequency of benign prostate hypertrophy in Calabar.

    Science.gov (United States)

    Umezurike, B I; Ekanem, T B; Eluwa, M A; Etta, K K; Udo-Affah, G A; Aligwekwe, A U

    2006-09-01

    The present study was to find out through histopathological records the most frequently occurring disease of the prostate from suspected prostate diseases in Calabar, Cross River State, Nigeria. A total number of 324 cases of prostatic biopsies and autopsy materials recorded in the histopathology laboratory of the University of Calabar Teaching Hospital (UCTH), Calabar between 1986 and 1995 were used for this study. Benign prostatic hypertrophy was observed as the major pathology among all the diseases of the prostate gland recorded in UCTH in Calabar having accounted for 76.3% (261 out of 342) while prostatic carcinoma accounted for 19% (65 out of 324), rest 4.7% (16 out of 342) were inflammatory lesions. The result indicated that benign prostatic hypertrophy occurs in men from 40 years and above. The frequency increased with age, reaching a maximum of 34.5% (90 out of 261) in the age group (70-79) years old. The people in Cross River State should be informed of the high frequency of benign prostatic hypertrophy and should be advised to seek health care promptly in suspected prostate related illness.

  11. Gene expression in skeletal muscle biopsies from people with type 2 diabetes and relatives: differential regulation of insulin signaling pathways.

    Directory of Open Access Journals (Sweden)

    Jane Palsgaard

    Full Text Available BACKGROUND: Gene expression alterations have previously been associated with type 2 diabetes, however whether these changes are primary causes or secondary effects of type 2 diabetes is not known. As healthy first degree relatives of people with type 2 diabetes have an increased risk of developing type 2 diabetes, they provide a good model in the search for primary causes of the disease. METHODS/PRINCIPAL FINDINGS: We determined gene expression profiles in skeletal muscle biopsies from Caucasian males with type 2 diabetes, healthy first degree relatives, and healthy controls. Gene expression was measured using Affymetrix Human Genome U133 Plus 2.0 Arrays covering the entire human genome. These arrays have not previously been used for this type of study. We show for the first time that genes involved in insulin signaling are significantly upregulated in first degree relatives and significantly downregulated in people with type 2 diabetes. On the individual gene level, 11 genes showed altered expression levels in first degree relatives compared to controls, among others KIF1B and GDF8 (myostatin. LDHB was found to have a decreased expression in both groups compared to controls. CONCLUSIONS/SIGNIFICANCE: We hypothesize that increased expression of insulin signaling molecules in first degree relatives of people with type 2 diabetes, work in concert with increased levels of insulin as a compensatory mechanism, counter-acting otherwise reduced insulin signaling activity, protecting these individuals from severe insulin resistance. This compensation is lost in people with type 2 diabetes where expression of insulin signaling molecules is reduced.

  12. Prostate; Prostate

    Energy Technology Data Exchange (ETDEWEB)

    Rouviere, O.; Valette, O.; Grivolat, S.; Colin-Pangaud, C.; Bouvier, R.; Chapelon, J.Y.; Gelet, A.; Lyonnet, D.; Rouviere, O.; Mege-Lechevallier, F.; Chapelon, J.Y.; Gelet, A.; Bouvier, R.; Boutitie, F.; Lyonnet, D. [69 - Lyon (France)

    2005-10-15

    Two methods to detect recurrence of prostate cancer are presented. Dynamic magnetic resonance imaging after radiotherapy and color doppler after high intensity focused ultrasounds (but with patients that have not received a hormones therapy). These two methods presents an useful contribution. (N.C.)

  13. Communicative processes and decision-making in relation to prostate cancer patients

    DEFF Research Database (Denmark)

    Løwe Netsey-Afedo, Mette Margrethe; Birkelund, Regner

    is far from being something patients experience. For many men with prostate cancer the disease and its treatment have long-term, and often lifelong, serious physical and psychological consequences. Many patients experience a reduced quality of life. In relation to the significant side effects......BACKGROUND: There are many benefits of involving patients in decision-making, including increased patient safety and improved health. Many patients with prostate cancer wish to be involved when making decisions in the course of their treatment. However, studies show that Patient Involvement and SDM...... of treatment, it is essential to involve patients' preferences, needs and desires when making decisions during the course of their disease. Furthermore, it is important that patients are adequately informed about treatment, side effects, and other specific issues important for the individual patient. The aim...

  14. Communicative processes and decision-making in relation to prostate cancer patients

    DEFF Research Database (Denmark)

    Løwe Netsey-Afedo, Mette Margrethe; Birkelund, Regner

    2016-01-01

    is far from being something patients experience. For many men with prostate cancer the disease and its treatment have long-term, and often lifelong, serious physical and psychological consequences. Many patients experience a reduced quality of life. In relation to the significant side effects......BACKGROUND: There are many benefits of involving patients in decision-making, including increased patient safety and improved health. Many patients with prostate cancer wish to be involved when making decisions in the course of their treatment. However, studies show that Patient Involvement and SDM...... of treatment, it is essential to involve patients' preferences, needs and desires when making decisions during the course of their disease. Furthermore, it is important that patients are adequately informed about treatment, side effects, and other specific issues important for the individual patient. The aim...

  15. Stromal microcalcification in prostate.

    Science.gov (United States)

    Muezzinoglu, B; Gurbuz, Y

    2001-06-01

    Prostatic calcification is most commonly encountered as calculus or intraluminal calcifications within atypical small glandular proliferations. This study was undertaken to detect stromal microcalcifications in prostate tissue. All slides from 194 needle biopsies were retrospectively reviewed. Six cases (3.1%) had stromal microcalcifications constantly associated with mononuclear inflammatory infiltrate around the each focus. Association with prostatic glands was not seen in any of the microcalcification foci. Three cases had simultaneous adenocarcinoma and one had high-grade prostatic intraepithelial neoplasia, all of which were apart from the microcalcification foci. In conclusion, stromal microcalcification is a dystrophic, inflammation-mediated, benign process.

  16. Biopsy in Musculoskeletal Tumors

    Directory of Open Access Journals (Sweden)

    Mohammad Gharehdaghi

    2014-09-01

    proximity to the skin incision, because this tract is also contaminated and must be excised with the surgical specimen. Imaging-guided core needle biopsy is a well-established technique for the diagnosis of bone and soft tissue tumors and tumor-like lesions in specialized orthopedic oncology centers. Although large lesions of the limbs can easily be biopsied without image guidance, lesions in the spine, para spinal area, and pelvis are difficult to target, therefore taking the advantage of C.T. guidance will improve the accuracy of targeting the lesion for biopsy purposes. We can benefit from image intensifiers for targeting limb lesions rather than C.T. guidance. Also sonographic guide can be applied for soft tissue lesions (Figure D, E, F. In soft tissue tumors, the results of percutaneous CNB are relatively inferior compared to open biopsy whereas almost equal results are expected for bony tumors except for low-grade chondrosarcoma. CNB is a safe, minimally invasive, and cost effective technique for the diagnosis of bone lesions if done by an experienced orthopedic oncologic surgeon and be evaluated by an experienced anatomical bone pathologist (1, 3. For soft tissue tumors, CNB results depend on the size of the lesion, its location and amount of tumor necrosis. Guided needle biopsy have become the standard technique in most orthopedic oncologic centers. The accuracy of this method in our center is more than 90% for bone tumors. Cores should be taken in different directions including areas of central necrotic tissues but from a single well planned entrance. The procedure is quick, especially for bone CNB or soft tissue FNA and CNB, and the diagnosis can be achieved within 24 – 48 hours. The material should be sufficient for immunohistochemistry evaluations as well (1-3. Because I have seen 3 cases of tumor implantation at the towel clips puncture site including 2 chondrosarcomas and a case of malignant schowanoma, so I highly suggest that never crush the skin by towel

  17. Transurethral resection of the prostate for the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia: how much should be resected?

    Directory of Open Access Journals (Sweden)

    Alberto A. Antunes

    2009-12-01

    Full Text Available Objective: To assess the impact of the percent of resected tissue on the improvement of urinary symptoms. Materials and methods: The study included a prospective analysis of 88 men with benign prostatic hyperplasia. Patients were divided in three groups according to the percent of resected tissue: Group 1 50%. Each patient was re-evaluated 3 months after surgery. We assessed the international prostatic symptom score, nocturia and serum prostate specific antigen levels. Results: All patients presented a significant decrease on mean International Prostate System Score (IPSS (23 to 5.9, Quality of Life (QoL (4.9 to 1.0 and nocturia (3.2 to 1.9. Variation in the IPSS was 16.7, 16.6 and 18.4 for patients from Group 1, 2 and 3 respectively (P = 0.504. Although the three groups presented a significant decrease in QoL, patients in Group 3 presented a significantly greater decrease when compared to Group 1. Variation in QoL was 3.1, 3.9 and 4.2 for patients from Group 1, 2 and 3 respectively (p = 0.046. There was no significant difference in nocturia variation according to the percent of resected tissue (p = 0.504. Median pre and postoperative PSA value was 3.7 and 1.9 ng/mL respectively. Patients from Group 1 did not show a significant variation (p = 0.694. Blood transfusions were not required in any group. Conclusions:Resection of less than 30% of prostatic tissue seems to be sufficient to alleviate lower urinary tract symptoms related to benign prostate hyperplasia. However, these patients may not show a significant decrease in serum PSA level.

  18. Parathyroid hormone related-protein promotes epithelial-to-mesenchymal transition in prostate cancer.

    Directory of Open Access Journals (Sweden)

    Weg M Ongkeko

    Full Text Available Parathyroid hormone-related protein (PTHrP possesses a variety of physiological and developmental functions and is also known to facilitate the progression of many common cancers, notably their skeletal invasion, primarily by increasing bone resorption. The purpose of this study was to determine whether PTHrP could promote epithelial-to-mesenchymal transition (EMT, a process implicated in cancer stem cells that is critically involved in cancer invasion and metastasis. EMT was observed in DU 145 prostate cancer cells stably overexpressing either the 1-141 or 1-173 isoform of PTHrP, where there was upregulation of Snail and vimentin and downregulation of E-cadherin relative to parental DU 145. By contrast, the opposite effect was observed in PC-3 prostate cancer cells where high levels of PTHrP were knocked-down via lentiviral siRNA transduction. Increased tumor progression was observed in PTHrP-overexpressing DU 145 cells while decreased progression was observed in PTHrP-knockdown PC-3 cells. PTHrP-overexpressing DU 145 formed larger tumors when implanted orthoptopically into nude mice and in one case resulted in spinal metastasis, an effect not observed among mice injected with parental DU 145 cells. PTHrP-overexpressing DU 145 cells also caused significant bone destruction when injected into the tibiae of nude mice, while parental DU 145 cells caused little to no destruction of bone. Together, these results suggest that PTHrP may work through EMT to promote an aggressive and metastatic phenotype in prostate cancer, a pathway of importance in cancer stem cells. Thus, continued efforts to elucidate the pathways involved in PTHrP-induced EMT as well as to develop ways to specifically target PTHrP signaling may lead to more effective therapies for prostate cancer.

