Is the Expression of p53, c-erb-B2 and Ki-67 Influence the Prognosis of the Non-muscle Invasive Urothelial Bladder Cancer?

PURPOSE: The immunohistochemial markers can be used to predict prognosis more accurately for several cancers. In non-muscle invasive urothelial carcinoma, p53, c-erb-B2 and Ki-67 are applicable. We investigated a retrospective analysis of the relation between the markers and clinical prognostic factors of urothelial bladder cancer. MATERIALS AND METHODS: Data from 268 non-muscle invasive urothelial bladder cancer (Ta, T1) patients from one single center were collected. Immunohistochemical evaluation was carried out on 268 (p53, c-erb-B2, Ki-67) cases. Clinical prognostic factors are as follows; number of tumor, tumor invasiveness, tumor grade and recurrence. The sum of all positivity of 3 markers was made as a new factor and evaluation of correlation between this factor and prognostic factors was also done. Statistical analysis was done by chi-squares test and Pearson's correlation test. RESULTS: Through chi-square test, there were significant relations between all markers and tumor invasiveness (p<0.001), tumor grade (p<0.001). Number of tumor is significantly related with Ki-67 (p=0.043). Recurrence is related with c-erb-B2 (p=0.010) and Ki-67 (p=0.043). There was also significant correlations between the sum of the markers and prognostic factors-tumor invasiveness (p<0,001), tumor grade (p<0.001) and recurrence (p=0.007). CONCLUSIONS: In this study, evaluated markers were closely related with clinical prognostic factors and may contribute to decision making on risk-assessment and management strategy for non-muscle invasive urothelial bladder cancer.

Pathological upgrading in prostate cancer patients eligible for active surveillance: Does prostate-specific antigen density matter?

PURPOSE: To evaluate prospectively the role of prostate-specific antigen (PSA) density in predicting Gleason score upgrading in prostate cancer patients eligible for active surveillance (T1/T2, biopsy Gleason score< or =6, PSA< or =10 ng/mL, and < or =2 positive biopsy cores). MATERIALS AND METHODS: Between January 2010 and November 2013, among patients who underwent greater than 10-core transrectal ultrasound-guided biopsy, 60 patients eligible for active surveillance underwent radical prostatectomy. By use of the modified Gleason criteria, the tumor grade of the surgical specimens was examined and compared with the biopsy results. RESULTS: Tumor upgrading occurred in 24 patients (40.0%). Extracapsular disease and positive surgical margins were found in 6 patients (10.0%) and 8 patients (17.30%), respectively. A statistically significant correlation between PSA density and postoperative upgrading was found (p=0.030); this was in contrast with the other studied parameters, which failed to reach significance, including PSA, prostate volume, number of biopsy cores, and number of positive cores. Tumor upgrading was also highly associated with extracapsular cancer extension (p=0.000). The estimated optimal cutoff value of PSA density was 0.13 ng/mL2, obtained by receiver operating characteristic analysis (area under the curve=0.66; p=0.020; 95% confidence interval, 0.53-0.78). CONCLUSIONS: PSA density is a strong predictor of Gleason score upgrading after radical prostatectomy in patients eligible for active surveillance. Because tumor upgrading increases the potential for postoperative pathological adverse findings and prognosis, PSA density should be considered when treating and consulting patients eligible for active surveillance.

Adolescent Varicocele: Are Somatometric Parameters a Cause?

PURPOSE: It has been reported that varicocele is found less frequently in obese men. Accordingly, we evaluated varicocele patients and statistically analyzed the correlation between varicocele and somatometric parameters. MATERIALS AND METHODS: A total of 211 patients underwent surgery for varicoceles. All patients underwent history taking, physical examination, and scrotal ultrasound to determine the presence and severity of varicocele. An age-matched control group consisted of 102 patients who were found not to have varicocele according to physical examinations and scrotal ultrasound. The age, weight, height, and body mass index (BMI) of the two groups were compared. The statistical analyses were performed by use of PASW Statistics ver. 18.0. A p-value of less than 0.05 was used for statistical significance. RESULTS: In the varicocele group, the mean age, height, weight, and BMI were 29.42+/-14.01 years, 168.53+/-9.97 cm, 62.14+/-13.17 kg, and 21.66+/-3.21 kg/m2, respectively. The distribution of varicocele grade was as follows: 103 (48.8%) grade III, 72 (34.1%) grade II, and 36 (17.1%) grade I. In the control group, the mean age, height, weight, and BMI were 30.83+/-17.31 years, 161.93+/-19.83 cm, 64.69+/-17.86 kg, and 24.04+/-3.64 kg/m2, respectively. Analyzing these data specifically in adolescents, they showed significant differences in age, height, and BMI (p=0.000, p=0.000, and p=0.004, respectively) between two groups. There were no significant differences in somatometric parameters between patients with different grades of varicocele. CONCLUSIONS: Our results showed that patients with varicoceles were significantly taller and had a lower BMI than did patients without varicoceles, especially among adolescents. Carefully designed future studies may be needed.