Use of endoglin [CD 105] as a marker for diagnosis and prognosis of prostatic cancer

To determine serum endoglin [CD 105] levels in cases of prostatic cancer and benign prostate hyperplasia Also, to evaluate its role in the diagnosis and prognosis of prostate cancer. This study included 70 patients and 12 normal control individuals. Measurement of serum PSA was performed for cases of prostate cancer and benign prostatic hyperplasia [BPH] while measurement of serum endoglin was performed for all patients and control individuals. These cases were classified into 3 groups. Group I included 42 patients with prostate cancer, the criteria for diagnosis were digital rectal examination [DRE] of irregular abnormal hard nodule/ nodules in the prostate or PSA > 4 ng /ml. The diagnosis wits confirmed by trans- rectal ultrasouand [TRUS] biopsy. According to Gleason's score, these patients were further classified into Grade II and III. Group II included 28 patients with benign prostatic hyperplasia [BPH].Group III included 12 healthy men as control group. Serum CD 105 concentration was estimated by using human endolin ELISA kit. There was a significant difference in PSA levels prostate cancer [mean 32.4 +/- 30.85 ng/ml] BPH [mean 2.84 +/- 1.67 ng/ml]. The mean values of CD 105 were 5.29, 2.12 and 0.15 ne/ml in group I, II and III [controls], respectively. The mean value of CD 105 in each group was significantly different from the other groups. In group I. the mean value of CD 105 of' grade III was 7.5 ng/ml and was significantly higher than that [4.89 ng/ml] of grade II prostate cancer. There was a significant correlation between CD 105 and PSA levels in prostate cancer. It was found that the cut of serum endoglin was 2.65 ng/ml for diagnosis of cancer prostate. Endoglin [CD105] has a critical role in the diagnosis and prognosis of cases of prostate cancer and it can be used as a marker for diagnosis of these cases

relationship between HLA-DR and prostate cancer

To determine the etiologie relationship between HLA class II [DR] and cancer prostate and its pattern on B lymphocytes of patients with prostate cancer patients and normal individuals by using INNO-LiPA technique. Thirty patients having cancer prostate were included whatever the age of patients, grade or stage of the disease and before any medical or surgical intervention and 60 normal persons. All the patients passed within the planned program such as complete history taking with clinical examination including digital rectal examination [DRE]. Laboratory investigations as complete blood picture, hepatic and renal function tests, serum prostatic specific antigen [PSA] and HLA typing for prostate cancer patients and healthy controls. Imaging tests as chest X-ray, abdomino-pelvic ultrasound and transrectal ultrasound [TRUS]. Histopathological examination of prostatic biopsy guided by TRUS. Our results revealed that the antigen of HLA-DRB4 was found in 10 patients [33.3%] with a relative risk of 1.4. X[2] of 0.16 and p value of 0.053 compared to [26.7%] of control group which is statistically significant. The antigen HLA-DRB-0406 was found in 4 patients [13.3%] with relative risk of 4.9, X[2] of 4.6 and p value of 0.044 compared to 3% of control group which is statistically significant. The antigen HLA-DRB1-0410 was found in I patients [6.7%] with a relative risk of 3.5, of 5.97 and p value of 0.043 compared to 2% of control group which is statistically significant. The antigen HLA-DRB 1405 was found in 2 patients [6.7%] with a relative risk of 2.7. X[2] of 5.03 and p value of 0.041 compared to 2.7% of control group which is statistically significant. HLA typing showed that HLA-DR alleles frequency in prostate cancer patients compared with normal persons is high. Beside its role as a risk factor for acquiring the disease, it could be used as a marker for early detection, to determine the biological behavior and activity of the tumor, prognostic marker and in choice of the appropriate line of treatment

Tubularization of the incised urethral plate [Snodgrass procedure] for distal and midpenile hypospadias repair

To evaluate tubularized incised plate urethroplasty [TIPU] in management of distal and midpenile hypospadias. Thirty-two boys [mean age 5.4 years] underwent tubularized incised plate urethroplasty.Twenty-five boys had distal and seven had mid-penile hypospadias. The operation -involved incision of the urethral plate, which was, then tubularized [Snodgrass procedu re]. The neourethra was then covered with a deepithelialized pedicled dartos flap from the inner prepuce before glans and skin closure. With a mean follow-up of 10 months [range 3-14], there were seven complications. Four patients developed a fistula, spontaneous closure occurred in two cases by regular dilatation while the remaining two cases required surgical closure. Two patients had meatal stenosis and responded to meatal dilatation and one patient had complete breakdown of the neourethra. The cosmetic appearance in the other patients is that of a normal slit-like terminal meatus. Tubularized incised plate urethroplasty is considered to be a successful technique for correction of distal and midpenile hypospadias with few complications and superior cosmetic results

Seven years experience with kock continent ileal reservoir and urethral kock bladder replacement

From May 1983 to June 1990, the Kock pouch was used for continent urinary diversion in 35 patients and the urethral Kock in 29. The indications were variable. No operative mortality was encountered, but 5 patients [7.8%] died from malignancy related causes and 2 older patients [3.12%] developed local pelvic recurrence during the first year. The mean follow-up period was 2.5 years. Early complications encountered in the two groups were not amazing and only 2 patients [one in each group] required intervention. Overall late complication rate that necessitated reoperation was [31.5%], being 34.5% among patients with Kock pouch and 20% among those with urethral Kock. Ultimate continence following Kock pouch was seen in 93%, while all the patients submitted to urethral Kock operation achieved diurnal continence with partial and infrequent enuresis in 16% within 6 months the mean capacity of the mature urethral Kock pouches and Kock reservoirs reached 650 ml and 590 ml, respectively. The average basal pressure in both groups was 4 cm H2O and the pressure at maximum capacity was almost always around 30 cm H2O. Stones in the pouchs were generally frequent [19.97%] and also was the stricture urethral in the urethral Kock group [12%]

Postoperative radiotherapy in partial and total cystectomy versus total cystectomy of T1/T2 bladder cancer

We have studied 52 patients with-early bladder cancer [TI/T2] who underwent partial or total cystectomy between January 1987 and December 1992 and this represent about 1% of the total recorded bladder cancer cases. The ten partial and eleven total cystectomy patients received postoperative radiotherapy. The remaining 31 cases underwent radical cystectomy only with no postoperative treatment The mean age of the studied group was 51.3 years. Twenty percent of cases had bladder tumor less than 3 cm while, in 80% it was more than 3 cm in diameter. Squamous cell carcinoma [SCO represented 52% compared to 42 transitional cell carcinoma [TCC] and 6% adenocarcinoma. During the first three years partial cystectomy showed 40% recurrence and 39% of total cystectomy only compared to 27% when postoperative radiotherapy was applied. Grade 3 histology showed 51% and 41% recurrence in SCC and TCC compared to 33% and 25% grade 2 respectively. Distant metastases occurred in 10% of the whole series with nearly equal percentage in the three subgroups. The over all three year survival rate was 75% of the whole series with a higher percentage when total cystectomy was followed with postoperative radiotherapy. There were 4 deaths due to disease and another two fatal surgical complications while there were 3 non-fatal major complications due to surgery and irradiation in the whole series with morbidity rate of 17%