Correlation of GSTP1 Polymorphism with Severity of Prostate Cancer in an Eastern Indian Population

Background:GSTP1is one of the Glutathione-S-Transferases(GSTs) which suppress tumor genesis by detoxifying toxic carcinogens and reactive oxygen species (ROS). Prostate cancer is related to several mutations affecting the expression of GSTP1. A single nucleotide polymorphism (SNP: Ile105Val) in the GSTP1gene results insignificant reduction in its anticancer activity. The current case control study was conducted to ascertain the risk of association of GSTP1polymorphism with risk of cancer prostate in an Eastern Indian population. Materials and Methods: During a study period of 2 years, DNA was isolated using the phenol chloroform extraction method from the blood of 225 histopathologically diagnosed prostate cancer patients and 120 matched controls. The GSTP1polymorphism was assessed by PCR amplification of thegene followed by restriction digestion with Alw261 (a restriction enzyme derived from Acinetobactro lwoffiRFL26). Histopathological grading in the case group was performed using Gleason’s scores and International Society of Urological Pathology (ISUP) grading. Results:Comparison of the distribution of different GSTP1alleles between the case and control groups was performed by chi square test and odds ratio analysis. A χ2 value of 18.56 suggested significantly higher number of Galleles in the case group. An odds ratio of 2.25 with a confidence interval of 1.52 to 3.34 for 95% CI showed that the Gallele in GSTP1gene were linked with greater risk of prostate cancer. Post hoc ANOVA and logistic regression suggested that cases having Galleles had more progressive form of diseases as evident from ISUP grades.Conclusion:From our study we can conclude that GSTP1polymorphism is not only significantly associated with risk of prostate cancer but also with its severity in our Eastern Indian population.GSTP1polymorphism should be considered as a prognostic indicator for prostate cancer patients along with planning for more aggressive management of the disease

Epithelioid Hemangioendothelioma of Penis.

Epithelioid Hemangioendothelioma is a rare vascular tumor of low malignant potential most commonly found in the lung, liver and soft tissues. Penis is a very rare site for it. We report a case of penile epithelioid hemangioendothelioma. Surgery is the standard treatment and close clinical follow up is necessary due to its unpredictable natural history.

Comparison of the efficacy and safety of topical diltiazem and nitroglycerine for pain relief during transrectal ultrasound guided biopsy of the prostate

INTRODUCTION AND OBJECTIVE: Transrectal ultrasound biopsy of prostate is a painful procedure. The introduction of the rectal probe is one of the major contributors to the pain associated with this procedure. Drugs that relax the anal sphincter should theoretically decrease this pain. This study was done to compare the efficacy and safety of two topical medications that relax the anal sphincter, diltiazem and nitroglycerine, in decreasing the pain associated with transrectal ultrasound guided prostate biopsy. MATERIALS AND METHODS: 66 patients who were to undergo their first prostate biopsy were randomized to receive either 2 mL of 2% topical diltiazem or 2 mL of 0.2% topical nitroglycerine or placebo 20 minutes before prostate biopsy. All patients also received 15 mL of intrarectal lignocaine. A 10-point visual analogue score was used to record the pain immediately after the insertion of the probe, during biopsy and at the end of the procedure. RESULTS: The pain scores due to probe insertion, during biopsy and at the end of the procedure in patients who received topical diltiazem or nitroglycerine were significantly lower compared to the placebo group (p < 0.001). There were no significant differences in the pain scores between the patients receiving diltiazem compared to those receiving nitroglycerine. Higher incidence of headache and fall in blood pressure was noted in patients who received nitroglycerine compared to those receiving diltiazem. CONCLUSION:Topical diltiazem and nitroglycerine are equally effective in reducing the pain associated with transrectal prostatic biopsy. Diltiazem is safer compared to nitroglycerine.