scholarly journals IS INFLAMMATION AN AGE-RELATED CAUSE OF BPH PROGRESSION

2011 ◽  
Vol 18 (1) ◽  
Author(s):  
Hendra Herman ◽  
Agus Rizal AH Hamid ◽  
Chaidir Arif Mochtar

Objective: To find the role of inflammation in BPH progression represented by prostate enlargement compared between age group. Material & method: Tissue samples of BPH were collected from biopsy, transurethral resection or open surgery. Clinical information was collected including such as patient age, prostate volume, serum prostate specific antigen (PSA) and history of retention before procedure. Patients were divided into three groups, below 63 years old (young adult), 63 - 69 years old (older adult) and equal or above 70 years old (elderly). The samples were analyzed to define the microscopic structure of the hyperplasia (stromal or glandular) and to detect prostatic intraepithelial neoplasia, atypical stromal acinic proliferation, atypical acinar hyperplasia or prostate cancer. Prostate cancer was excluded from study samples. Grade of inflammation was determined by a pathologist depending on number of inflammatory cells. Grade of inflammation was classified in two groups, with mild inflammation or moderate-to-severe inflammation. Results: A total of 1189 patients were reviewed, 1172 were diagnosed with BPH. There were 381 patients (32,5%) with age below 63 years old (young adult), 380 (32,4%) between 63-69 years old (older adult) and 411 (35,1%) in equal or above 70 years old (elderly). In young-adult group, median of prostate volume between mild and moderate to severe inflammations was 42,56 and 45,75 (p = 0,500), for older adult group median was 45,00 and 51,00 (p = 0,038), for elderly group median was 49,00 and 51,98 (p = 0,621). Conclusion: Inflammation has a role in progression of prostate enlargement especially for the older adult group. Keywords: inflammation in BPH progression, prostate volume, age, PSA.

2013 ◽  
Vol 7 (1-2) ◽  
pp. 93 ◽  
Author(s):  
Stavros Sfoungaristos ◽  
Petros Perimenis

Introduction: Preoperative Gleason score is crucial, in combination with other preoperative parameters, in selecting the appropriate treatment for patients with clinically localized prostate cancer. The aim of the present study is to determine the clinical and pathological variables that can predict differences in Gleason score between biopsy and radical prostatectomy.Methods: We retrospectively analyzed the medical records of 302 patients who had a radical prostatectomy between January 2005 and September 2010. The association between grade changes and preoperative Gleason score, age, prostate volume, prostate-specific antigen (PSA), PSA density, number of biopsy cores, presence of prostatitis and high-grade prostatic intraepithelial neoplasia was analyzed. We also conducted a secondary analysis of the factors that influence upgrading in patients with preoperative Gleason score ≤6 (group 1) and downgrading in patients with Gleason score ≤7 (group 2).Results: No difference in Gleason score was noted in 44.3% of patients, while a downgrade was noted in 13.7% and upgrade in 42.1%. About 2/3 of patients with a Gleason score of ≤6 upgraded after radical prostatectomy. PSA density (p = 0.008) and prostate volume (p = 0.032) were significantly correlated with upgrade. No significant predictors were found for patients with Gleason score ≤7 who downgraded postoperatively.Conclusion: Smaller prostate volume and higher values of PSA density are predictors for upgrade in patients with biopsy Gleason score ≤6 and this should be considered when deferred treatment modalities are planned.