  19. A nomogram based on age,prostate-specific antigen level,prostate volume and digital rectal examination for predicting risk of prostate cancer

    Institute of Scientific and Technical Information of China (English)

    Ping Tang; Hui Chen; Matthew Uhlman; Yu-Rong Lin; Xiang-Rong Deng; Bin Wang; Wen-Jun Yang; Ke-Ji Xie

    2013-01-01

    Nomograms for predicting the risk of prostate cancer developed using other populations may introduce sizable bias when applied to a Chinese cohort.In the present study,we sought to develop a nomogram for predicting the probability of a positive initial prostate biopsy in a Chinese population.A total of 535 Chinese men who underwent a prostatic biopsy for the detection of prostate cancer in the past decade with complete biopsy data were included.Stepwise logistic regression was used to determine the independent predictors of a positive initial biopsy.Age,prostate-specific antigen (PSA),prostate volume (PV),digital rectal examination (DRE) status,% free PSA and transrectal ultrasound (TRUS) findings were included in the analysis.A nomogram model was developed that was based on these independent predictors to calculate the probability of a positive initial prostate biopsy.A receiver-operating characteristic curve was used to assess the accuracy of using the nomogram and PSA levels alone for predicting positive prostate biopsy.The rate for positive initial prostate biopsy was 41.7% (223/535).The independent variables used to predict a positive initial prostate biopsy were age,PSA,PV and DRE status.The areas under the receiver-operating characteristic curve for a positive initial prostate biopsy for PSA alone and the nomogram were 79.7% and 84.8%,respectively.Our results indicate that the risk of a positive initial prostate biopsy can be predicted to a satisfactory level in a Chinese population using our nomogram.The nomogram can be used to identify and Counsel patients who should consider a prostate biopsy,ultimately enhancing accuracy in diagnosing prostate cancer.

  20. Biopsy - biliary tract

    Science.gov (United States)

    Cytology analysis - biliary tract; Biliary tract biopsy ... A sample for a biliary tract biopsy can be obtained in different ways. A needle biopsy can be done if you have a well-defined tumor. The biopsy site ...

  1. Nasal mucosal biopsy

    Science.gov (United States)

    Biopsy - nasal mucosa; Nose biopsy ... to fast for a few hours before the biopsy. ... Nasal mucosal biopsy is usually done when abnormal tissue is seen during examination of the nose. It may also be done ...

  2. IL-8 secretion in primary cultures of prostate cells is associated with prostate cancer aggressiveness

    Directory of Open Access Journals (Sweden)

    Neveu B

    2014-05-01

    Full Text Available Bertrand Neveu*, Xavier Moreel*, Marie-Pier Deschênes-Rompré, Alain Bergeron, Hélène LaRue, Cherifa Ayari, Yves Fradet, Vincent FradetDepartment of Surgery, Laval University Cancer Research Centre, CHU de Quebec Research Centre, Quebec, QC, Canada *These authors contributed equally to this workBackground: Chronic inflammation is believed to be a major factor in prostate cancer initiation and promotion and has been studied using prostate cancer cells and immortalized cell lines. However, little is known about the contribution of normal cells to the prostatic microenvironment and inflammation. We aim to study the contribution of normal prostate epithelial cells to prostate inflammation and to link the inflammatory status of normal cells to prostate cancer aggressiveness.Materials and methods: Short-term primary cell cultures of normal epithelial prostate cells were derived from prostate biopsies from 25 men undergoing radical prostatectomy, cystoprostatectomy, or organ donation. Cells were treated with polyinosinic:polycytidylic acid, a mimic of double-stranded viral RNA and a potent inducer of the inflammatory response. Secretion of interleukin (IL-8 in the cell culture medium by untreated and treated cells was measured and we determined the association between IL-8 levels in these primary cell cultures and prostate cancer characteristics. The Fligner–Policello test was used to compare the groups.Results: Baseline and induced IL-8 secretion were highly variable between cultured cells from different patients. This variation was not related to drug use, past medical history, age, or preoperative prostate-specific antigen value. Nonetheless, an elevated secretion of IL-8 from normal cultured epithelial cells was associated with prostate cancer aggressiveness (P=0.0005.Conclusion: The baseline secretion of IL-8 from normal prostate epithelial cells in culture is strongly correlated with cancer aggressiveness and may drive prostate cancer

  3. Mitochondrial DNA haplotyping revealed the presence of mixed up benign and neoplastic tissue sections from two individuals on the same prostatic biopsy slide.

    Science.gov (United States)

    Alonso, A; Alves, C; Suárez-Mier, M P; Albarrán, C; Pereira, L; Fernández de Simón, L; Martín, P; García, O; Gusmão, L; Sancho, M; Amorim, A

    2005-01-01

    DNA typing was requested to investigate a presumptive cancer diagnosis error by confirming whether benign and cancerous prostatic tissue in the same presurgical haematoxylin and eosin stained slide belonged to the same person. After independent histological re-examination of the slide by a pathologist, manual slide dissection was used to guarantee independent and high recovery DNA isolation from each tissue section, avoiding carryover and background contamination. Nuclear DNA quantification performed by real time polymerase chain reaction (PCR) revealed the absence of human DNA for short tandem repeat (STR) typing. Mitochondrial DNA was only obtained by performing PCR of very short fragments ( approximately 100 bp), indicating high DNA degradation. Different low frequency hypervariable region I haplotypes were obtained from each tissue section (normal tissue section haplotype: 16224C, 16234T, 16311C, 16356C; cancer tissue section haplotype: 16256T, 16270T, 16293G). Only the normal tissue section haplotype matched that obtained from the patient's blood sample, indicating that the cancer tissue section originated from an unknown patient. These results supported the hypothesis of sample mix up during block processing or slide preparation by a carryover mechanism. Mitochondrial genetic typing is recommended to exclude the possibility of carryover artefacts when low DNA content and high degradation compromise conventional STR typing.

  4. Biopsy needle detection in transrectal ultrasound.

    Science.gov (United States)

    Ayvaci, Alper; Yan, Pingkun; Xu, Sheng; Soatto, Stefano; Kruecker, Jochen

    2011-01-01

    Using the fusion of pre-operative MRI and real time intra-procedural transrectal ultrasound (TRUS) to guide prostate biopsy has been shown as a very promising approach to yield better clinical outcome than the routinely performed TRUS only guided biopsy. In several situations of the MRI/TRUS fusion guided biopsy, it is important to know the exact location of the deployed biopsy needle, which is imaged in the TRUS video. In this paper, we present a method to automatically detect and segment the biopsy needle in TRUS. To achieve this goal, we propose to combine information from multiple resources, including ultrasound probe stability, TRUS video background model, and the prior knowledge of needle orientation and position. The proposed algorithm was tested on TRUS video sequences which have in total more than 25,000 frames. The needle deployments were successfully detected and segmented in the sequences with high accuracy and low false-positive detection rate.

  5. The value and limitations of contrast-enhanced transrectal ultrasonography for the detection of prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Han-Xue, E-mail: zhaohx861@163.com [Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, Dong-Jiao-Min-Xiang, Dong Cheng District, Beijing 100730 (China); Xia, Chun-Xia, E-mail: star9901482@163.com [Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, Dong-Jiao-Min-Xiang, Dong Cheng District, Beijing 100730 (China); Yin, Hong-Xia, E-mail: hongxia_yin79@yahoo.com.cn [Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Dong-Jiao-Min-Xiang, Dong Cheng District, Beijing 100730 (China); Guo, Ning, E-mail: ningguo99@sina.com.cn [Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, Dong-Jiao-Min-Xiang, Dong Cheng District, Beijing 100730 (China); Zhu, Qiang, E-mail: qzhutrhos@gmail.com [Department of Diagnostic Ultrasound, Beijing Tongren Hospital, Capital Medical University, Dong-Jiao-Min-Xiang, Dong Cheng District, Beijing 100730 (China)

    2013-11-01

    Objectives: To evaluate the role of contrast-enhanced transrectal ultrasonography (CE-TRUS) for detecting prostate carcinoma. Methods: Sixty-five patients with elevated serum prostate-specific antigen (PSA) and/or abnormal digital rectal examination (DRE) were assessed using transrectal ultrasound (TRUS) and CE-TRUS. In all the patients, CE-TRUS was performed with intravenous injection of contrast agent (SonoVue, 2.4 ml) before biopsy. The cancer detection rates of the two techniques were compared. False-positive and false-negative findings related to CE-TRUS were analyzed in comparison to the pathological results of biopsy or radical prostatectomy. The targeted biopsy to abnormal CE-TRUS areas was also compared to systematic biopsy. Results: Prostate cancer was detected in 29 of the 65 patients. CE-TRUS showed rapid focal enhancement or asymmetric vessels of peripheral zones in 28 patients; 23 of them had prostate cancer. CE-TRUS had 79.3% sensitivity, compared to 65.5% of TRUS (P < 0.05). There were five false-positive and six false-negative findings from CE-TRUS. Benign prostate hyperplasia, and acute and chronic prostatitis were important causes related to the false-positive results of CE-TRUS. Prostate cancer originating from the transition zone or peripheral zone with lower PSA levels, small-size foci, and moderately or well-differentiated tumor was missed by CE-TRUS. The cancer detection rate of targeted biopsy (75%, 33/44 cores) was significantly higher than one of systematic biopsy (48.2%, 162/336) in those 28 cases (P < 0.05). In addition, no significant correlation was found between the cancer detection rate with CE-TRUS and serum PSA levels. Conclusion: CE-TRUS may improve the detection rate of prostate cancer through targeted biopsy of contrast-enhanced abnormalities. Our findings indicate that systematic biopsies should not be eliminated on the basis of false-positive and false-negative findings related to CE-TRUS.

  6. Quantitative real-time RT-PCR of CD24 mRNA in the detection of prostate cancer

    Directory of Open Access Journals (Sweden)

    Christoph F

    2006-03-01

    Full Text Available Abstract Background Gene expression profiling has recently shown that the mRNA for CD24 is overexpressed in prostate carcinomas (Pca compared to benign or normal prostate epithelial tissues. Immunohistochemical studies have reported the usefulness of anti-CD24 for detecting prostate cancer over the full range of prostate specimens encountered in surgical pathology, e.g. needle biopsies, transurethral resection of prostate chips, or prostatectomies. It is a small mucin-like cell surface protein and thus promises to become at least a standard adjunctive stain for atypical prostate biopsies. We tested the usefulness of real-time RT-PCR for specific and sensitive detection of CD24 transcripts as a supplementary measure for discriminating between malignant and benign lesions in prostatic tissues. Methods Total RNA was isolated from snap-frozen chips in 55 cases of benign prostatic hyperplasia (BPH and from frozen sections in 59 prostatectomy cases. The latter contain at least 50% malignant epithelia. Relative quantification of CD24 transcripts was performed on the LightCycler instrument using hybridization probes for detection and porphobilinogen deaminase transcripts (PBGD for normalization. Results Normalized CD24 transcript levels showed an average 2.69-fold increase in 59 Pca-cases (mean 0.21 when compared to 55 cases of BPH (mean 0.08. This difference was highly significant (p Conclusion The present study demonstrates the feasibility of quantitative CD24 RNA transcript detection in prostatic tissues even without previous laser microdissection.

