ABSTRACT
Objective To investigate the feasibility of applying transvescal approach laparoendoscopic single-site radical prostatectomy (TVSSLRP) and assess the oncological and functional outcomes.Methods Eight patients with clinically localized prostate cancer (PCa) of low risk underwent TVSSLRP.Demographic data were accrued including patient age,body mass index (BMI),preoperative PSA level,the International Index of Erectile Function 5,biopsy Gleason score,clinical TNM stage and D'Amico risk classification.One surgeon performed all TVSSLRP procedures.A homemade triple-port was introduced percutaneouly into the bladder to establish pneumovesicum through a 4 cm incision.The major steps of the surgery were described as follows:initial incision was made along posterior margin of the bladder neck to expose bilateral vas deference and spermatic vesicle.After opening Denonvilliers' fascia and extending the space to lateral prostatic pedicles,an intra-fascial nerve sparing procedure was performed.The puboprastatic ligaments were then separated close to the prostate surface and the dorsal vein complex was cautiously swept off.Subsequently,careful apical dissection and urethral transection was sequentially conducted. To reduce the tension of vesico-urethral anastomosis,3 additional incisions parallel to vesio-urethral margin were created and a novel tension - reduced V-LocTM barbed polydioxanone sutures was used. Results All the operations were successfully performed and there was no conversion to standard laparoscopic approach or open surgery.The total operative time range was 75 - 180 min with mean time of 125 min.The blood loss was 85 -450 ml with mean 140 ml and no blood transfusion was required.The catheter was removed after a mean (range) of 14 (9 -16) days.No intra-operative complications occurred. No patient had positive surgical margins.The mean (range) hospital stay was 17 (13 -25) days after surgery. All the cases were continent after removal of the catheter.No cases demonstrated vesico-urethral stricture and biochemical recurrence on 12 - 18 months follow up postoperatively. Conclusions TVSSLRP is technically feasible for cases with organ-confined prostate cancer with good oncological and functional results.
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Objective To investigate the expression of six-transmembrane epithelial antigen of the prostate (STEAP) in prostate cancer and its relationship with prostate specific antigen (PSA).Methods A retrospective analysis was performed of 65 consecutive patients verified for prostate canc-er by prostate biopsy or post-operational pathological examination.The clinical stage was classified ac-cording to TNM system and the pathological grade was classified according to Gleason score.STEAP expression in 65 prostate cancer samples (T1 9,T2 14,T3 17,T4 25;high differentiation 37,moder-ate differentiation 12 and low differentiation 16) was studied by using STEAP monoclonal antibody (Santa Cruz Biotech,USA) and SP immunohistochemical staining.Positive staining gray values were introduced to describe the intensity of STEAP expression.STEAP expression level was analyzed with respect to stage,grade,serum total PSA and free/total PSA (f/t PSA) ratio respectively.Results The serum total PSA concentration and f/t PSA ratio in all cases was (27.65±8.34) ng/ml and 0.15～0.04 respectively.STEAP was positively stained in 63 patients (T1 7,T2 14,T3 17,T4 25; high differentiation 37,moderate differentiation 11 and low differentiation 15).The mean STEAP-positive staining gray values in stage T1,T2,T3 and T4 of prostate cancer were 26.8%,45.6%,62.3% and 76.5%,respectively and in high,moderate and low differentiation group were 71.2%,52.8%,and 34.4% respectively.The positive staining gray values of STEAP expression was posi-tively correlated to the clinical stage of cancer and negatively correlated to the Gleason score and the ratio of f/t PSA (P<0.01,respectively).There was no significant relationship between STEAP ex-pression and serum total PSA concentration (P>0.05).Conclusion STEAP expression may act as one of new markers to the invasion degree and pathological grade of prostate cancer.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the relationship between six-transmembrane epithelial antigen of the prostate (STEAP) expression and the histologic grading of prostatic carcinoma (PCa).</p><p><b>METHODS</b>Different prostatic tissues and non-prostatic tumors, 131 cases of PCa, 164 cases of benign prostate hyperplasia (BPH), and 56 cases of non-prostatic malignancies, were analyzed for the expression of STEAP by using STEAP monoclonal antibody and SP immunohistochemical staining. The positive area unit (PU) was introduced to describe the intensity of STEAP expression.</p><p><b>RESULTS</b>The prostatic tissues of all but 3 cases of PCa and 5 cases of BPH were stained positively, while all of the non-prostatic tumors were stained negatively. There was a significant negative correlation between the STEAP expression and the histologic grading of PCa.</p><p><b>CONCLUSION</b>STEAP can be a prognostic marker of PCa and a potential therapeutic target in PCa.</p>