scholarly journals A Comparative Performance Analysis of Total PSA, Percentage Free PSA, PSA Velocity, and PSA Density versus the Detection of Primary Circulating Prostate Cells in Predicting Initial Prostate Biopsy Findings in Chilean Men

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Nigel P. Murray ◽  
Eduardo Reyes ◽  
Nelson Orellana ◽  
Cynthia Fuentealba ◽  
Ricardo Dueñas
Keyword(s):  
Prostate Biopsy ◽  
Diagnostic Yield ◽  
Screening Tests ◽  
Total Serum ◽  
Low Grade ◽  
Predictive Values ◽  
Psa Density ◽  
Prostate Cells ◽  
Specificity And Sensitivity ◽  
Psa Velocity

Introduction. PSA parameters have been used in an attempt to improve the diagnostic yield of prostate screening tests; the detection of primary malignant circulating prostate cells (CPCs) may improve the diagnostic yield of screening and therefore avoid unnecessary biopsies.Patients and Methods. Prospective study of all men undergoing initial prostate biopsy due to an elevated total serum PSA. Free percent PSA, PSA velocity, and PSA density were determined. Primary CPCs were detected using standard immunocytochemistry. A positive test for CPCs was defined as one cell PSA (+) P504S (+) in an 8 ml blood sample. Positive predictive and negative predictive values, specificity, and sensitivity were calculated for each test as well as the number of biopsies avoided and cancers missed.Results. 303 men participated in the study of whom 113/303 (37.3%) men had prostate cancer. Of the three PSA based parameters, free percent PSA was superior, sensitivity 70.8%, and specificity 67.4%. Primary CPCs detection had a sensitivity of 88.5% and a specificity of 88.4% avoiding 181 (59.7%) biopsies, detecting 93/95 (98%) of clinically significant cancers, and missing 13 (11.5%) low grade, small volume tumors.Conclusions. The use of primary CPCs as a sequential test could decrease the number of initial prostate biopsies missing those cancers which are treated by active observation.

1490: Association of Ethnicity, PSA Velocity and PSA Density Among Patients Found to have Cancer on Repeat Prostate Biopsy

2006 ◽  
Vol 175 (4S) ◽  
pp. 481-482
Author(s):  
Brent V. Yanke ◽  
Brett S. Carver ◽  
Dennis D. Venable ◽  
James A. Eastham
Keyword(s):  
Prostate Biopsy ◽  
Psa Density ◽  
Psa Velocity

EP.TH.939Is routine CTU necessary in the investigation of haematuria?

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Alexandra Miller ◽  
Grace Rake ◽  
Elizabeth Bright
Keyword(s):  
Cancer Detection ◽  
Diagnostic Yield ◽  
Small Sample ◽  
Case Note ◽  
Screening Tests ◽  
Low Grade ◽  
Retrospective Case ◽  
Upper Tract ◽  
Flexible Cystoscopy ◽  
Case Note Review

Abstract Aims Upper tract urothelial cancer’s (UTUC) are rare of which 17% have concurrent BT’s. Whilst CTU is the gold standard imaging for UTUC, its routine use is questionable due to low diagnostic yield.1 There is no consensus in our department regarding the use of CTU in screening haematuria patients, regardless of whether a BT is identified. We therefore sought to investigate the diagnostic yield of CTU. Method Retrospective case-note review of haematuria patients (May-October 2018), screening tests utilised and their diagnostic yield. Results 764 patients (mean age=68) presented with VH (n = 448) or NVH (n = 316). All underwent flexible cystoscopy (FC) and upper tract imaging, (346 = USS; 126=CTU; 257= USS and CTU). BT and UTUC were diagnosed in 69 (9%) and 5 patients (0.7%), respectively. Of the 5 patients with UTUC (VH = 4, NVH=1) 2 had synchronous bladder tumours, both were low grade. All 5 underwent CTU but only 3 had a prior USS, of which USS detected UTUC in 2 of these 3. CTU was performed in 384 patients (VH n = 323, NVH n = 61) yielding only one UTUC diagnosis when other investigations were negative. This patient presented with VH. CTU provided no additional cancer detection in all patients with BT. Conclusions Due to the small sample of synchronous tumours, location or grade of BT is not a predictor of UTUC2. In all patients screened with FC and USS, CTU only detected one additional UTUC. On the basis of these results, CTU screening is not indicated for patients presenting with NVH.

Effects of Transport Medium Composition on in vitro Drug Permeation across Excised Pig Intestinal Tissue

2020 ◽  
Vol 10 ◽  
Author(s):  
Bianca Peterson ◽  
Henrico Heystek ◽  
Josias H. Hamman ◽  
Johan D. Steyn
Keyword(s):  
Medium Composition ◽  
Screening Tests ◽  
Intestinal Tissue ◽  
Predictive Values ◽  
Transport Medium ◽  
Intestinal Fluids ◽  
Lower Permeability ◽  
The Impact ◽  
Simulated Intestinal Fluids