  7. 经直肠前列腺穿刺活检术并发感染性休克和MODS的临床研究%Clinical Analysis of Septic shock and MODS following transrectal ultrasound-guided prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    唐普贤; 王建业; 刘明; 何清; 冯喆; 韦军民

    2012-01-01

    Objective To investigate the diagnosis and treatment of septic shock and multiple organ dysfunction syndrome (MODS) following transrectal ultrasound-guided prostate biopsy (TRUSPB). Methods We reported two cases,45 and 46 years old,of septic shock and MODS after TRUSPB from June 1996 to May 2011.10 cases like these two cases in literatures were acquired (3 cases in Chinese and 7 cases in English) from 1991 to 2011,and the causes of severe infections following transrectal prostate biopsy and its prophylactic procedures were discussed as well. Results The two cases,suffered postoperative septic shock and MODS 16 -40 h after being smoothly performed TRUSPB.One patient died four days after surgery and the other improved after five days antibiotic treatment.All the 12 cases had abrupt onsets and deteriorated rapidly,2 cases died and 1 case was performed amputation due to double lower limb gangrene,resulted in high mortality and morbidity.There are many risk factors,such as repeated puncture (4/12),diabetes (3/12),chronic infections (3/12) and used immune suppression (1/12),et al; blood culture was positive in 9 case and E.coli bacteria was the main bacteria(8/9),besides,half of them were multi-drug resistant (4/8) and other 2 cases were ESBLs ( + ) or 1 case was quinolone-resistant repectively.9 cases recovered after actively controlled infection using carbapenem and other treatment. Conclusions Transrectal ultrasound-guided prostate biopsy could cause serious complications such as septic shock,to which more attentions should be paid.Preoperative use of carbapenem should be recommended for patients with repeating biopsy or other risk factors.%目的 探讨B超引导下经直肠前列腺穿刺活检术(TRUSPB)并发感染性休克和多器官功能不全综合征(MODS)的诊断与治疗. 方法 1996年6月至2011年5月行TRUSPB并发感染性休克和MODS的患者2例,年龄分别为45、46岁,回顾2例患者的诊治经过,结合1991-2011年文献报道10

  8. Prospective Randomized Phase 2 Trial of Intensity Modulated Radiation Therapy With or Without Oncolytic Adenovirus-Mediated Cytotoxic Gene Therapy in Intermediate-Risk Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Freytag, Svend O., E-mail: sfreyta1@hfhs.org [Department of Radiation Oncology, Henry Ford Health System, Detroit, Michigan (United States); Stricker, Hans [Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan (United States); Lu, Mei [Public Health Sciences, Henry Ford Health System, Detroit, Michigan (United States); Elshaikh, Mohamed; Aref, Ibrahim; Pradhan, Deepak; Levin, Kenneth; Kim, Jae Ho [Department of Radiation Oncology, Henry Ford Health System, Detroit, Michigan (United States); Peabody, James [Vattikuti Urology Institute, Henry Ford Health System, Detroit, Michigan (United States); Siddiqui, Farzan; Barton, Kenneth; Pegg, Jan; Zhang, Yingshu; Cheng, Jingfang [Department of Radiation Oncology, Henry Ford Health System, Detroit, Michigan (United States); Oja-Tebbe, Nancy; Bourgeois, Renee [Public Health Sciences, Henry Ford Health System, Detroit, Michigan (United States); Gupta, Nilesh; Lane, Zhaoli [Pathology, Henry Ford Health System, Detroit, Michigan (United States); Rodriguez, Ron [Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); DeWeese, Theodore [Department of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); and others

    2014-06-01

    Purpose: To assess the safety and efficacy of combining oncolytic adenovirus-mediated cytotoxic gene therapy (OAMCGT) with intensity modulated radiation therapy (IMRT) in intermediate-risk prostate cancer. Methods and Materials: Forty-four men with intermediate-risk prostate cancer were randomly assigned to receive either OAMCGT plus IMRT (arm 1; n=21) or IMRT only (arm 2; n=23). The primary phase 2 endpoint was acute (≤90 days) toxicity. Secondary endpoints included quality of life (QOL), prostate biopsy (12-core) positivity at 2 years, freedom from biochemical/clinical failure (FFF), freedom from metastases, and survival. Results: Men in arm 1 exhibited a greater incidence of low-grade influenza-like symptoms, transaminitis, neutropenia, and thrombocytopenia than men in arm 2. There were no significant differences in gastrointestinal or genitourinary events or QOL between the 2 arms. Two-year prostate biopsies were obtained from 37 men (84%). Thirty-three percent of men in arm 1 were biopsy-positive versus 58% in arm 2, representing a 42% relative reduction in biopsy positivity in the investigational arm (P=.13). There was a 60% relative reduction in biopsy positivity in the investigational arm in men with <50% positive biopsy cores at baseline (P=.07). To date, 1 patient in each arm exhibited biochemical failure (arm 1, 4.8%; arm 2, 4.3%). No patient developed hormone-refractory or metastatic disease, and none has died from prostate cancer. Conclusions: Combining OAMCGT with IMRT does not exacerbate the most common side effects of prostate radiation therapy and suggests a clinically meaningful reduction in positive biopsy results at 2 years in men with intermediate-risk prostate cancer.

  9. Blood biomarker levels to aid discovery of cancer-related single-nucleotide polymorphisms: kallikreins and prostate cancer.

    Science.gov (United States)

    Klein, Robert J; Halldén, Christer; Cronin, Angel M; Ploner, Alexander; Wiklund, Fredrik; Bjartell, Anders S; Stattin, Pär; Xu, Jianfeng; Scardino, Peter T; Offit, Kenneth; Vickers, Andrew J; Grönberg, Henrik; Lilja, Hans

    2010-05-01

    Polymorphisms associated with prostate cancer include those in three genes encoding major secretory products of the prostate: KLK2 (encoding kallikrein-related peptidase 2; hK2), KLK3 (encoding prostate-specific antigen; PSA), and MSMB (encoding beta-microseminoprotein). PSA and hK2, members of the kallikrein family, are elevated in sera of men with prostate cancer. In a comprehensive analysis that included sequencing of all coding, flanking, and 2 kb of putative promoter regions of all 15 kallikrein (KLK) genes spanning approximately 280 kb on chromosome 19q, we identified novel single-nucleotide polymorphisms (SNP) and genotyped 104 SNPs in 1,419 cancer cases and 736 controls in Cancer Prostate in Sweden 1, with independent replication in 1,267 cases and 901 controls in Cancer Prostate in Sweden 2. This verified prior associations of SNPs in KLK2 and in MSMB (but not in KLK3) with prostate cancer. Twelve SNPs in KLK2 and KLK3 were associated with levels of PSA forms or hK2 in plasma of control subjects. Based on our comprehensive approach, this is likely to represent all common KLK variants associated with these phenotypes. A T allele at rs198977 in KLK2 was associated with increased cancer risk and a striking decrease of hK2 levels in blood. We also found a strong interaction between rs198977 genotype and hK2 levels in blood in predicting cancer risk. Based on this strong association, we developed a model for predicting prostate cancer risk from standard biomarkers, rs198977 genotype, and rs198977 x hK2 interaction; this model had greater accuracy than did biomarkers alone (area under the receiver operating characteristic curve, 0.874 versus 0.866), providing proof in principle to clinical application for our findings.

  10. The neuroendocrine-derived peptide parathyroid hormone-related protein promotes prostate cancer cell growth by stabilizing the androgen receptor.

    Science.gov (United States)

    DaSilva, John; Gioeli, Daniel; Weber, Michael J; Parsons, Sarah J

    2009-09-15

    During progression to an androgen-independent state following androgen ablation therapy, prostate cancer cells continue to express the androgen receptor (AR) and androgen-regulated genes, indicating that AR is critical for the proliferation of hormone-refractory prostate cancer cells. Multiple mechanisms have been proposed for the development of AR-dependent hormone-refractory disease, including changes in expression of AR coregulatory proteins, AR mutation, growth factor-mediated activation of AR, and AR protein up-regulation. The most prominent of these progressive changes is the up-regulation of AR that occurs in >90% of prostate cancers. A common feature of the most aggressive hormone-refractory prostate cancers is the accumulation of cells with neuroendocrine characteristics that produce paracrine factors and may provide a novel mechanism for the regulation of AR during advanced stages of the disease. In this study, we show that neuroendocrine-derived parathyroid hormone-related protein (PTHrP)-mediated signaling through the epidermal growth factor receptor (EGFR) and Src pathways contributes to the phenotype of advanced prostate cancer by reducing AR protein turnover. PTHrP-induced accumulation of AR depended on the activity of Src and EGFR and consequent phosphorylation of the AR on Tyr(534). PTHrP-induced tyrosine phosphorylation of AR resulted in reduced AR ubiquitination and interaction with the ubiquitin ligase COOH terminus of Hsp70-interacting protein. These events result in increased accumulation of AR and thus enhanced growth of prostate cancer cells at low levels of androgen.

  11. MRI of the prostate: potential role of robots

    NARCIS (Netherlands)

    Fütterer, Jurgen J.; Misra, Sarthak; Macura, Katarzyna J.