Author(s):  
С.В. Понкратов ◽  
А.В. Олексюк ◽  
И.Б. Олексюк ◽  
К.Л. Козлов

Дифференциальная диагностика рака предстательной железы (РПЖ) в настоящее время требует поиска новых, более эффективных подходов с учетом многофакторного анализа. Одним из таких факторов является возраст пациента. У мужчин старше 45 лет наблюдают выраженные инволютивные изменения тканей предстательной железы, что важно учитывать при оценке морфологических и лабораторных критериев при РПЖ. Цель работы оценить возрастные изменения объема предстательной железы и лабораторных показателей анализа крови при РПЖ. У 632 пациентов 42-88 лет методом трансректального УЗИ (ТРУЗИ) оценивали объемные показатели предстательной железы и уровень простатспецифического антигена (ПСА) и 2-про-ПСА в крови. С возрастом наблюдают повышение плотности транзиторной, периферической и центральной зон предстательной железы. Это коррелирует с повышением частоты выявления РПЖ. Уровень ПСА и 2-про-ПСА в крови у пациентов с РПЖ повышается при переходе от среднего к старческому возрасту в 1,4-2,8 раза. Таким образом информация, полученная в ходе оценки объемных показателей предстательной железы по данным ТРУЗИ и лабораторного исследования при постановке диагноза РПЖ, должна учитывать возраст пациента. At this moment differential diagnostic of the prostate cancer (PC) needs the new, more effective ways with regard of multifactor analysis. One of this factor is patient s age. Men older than 45 years old have expressed involution changes of prostate tissues. This fact must be take into account in valuation morphologic and laboratory criteria s in PC. The goal of the investigation is to take into account age-related changes of the prostate volume and laboratory criteria of blood analysis in PC. 632 patients in age from 42 to 88 years old were exanimated by trans rectal ultrasound examination (TRUS) method (volume parameters of the prostate) and by levels of prostate-specific antigen (PSA) and (-2) pro-PSA in blood. The increase of patient s age correlated with increase of the density of transient, peripheral and central zones of prostate. It correlates with the probability of the frequency of PC verification. Levels of PSA and 2-pro-PSA in blood of PC patients increase during the transition from middle to elderly age in 1,4-2,8 times. Thus the information, which was obtained during the examination of volume prostate characteristics by TRUS method and laboratory diagnostic of PC, must take to account patient s age.


2002 ◽  
Vol 74 (8) ◽  
pp. 1443-1450 ◽  
Author(s):  
Omer Kucuk ◽  
Fazlul H. Sarkar ◽  
Wael Sakr ◽  
Fred Khachik ◽  
Zora Djuric ◽  
...  

Dietary intake of lycopene is associated with reduced risk of prostate cancer (PCa). We conducted a clinical trial in men with prostate cancer to investigate the biological and clinical effects of lycopene supplementation. Twenty-six men with prostate cancer were randomly assigned to receive a lycopene supplement or no supplement for three weeks before radical prostatectomy. Subjects in the intervention group (n = 15) were instructed to take a tomato oleoresin extract soft gel capsule (Lyc-O-Mato®, LycoRed Company, Beer Sheva, Israel) containing 15 mg lycopene, 1.5 mg phytoene, 1.5 mg phytofluene, and 5 mg tocopherol twice daily with meals. Prostatectomy specimens were evaluated for pathologic stage, Gleason score, volume of cancer, and extent of high-grade prostatic intraepithelial neoplasia (HGPIN). Biomarkers of cell proliferation and apoptosis were assessed by Western blot analysis in benign and cancerous tissue samples obtained from the prostatectomy specimens. Oxidative stress was assessed by measuring the peripheral blood lymphocyte DNA oxidation product 5-hydroxymethyl-deoxyuridine (5-OH-mdU). Plasma levels of lycopene, insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), and prostate-specific antigen (PSA) were measured at baseline and after three weeks of study period. After the intervention, more men in the intervention group had smaller (<4 cc) tumors, organ-confined disease without involvement of surgical margins or extra-prostatic tissues, and focal involvement of the prostate with HGPIN compared to the control group. Mean plasma PSA levels were lower in the intervention group compared to the control group. This pilot study suggests that a tomato extract containing lycopene and other tomato carotenoids and phytochemicals may have a potential role in the treatment of prostate cancer. Larger clinical trials are necessary to definitively address potential uses of lycopene or tomato extract in the prevention or treatment of prostate cancer.


