Clinical significance and management of prostatic intraepithelial neoplasia / 中华男科学杂志

Prostatic intraepithelial neoplasia (PIN) refers to the cellular proliferations within prostatic ducts, ductules, and acini. PIN is divided into three grades, PIN 1, PIN 2 and PIN 3, PIN 1 is a low grade (LPIN); PIN 2 and PIN 3 are high grades (HPIN). Clinically, the term PIN is usually used to indicate HPIN. LPIN is not used as a separate pathological diagnostic entity. HPIN is widely regarded as the precancerous change of prostatic carcinoma. HPIN and prostatic carcinoma share many similarities in epidemiology, genetics, morphology, as well as in location and clinical features. And so they are two closely related entities. HPIN is pathologically diagnosed, and shows no specificity on digital rectal examination (DRE) and transrectal ultrasonography (TRUS). HPIN does not elevate serum prostatic specific antigen (PSA) concentration. HPIN with an elevation of serum PSA should be considered as the possible coexistence of HPIN and prostatic carcinoma. There has been no consensus on the management of HPIN, but it is widely held that simple HPIN detected by extended needle biopsy has no therapeutic implications, but should be followed up at regular intervals. If there are changes in PSA and/or DRE, repeated needle biopsy is imperative. The natural biological behaviour of HPIN is yet poorly understood. Currently, most urological experts do not recommend antiandrogen therapy to patients with simple HPIN.

Correlation of apoptosis with androgen receptor in prostate cancer / 临床与实验病理学杂志

Purpose　To investigate relationship between androgen receptor and apoptotic index and to further understand the tumor biology of prostate cancer. Methods　Fifty-six patients with histologically proven prostate cancer and 20 cases with benign prostatic hyperplasia(BPH) were collected. Androgen receptor(AR) were stained by 2H12 monoclonal antibody using immunohistochemical method. The apoptotic index (AI) was determined by the terminal deoxynucleotidyl transterase-mediated dUTP biotin nick end labeling (TUNEL) technique on serial sections of formalin fixed, paraffin embedded tissues. Results　AR was not found significantly difference (P>0.05) between prostate cancer and BPH. The association of AR with AI according to Gleason score were not observed in prostate cancer. AI were significantly higher in prostate cancer compared to BPH (P<0.05).AI were also significantly higher in AR-positive prostate cancer than in AR-negative prostate cancer（P<0.05）. Conclusion　AR expression can induce prostate cancer cells to become apoptosis, and may be a useful predictor in functional classification and endocrine response of prostate cancer.

Value of urinary cytokeratin 8 and 18 as a diagnostic marker for transitional cell carcinoma / 中华泌尿外科杂志

Objective To determine the clinical efficacy of cytokeratin 8 and 18 as a novel urine marker for transitional cell carcinoma (TCC) of urinary tract. Methods Urinary concentrations of cytokeratin 8 and 18 were determined by an enzyme-linked immunosorbent assay (ELISA) in 52 cases of TCC and 86 cases of other urological conditions. Results The urinary values of cytokeratin 8 and 18 in the TCC patients (mean 34.8 ?g/l) were significantly higher than those in the patients without TCC (mean 9.4 ?g/l)(P

Inflammatory myofibroblastoma of the kidney / 中华泌尿外科杂志

Objective To report the diagnosis and treatment of a case of renal inflammatory myofibroblastoma. Methods A 30-year-old man presented with space-occupying lesion of the kidney with no symptoms in physical examination.No abnormality was found in the laboratory tests.B-ultrasound showed a clear-edged,solid mass which was 4.5 cm?3.7 cm in size and had heterogeneous echo in the upper,middle part of the left kidney.CT showed a similar value of the mass to that of the normal tissue.Enhanced MRI showed heterogeneous intensification of the mass whose signal was slightly lower than that of the normal tissue.Preliminary diagnosis of renal cancer was made. Results Nephrectomy was performed.On pathological examination the tumor was mainly composed of spindle-shaped,fibrous cells, and positive staining for Vimentin,SMA and HHF35 were observed immunohistochemically.Inflammatory myofibroblastoma of the kidney was diagnosed.Follow-up of 54 months showed no recurrence and metastasis of the tumor. Conclusions Inflammatory myofibroblastoma is a kind of rare,benign or low-grade malignant tumor of the kidney, and the clinical diagnosis is often difficult.Definite diagnosis relies on pathology.For the sake of avoidance of resecting the kidney by mistake, pathological examination is the preferred choice during operation.

The use of flutamide before transurethral resection of the middle-or large-sized hyperplastic prostate / 中华泌尿外科杂志

0.05).In groups A and B,the intraoperative blood loss was(94.4?51.6)ml and(155.8?84.3)ml;the 4% mannitol solution used for intraoperative irrigation was(18.4?6.2)L and(25.4?8.8)L;the operative time was(65.0?16.4)min and((86.8?)25.0)min;the time for postoperative bladder infusion was(46.5?9.1)h and(57.8?17.4)h;the infused saline volume was(19.2?4.2)L and(26.7?10.2)L;the degree of satisfaction of the surgeons with the TURP field was 75.0%(36/48) and 41.9%(26/62);the cases who needed to increase the perfusion pressure during TURP accounted for 22.9%(11/48) and 45.2%(28/62);the blood transfusion rates were 6.2%(3/48) and 22.6%(14/62);and the incidence rates of secondary prostatic bleeding were(10.4)%(5/48) and 25.8%(16/62),respectively.The differences in all these parameters were statistically significant between the 2 groups(P