    2010-01-01

    Prostate cancer is the most frequently diagnosed malignancy in the male population. Transrectal ultrasound- guided biopsy is still the imaging modality of choice in detecting prostate cancer. However, with prostate cancer being detected at an earlier stage, most prostate cancers tend to be isoechoic

  12. Algorithms, nomograms and the detection of indolent prostate cancer

    NARCIS (Netherlands)

    M.J. Roobol-Bouts (Monique)

    2008-01-01

    textabstractPurpose: Prostate cancer is the most commonly diagnosed cancer in men. However, only about 12% of the men diagnosed with prostate cancer will die of their disease. Result: The serum PSA test can detect prostate cancers early, but using a PSA based cut-off indication for prostate biopsy r

  13. Impact of Individual Risk Assessment on Prostate Cancer Diagnosis

    NARCIS (Netherlands)

    H.A. van Vugt (Heidi)

    2012-01-01

    textabstractCurrent prostate-specific antigen screening practice leads to two important unwanted side effects; first of all screening induces many unnecessary prostate biopsies and secondly it leads to overdiagnosis and overtreatment of prostate cancer. The large amount of unnecessary prostate biops

  14. Health-related Quality of Life in Vacuum-Assisted Breast Biopsy: short-term effects, long-term effects and predictors

    Directory of Open Access Journals (Sweden)

    Zografos George C

    2010-01-01

    Full Text Available Abstract Background The impact of Vacuum-assisted breast biopsy (VABB, 11-Gauge upon Health-related Quality of Life (HRQoL remains an open field. This study aims to: i assess short-term (4 days after VABB responses in terms of HRQoL after VABB, ii evaluate long-term (18 months after VABB responses, if any, and iii examine whether these responses are modified by a variety of possible predictors (anthropometric, sociodemographic, lifestyle habits, breast-related parameters, reproductive history, VABB-related features and complications, seasonality. Methods This study included 102 eligible patients undergoing VABB and having benign lesions. A variable number of cores (24-96 cores has been excised. HRQoL was assessed by EQ-5D and SF-36® questionnaires: i in the morning of the VABB procedure day (baseline measurement, ii four days after VABB (early post-biopsy measurement and iii 18 months after VABB (late post-biopsy measurement. Statistical analysis comprised two steps: i. evaluation of differences in EQ-5D/SF-36 dimensions and calculated scores (baseline versus early post-biopsy measurement and baseline versus late post-biopsy measurement and ii. assessment of predictors through multivariate linear, logistic, ordinal logistic regression, as appropriate. Results At baseline patients presented with considerable anxiety (EQ-5D anxiety/depression dimension, EQ-5D TTO/VAS indices, SF-36 Mental Health dimension. At the early post-biopsy measurement women exhibited deterioration in Usual Activities (EQ-5D and Role Functioning-Physical dimensions. At the late measurement women exhibited pain (EQ-5D pain/discomfort and SF-36 Bodily Pain, deterioration in Physical Functioning (SF-36 PF and overall SF-36 Physical Component Scale (PCS. Mastalgia, older age and lower income emerged as significant predictors for baseline anxiety, whereas seasonality modified early activities-related responses. Pain seemed idiosyncratic. Conclusions The HRQoL profile of

  15. Parotid gland biopsy compared with labial biopsy in the diagnosis of patients with primary Sjogren's syndrome

    NARCIS (Netherlands)

    Pijpe, J.; Kalk, W. W. I.; van der Wal, J. E.; Vissink, A.; Kluin, Ph. M.; Roodenburg, J. L. N.; Bootsma, H.; Kallenberg, C. G. M.; Spijkervet, F. K. L.

    2007-01-01

    Objective. To assess the value of the parotid biopsy as a diagnostic tool for primary Sjogren's syndrome ( pSS), and to compare the parotid biopsy and the labial biopsy with regard to diagnostic value and biopsy-related morbidity. Methods. In 15 consecutive patients with pSS and 20 controls, the par

  16. Utility of color Doppler transrectal ultrasound in the diagnosis of prostate cancer: a study of 101 cases; Utilidad de la ecografia transrectal con Doppler color en el diagnostico del cancer de prostata. Estudio de 101 casos

    Energy Technology Data Exchange (ETDEWEB)

    Morales, F. J.; Jornet, J.; Cervera, J.; Labrador, T. [Instituto Valenciano de Oncologia. Valencia (Spain)

    2001-07-01

    To determine the value of color Doppler ultrasound in the detection of prostate cancer. To relate asymmetries in vascularisation with the results of directed biopsy. Between May and November 2000, we studied 101 patients suspected of having prostate cancer. The selection criteria were a prostate-specific antigen level of over 3 ng/ml, suspicious digital rectal examination or both. The volume, capsule and internal architecture were assessed, focusing on nodules, suspicious hypoechoic areas and asymmetric color intensity. Sextant biopsies were carried out with an 18-gauge needle and samples were also taken of the areas of increased color intensity. (Author) 16 refs.

  17. Contemporary issues in the diagnosis of prostate cancer for the radiologist

    Energy Technology Data Exchange (ETDEWEB)

    Clements, Richard [Royal Gwent Hospital, Department of Radiology, Newport, Gwent (United Kingdom)

    2006-07-15

    Prostate cancer diagnostic techniques have improved considerably in recent years, but they must yet be optimised to ensure cancer detection at a potentially curable stage. Arrangements for prostate biopsy vary throughout Europe, and prostate biopsy may be undertaken by urologists or radiologists. This review discusses current issues relevant for radiologists involved in the detection of early prostate cancer. Prostate biopsy should be based on a systematic approach involving 8-12 cores obtained with peri-prostatic infiltration of local anaesthetic. Quality issues being considered by the United Kingdom Prostate Cancer Risk Management Programme are discussed. (orig.)

  18. Prostatitis - bacterial

    Science.gov (United States)

    ... infection in or around the testicles ( epididymitis or orchitis ), you may also have symptoms of that condition. ... In: Wein AJ, ed. Prostatitis and related conditions, orchitis, and epididymitis. Campbell-Walsh Urology . 10th ed. Philadelphia, ...

  19. Magnetic resonance imaging and morphometric histologic analysis of prostate tissue composition in predicting the clinical outcome of terazosin therapy in benign prostatic hyperplasia

    Energy Technology Data Exchange (ETDEWEB)

    Isen, K. [Karaelmas Univ., Zonguldak (Turkey). School of Medicine; Sinik, Z.; Alkibay, T.; Sezer, C.; Soezen, S.; Atilla, S.; Ataoglu, O.; Isik, S.

    2001-02-01

    The purpose of this study was to determine whether magnetic resonance imaging (MRI) or quantitative color-imaged morphometric analysis (MA) of the prostate gland are related to the clinical response to terazosin. Thirty-six male patients with symptomatic benign prostatic hyperplasia (BPH) with a serum prostate-specific antigen level of 4-10 ng/mL underwent MRI with body coil, transrectal prostate unltrasonography and biopsy prior to terazosin therapy. For MRI-determined stromal and non-stromal BPH, the ratio of the signal intensity of the inner gland to the obturator internus muscle was evaluated. Histologic sections were stained with hematoxylin and eosin. The MA of the specimens was performed by Samba 2000. Results of the two techniques were interpreted according to the terazosin therapy results. The mean stromal percentage was 60.5{+-}18.0%. No statistically significant relationship was found between the clinical outcome of terazosin and the MRI findings. The MA results showed a significant relationship between the percentage of stroma and the percent change of the peak urinary flow rate, but not with the percent change of the international prostate symptom score after terazosin therapy (P<0.05). Magnetic resonance imaging alone is not sufficient in predicting the response to terazosin therapy. Morphometric analysis of BPH tissue composition can be used in predicting the clinical outcome of terazosin therapy but it is suitable only in patients for whom prostatic biopsy is necessary in order to rule out prostate cancer. (author)

  20. Clinical significance of serum high sensitive C-reactive protein in patients undergone prostate biopsy%前列腺穿刺活检患者中血清高敏C反应蛋白测定的临床意义

    Institute of Scientific and Technical Information of China (English)

    莫晓东; 蔡晓峰; 李纲; 张学锋; 唐敬; 浦金贤; 侯建全

    2014-01-01

    Objective To assess the clinical significance of serum high sensitive C-reactive protein (hs-CRP) in patients undergone prostate biopsy.Methods A total of 273 consecutive patients were enrolled,aged 44-95 years (mean,69 years).All the patients underwent prostate biopsy.The pathological findings showed 96 cases with prostate cancer (PCa) and 177 cases with benign prostate hyperplasia (BPH).The difference of hs-CRP level between patients with PCa and those with BPH was analyzed.The positive prostate biopsy rate was compared between the patients with high hs-CRP level and those with normal hs-CRP level.Logistic regression was used to evaluate the effect of factors such as hs-CRP,tPSA,PSA density,prostate volume and age on prostate biopsy.Results The medians (interquartile range) of hs-CRP were 3.22 mg/L (1.22-9.84 mg/L) in patients with PCa and 1.24 mg/L (0.55-2.76 mg/L) in those with BPH,respectively,with significant difference(P<0.05).The positive prostate biopsy rate in patients with high hs-CRP (> 3 mg/L)was 55% (51/92),higher than that in those with normal hs-CRP (≤ 3 mg/L).The odds ratio of hs-CRP was larger than that of all other factors analyzed including tPSA,prostate volume and age according to the Logistic regression analysis.Conclusions Elevated serum hs-CRP level is associated with increased positive prostate biopsy.Serum hs-CRP acts as an independent factor increasing the positive prostate biopsy rate in patients undergone prostate biopsy.%目的 探讨血清高敏C反应蛋白(hs-CRP)在前列腺穿刺活检患者中的临床意义.方法 测定273例经直肠前列腺穿刺活检患者的hs-CRP水平.年龄44~ 95岁,平均69岁.病理诊断为前列腺癌(PCa) 96例,良性前列腺增生(BPH) 177例.比较PCa和BPH患者hs-CRP的差异,以及hs-CRP增高和正常者的前列腺穿刺阳性率.采用Logistic回归法分析hs-CRP、总PSA(tPSA)、PSA密度(PSAD)、前列腺总体积(TPV)和年龄等因素对前列腺穿刺阳性率的影响.

  1. Update on prostate brachytherapy: long-term outcomes and treatment-related morbidity.

    Science.gov (United States)

    Kao, Johnny; Cesaretti, Jamie A; Stone, Nelson N; Stock, Richard G

    2011-06-01

    Current research in prostate brachytherapy focuses on five key concepts covered in this review. Transrectal ultrasound-guided prostate brachytherapy assisted by intraoperative treatment planning is the most advanced form of image-guided radiation delivery. Prostate brachytherapy alone for low-risk prostate cancer achieves lower prostate-specific antigen (PSA) nadirs than intensity-modulated radiotherapy (IMRT) or protons while maintaining durable biochemical control in about 90% of patients without late failures seen in surgically treated patients. As an organ-conserving treatment option, seed implant results in a lower rate of erectile dysfunction and urinary incontinence than surgery that has been validated in several recent prospective studies. Combined IMRT and seed implant has emerged as a rational and highly effective approach to radiation-dose escalation for intermediate- and high-risk prostate cancer. Preliminary results suggest that seed implantation may play a role in improving outcomes for historically poor-prognosis locally advanced and recurrent prostate cancers.

  2. To treat or not to treat with testosterone replacement therapy: a contemporary review of management of late-onset hypogonadism and critical issues related to prostate cancer.

