Intraprostatic Chronic Inflammation is Associated with a Reduced Risk of Prostate Cancer in Patients Elected to a First Random Biopsy Set

2016 ◽  
Vol 103 (5) ◽  
pp. 475-482 ◽  
Author(s):  
Antonio B. Porcaro ◽  
Giovanni Novella ◽  
Nicolò de Luyk ◽  
Paolo Corsi ◽  
Giovanni Cacciamani ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Chronic Inflammation ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Science Research ◽  
Multivariate Logistic Regression Model ◽  
Clinical Factors ◽  
Clinical Model ◽  
Random Biopsy ◽  
Reduced Risk

Objectives To investigate the associations of clinical factors and intraprostatic chronic inflammatory infiltrate (CII) with the risk of prostate cancer (PCa) in a large contemporary cohort of patients elected to a first random biopsy set. Materials and Methods The study evaluated 596 patients who were elected to a first random biopsy set because of suspected PCa in the period between September 2010 and September 2015. The multivariate logistic regression model investigated the possible associations of clinical factors and intraprostatic CII with PCa. Results Prostate cancer was detected in 292 of 596 patients (49%). Intraprostatic CII was detected in 26.3% of cases. Age (odds ratio, OR = 1.060; p<.0001), prostate-specific antigen (PSA; OR = 1.174; p<.0001), prostate volume (PV; OR = 0.951; p<.0001) and abnormal digital rectal examination (DRE; OR = 2.170; p = 0.001) were independent predictors of PCa risk; moreover, intraprostatic CII was an important independent factor lowering the risk of PCa (OR = 0.258; p<.0001) in the multivariate clinical model. Conclusions In a large contemporary cohort of patients elected to a first random biopsy set, the detection of intraprostatic CII was not negligible (26.3%) and associated with a reduced risk of PCa. In the prostate microenvironment, intraprostatic CII might lower the risk of PCa by activating the response of the immune system at the early stages of cancer induction and progression. Specific serum biomarkers and imaging modalities associated with intraprostatic CII are required. Advanced basic science research is warranted to investigate and develop the controversial topic of intraprostatic chronic inflammation in relation to PCa.

Prostate Volume Index Stratified Prostate Cancer Risk in Patients Elected to a First Random Biopsy Set

2017 ◽  
Vol 103 (4) ◽  
pp. 374-379 ◽  
Author(s):  
Antonio B. Porcaro ◽  
Paolo Corsi ◽  
Nicolò de Luyk ◽  
Marco Sebben ◽  
Alessandro Tafuri ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Goodness Of Fit ◽  
Prostate Volume ◽  
Digital Rectal Examination ◽  
Prostate Cancer Risk ◽  
Peripheral Zone ◽  
Transitional Zone ◽  
Volume Index ◽  
Multivariate Logistic Regression Model ◽  
Random Biopsy

Objective To investigate prostate volume index (PVI), defined as the ratio of volume of the transitional zone on that of the peripheral zone, as a factor stratifying prostate cancer (PCA) risk in patients elected to a first random biopsy set. Methods The study evaluated 596 patients who were elected to a first random biopsy set because of suspected PCA in a period between September 2010 and September 2015. Prostate volume index was dichotomized to PVI ≤1 vs PVI >1. The multivariate logistic regression model investigated clinical factors with dichotomized PVI associating with PCA. Results The detection rate of PCA was 49%. The dichotomized PVI >1 stratified PCA risk (odds ratio [OR] 0.455; p<0.0001) beyond age (OR 1.062; p<0.0001), PSA (OR 1.167; p<0.0001), PV (OR 0.957; p<0.0001), and abnormal digital rectal examination (OR 2.094; p<0.0001). The goodness of fit statistics assessed model efficacy. Conclusions A large cohort of patients elected to a first random biopsy set had PCA risk stratified by dichotomized PVI beyond other clinical independent factors. Confirmatory studies are required.

scholarly journals Use of Nomograms for Early Detection in Prostate Cancer

2010 ◽  
Vol 8 (2) ◽  
pp. 271-276 ◽  
Author(s):  
Devon C. Snow ◽  
Eric A. Klein
Keyword(s):  
Prostate Cancer ◽  
Screening Tool ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Clinical Factors ◽  
Negative Biopsy ◽  
Prostate Biopsies ◽  
Prostate Cancer Prevention ◽  
Clinically Significant

Since the first introduction of prostate-specific antigen (PSA) as a screening tool in the 1980s, the accurate diagnoses of clinically significant prostate cancer remains a challenge. Analysis of a correlation between PSA levels and prostate biopsies of men with PSA 3 ng/mL or less in the placebo group of the Prostate Cancer Prevention Trial suggested that no “normal” PSA level exists. With the acknowledgement that PSA level is considered a continuum rather than a dichotomous marker, accurately diagnosing clinically significant prostate cancer is even more challenging. Nomograms are increasingly being used as tools in the clinical setting to address this challenge. Through incorporating multiple clinical factors, such as PSA, digital rectal examination, age, race, prostate volume, family history, and previous negative biopsy, risk calculators can improve sensitivity of diagnosis over using a PSA cutoff alone. This article discusses the rational for the use of nomograms and the advantages and limitations for the most commonly used nomograms.

