The Prostate Cancer Patient Had Higher C-Reactive Protein Than BPH Patient

PURPOSE: C-reactive protein (CRP) is a general marker for inflammation and it has been associated with prostate cancer. We hypothesized that a correlation may exist between CRP and prostate cancer in patients undergoing transrectal biopsy of the prostate because of rising prostate-specific antigen (PSA) levels. MATERIALS AND METHODS: From January 2009 to March 2012, we retrospectively reviewed 710 patients who visited our urology department and were diagnosed as having a PSA value over 4.0 ng/mL. Patients with acute infections, rheumatoid arthritis, gout, asthma, chronic lung disease, myocardial infarction, or apoplexy and those who had taken nonsteroidal anti-inflammatory drugs were exempted from the research because these variables could have impacted CRP. After we applied the exclusion criteria, we selected 63 patients with prostate cancer and 140 patients with benign prostatic hyperplasia (BPH). RESULTS: A total of 203 patients were observed: 140 patients had BPH, and 63 patients had prostate cancer. Prostate cancer patients were divided into two groups by tumor-node-metastasis classification. The patients below T2 were group A, and those above T3 were group B. The natural logarithm of C-reactive protein (lnCRP) differed between the BPH group and the prostate cancer group. The lnCRP also differed between the BPH group and prostate cancer groups A and B (p<0.05). CONCLUSIONS: The serum CRP level of the prostate cancer group was higher than that of the BPH group. Inflammation may be correlated with prostate cancer according to the serum CRP level.

A Retrospective Study of the Management of Vulvodynia

PURPOSE: Vulvodynia is characterized by chronic vulvar pain caused by sexual intercourse and often results in female sexual dysfunction. Because the causes of vulvodynia are not clear, many patients do not receive optimal treatment. Recently, gabapentin and botulinum toxin A have both been shown to be effective treatments for vulvodynia. In this study, we retrospectively analyzed the clinical outcomes of botulinum toxin A and gabapentin treatment for chronic pain in women with this condition. MATERIALS AND METHODS: Seventy-three women with vulvar pain were administered either gabapentin (n=62) or botulinum toxin A (n=11) injections. Effectiveness was measured by use of a visual analogue scale (VAS). We analyzed the treatment method, treatment duration, success of treatment, and side effects or adverse reactions. RESULTS: Pain levels in both groups significantly decreased after treatment. In the gabapentin group, the VAS score decreased from 8.6 before treatment to 3.2 after treatment (p<0.001). The VAS score in the botulinum toxin A group was reduced from 8.1 to 2.5 (p<0.001). Side effects for both therapies were few and subsided with treatment with general antibiotics and nonsteroidal antiinflammatory drugs. CONCLUSIONS: Gabapentin and botulinum toxin A are safe and effective treatments for vulvodynia. This condition can cause sexual dysfunction and affect quality of life. However, with proper management, satisfactory outcomes for women with vulvodynia can be achieved.

Clinical Use of High-Sensitivity C-Reactive Protein (hs-CRP) in Chronic Pelvic Pain Syndrome

PURPOSE: The cause of chronic pelvic pain syndrome (CPPS) has traditionally been regarded as inflammation of the pelvis and pelvic organs. C-reactive protein (CRP) is an indicator of acute and chronic inflammation. We aimed to determine the clinical significance and use of high-sensitivity C-reactive protein (hs-CRP) in patients with CPPS. MATERIALS AND METHODS: From January 2005 to December 2006, we retrospectively reviewed 70 patients diagnosed as having CPPS (mean age, 45.4+/-10.09 years old). The variables we assessed in these patients were white blood cell count in the third voided urine specimen (VB3), scores on the NIH-Chronic Prostatitis Symptom Index (NIH-CPSI), peak flow rate (Qmax), postvoid residual urine (PVR), and hs-CRP level. Items were checked again after 8 weeks of treatment with antibiotics and anti-inflammatory agents. Patients who showed improvement in symptom scores were regarded as being in the positive response group. We analyzed correlations of hs-CRP with the other CPPS items. RESULTS: The hs-CRP level was statistically significantly correlated with other CPPS items in both the NIH category IIIa and IIIb groups. In the positive response group, there were statistically significant changes in the hs-CRP level, WBC count in VB3, and scores on the NIH-CPSI after treatment (p<0.05). In the negative response group, there were no significant changes in CPPS items. CONCLUSIONS: The hs-CRP level had a clinically significant correlation with other CPPS items. In the positive response group especially, the hs-CRP level decreased after treatment. Measuring hs-CRP may have benefits in determining the severity of CPPS and in predicting the response to treatment.

Usefulness of NMP22 BladderChek for the Diagnosis and Monitoring of Bladder Cancer / 대한진단검사의학회지

BACKGROUND: As bladder cancer is a superficial tumor with frequent recurrences, early detection and confirmation of recurrence are important. We evaluated the usefulness of NMP22 BladderChek (NMP22BC) for the diagnosis and monitoring of bladder cancer. METHODS: From July to December 2004, we enrolled in the study 670 patients who visited the urology clinic in Ewha Womans University, Dongdaemun Hospital with hematuria or dysuria and were tested with NMP22BC. We also performed the NMP22BC and BTA stat tests simultaneously in 21 patients and interference test in 10 patients. RESULTS: NMP22BC tests were negative in 97% of the patients who had been cured of bladder cancer and were positive in 95% of the patients with recurred bladder cancer. The diagnostic sensitivity, specificity, positive and negative predictive value, and efficiency were 95.0%, 91.5%, 25.7%, 99.8%, and 91.6%, respectively, with 8.5% false positive and 5% false negative rates. Fifty-five patients showed false positive in the NMP22BC test, the main cause of which was the presence of WBCs in urine. There was a good agreement between the NMP22BC and BTA stat tests (kappa agreement value, 0.5; P=0.008). According to the interference test, two patients with more than 3+ in leukocyte esterase results showed false positive in the NMP22BC test. CONCLUSIONS: NMP22BC test was simple to perform, rapid to produce the results, and useful in diagnosing a bladder cancer recurrence; the test shows a high efficiency with a high sensitivity, specificity, negative predictive value, and low false negative rate.