    Science.gov (United States)

    Kava, Bruce R

    2014-07-01

    Over the last 10 years there has been a dramatic increase in the number of patients identified and treated with testosterone replacement therapy (TRT) for late-onset hypogonadism (LOH). By virtue of age, race, and family history, many of these patients are concurrently at risk for harboring indolent prostate cancer. Other men are at increased risk for prostate cancer as a result of an elevated serum PSA level or having had a prior prostate biopsy showing prostatic intraepithelial neoplasia (PIN) or atypical small acinar proliferation (ASAP). The clinician is often challenged with the decision whether to initiate TRT in these patients. This review presents a contemporary overview of the rationale for TRT, as well as the relationship between testosterone (endogenous and exogenous) and premalignant and malignant lesions of the prostate. We will discuss preliminary data from several recent series demonstrating that TRT may be safely administered in select patients with certain premalignant and bona fide malignant tumors of the prostate. In the absence of a large randomized clinical trial with long-term outcome data evaluating TRT, we hope that this overview will provide clinicians with an evidence-based approach to managing these anxiety-provoking - and often frustrating - clinical scenarios.

  3. Bone biopsy (image)

    Science.gov (United States)

    A bone biopsy is performed by making a small incision into the skin. A biopsy needle retrieves a sample of bone and it ... examination. The most common reasons for bone lesion biopsy are to distinguish between benign and malignant bone ...

  4. Muscle biopsy (image)

    Science.gov (United States)

    A muscle biopsy involves removal of a plug of tissue usually by a needle to be later used for examination. Sometimes ... there is a patchy condition expected an open biopsy may be used. Open biopsy involves a small ...

  5. Skin lesion biopsy

    Science.gov (United States)

    ... procedure will leave a small indented area. This type of biopsy is often done when a skin cancer is ... may have stitches to close the area. This type of biopsy is often done to diagnose rashes . EXCISIONAL BIOPSY ...

  6. Bone lesion biopsy

    Science.gov (United States)

    Bone biopsy; Biopsy - bone ... needle is gently pushed and twisted into the bone. Once the sample is obtained, the needle is ... sample is sent to a lab for examination. Bone biopsy may also be done under general anesthesia ...

  7. Clinical Analysis of 29 Cases with Primary Malignant Lymphoma of the Prostate

    Institute of Scientific and Technical Information of China (English)

    Tong Fang

    2007-01-01

    OBJECTIVE To summarize the clinical characteristics, pathology, treatment and prognosis of malignant lymphoma of the prostate. METHODS Clinical data from 29 patients with primary malignant lymphoma of the prostate were reviewed retrospectively. The median age was 66 years. Clinical signs and symptoms were due to lower urinary tract obstruction resulting from a diffusely enlarged prostate. Prostate biopsies revealed diffuse large B-cell non-Hodgkin's lymphoma. The therapeutic modalities included prostatectomy, radiotherapy and chemotherapy. RESULTS Extraprostatic involvement at various sites became evident in 19 of the 29 patients after diagnosis. Ten patients died from lymphoma with a median survival of 23 months (range, 2-30 months). Seven patients were alive up to 60 months.CONCLUSION Malignant lymphoma involving the prostate was rare and has a rather poor prognosis. Prognosis related to the patient age, histologic type, and treatment or clinical stage of the disease at presentation.

  8. About the Prostate

    Science.gov (United States)

    ... develops from the transition zone that surrounds the urethra, or urinary tube. This is why BPH may cause more difficulty with urination than prostate cancer typically does. Treatment-Related Changes Because the prostate ...

  9. Diagnosis and treatment for prostate cancer

    Institute of Scientific and Technical Information of China (English)

    Zuoxing Niu; Guohua Ren; Shuping Song

    2008-01-01

    The morbility of prostate cancer has risen in China in recent years, it is important to diagnose and treat prostate cancer standardly and systemically.This review analyzed the status and advances of PSA examination, digital rectal examination, prostate biopsy in prostate cancer, and it gave a detailed description of radical prostatectomy, radiotherapy, chemotherapy, hormonal therapy, etc.The advances of targeted therapy and tumor vaccine is also discussed.

  10. Prostate-specific Antigen (PSA Density and Free to Total PSA Ratio in Diagnosing Prostate Cancer with Prostate-Specific Anti¬gen Levels of 4.0 ng/ml or Less

    Directory of Open Access Journals (Sweden)

    Xin LIU

    2015-11-01

    Full Text Available Background: We aimed to value the usefulness of free to total prostate-specific antigen and Prostate-specific antigen (PSA density for prostate cancer in the patients with PSA levels of 4.0 ng/ml or less.Methods: A total of 343 subjects with PSA levels of 4.0 ng/ml or less were biopsied. All patients were divided into four groups according to the PSA levels: 0 to 1.0 ng/ml, 1.1 to 2.0 ng/ml, 2.1 to 3.0 ng/ml, and 3.1 to 4.0 ng/ml. The reliability of cancer detection in relation to the f/t PSA ratio and PSAD were estimated.Results: Overall, 65 people were diagnosed with prostate cancer. The detection rate was 16.28%、17.17%, 21.82%, 25.00% in subjects with PSA levels of 0 to 1.0 ng/ml, 1.1 to 2.0 ng/ml, 2.1 to 3.0 ng/ml, and 3.1 to 4.0 ng/ml, respectively. The f/t PSA ratio was significantly lower in patients with prostate cancer and PSA levels of 2.1 to 4.0 ng/ml (P<0.05. The PSAD had no statistical significance between the two groups.Conclusions: Routine prostate biopsy should be undertaken if the f/t PSA ratio less than 15% with /without abnormal DRE/TRUS findings. Keywords: Biopsy, Prostate cancer, Prostate-specific antigen, PSA ratio, PSAD 

  11. Casodex treatment induces hypoxia-related gene expression in the LNCaP prostate cancer progression model

    Directory of Open Access Journals (Sweden)

    Gopalakrishnan Velliyur K

    2005-03-01

    Full Text Available Abstract Background The changes in gene expression profile as prostate cancer progresses from an androgen-dependent disease to an androgen-independent disease are still largely unknown. Methods We examined the gene expression profile in the LNCaP prostate cancer progression model during chronic treatment with Casodex using cDNA microarrays consisting of 2305 randomly chosen genes. Results Our studies revealed a representative collection of genes whose expression was differentially regulated in LNCaP cells upon treatment with Casodex. A set of 15 genes were shown to be highly expressed in Casodex-treated LNCaP cells compared to the reference sample. This set of highly expressed genes represents a signature collection unique to prostate cancer since their expression was significantly greater than that of the collective pool of ten cancer cell lines of the reference sample. The highly expressed signature collection included the hypoxia-related genes membrane metallo-endopeptidase (MME, cyclin G2, and Bcl2/adenovirus E1B 19 kDa (BNIP3. Given the roles of these genes in angiogenesis, cell cycle regulation, and apoptosis, we further analyzed their expression and concluded that these genes may be involved in the molecular changes that lead to androgen-independence in prostate cancer. Conclusion Our data indicate that one of the mechanisms of Casodex action in prostate cancer cells is induction of hypoxic gene expression.

  12. Heterogeneous methodology of racial/ethnic classification may be responsible for the different risk assessments for prostate cancer between Black and White men in Brazil

    Directory of Open Access Journals (Sweden)

    Frederico R. Romero

    2015-04-01

    Full Text Available Objectives To evaluate if the different results of prostate cancer risk between black and white Brazilian men may be associated with the varying methodology used to define participants as either Blacks or Whites. Patients and Methods We evaluated median PSA values, rate of PSA level ≥4.0 ng/mL, indications for prostate biopsy, prostate cancer detection rate, biopsy/cancer rate, cancer/biopsy rate, and the relative risk of cancer between blacks versus whites, blacks versus non-blacks (browns and whites, non-whites (browns and blacks versus whites, African versus non-African descendants, and African descendants or blacks versus non-African descendants and non-blacks. Results From 1544 participants, there were 51.4% whites, 37.2% browns, 11.4% blacks, and 5.4% African descendants. Median PSA level was 0.9 ng/mL in whites, browns, and non-African descendants, compared to 1.2 ng/mL in blacks, and African descendants or blacks, and 1.3 ng/mL in African descendants. Indications for prostate biopsy were present in 16.9% for African descendants, 15.9% of black, 12.3% of white, 11.4% for non-African descendants, and 9.9% of brown participants. Prostate cancer was diagnosed in 30.3% of performed biopsies: 6.2% of African descendants, 5.1% of blacks, 3.3% of whites, 3.0% of non-African descendants, and 2.6% of browns. Conclusions Median PSA values were higher for Blacks versus Whites in all classification systems, except for non-white versus white men. The rate of prostate biopsy, prostate cancer detection rate, and relative risk for cancer was increased in African descendants, and African descendants or blacks, compared to non-African descendants, and non-African descendants and non-blacks, respectively.

  13. Granulomatous prostatitis after intravesical immunotherapy mimicking prostate cancer.

    Science.gov (United States)

    Białek, Waldemar; Rudzki, Sławomir; Iberszer, Paweł; Wronecki, Lech

    2016-12-01

    Intravesical immunotherapy with attenuated strains of Mycobacterium bovis is a widely used therapeutic option in patients with non-muscle-invasive transitional cell carcinoma of the bladder. A rare complication of intravesical therapy with the Bacillus Calmette-Guérin vaccine is granulomatous prostatitis, which due to increasing levels of prostate-specific antigen and abnormalities found in transrectal examination of the prostate may suggest concomitant prostate cancer. A case of extensive granulomatous prostatitis in a 61-year-old patient which occurred after the first course of a well-tolerated Bacillus Calmette-Guérin therapy is presented. Due to abnormalities found in rectal examination and an abnormal transrectal ultrasound image of the prostate with extensive infiltration mimicking neoplastic hyperplasia a core biopsy of the prostate was performed. Histopathological examination revealed inflammatory infiltration sites of tuberculosis origin.

  14. Prostate Problems

    Science.gov (United States)

    ... know the exact cause of your prostate problem. Prostatitis The cause of prostatitis depends on whether you ... prostate problem in men older than age 50. Prostatitis If you have a UTI, you may be ...

  15. Assessment of the contents related to screening on Portuguese language websites providing information on breast and prostate cancer

    Directory of Open Access Journals (Sweden)

    Daniel Ferreira

    2013-11-01

    Full Text Available The objective of this study was to assess the quality of the contents related to screening in a sample of websites providing information on breast and prostate cancer in the Portuguese language. The first 200 results of each cancer-specific Google search were considered. The accuracy of the screening contents was defined in accordance with the state of the art, and its readability was assessed. Most websites mentioned mammography as a method for breast cancer screening (80%, although only 28% referred to it as the only recommended method. Almost all websites mentioned PSA evaluation as a possible screening test, but correct information regarding its effectiveness was given in less than 10%. For both breast and prostate cancer screening contents, the potential for overdiagnosis and false positive results was seldom addressed, and the median readability index was approximately 70. There is ample margin for improving the quality of websites providing information on breast and prostate cancer in Portuguese.