Background:: Knowledge of the permeation characteristics of new chemical entities across biological membranes is essential to drug research and development. Transport medium composition may affect the absorption of compounds during in vitro drug transport testing. To preserve the predictive values of screening tests, the possible influence of transport media on the solubility of model drugs, and on the activities of tight junctions and efflux transporter proteins (e.g. P-glycoprotein) must be known. Objective:: The aim of this study was to compare the impact of different transport media on the bi-directional transport of standard compounds, selected from the four classes of the Biopharmaceutical Classification System (BCS), across excised pig intestinal tissue. Methods:: The Sweetana-Grass diffusion apparatus was used for the transport studies. Krebs-Ringer bicarbonate (KRB) buffer and simulated intestinal fluids in the fed (FeSSIF) and fasted (FaSSIF) states were used as the three transport media, while the chosen compounds were abacavir (BCS class 1), dapsone (BCS class 2), lamivudine (BCS class 3) and furosemide (BCS class 4). Results:: Abacavir exhibited lower permeability in both the simulated intestinal fluids than in the KRB buffer. Dapsone showed similar permeability in all media. Lamivudine exhibited lower permeability in FaSSIF than in the other two media. Furosemide exhibited improved transport with pronounced efflux in FaSSIF. Conclusion:: Different permeation behaviors were observed for the selected drugs in the respective media, which may have resulted from their different physico-chemical properties, as well as from the effects that dissimilar transport media components had on excised pig intestinal tissue.

scholarly journals Is PSA density of the peripheral zone as a useful predictor for prostate cancer in patients with gray zone PSA levels?

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jaegeun Lee ◽  
Seung Woo Yang ◽  
Long Jin ◽  
Chung Lyul Lee ◽  
Ji Yong Lee ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Diagnosis ◽  
Prostate Biopsy ◽  
Peripheral Zone ◽  
Transitional Zone ◽  
Gray Zone ◽  
Prostate Cancer Diagnosis ◽  
Psa Density ◽  
Diagnosis Group ◽  
Predictive Rate

Abstract Background Serum prostate-specific antigen (PSA) is widely used in screening tests for prostate cancer. As the low specificity of PSA results in unnecessary and invasive prostate biopsies, we evaluated the clinical significance of various PSAs and PSA density (PSAD) related to peripheral zones in patients with gray zone PSA level (4–10 ng/mL). Methods A total of 1300 patients underwent transrectal ultrasonography-guided prostate biopsy from 2014 to 2019. Among them, 545 patients in the gray zone were divided into the prostate cancer diagnosis group and the non-prostate cancer diagnosis group, and PSA, relative extra transitional zone PSA (RETzPSA), estimated post holmium laser enucleation of the prostate PSA (EPHPSA), PSAD, peripheral zone PSA density (PZPSAD) and extra-transitional zone density (ETzD) were compared and analyzed using receiver-operating characteristics (ROC) analysis after 1:1 matching using propensity score. Results Area under the ROC curve values of PSA, EPHPSA, RETzPSA, PSA density, ETzD, and PZPSAD were 0.553 (95% CI: 0.495–0.610), 0.611 (95% CI: 0.554–0.666), 0.673 (95% CI: 0.617–0.725), 0.745 (95% CI: 0.693–0.793), 0.731 (95% CI: 0.677–0.780) and 0.677 (95% CI: 0.611–0.719), respectively. PSAD had 67.11% sensitivity, 71.71% specificity, and 70.34% positive predictive rate at 0.18 ng/mL/cc. ETzD had 69.08% sensitivity, 64.47% specificity, and 66.04% positive predictive rate at 0.04 ng/mL/cc. When the cut-off value of PSAD was increased to 0.18 ng/mL/cc, the best results were obtained with an odds ratio of 5.171 (95% CI: 3.171–8.432), followed by ETzD with 4.054 (95% CI: 2.513–6.540). Conclusions These results suggested that volume-adjusted parameters (ETzD and PSAD) might be more sensitive and accurate than various PSA in gray zone patients who required prostate biopsy to reduce unnecessary biopsy.

scholarly journals Screening for Tuberculosis in Health Care Workers: Experience in an Italian Teaching Hospital

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Christian Napoli ◽  
Filippo Ferretti ◽  
Filippo Di Ninno ◽  
Riccardo Orioli ◽  
Alessandra Marani ◽  
...  
Keyword(s):  
Health Care ◽  
Teaching Hospital ◽  
Health Care Workers ◽  
Screening Tests ◽  
Specificity And Sensitivity ◽  
Large Teaching Hospital ◽  
Care Workers ◽  
Low Incidence ◽  
Positive Results

Health care workers (HCW) are particularly at risk of acquiring tuberculosis (TB), even in countries with low TB incidence. Therefore, TB screening in HCW is a useful prevention strategy in countries with both low and high TB incidence. Tuberculin skin test (TST) is widely used although it suffers of low specificity; on the contrary, the in vitro enzyme immunoassay tests (IGRA) show superior specificity and sensitivity but are more expensive. The present study reports the results of a three-year TB surveillance among HCW in a large teaching hospital in Rome, using TST (by standard Mantoux technique) and IGRA (by QuantiFERON-TB) as first- and second-level screening tests, respectively. Out of 2290 HCW enrolled, 141 (6.1%) had a positive TST; among them, 99 (70.2%) underwent the IGRA and 16 tested positive (16.1%). The frequency of HCW tested positive for TB seems not far from other experiences in low incidence countries. Our results confirm the higher specificity of IGRA, but, due to its higher cost, TST can be considered a good first level screening test, whose positive results should be further confirmed by IGRA before the patients undergo X-ray diagnosis and/or chemotherapy.

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