ABSTRACT
Lymph node [LN] metastasis is considered an important prognostic factor in patients with prostate cancer. The aim of this study was to determine the rate of LN metastasis among an Iranian population who underwent radical prostatectomy [RP] with pelvic LN dissection [PLND]. In a retrospective review of medical records, 450 RP cases were included and the data on LN metastasis were extracted from surgical pathology reports. Overall, 4.7% of the patients had LN metastasis. The rate of surgical stage T3 [50% vs. 13.5%; P=0.021] and pathological Gleason score [3]7 [82.4% vs. 48.8%; P=0.002] was significantly higher among LN-positive patients. All patients with LN metastasis had a serum prostate specific antigen level >4 ng/ml. The diagnosis of prostate cancer is in an acceptable, but not ideal, stage of the disease; this may be due to screening examinations and tests
ABSTRACT
Our aim was to evaluate the value of serum prostate-specific antigen doubling time [PSADT] to differentiate patients with high-grade prostate cancer who require more aggressive therapy from those with low-grade cancer. Of 460 patients with extended 12-core transrectal ultrasonography-guided biopsy of the prostate, 59 with confirmed prostate cancer were selected. They had not received any previous treatment for prostate cancer and had at least 2 consecutive serum PSA tests with a rising trend. The PSADT was calculated in patients with 2 serum PSA levels measured with an interval more than 3 months. Of 59 patients with prostate cancer, 35 [59.3%] had low-grade and 24 [40.7%] had high-grade tumors. There was no difference in age between the two groups. The median PSADT in patients with high-grade tumors were 12.70 months [range, 0.7 to 44.8 months] and 25.00 months [range, 1.65 to 41.2 months; P=.001]. A total of 21 patients with high-grade tumors [87.5%] had a PSADT less than 12 months, while only 9 of those with low-grade tumors [25.7%] had a PSADT less than 12 months. A PSADT with low-grade tumors [25.7%] had a PSADT less than 12 months. A PSADT cutoff of 12 months provided a sensitivity of 74% and a specificity of 87% for differentiation of high-grade from low-grade cancers. We concluded that men with a short PSADT [<12 months] were at a higher risk of harboring a high-grade prostate cancer. Our data suggests PSADT can identify patients with high-grade tumors who require more aggressive therapy
Subject(s)
Humans , Male , Prostatic Neoplasms/diagnosis , Prognosis , Risk Assessment , Prostatic Neoplasms/pathologyABSTRACT
The aim of this study was to determine the diagnostic value of urine nuclear matrix protein 22 [NMP22] level in detection of transitional cell carcinoma [TCC] of the bladder. A total of 76 patients with newly-diagnosed or recurrent TCC and 75 controls without urinary tract disorders participated in this study. A urine sample was obtained for measurement of the NMP22 level using the enzyme-linked immunoabsorbent assay. The resulted values were evaluated in comparison with the results of pathologic examination. A total of 76 patients with TCC of the bladder and 75 volunteers without TCC were enrolled in the study. The mean level of urine NMP22 had an increasing trend associated with tumor grade [P = .01] and tumor stage [P < .001]. In participant without TCC, the mean urinary NMP22 level was 5.48 +/- 6.34 U/mL, while this value was 25.01 +/- 35.33 U/mL in patients with TCC of the bladder [P < .001]. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of urine NMP22 for detection of TCC were 75.5%, 86.7%, 85.1%, 77.4%, and 80.8%, respectively. The sensitivity of NMP22 in detecting stage Ta tumors appeared to be low [31.3%], but for grade 1 tumors, the sensitivity was 66.7%. Measurement of urine NMP22 is a noninvasive, highly sensitive, and specific method for detecting TCC of the bladder and estimating its grade and stage. Further studies can be helpful to determine whether it can be used in clinical practice