  16. Assessment of the contents related to screening on Portuguese language websites providing information on breast and prostate cancer.

    Science.gov (United States)

    Ferreira, Daniel; Carreira, Helena; Silva, Susana; Lunet, Nuno

    2013-11-01

    The objective of this study was to assess the quality of the contents related to screening in a sample of websites providing information on breast and prostate cancer in the Portuguese language. The first 200 results of each cancer-specific Google search were considered. The accuracy of the screening contents was defined in accordance with the state of the art, and its readability was assessed. Most websites mentioned mammography as a method for breast cancer screening (80%), although only 28% referred to it as the only recommended method. Almost all websites mentioned PSA evaluation as a possible screening test, but correct information regarding its effectiveness was given in less than 10%. For both breast and prostate cancer screening contents, the potential for overdiagnosis and false positive results was seldom addressed, and the median readability index was approximately 70. There is ample margin for improving the quality of websites providing information on breast and prostate cancer in Portuguese.

  17. Age-related changes in the innervation of the prostate gland

    OpenAIRE

    2013-01-01

    The adult prostate gland grows and develops under hormonal control while its physiological functions are controlled by the autonomic nervous system. The prostate gland receives sympathetic input via the hypogastric nerve and parasympathetic input via the pelvic nerve. In addition, the hypogastric and pelvic nerves also provide sensory inputs to the gland. This review provides a summary of the innervation of the adult prostate gland and describes the changes which occur with age and disease. G...

  18. Antibiotic and anti-inflammatory use and the risk of prostate cancer

    Directory of Open Access Journals (Sweden)

    Bent Stephen

    2009-04-01

    Full Text Available Abstract Background Prostate inflammation or infection may increase the risk of prostate cancer. Antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs are used to treat prostatitis and urinary tract infections (UTIs. The objective of our study was to assess whether their use decreases the risk of prostate cancer. Methods We conducted a case-control study among men with incident prostate cancer (N = 65 cases and without prostate cancer (N = 195 controls at the San Francisco Veteran Affairs medical center (VAMC between June 1996 and June 2006. Cases were all patients who had prostate biopsies positive for cancer. We matched controls to cases on age group and race at a 3:1 ratio, and each matched pair was given an identical index date. Total antibiotic, aspirin, and NSAID use (number of prescriptions was computed for each participant by drug type and was restricted to a fill date at least 1 year before the index date. Logistic regression was used for analysis. We adjusted for the matching variables (age group and race and potential confounders (years of VAMC enrollment and number of clinic visits. Results Neither total antibiotic use nor total anti-inflammatory use reduces the risk of prostate cancer (P > 0.05. Conclusion Our analysis did not reveal a relation between use of antibiotics, aspirin, or NSAIDs and the risk of prostate cancer.

  19. The impact of gastrointestinal and genitourinary toxicity on health related quality of life among irradiated prostate cancer patients

    NARCIS (Netherlands)

    Schaake, Wouter; Wiegman, Erwin M; de Groot, Martijn; van der Laan, Hans Paul; van der Schans, Cees P.; van den Bergh, Alfons C M; Langendijk, Johannes A

    2014-01-01

    PURPOSE: To determine the impact of late radiation-induced toxicity on health-related quality of life (HRQoL) among patients with prostate cancer. PATIENTS AND METHODS: The study sample was composed of 227 patients, treated with external beam radiotherapy. Common Terminology Criteria for Adverse Eve

  20. Correlação entre a graduação histológica de biópsias e do espécimen cirúrgico em câncer da prostata Correlation between histologic biopsy grading and radical prostatectomy specimen in prostate cancer

    Directory of Open Access Journals (Sweden)

    José Cury

    1999-02-01

    Full Text Available Foram estudados, retrospectivamente, os prontuários de 120 pacientes com câncer localizado da próstata nos estádios clínicos T1, T2 e T3a e que foram submetidos a 1infadenectomia ilíaca e a cirurgia radical da próstata. Todos haviam sido graduados pela escala de Gleason através de biópsias da próstata guiadas pela ultra-sonografia transretal. Correlacionamos a graduação histo1ógica destas biópsias da próstata com a graduação final obtida no exame da peça cirúrgica correspondente e obtivemos exata concordância em 39 pacientes (32,50%. Ao considerarmos a concordância de ± 1unidade, observamos concordância de resultado em 81 pacientes (67,50%. A subgraduação histológica das biópsias prostáticas foi encontrada em 75 pacientes (62,50% dos casos.The treatment of patients with adenocarcinoma of the prostate is based on the tumor stage and grade. For this reason the interpretation of the biopsy especimen is crucial and demands a great expertize from its examiner. ln order to define the accuracy of biopsy interpretation we settled the present study, trying to correlate the relationship between the histological grade of the biopsy especimens and the definitive pathological report read by the same pathologist. One hundred and twenty patients with localized prostate cancer stages TI - T3a submitted to radical prostatectomy were evaluated. The histological grade of the tumor was defined using the Gleason score sistem and a correlation was made between the score of biopsy and the surgical especimens. Complete agreement of the Gleason score was seen in 39 patients (32,5% and if 1 digit discordance (± 1 Gleason score was not considered, agreement was seen in 81 patients (67,5%. Seventy five tumors (62,5% were undergraded and the rate of discordance was more common in patients with grade 2 to 4 tumors. According to our date, we conclude that the histological evaluation of the biopsy especimen in prostate cancer tends to underevaluate

  1. Lower urinary tract symptoms, benign prostatic hyperplasia/benign prostatic enlargement and erectile dysfunction: are these conditions related to vascular dysfunction?

    Science.gov (United States)

    Shimizu, Shogo; Tsounapi, Panagiota; Shimizu, Takahiro; Honda, Masashi; Inoue, Keiji; Dimitriadis, Fotios; Saito, Motoaki

    2014-09-01

    Although the pathogenesis of lower urinary tract symptoms, benign prostatic hyperplasia/benign prostatic enlargement and erectile dysfunction is poorly understood and thought to be multifactorial, it has been traditionally recognized that these conditions increase with age. There is increasing evidence that there is an association between cardiovascular disease and lower urinary tract symptoms as well as benign prostatic hyperplasia/benign prostatic enlargement and erectile dysfunction in elderly patients. Age might activate systemic vascular risk factors, resulting in disturbed blood flow. Hypertension, diabetes, hyperlipidemia and atherosclerosis are also linked to the etiology of lower urinary tract symptoms, benign prostatic hyperplasia/benign prostatic enlargement and erectile dysfunction. In the present review, we discuss the relationship between decreased pelvic blood flow and lower urinary tract symptoms, benign prostatic hyperplasia/benign prostatic enlargement and erectile dysfunction. Furthermore, we suggest possible common mechanisms underlining these urological conditions.

  2. Biopsy with the New Essen Biopsy Forceps

    Directory of Open Access Journals (Sweden)

    Peter G. Traine

    2013-01-01

    Full Text Available Purpose. To present initial experience with a novel biopsy method, the Essen biopsy forceps. Therefore, two patients with diagnostic suspicion of uveal melanoma underwent biopsy for histopathological confirmation. Case Presentation. Two patients presented with painless unilateral vision reduction. Ultrasound revealed the diagnostic suspicion of uveal melanoma. Therefore, biopsy with the Essen biopsy forceps using a sutureless 23-gauge three-port vitrectomy system was performed. The specimens were then submitted to a pathologist and processed. Histopathology of the obtained specimen confirmed the diagnostic suspicion of choroid melanoma in both patients. Conclusion. Essen biopsy forceps is a very practicable alternative method to the FNAB, allowing a combined histopathological and immunohistochemical examination for achieving high diagnostic accuracy at minimal risk.

  3. Generalized Lymphadenopathy: Unusual Presentation of Prostate Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Bulent Cetin

    2011-01-01

    Full Text Available Generalized lymphadenopathy is a rare manifestation of metastatic prostate cancer. Here, we report the case of a 59-year-old male patient with supraclavicular, mediastinal, hilar, and retroperitoneal and inguinal lymphadenopathy, which suggested the diagnosis of lymphoma. There were no urinary symptoms. A biopsy of the inguinal lymph node was compatible with adenocarcinoma, whose prostatic origin was shown by immunohistochemical staining with PSA. The origin of the primary tumor was confirmed by directed prostate biopsy. We emphasize that a suspicion of prostate cancer in men with adenocarcinoma of undetermined origin is important for an adequate diagnostic and therapeutic approach.

  4. Initial experience with identifying high-grade prostate cancer using diffusion-weighted MR imaging (DWI) in patients with a Gleason score biopsy: a radical prostatectomy correlated series.

    NARCIS (Netherlands)

    Somford, D.M.; Hambrock, T.; Hulsbergen- van de Kaa, C.A.; Futterer, J.J.; Oort, I.M. van; Basten, J.P. van; Karthaus, H.F.M.; Witjes, J.A.; Barentsz, J.O.

    2012-01-01

    INTRODUCTION: Diffusion-weighted magnetic resonance (MR) imaging (DWI) might be able to fulfill the need to accurately identify high-grade prostate carcinoma, in patients initially selected for active surveillance in the Prostate Specific Antigen (PSA) screening era based on transrectal ultrasound-g

  5. Childhood Height and Birth Weight in Relation to Future Prostate Cancer Risk

    DEFF Research Database (Denmark)

    Cook, Michael B; Gamborg, Michael; Aarestrup, Julie;

    2013-01-01

    Adult height has been positively associated with prostate cancer risk. However, the exposure window of importance is currently unknown and assessments of height during earlier growth periods are scarce. In addition, the association between birth weight and prostate cancer remains undetermined. We...

  6. Skin biopsy: Biopsy issues in specific diseases.

    Science.gov (United States)

    Elston, Dirk M; Stratman, Erik J; Miller, Stanley J

    2016-01-01

    Misdiagnosis may result from biopsy site selection, technique, or choice of transport media. Important potential sources of error include false-negative direct immunofluorescence results based on poor site selection, uninformative biopsy specimens based on both site selection and technique, and spurious interpretations of pigmented lesions and nonmelanoma skin cancer based on biopsy technique. Part I of this 2-part continuing medical education article addresses common pitfalls involving site selection and biopsy technique in the diagnosis of bullous diseases, vasculitis, panniculitis, connective tissue diseases, drug eruptions, graft-versus-host disease, staphylococcal scalded skin syndrome, hair disorders, and neoplastic disorders. Understanding these potential pitfalls can result in improved diagnostic yield and patient outcomes.