2013 ◽  
Vol 59 (1) ◽  
pp. 261-269 ◽  
Author(s):  
Konstantinos Mavridis ◽  
Konstantinos Stravodimos ◽  
Andreas Scorilas

INTRODUCTION The extensive use of prostate-specific antigen as a general prostate cancer biomarker has introduced the hazards of overdiagnosis and overtreatment. Recent studies have revealed the immense biomarker capacity of microRNAs (miRNAs) in prostate cancer. The aim of this study was to analyze the expression pattern of miR-224, a cancer-related miRNA, in prostate tumors and investigate its clinical utility. METHODS Total RNA was isolated from 139 prostate tissue samples. After the polyadenylation of total RNA by poly(A) polymerase, cDNA was synthesized with a suitable poly(T) adapter. miR-224 expression was assessed by quantitative real-time PCR and analyzed with the comparative quantification cycle method, Cq(2−ΔΔCq). We performed comprehensive biostatistical analyses to explore the clinical value of miR-224 in prostate cancer. RESULTS miR-224 expression was significantly downregulated in malignant samples compared with benign samples (P &lt; 0.001). Higher miR-224 expression levels were found in prostate tumors that were less aggressive (P = 0.017) and in an earlier disease stage (P = 0.018). Patients with prostate cancer who were positive for miR-224 had significantly enhanced progression-free survival intervals compared with miR-224–negative patients (P = 0.021). Univariate bootstrap Cox regression confirmed that miR-224 was associated with favorable prognosis (hazard ratio 0.314, P = 0.013); nonetheless, multivariate analysis, adjusted for conventional markers, did not identify miR-224 as an independent prognostic indicator. CONCLUSIONS miR-224 is aberrantly expressed in prostate cancer. Its assessment by cost-effective quantitative molecular methodologies could provide a useful biomarker for prostate cancer.


2021 ◽  
pp. 1-6
Author(s):  
Robert Peters ◽  
Carsten Stephan ◽  
Klaus Jung ◽  
Michael Lein ◽  
Frank Friedersdorff ◽  
...  

<b><i>Background:</i></b> Beyond prostate-specific antigen (PSA), other biomarkers for prostate cancer (PCa) detection are available and need to be evaluated for clinical routine. <b><i>Objective:</i></b> The aim of the study was to evaluate the Prostate Health Index (PHI) density (PHID) in comparison with PHI in a large Caucasian group &#x3e;1,000 men. <b><i>Methods:</i></b> PHID values were used from available patient data with PSA, free PSA, and [−2]pro­PSA and prostate volume from 3 former surveys from 2002 to 2014. Those 1,446 patients from a single-center cohort included 701 men with PCa and 745 with no PCa. All patients received initial or repeat biopsies. The diagnostic accuracy was evaluated by receiver operating characteristic (ROC) curves comparing area under the ROC curves (AUCs), precision-recall approach, and decision curve analysis (DCA). <b><i>Results:</i></b> PHID medians differed almost 2-fold between PCa (1.12) and no PCa (0.62) in comparison to PHI (48.6 vs. 33; <i>p</i> always &#x3c;0.0001). However, PHID and PHI were equal regarding the AUC (0.737 vs. 0.749; <i>p</i> = 0.226), and the curves of the precision-recall analysis also overlapped in the sensitivity range between 70 and 100%. DCA had a maximum net benefit of only ∼5% for PHID versus PHI between 45 and 55% threshold probability. Contrary, in the 689 men with a prostate volume ≤40 cm<sup>3</sup>, PHI (AUC 0.732) showed a significant larger AUC than PHID (AUC 0.69, <i>p</i> = 0.014). <b><i>Conclusions:</i></b> Based on DCA, PHID had only a small advantage in comparison with PHI alone, while ROC analysis and precision-recall analysis showed similar results. In smaller prostates, PHI even outperformed PHID. The increment for PHID in this large Caucasian cohort is too small to justify a routine clinical use.


