ABSTRACT
OBJECTIVE: To investigate the morbidity and pathological features of incidental prostate cancer and their clinical significance. METHODS: 1483 prostate specimens obtained during operation, including transurethral resection of prostate (TURP) and total resection of the prostate, for the diagnoses of benign prostatic hypertrophy (BPH) or bladder cancer between January 1999 and August 2005 underwent pathological examination and 34beta12 and p63 immunohistochemical staining so as to detect incidental prostate cancer. The volume of incidental prostate cancer was calculated by the image analysis system. The clinical data were analyzed retrospectively. Comparison between the clinical and pathological feature of incidental prostate cancer was made. RESULTS: 53 cases of incidental prostate cancer, with the Gleason scores from 2 (1+1) to 9 (4+5) and the volumes from 0.18 to 1440.00 mm(3) were detected. The morbidity of incidental prostate cancer was 3.6%. The volume of 47 cases (88.7%) were less than 0.5 cm(3) as the threshold of insignificant cancer, and the volumes of 6 cases (11.3%) were more than 0.5 cm(3). All incidental prostate cancers of clinical significance were detected in the TURP samples. Among the incidental prostate cancers found in the TURP samples 20% were clinically significant cancers. The clinically significant incidental cancers were located in the central or transitional zone with the Gleason scores of 3 + 4 (2 cases), 4 + 2 (1 case), or 4 + 5 (3 cases). These clinically significant cancers were of diffuse distribution, and their preoperative clinical features were negative in palpation/image examination, elevation of serum PSA, and negative in puncture examination. CONCLUSION: Nowadays, the morbidity of incidental prostate cancer is lower than that of 1980s'. Among the incidental cancers 11.3% were of clinical significance. That the preoperative clinical examination cannot find these clinical significant cancers is partially caused by the pathological features of these tumors.
Subject(s)
Prostatic Neoplasms/epidemiology , Prostatic Neoplasms/pathology , Aged , China/epidemiology , Humans , Immunohistochemistry , Incidence , Keratins/analysis , Male , Neoplasm Staging , Prostatic Neoplasms/metabolism , Retrospective Studies , Trans-Activators/analysis , Transcription Factors , Tumor Suppressor Proteins/analysisABSTRACT
OBJECTIVE: To summarize the experience of ultrasound guided percutaneous aspiration and sclerotherapy for peripelvic cysts and investigate the clinical effect. METHODS: A total of 169 cases of peripelvic cyst patients were evaluated, of whom 36 cases (21.3%) had hydronephrosis secondary to peripelvic cysts, 8 cases (4.7%) had renal calculus. All patients underwent ultrasound and intravenous phelography (IVP) examination, 59 patients also had CT scan. Hydatid fluid was analyzed by amine test. Percutaneous aspiration was guided by ultrasound, 95% alcohol was used to sclerosis the peripelvic cysts when amine test was negative or positive but did not have communication with pelvis through opacification. Ultrasound were done at 1, 3, 6 months and every 1 year thereafter, follow-up period were 6 months to 5 years. RESULTS: One hundred and sixty-five peripelvic cysts (97.6%) were cured by once sclerotherapy, the diameter of another 4 cases (2.4%) diminished to less than 1.5 cm by once sclerotherapy. Thirty-six cases of hydronephrosis were all resolved after sclerotherapy. Eight cases had renal calculus, of whom 4 cases underwent extracorporeal shockwave lithotripsy, 2 cases underwent percutaneous nephrolithotomy, and 2 cases did not treat the stone. Five patients had gross hematuria after aspiration, but all diminished in 3-5 d. CONCLUSION: Ultrasound guided percutaneous aspiration and sclerotherapy for peripelvic cysts had the superiority of safety, effectiveness micro-invasion and low complication.
Subject(s)
Kidney Diseases, Cystic/therapy , Paracentesis/methods , Sclerotherapy/methods , Adolescent , Adult , Aged , Child , Combined Modality Therapy , Ethanol/administration & dosage , Female , Follow-Up Studies , Humans , Injections, Intralesional , Kidney Diseases, Cystic/diagnostic imaging , Kidney Pelvis , Male , Middle Aged , Sclerosing Solutions/administration & dosage , UltrasonographySubject(s)
Prostate/pathology , Prostatic Hyperplasia/diagnosis , Age Factors , Humans , Male , Prostatic Hyperplasia/therapyABSTRACT
OBJECTIVE: To investigate the prognostic value of some clinicopathologic indexes and biologic tumor markers in predicting recurrence in T1 transitional cell carcinoma (TCC) of the bladder. METHODS: The expressions of p53, E-cadherin and VEGF of 75 patients with T1 primary bladder TCC were detected by streptabitin peroxidase (SP) immunohistochemical methods. The effects of clinicopathologic indexes and biologic tumor markers on recurrence were assessed by Kaplan-Meier and Cox proportional hazards model. RESULTS: The 1-, 3-, and 5-year recurrence- free survival rates were 68.0%, 45.3% and 20.9%. In Kaplan-Meier analysis, tumor mutifocality and the expression of p53, E-cadherin and VEGF were associated with recurrence. In multivariate analysis, the independent recurrence variables were tumor mutifocality, the expression of p53 and E-cadherin. CONCLUSION: Tumor mutifocality and the abnormal expression of p53 and E-cadherin are the variables that independently predict recurrence in T1 transitional cell carcinoma of the bladder.