  7. Treatment-related symptoms during the first year following transperineal [sup 125]I prostate implantation

    Energy Technology Data Exchange (ETDEWEB)

    Kleinberg, L.; Wallner, K.; Roy, J.; Zelefsky, M.; Arterbery, V.E.; Fuks, Z.; Harrison, L. (Memorial Sloan-Kettering Cancer Center, New York, NY (United States))

    1994-03-01

    The purpose was to summarize the urinary, rectal, and sexual symptoms occurring during the first 12 months following [sup 125]I prostatic implantation. Thirty-one patients with Stage T[sub 1] or T[sub 2] prostatic carcinoma were evaluate for morbidity following computed tomography-guided transperineal [sup 125]I implants from 1988 to 1991. The median total activity used was 47 mCi (range 35-37 mCi). Toxicity was evaluated using a modification of the Radiation Therapy Oncology Group grading system. Nocturia was the most common treatment-related symptom, reported by 80% of patients within 2 months after implantation, and persisted at 12 months in 45% of the patients. Mild dysuria developed in 48% of patients within 2 months of implantation; two patients needed analgesics for their dysuria. Terazosin hydrochloride (2-10 mg qd) provided subjective improvement of urinary symptoms in seven of eight patients in whom it was tried. Rectal urgency, soft stools, and increased frequency of bowel movements was reported by 25% of the patients within 1-2 months after implantation. The incidence of assymptomatic rectal bleeding or ulceration occurring at any time after implantation was 47%, but resolved in all patients with expectant treatment. Self-limiting ulceration of the rectal mucosal occurred in 16%, but only one patient developed a prostato-rectal fistula, managed with an ileal conduit. Five of the 18 potent patients experienced discomfort on erection or ejaculation, beginning within several weeks of their implant. The discomfort resolved within 6 months in three of the patients, but persisted for 18 and 24 months in the other two. [sup 125]I implantation, as performed in this series, is generally associated with only mild-moderate genitourinary and rectal symptoms that may persist 6 months or more after implantation. 16 refs., 6 figs., 2 tabs.

  8. Human epidermal growth factor receptor type 2 protein expression in Chinese metastatic prostate cancer patients correlates with cancer specific survival and increases after exposure to hormonal therapy

    Institute of Scientific and Technical Information of China (English)

    Bo Dai; Yun-Yi Kong; Ding-Wei Ye; Chun-Guang Ma; Xiao-Yan Zhou; Xu-Dong Yao

    2008-01-01

    Aim: To investigate human epidermal growth factor receptor type 2 (HER2) protein expression and gene amplification in Chinese metastatic prostate cancer patients and their potential value as prognostic factors. Methods: Immuno-histochemistry (IHC) was performed to investigate HER2 protein expression in prostate biopsy specimens from 104 Chinese metastatic prostate cancer patients. After 3-11 months of hormonal therapy, 12 patients underwent transure- thral resection of the prostate (TURP). HER2 protein expression of TURP specimens was compared with that of the original biopsy specimens. Of these, 10 biopsy and 4 TURP specimens with HER2 IHC staining scores ≥ 2+ were investigated for HER2 gene amplification status by fluorescent in situ hybridization (FISH). Results: Of the 104 prostate biopsy specimens, HER2 protein expression was 0, 1+, 2+ and 3+ in 49 (47.1%), 45 (43.3%), 8 (7.7%) and 2 (1.9%) cases, respectively. There was a significant association between HER2 expression and Gleason score (P = 0.026). HER2 protein expression of prostate cancer tissues increased in 33.3% of patients after hormonal therapy. None of the 14 specimens with HER2 IHC scores > 2+ showed HER2 gene amplification. Patients with HER2 scores ≥ 2+ had a significantly higher chance of dying from prostate cancer than those with HER2 scores of 0 (P = 0.004) and 1+ (P = 0.034). Multivariate Cox regression analysis showed that HER2 protein expression intensity was an independent predictor of cancer-related death (P = 0.039). Conclusion: An HER2 IHC score ≥ 2+ should be defined as HER2 protein overexpression in prostate cancer. Overexpression of HER2 protein in cancer tissue might suggest an increased risk of dying from prostate cancer. HER2 protein expression increases in some individual patients after hormonal therapy.

  9. Prostate Cancer Screening in Jamaica: Results of the Largest National Screening Clinic

    Directory of Open Access Journals (Sweden)

    Belinda F. Morrison

    2016-01-01

    Full Text Available Prostate cancer is highly prevalent in Jamaica and is the leading cause of cancer-related deaths. Our aim was to evaluate the patterns of screening in the largest organized screening clinic in Jamaica at the Jamaica Cancer Society. A retrospective analysis of all men presenting for screening at the Jamaica Cancer Society from 1995 to 2005 was done. All patients had digital rectal examinations (DRE and prostate specific antigen (PSA tests done. Results of prostate biopsies were noted. 1117 men of mean age 59.9 ± 8.2 years presented for screening. The median documented PSA was 1.6 ng/mL (maximum of 5170 ng/mL. Most patients presented for only 1 screen. There was a gradual reduction in the mean age of presentation for screening over the period. Prostate biopsies were requested on 11% of screening visits; however, only 59% of these were done. 5.6% of all persons screened were found to have cancer. Of the cancers diagnosed, Gleason 6 adenocarcinoma was the commonest grade and median PSA was 8.9 ng/mL (range 1.5–1059 ng/mL. Older men tend to screen for prostate cancer in Jamaica. However, compliance with regular maintenance visits and requests for confirmatory biopsies are poor. Screening needs intervention in the Jamaican population.

  10. MR imaging of the prostate; MRT der Prostata

    Energy Technology Data Exchange (ETDEWEB)

    Asbach, P.; Haas, M.; Hamm, B. [Charite Campus Benjamin Franklin, Klinik fuer Radiologie, Berlin (Germany)

    2015-12-15

    Prostate cancer is the most common form of cancer in men in Germany; however, there is a distinct difference between incidence and mortality. The detection of prostate cancer is based on clinical and laboratory testing using serum prostate-specific antigen (PSA) levels and transrectal ultrasound with randomized biopsy. Multiparametric MR imaging of the prostate can provide valuable diagnostic information for detection of prostate cancer, especially after negative results of a biopsy prior to repeat biopsy. In addition the use of MR ultrasound fusion-guided biopsy has gained in diagnostic importance and has increased the prostate cancer detection rate. The prostate imaging reporting and data system (PI-RADS) classification has standardized the reporting of prostate MRI which has positively influenced the acceptance by urologists. (orig.) [German] Das Prostatakarzinom ist in Deutschland die haeufigste Krebserkrankung des Mannes, wobei ein deutlicher Unterschied zwischen Inzidenz und Mortalitaet besteht. Die Detektion des Prostatakarzinoms basiert auf klinischer und laborchemischer Untersuchung (prostataspezifisches-Antigen[PSA]-Wert) sowie der transrektalen Ultraschalluntersuchung mit randomisierter Biopsie. Die multiparametrische MR-Tomographie kann zur Detektion des Prostatakarzinoms, insbesondere bei negativer Biopsie vor einer erneuten Biopsie wertvolle diagnostische Informationen liefern. Zudem wird zunehmend die MRT-Ultraschall-Fusionsbiopsie in der Diagnostik eingesetzt, wodurch die Detektionsrate des Prostatakarzinoms deutlich gesteigert werden kann. Mit Einfuehrung der PI-RADS-Klassifikation (Prostate Imaging-Reporting and Data System) konnte zudem eine Standardisierung der Befundung erreicht werden, was die Akzeptanz der MRT der Prostata in der Urologie erhoeht hat. (orig.)

  11. 前列腺特异性抗原密度预测首次前列腺活检标本Gleason评分升高的价值%Value of prostate-specific antigen density in predicting an upgrade in Gleason score for initial prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    陈超; 谢立平; 郑祥毅; 林奕伟; 朱翮嘉; 汪朔; 沈柏华; 蔡柏森; 尤启汉

    2013-01-01

    Objective To investigate the performance of PSAD as a predictor of Gleason score upgrade between initial prostate biopsy and radical prostatectomy(RP)in the patients with low or intermediate risk prostate cancers(PCa).Methods This study comprised a retrospective analysis of data from 170 PCa patients(PSA≤20 μg/L,stage≤T2b,Gleason score≤7).The median age was 68 yrs,the median PSA was 10.2 μg/L,the median PSAD was 0.35 mg/L2 and the median prostate volume was 28.4 ml.There were 95 cases in cT1 and 75 cases in cT2.According to biopsy Gleason score,patients were divided into three groups:3+3(91 cases),3+4(42 cases)and 4+3(37 cases).Each group was further stratified into to subgroups according to whether their RP Gleason score was concordant or upgraded.Receiver-operating characteristic(ROC)curves for predictive power of PSAD were generated for each group,and the area under the curve(AUC)was calculated.Results Of the 170 patients,79(46.5%)had an upgrade in Gleason score,51(56.0%)in 3+3 group,17(40.5%)in 3+4 group,11(29.7%)in 4+3 group,respectively.In the 3+3 group,PSAD was significantly higher in subgroup with upgraded Gleason score compared with the subgroup of concordant Gleason score(0.37 mg/L2 versus 0.23 mg/L2,P<0.01).In the other two groups,PSAD were not of significant differences between subgroup with upgraded Gleason score and the subgroup of concordant Gleason score(0.33 mg/L2 versus 0.36 mg/L2,0.49 mg/L2 versus 0.58 mg/L2,P>0.05).ROC analysis showed a decline in AUC with increasing biopsy Gleason score.It was 0.762 for 3+3 group,0.529 for 3+4 group and 0.413 for 4+3 group.The pathologic stage in upgraded cases were more advanced in all the groups(P<0.05).Conclusion PSAD has the ability of predicting Gleason score upgrade after RP in the biopsy Gleason score 3+3 PCa patients whose clinical risk stratification are low or intermediate.%目的 评价前列腺特异性抗原密度(PSAD)预测临床低中危前列腺癌(PCa)患者首次前列

  12. Current early diagnostic biomarkers of prostate cancer

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    Min Qu

    2014-08-01

    Full Text Available Prostate cancer (PCa has become to have the highest incidence and the second mortality rate in western countries, affecting men's health to a large extent. Although prostate-specific antigen (PSA was discovered to help diagnose the cancer in an early stage for decades, its specificity is relative low, resulting in unnecessary biopsy for healthy people and over-treatment for patients. Thus, it is imperative to identify more and more effective biomarkers for early diagnosis of PCa in order to distinguish patients from healthy populations, which helps guide an early treatment to lower disease-related mortality by noninvasive or minimal invasive approaches. This review generally describes the current early diagnostic biomarkers of PCa in addition to PSA and summarizes the advantages and disadvantages of these biomarkers.

  13. Identification of immunity-related genes in prostate cancer and potential role of the ETS family of transcription factors in their regulation.

