ABSTRACT
INTRODUCTION: Published results of HistoScanning™ (HS) for prostate cancer (PCa) diagnostics are inconsistent and their value remains unclear. We prospectively analyzed the detection rate and tumor volume concordance in PCa patients. MATERIAL AND METHODS: Two hundred and eighty-two patients with biopsy-proven PCa scheduled for radical prostatectomy (RP) were included. All patients underwent ultrasonographical examination by HS prior to surgery. HS was evaluated compared to RP specimen as to (1) the prediction of overall tumor volume and (2) accuracy of HS in detection of PCa lesions larger than 0.2/0.5 ml, separated for each sextant. For each sextant, receiver operating characteristic (ROC)-analysis and area under the curve were determined. Sensitivity and specificity were calculated and visualized in ROC-curves. RESULTS: HS tends to underestimate volume of cancerous lesions, particularly larger lesions >8 ml. Using a 0.2 ml detection threshold, specificity and sensitivity of HS were between 29-68% and 46-78%. For a 0.5 ml detection threshold, sextant-specific specificity increased to 59-92% and sensitivity decreased to 16-54%. Stratification according to pre-operational PSA values did not improve performance characteristics of HS. CONCLUSIONS: Our results do not support a significant contribution of HS to PCa diagnostics.
Subject(s)
Prostatic Neoplasms/diagnostic imaging , Ultrasonography/methods , Adult , Aged , Area Under Curve , Biopsy , Humans , Image Interpretation, Computer-Assisted , Male , Middle Aged , Predictive Value of Tests , Prostatectomy , Prostatic Neoplasms/pathology , Prostatic Neoplasms/surgery , ROC Curve , Reproducibility of Results , Tumor BurdenABSTRACT
BACKGROUND: The endogenous lectin galectin-3 can regulate cell adhesion and proliferation in vitro, thus prompting the examination of its clinical relevance in breast cancer. MATERIALS AND METHODS: Immunohistochemical processing of tissue sections (n = 273; drop-out rate 20.4%) was used for the assessment of galectin-3 expression. Cytoplasmic/nuclear staining and presence in the tumor stroma were analyzed in human breast cancer patients. RESULTS: A weak correlation with positive steroid receptor status was revealed for cytoplasmic positivity. Nuclear staining was correlated to the lobular type of invasive carcinoma, and tumor stroma expression to high-grade malignancy. Multiple testing of cut-off points to divide the cases into groups based on different levels of immunopositivity combined with univariate Kaplan-Meier survival analysis and computations following the multivariate Cox regression model disclosed no prognostic correlation to either cytoplasmic or nuclear expression of galectin-3. The presence of galectin-3 in the stroma, however, indicated an unfavorable prognosis. Prediction of overall survival was feasible using a model consisting of stage and c-erbB2 status. CONCLUSION: These data signify that caution should be exercised in extrapolating from the anti-apoptotic/prometastatic activity of galectin-3 in model systems to the clinical situation.
