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Objective To evaluate the clinical significance of prostatic hypoechoic lesions on transrectal ultrasound (TRUS) for prostate cancer detection.Methods Four hundred and thirty-eight patients referred for biopsy of the prostate from August 1999 to August 2004. Every patient received 6-13 biopsy cores of the prostate. If a hypoechoic was identified, the biopsy was taken from this lesion. Correlation between hypo-echoic lesions, isoechoic areas and cancer detection for each core was performed. Results Among 438 patients, cancer was detected in 112(25.6%). Hypo-echoic lesions were seen in 75 (67%) patients with prostate cancer, the isoechoic were as in 37 (33%). A total of 3504 biopsy cores were obtained from 438 patients, and 636 biopsy cores were taken from hypoechoic lesions. Among 636 biopsy cores, 163 (25.6%) were cancer and 473(74.4%)were not. The cancer detective rate in patients with hypoechoic lesions (75/298, 25.2%) was similar to non-hypoechoic lesions (37/140, 26.4%) on TRUS. There was no statistically significant difference between them (P
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<p><b>OBJECTIVE</b>To determine the influence of androgen deprivation therapy (ADT) on bone mineral density (BMD) in men with prostate cancer.</p><p><b>METHODS</b>Forty-nine men with prostate cancer underwent BMD determination and then were classified into two groups: non-ADT group (21 cases), who were about to receive ADT, and ADT group (28 cases), who had received ADT for more than 1 year. BMD was determined by dual energy X-ray absorptiometry (DEXA) in the lumbar spine (L2-4) and femoral neck in all the patients. The Age-Matched Z scores were used as the reference standard for controlling the difference of age, sex and weight.</p><p><b>RESULTS</b>Thirteen (62%) of the non-ADT group and 23 (82%) of the ADT group fulfilled the BMD criteria for osteopenia or osteoporosis. Z scores for the Age-Matched control in the lumbar spine and femoral neck were -(0.9 +/- 0.7) and -(0.6 +/- 0.5) in the non-ADT group, and -(1.8 +/- 1.1) and -(1.6 +/- 1.0) in the ADT group, respectively (P<0.01). The men of the ADT group had significantly lower BMD in the lumbar spine and femoral neck than those of the non-ADT group.</p><p><b>CONCLUSION</b>Pre-existing osteopenia and osteoporosis are common in men with prostate cancer before ADT. ADT is significantly associated with the loss of BMD and the evaluation of BMD is necessary before ADT for men with prostate cancer.</p>
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Middle Aged , Absorptiometry, Photon , Androgen Antagonists , Therapeutic Uses , Bone Density , Orchiectomy , Osteoporosis , Prostatic Neoplasms , General SurgeryABSTRACT
Objective To evaluate the clinical significance of prostatic hypoechoic lesions on transrectal ultrasound(TRUS) for prostate cancer detection Methods 438 patients referred to our hospital between August 1999 and August 2006 for biopsy of the prostate.Every patient received 6～13 biopsy cores of the prostate.If a hypoechoic was identified,the biopsy was taken from this lesion.Correlation between hypoechoic lesions,isoechoic areas and cancer detection for each core was performed.Results Among 438 patients,cancer was detected in 112(25.6%) patients.Hypoechoic lesions were seen in 75(67%)patients with prostate cancer,the isoechoic areas in 37(33%).A total of 3504 biopsy cores were obtained from 438 patients.Among them,636 biopsy cores were taken from hypoechoic lesions.163(25.6%)biopsy cores taken from hypoechoic lesions harbored cancer and 473(74.4%) had no cancer.The cancer detection rate was similar in patients with hypoechoic lesions on TRUS or not,25.4%(75/298)and 26.4%(37/140)respectively.The difference was not statistically significant(P
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Objective To evaluate the clinical value of transrectal ultrasound guided systematic 13 cores prostate biopsy. Methods A total of 160 patients referred for abnormal digital rectal examination and (or) prostate specific antigen 4ng/ml or greater underwent transrectal ultrasound guided systematic 13 cores prostate biopsy.That was,in addition to the standard sextant biopsies,cores were taken from the far lateral and middle regions of the gland as described by Eskew.Pathological findings of the additional regions were compared with those of the sextant regions. Results Of the patients 35 % had cancer on biopsy(56 /160).Of the 56 patients with prostate cancer 12(21%)had carcinoma only in the additional regions,which would be undetected on the sextant biopsy technique (P
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Objective To evaluate the safety and efficacy of transrectal ultrasound guided prostatic nerve blockade for pain control during transrectal prostate biopsy.Methods Seventy-three patients requiring systematic 13 cores biopsy of the prostate were randomized into two groups.Group A(37 cases) received an injection of 5 ml 1% lidocaine into the prostatic neurovascular bundles on each side at the base of the prostate under ultrasound guidance,and group B(36 cases) received 5 ml saline ( 0.9% sodium chloride) at the same way.Pain during biopsy was assessed using a 10-point linear visual analog pain scale immediately after this procedure.Results The mean pain scores during transrectal prostate biopsy were significantly lower in group A than that in group B( 1.1? 0.6 vs 5.9? 3.1,t= 4.81,P