    Science.gov (United States)

    Shaikhibrahim, Zaki; Lindstrot, Andreas; Ellinger, Jörg; Rogenhofer, Sebastian; Buettner, Reinhard; Wernert, Nicolas

    2011-11-01

    The role of the immune response in tumor progression, and disease outcome is still debated, and a lack of knowledge of the immune defenses in prostate cancer still exists. In addition, the ETS family of transcription factors which is involved in translocations frequently found in prostate cancer is reported to be essential for the regulation of immunity-related genes. In order to identify immunity-related genes in prostate cancer, we performed two microarrays using RNA extracted from laser microdissected glands of the normal prostate proper (or the peripheral zone) and moderately and poorly differentiated prostate carcinomas from patients who had undergone radical prostatectomy. Many differentially expressed genes were found, however, only immunity-related genes (B cell, innate, and T cell immunity) with an expression of more than 10-fold increase or decrease and a Pimmunity-related genes in prostate cancer, and provided insights into their potential regulation, which may lead to a better early detection, immunotherapy, and therapeutic drug treatment of this disease. Unraveling the dynamics of the ETS-immunity-related genes will provide an invaluable insight into understanding prostate cancer immunology.

  14. Collagen I and III and metalloproteinase gene and protein expression in prostate cancer in relation to Gleason score

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    Antonio H. Duarte

    2012-06-01

    Full Text Available PURPOSE: To evaluate if the expression of metalloproteinase, collagen I and III are related to Gleason score, preoperative PSA and pathological stage in prostate cancer. MATERIALS AND METHODS: Our study group included radical prostatectomy specimens of 33 patients with prostatic adenocarcinoma who underwent surgery from 2001 to 2009. Patients were divided into 3 groups: Gleason score=6 (13 patients, Gleason score=7 (10 patients, Gleason score>8 (10 patients. The control group included prostates of patients submitted to cystoprostatectomy and benign prostatic tissues adjacent to the cancer area. Specific areas of tissues were selected under microscope and further processed for collagen I and III analysis by real time PCR. In addition, 10 deparaffined sections of each group were used to evaluate collagen I, III and metalloproteinase immune expression. The results were correlated with Gleason score, preoperative PSA and pathological stage. RESULTS: We found significant difference in both collagen I and III gene expression between benign and tumoral areas in the prostate samples from Gleason score=6 (collagen I=0.4±0.2 vs 5±2.4, p8 (collagen I=8±3.4 vs 1.4±0.8, p<0.07; collagen III=1.8±0.5 vs 0.6±0.1, p<0.05. There was no correlation of collagen expression with Gleason score, preoperative PSA or pathological stage. There was a positive correlation between metalloproteinase expression and Gleason score (r²=0.47. CONCLUSIONS: The positive correlation between metalloproteinase expression and Gleason score suggests that metalloproteinase could be a promising factor to improve Gleason score evaluation. Its expression and regulation do not seem to be related with collagen degradation.

  15. Pain-related behavior was not observed in dairy cattle in the days after liver biopsy, regardless of whether NSAIDs were administered.

    Science.gov (United States)

    Barrett, Lorelle A; Beausoleil, Ngaio J; Benschop, Jackie; Stafford, Kevin J

    2016-02-01

    For liver biopsy in cattle, it is routine practice to only provide local anesthesia (LA) to the skin and muscle layers, with visceral tissues remaining unanesthetized. Cattle being biopsied may therefore benefit from additional analgesia. This study aimed to determine if non-steroidal anti-inflammatory drugs would decrease post-biopsy pain in cattle. Twenty-four dairy cows were allocated into four treatment groups: biopsy under LA only; biopsy under LA with ketoprofen; biopsy under LA with meloxicam; and a sham-biopsied control group. Behavior was observed for 4h immediately following biopsy, and for 2h each day for the first three days after biopsy. No significant differences in behavior were found between any treatment groups on any day. This suggests that any post-biopsy pain present was not of enough significance to alter the cows' normal behavior patterns. Without identifying post-biopsy pain, it is not possible to determine what effect NSAID analgesia may have had on alleviating it.

  16. Correlation of hepatitis C and prostate cancer, inverse correlation of basal cell hyperplasia or prostatitis and epidemic syphilis of unknown duration

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    Annika Krystyna

    2011-04-01

    Full Text Available PURPOSE: The accuracy of prostate specific antigen (PSA to detect prostate cancer has not yet been determined. Autopsy evidence suggests one-third of men have evidence of prostate cancer. Correlation between prostate cancer and sexually transmitted infection is indeterminate. MATERIALS AND METHODS: A retrospective database was created of all men who underwent transrectal ultrasound guided prostate biopsy over 3 years. Men were 49% African or African Caribbean, and 51% Central or South American. Information about prostate specific antigen, cholesterol, hepatitis A, B and C, human immunodeficiency virus, syphilis, tuberculin skin testing and histology were collected. RESULTS: Hepatitis C antibody detection correlated with prostate cancer OR 11.2 (95% CI 3.0 to 72.4. The odds of prostate cancer increased annually (p = 0.0003. However, no correlation was found between prostate cancer and the following: PSA, biopsy date, repeat biopsy, more than 12 cores at biopsy, total cholesterol, high density lipoprotein, triglycerides, low density lipoprotein, risk measure reported with free and total PSA, hepatitis B surface antibody, high grade prostatic intraepithelial neoplasia or atypical small acinar proliferation. Histologic prostatitis and basal cell hyperplasia were inversely correlated with prostate cancer. Syphilis of unknown duration occurred in 17% of men with indeterminate correlation to prostate cancer. CONCLUSION: In inner city men of African and African-Caribbean, or Central and South American descent, prostate specific antigen levels did not correlate with prostate cancer. Hepatitis C antibody detection correlates significantly with prostate cancer. One prostate biopsy is sufficient to diagnose statistically significant prostate cancer. Histologic prostatitis and basal cell hyperplasia decrease odds of prostate cancer. Atypical small acinar proliferation may not correlate to prostate cancer and is pending further investigation. Men should be

  17. Ultrasonographic and cytopathologic aspects of prostate disease in 52 dogs

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    Antonio Carlos Cunha Lacreta Junior

    2012-03-01

    Full Text Available This study evaluated 52 dogs, which were male, intact, varied in age, of pure or mixed breed, with clinical signs suggestive of prostatic disease. Each individual underwent an ultrasound examination and fine-needle aspiration biopsy of the prostate gland for cytological evaluation. Benign prostatic hyperplasia (BPH was the most frequent prostatic disease, followed by cystic benign prostatic hyperplasia, bacterial prostatitis, abscesses, cysts, adenocarcinoma, nonbacterial prostatitis and paraprostatic cysts. The highest frequencies of prostate disorder were found in mixed breeds, followed by poodles and German shepherds. Ultrasound examination allowed the determination of prostate size, as well as the visualization of the diseases affecting the gland, and was effective in guiding aspiration biopsy. The cytological evaluation of the gland, especially when associated with changes in ultrasound images, revealed the presumptive diagnosis of the condition.

  18. Determinación de la utilidad de la relación APE l/t (Antígeno Prostático Específico libre sobre el total en pacientes con sospecha de cáncer de próstata estudiados por biopsia ecográfica endorrectal Utility of Free/Total Serum Prostate-Specific Antigen Ratio in prostatic cancer studied with endorectal ultrasound biopsy

    Directory of Open Access Journals (Sweden)

    Alberto Marangoni

    2008-09-01

    Full Text Available Introducción: Los marcadores tumorales son importantes al momento de decidir la realización de biopsias para el diagnóstico de cáncer de próstata. El objetivo de este trabajo es evaluar la exactitud diagnóstica del APE libre como marcador tumoral en casos de pacientes con sospecha de cáncer prostático en su relación con el APE total (APEL/T y determinar un valor de corte ajustado. Material y Método: En total, fueron evaluados 248 pacientes de entre 38 y 88 años de edad, en un período comprendido entre noviembre de 2001 y junio de 2007, con un análisis del APE libre, identificación de la presencia de un área hipoecogénica como ayuda diagnóstica y un análisis anatomopatológico para confirmación pospunción prostática endorrectal, realizado en forma prospectiva. Resultados: La identificación de pacientes con cáncer de próstata a través de la sospecha por el APE libre es relativa pero puede ser potenciada con otros hallazgos. Un 23,3% de pacientes con APEL/T por debajo de 0,20 presentaron biopsias positivas, pero, con un valor de 0,14, el porcentaje fue del 60%. Discusión: La identificación de pacientes para ser estudiados mediante Biopsia Prostática Endorrectal (BPE es un problema de la práctica diaria en los consultorios de Urología. Debido a que la BPE es un procedimiento diagnóstico medianamente invasivo y no exento de morbilidad, es que se debería ajustar su indicación. La relación APEL/T debe ser considerada en este contexto con mayor importancia. Conclusión: La identificación de valores alterados de la relación APE L/T con un valor de corte ajustado a 0,14 puede ayudar en el diagnóstico presuntivo de cáncer de próstata y a la elección de pacientes para biopsia a fin de ahorrar biopsias innecesarias.Introduction: The tumor markers are important to decide to perform biopsies in the prostate cancer diagnosis. The goal of this article is to evaluate the diagnosis precision of FPSA (Free Prostatic Specific

  19. Association of prostate volume with incidence and aggressiveness of prostate cancer

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    Al-Khalil S

    2016-10-01

    Full Text Available Shadi Al-Khalil, Christine Ibilibor, James Thomas Cammack, Werner de Riese Department of Urology, Texas Tech University Health Sciences Center, Lubbock, TX, USA Objective: The aim of this study was to investigate the possible correlation between prostate volume and aggressiveness and incidence of prostate cancer (PCa.Patients and methods: A chart review of a cohort of 448 consecutive prostate biopsy-naive men was performed. These men underwent at least a 12-core biopsy at our institution due to increased prostate-specific antigen serum levels (>4 ng/mL and/or suspicious findings on digital rectal examination during the period between 2008 and 2013. Transrectal ultrasound was used to determine the prostate volume.Results: The positive biopsy rate was 66% for patients with a prostate volume of ≤35 cc and 40% for patients with a prostate volume of ≥65 cc (P<0.001. Of the 110 patients testing positive on biopsy with a volume of ≤35 cc, 10 patients (9.1% had a Gleason score of ≥8. Of the 27 patients testing positive on biopsy with a volume of ≥65 cc, only 1 patient (3.7% had a Gleason score of ≥8.Conclusion: These results suggest that there may be an association between prostate volume and the incidence and aggressiveness of PCa. The larger the prostate, the lower the positive biopsy rate for PCa and the lower the Gleason score. Keywords: prostate cancer, prostate-specific antigen, prostate volume

  20. Sentinel node biopsy (image)

    Science.gov (United States)

    Sentinel node biopsy is a technique which helps determine if a cancer has spread (metastasized), or is contained locally. When a ... is closest to the cancer site. Sentinel node biopsy is used to stage many kinds of cancer, ...