2016 ◽  
Vol 43 (6) ◽  
pp. 430-437
Author(s):  
GUSTAVO DAVID LUDWIG ◽  
HENRIQUE PERES ROCHA ◽  
LÚCIO JOSÉ BOTELHO ◽  
MAIARA BRUSCO FREITAS

ABSTRACT Objective: to develop a predictive model to estimate the probability of prostate cancer prior to biopsy. Methods: from September 2009 to January 2014, 445 men underwent prostate biopsy in a radiology service. We excluded from the study patients with diseases that could compromise the data analysis, who had undergone prostatic resection or used 5-alpha-reductase inhibitors. Thus, we selected 412 patients. Variables included in the model were age, prostate specific antigen (PSA), digital rectal examination, prostate volume and abnormal sonographic findings. We constructed Receiver Operating Characteristic (ROC) curves and calculated the areas under the curve, as well as the model's Positive Predictive Value (PPV) . Results: of the 412 men, 155 (37.62%) had prostate cancer (PC). The mean age was 63.8 years and the median PSA was 7.22ng/ml. In addition, 21.6% and 20.6% of patients had abnormalities on digital rectal examination and image suggestive of cancer by ultrasound, respectively. The median prostate volume and PSA density were 45.15cm3 and 0.15ng/ml/cm3, respectively. Univariate and multivariate analyses showed that only five studied risk factors are predictors of PC in the study (p<0.05). The PSA density was excluded from the model (p=0.314). The area under the ROC curve for PC prediction was 0.86. The PPV was 48.08% for 95%sensitivity and 52.37% for 90% sensitivity. Conclusion: the results indicate that clinical, laboratory and ultrasound data, besides easily obtained, can better stratify the risk of patients undergoing prostate biopsy.


2021 ◽  
Vol 10 ◽  
Author(s):  
Pei Chen ◽  
Yu-ling Zhang ◽  
Bai Xue ◽  
Guo-ying Xu

PurposeThe prognostic value of caveolin-1 in prostate cancer remains uncertain. Hence, this meta-analysis was performed to evaluate the prognostic value of caveolin-1 in prostate cancer, as well as ascertain the relationship between caveolin-1 expression and clinicopathological characteristics of prostate cancer patients.MethodsThe PubMed, Embase, Chinese National Knowledge Infrastructure and Chinese Biology Medicine databases were electronically searched to retrieve published studies on caveolin-1 expression in prostate cancer. After study selection and data extraction, the meta-analysis was conducted using Review manager 5.3 software. Odds ratio (OR) with 95% confidence interval (CI) was used to estimate the pooled effect. Funnel plot was used to assess publication bias.ResultsA total of ten studies were enrolled, which included 3976 cases of prostate cancer, 72 cases of high-grade intraepithelial neoplasia (HGPIN), and 157 normal controls. Results of the meta-analysis showed that the positive rate of caveolin-1 expression in prostate cancer was 18.28 times higher than that in normal control (OR= 18.28, 95% CI: 9.02–37.04, p&lt;0.01), and 4.73 times higher than that in HGPIN (OR= 4.73, 95% CI: 2.38–9.42, p&lt;0.01). The relationship between caveolin-1 and clinicopathological characteristics of prostate cancer showed that the differences in caveolin-1 expression in patients with prostate-specific antigen (PSA) &gt;10 vs. ≤ 10 (OR=2.09, 95% CI: 1.35–3.22, p&lt;0.01), differentiation degree low vs. medium/high (OR=2.74, 95% CI: 1.84–4.08, p&lt;0.01), TNM stage T3+T4 vs. T1+T2 (OR=2.77, 95% CI: 1.78–4.29, p&lt;0.01), and lymph node metastasis present vs. absent (OR=2.61, 95% CI: 1.84–3.69, p&lt;0.01) were statistically significant. The correlation analysis between caveolin-1 and the survival time of patients with prostate cancer demonstrated that caveolin-1 was closely related to the prognosis of prostate cancer patients (HR=1.50, 95% CI: 1.28–1.76, p&lt;0.01).ConclusionCaveolin-1 is overexpressed in prostate cancer, which can serve as a risk factor and adverse clinicopathological feature of prostate cancer. Caveolin-1 can also predict poor survival in prostate cancer patients after radical prostatectomy.


Sign in / Sign up

Export Citation Format

Share Document