Significance of Neuroendocrine Cell Differentiation in Specimens from Patients with Prostate Cancer / 대한비뇨기과학회지

PURPOSE: The neuroendocrine cell(NEC) is one of the constitutional cells found in the prostate gland; these cells secret neurotransmitters. These neuroendocrine products have been associated with prostate cancer progression. We evaluated the significance of neuroendocrine differentiation(NED) in radical prostatectomy specimens. MATERIALS AND METHODS: We studied 45 patients who underwent bilateral pelvic lymphadenectomy and radical prostatectomy. The patients were classified into three groups according to their pathological stage. Group A included cases with organ confined tumors, Group B local advanced tumors and Group C cases had any T stage and lymph node metastasis. The cellular expression of chromogranin A in matched samples from the same patients was evaluated by immunohistochemical staining using commercially available monoclonal antibodies. RESULTS: Sixteen(35.6%) tumors had chromogranin A stained cells. Chromogranin A immunoreactivity was greatest in cases with lymph node involvement(75.0%) compared to those with primary prostate cancer(5.9% in group A and 37.5% in group B). Pathologically advanced tumors or tumors with the highest histological grades were associated with increased NED. The median staining score was 0 in Group A, 0 in Group B and 1 in Group C. The logistic regression analysis the odds ratio for group C cases showed a relative risk of 32.07(95% CI: 2.783-369.416) for NED compared to Group A. An increased prostate-specific antigen(PSA) and Gleason score were also associated with the NED. CONCLUSIONS: The degree of NEC immunohistochemical staining using the chromogranin A monoclonal antibody was marginally useful for predicting the outcome in prostate cancer patients after radical prostatectomy, especially in node positive patients. However, it is important to determine a therapeutic plan for patients with low PSA and internal organ metastasis.

An analysis of the risk factors for metabolic syndrome affecting stress urinary incontinence in korean middle-aged and older women / 대한산부인과학회지

OBJECTIVE: The purpose of this study was to identify the relationship between metabolic syndrome and stress urinary incontinence. METHODS: Based form 362 case, the risk factors including the parameters of metabolic syndrome for stress urinary incontinence (SUI) were analyzed retrospectively: body mass index (BMI), hypertension, insulin resistance, triglyceride, HDL-cholesterol. RESULTS: The risk for metabolic syndrome were associated positively with SUI. Women with the risks for metabolic syndrome had 2.503 times of the odds for SUI compared without the risks for metabolic syndrome (95% CI 1.28-4.87, p<0.001). The independent risk factors for SUI were BMI (OR 3.574 ; 95% CI 0.09-0.31, p<0.001) and insulin resistance (OR 2.563 ; 95% CI 0.04-0.31, p=0.011) by multivariate analysis. CONCLUSION: Our results suggested that metabolic syndrome was the important factor of the stress urnary incontinence. And we confirmed the need for the treatment of metabolic disturbance and the prevention of metabolic syndrome aimed at correcting hormonal-metabolic disturbance in middle-aged and older women with SUI.