scholarly journals Prostate cancer screening: A survey of medical students’ knowledge in Lome, Togo, and associated determinants in a resource-limited African context

2021 ◽  
Vol 9 ◽  
pp. 205031212110328
Author(s):  
Tchin Darré ◽  
Toukilnan Djiwa ◽  
Tchilabalo Matchonna Kpatcha ◽  
Albadia Sidibé ◽  
Edoé Sewa ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Medical Students ◽  
Confidence Interval ◽  
Prostate Cancer Screening ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
P Value ◽  
Theoretical Knowledge ◽  
Practical Level

Objectives: The aims of this study were to assess the knowledge of medical students in Lomé about these means of screening for prostate cancer in a context of limited resources and controversy about prostate cancer screening, and to identify the determinants associated with these results. Methods: This was a prospective descriptive and cross-sectional study conducted in the form of a survey of medical students regularly enrolled at the Faculty of Health Sciences of the University of Lomé for the 2019–2020 academic years. Results: Of the 1635 eligible students, 1017 correctly completed the form, corresponding to a rate of 62.20%. The average age was 22 ± 3.35 years. The sex ratio (M/F) was 2.5. Undergraduate students were the most represented (53.69%). Students who had not received any training on prostate cancer were the most represented (57.13%). Only 12.88% of the students had completed a training course in urology. Concerning the prostate-specific antigen blood test, there was a statistically significant relationship between the students’ knowledge and some of their socio-demographic characteristics, namely age (p value = 0.0037; 95% confidence interval (0.50–1.77)); gender (p value = 0.0034; 95% confidence interval (1.43–2.38)); study cycle (p value ˂ 0.0001; 95% confidence interval (0.56–5.13)) and whether or not they had completed a placement in a urology department (p value ˂ 0.0001; 95% confidence interval (0.49–1.55)). On the contrary, there was no statistically significant relationship between students’ knowledge of the digital rectal examination and their study cycle (p value = 0.082; 95% confidence interval (0.18–3.44)). Conclusion: Medical students in Lomé have a good theoretical knowledge and a fair practical level of the digital rectal examination clinical examination and an average theoretical knowledge and a below average practical level of prostate-specific antigen, increasing however along the curriculum in the context of prostate cancer screening.

scholarly journals Prostate Cancer Liquid Biopsy Biomarkers’ Clinical Utility in Diagnosis and Prognosis

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3373
Author(s):  
Milena Matuszczak ◽  
Jack A. Schalken ◽  
Maciej Salagierski
Keyword(s):  
Prostate Cancer ◽  
Liquid Biopsy ◽  
Current Knowledge ◽  
Prostate Gland ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Digital Rectal Examination ◽  
Cost Effective ◽  
Non Invasive ◽  
Diagnosis And Prognosis

Prostate cancer (PCa) is the most common cancer in men worldwide. The current gold standard for diagnosing PCa relies on a transrectal ultrasound-guided systematic core needle biopsy indicated after detection changes in a digital rectal examination (DRE) and elevated prostate-specific antigen (PSA) level in the blood serum. PSA is a marker produced by prostate cells, not just cancer cells. Therefore, an elevated PSA level may be associated with other symptoms such as benign prostatic hyperplasia or inflammation of the prostate gland. Due to this marker’s low specificity, a common problem is overdiagnosis, which leads to unnecessary biopsies and overtreatment. This is associated with various treatment complications (such as bleeding or infection) and generates unnecessary costs. Therefore, there is no doubt that the improvement of the current procedure by applying effective, sensitive and specific markers is an urgent need. Several non-invasive, cost-effective, high-accuracy liquid biopsy diagnostic biomarkers such as Progensa PCA3, MyProstateScore ExoDx, SelectMDx, PHI, 4K, Stockholm3 and ConfirmMDx have been developed in recent years. This article compares current knowledge about them and their potential application in clinical practice.

scholarly journals Analysis of risk factors for determining the need for prostate biopsy in patients with negative MRI

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Linghui Liang ◽  
Feng Qi ◽  
Yifei Cheng ◽  
Lei Zhang ◽  
Dongliang Cao ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Detection Efficiency ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Multivariable Logistic Regression Analysis ◽  
Detection Rates ◽  
Prostate Biopsies ◽  
Clinically Significant ◽  
Definition Of ◽  
Medical University

AbstractTo analyze the clinical characteristics of patients with negative biparametric magnetic resonance imaging (bpMRI) who didn’t need prostate biopsies (PBs). A total of 1,012 male patients who underwent PBs in the First Affiliated Hospital of Nanjing Medical University from March 2018 to November 2019, of 225 had prebiopsy negative bpMRI (defined as Prostate Imaging Reporting and Data System (PI-RADS 2.1) score less than 3). The detection efficiency of clinically significant prostate cancer (CSPCa) was assessed according to age, digital rectal examination (DRE), prostate volume (PV) on bpMRI, prostate-specific antigen (PSA) and PSA density (PSAD). The definition of CSPCa for Gleason score > 6. Univariate and multivariable logistic regression analysis were used to identify predictive factors of absent CSPCa on PBs. Moreover, absent CSPCa contained clinically insignificant prostate cancer (CIPCa) and benign result. The detection rates of present prostate cancer (PCa) and CSPCa were 27.11% and 16.44%, respectively. Patients who were diagnosed as CSPCa had an older age (P < 0.001), suspicious DRE (P < 0.001), a smaller PV (P < 0.001), higher PSA value (P = 0.008) and higher PSAD (P < 0.001) compared to the CIPCa group and benign result group. PSAD < 0.15 ng/ml/cm3 (P = 0.004) and suspicious DRE (P < 0.001) were independent predictors of absent CSPCa on BPs. The negative forecast value of bpMRI for BP detection of CSPCa increased with decreasing PSAD, mainly in patients with naive PB (P < 0.001) but not in prior negative PB patients. 25.33% of the men had the combination of negative bpMRI, PSAD < 0.15 ng/ml/cm3 and PB naive, and none had CSPCa on repeat PBs. The incidence of PB was determined, CSPCa was 1.59%, 0% and 16.67% in patients with negative bpMRI and PSAD < 0.15 ng/ml/cm3, patients with negative bpMRI, PSAD < 0.15 ng/ml/cm3 and biopsy naive and patients with negative bpMRI, PSAD < 0.15 ng/ml/cm3 and prior negative PB, separately. We found that a part of patients with negative bpMRI, a younger age, no suspicious DRE and PSAD < 0.15 ng/ml/cm3 may securely avoid PBs. Conversely PB should be considered in patients regardless of negative bpMRI, especially who with a greater age, obviously suspicious DRE, significantly increased PSA value, a significantly small PV on MRI and PSAD > 0.15 ng/ml/cm3.

scholarly journals Clinical diagnosis of prostate cancer using digital rectal examination and prostate-specific antigen tests: a systematic review and meta-analysis of sensitivity and specificity

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Nelson C. Okpua ◽  
Simon I. Okekpa ◽  
Stanley Njaka ◽  
Augusta N. Emeh
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Sensitivity And Specificity ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Antigen Test ◽  
Rectal Examination ◽  
Prostate Specific Antigen Test ◽  
Prostate Cancers ◽  
Antigen Tests

Abstract Background Being diagnosed with cancer, irrespective of type initiates a serious psychological concern. The increasing rate of detection of indolent prostate cancers is a source of worry to public health. Digital rectal examination and prostate-specific antigen tests are the commonly used prostate cancer screening tests. Understanding the diagnostic accuracies of these tests may provide clearer pictures of their characteristics and values in prostate cancer diagnosis. This review compared the sensitivities and specificities of digital rectal examination and prostate-specific antigen test in detection of clinically important prostate cancers using studies from wider population. Main body We conducted literature search in PubMed, Medline, Science Direct, Wiley Online, CINAHL, Scopus, AJOL and Google Scholar, using key words and Boolean operators. Studies comparing the sensitivity and specificity of digital rectal examination and prostate-specific antigen tests in men 40 years and above, using biopsy as reference standard were retrieved. Data were extracted and analysed using Review manager (RevMan 5.3) statistical software. The overall quality of the studies was good, and heterogeneity was observed across the studies. The result comparatively shows that prostate-specific antigen test has higher sensitivity (P < 0.00001, RR 0.74, CI 0.67–0.83) and specificity (P < 0.00001, RR 1.81, CI 1.54–2.12) in the detection of prostate cancers than digital rectal examination. Conclusion Prostate-specific antigen test has higher sensitivity and specificity in detecting prostate cancers from men of multiple ethnic origins. However, combination of prostate-specific antigen test and standardized digital rectal examination procedure, along with patients history, may improve the accuracy and minimize over-diagnoses of indolent prostate cancers.

Religious Involvement and Prostate Cancer Screening Behaviors Among Southeastern African American Men

2008 ◽  
Vol 3 (3) ◽  
pp. 214-223 ◽  
Author(s):  
Cheryl L. Holt ◽  
Theresa A. Wynn ◽  
Jasmine Darrington
Keyword(s):  
Prostate Cancer ◽  
African American ◽  
Cancer Screening ◽  
African American Men ◽  
Prostate Cancer Screening ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Religious Involvement ◽  
Educational Interventions ◽  
Religious Behaviors

This study examined the relationship between religious involvement and prostate cancer screening behavior among a probability sample of 199 African American men. Religious involvement was assessed by telephone via a multidimensional instrument. Engaging in religious behaviors was predictive of reporting a digital rectal examination (DRE) within the past year. Religious beliefs and behaviors were predictive of behavioral intention for DRE in the next 6 months. Religious behaviors were predictive of reporting an appointment for a DRE in the next 6 months. All analyses were controlled for age, education, and marital status. None of the predictions were significant for prostate-specific antigen testing. Understanding the role of religious involvement in cancer beliefs and screening is important. Such knowledge can inform educational interventions for this group, which is disproportionately affected by prostate cancer.

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