Diagnostic and Therapeutic Implications of Sortilin Expressed on the Surface of Bladder Carcinoma Cells.

Background & Objective: Cell surface expression of sortilin in different types of cancer signifies it as a therapeutic target for cancer therapy. The aim of this study was to detect sortilin expression in bladder cancer cells using an anti-sortilin monoclonal antibody (mAb) to evaluate sortilin as a target for developing diagnostic and therapeutic agents against bladder carcinoma. Methods: The protein expression of sortilin in bladder cancer tissues and cell lines (5637 and EJ138) was investigated by immunohistochemistry (IHC), immune-cytochemistry (ICC), and flow cytometry. Furthermore, the capability of anti-sortilin mAb in apoptosis induction in bladder cancer cells was evaluated. Results: A high expression level was observed in bladder carcinoma tissues (P≤0.001) and cell lines, using IHC and ICC, respectively. Flow cytometry results showed cell surface expression of 27.5±3% (P≤0.01), 74.4±7.8% (P≤0.001), and 4.2±0.4% of sortilin in EJ138, 5637, and HFFF cells, respectively. In EJ138 anti-sortilin mAb induced apoptosis in 25.2±11.5% (P≤0.05) (early) and 4.5±1.1% (P>0.05) (late) after 6 h incubation, while for 12 h, the values of 11.6±3.8% (P>0.05) and 20.7±4.4% (P≤0.05) were achieved. In 5637 cells, 6 h incubation resulted in 10.2±0.3% (P>0.05) and 6.6±1.4% (P>0.05) apoptosis induction, while these values were 12.1±0.8% (P>0.05) and 27.4±4.5% (P≤0.01) after 12 h. The HFFF cells did not show significant apoptosis. Conclusion: The overexpression of sortilin in bladder tumor cells and its potential in inducing apoptosis via directed targeting with the specific monoclonal antibody may represent this protein as a potential candidate of targeted therapy in bladder carcinoma.

Application of next-generation sequencing in the diagnosis of gastric cancer.

Objectives: Gastric cancer (GC) is a disease with high mortality, poor prognosis and numerous risk factors. GC has an asymptomatic nature in early stages of the diseases, making timely diagnosis complicated using common conventional approaches, namely pathological examinations and imaging tests. Recently, molecular profiling of GC using next generation sequencing (NGS) has opened new doors to efficient prognostic, diagnostic, and therapeutic strategies. The current review aims to thoroughly discuss and compare the current NGS techniques and commercial platforms utilized for GC diagnosis and treatment, highlighting the most recent NGS-based GC studies. Furthermore, this review addresses the challenges of clinical implementation of NGS in GC.Materials and methods: This review was conducted according to the eligible studies identified via search of Web of Science, PubMed, Scopus, Embase and the Cochrane Library. In the present study, data on gastric cancer patients and NGS methods used to diagnose the disease were reviewed.Conclusion: Given the ever-rising advancements in NGS technologies, bioinformatics, healthcare guidelines and refined classifications, it is hoped that these technologies can actualize their advantages and optimize GC patients' experience.

A possible protective role for Bacillus Calmette-Guérin therapy in urinary bladder cancer in the era of COVID-19: a brief report.

Given the systemic immunogenic effects of Bacillus Calmette-Guérin (BCG) therapy in patients with bladder cancer and its non-specific immunogenic effects in viral respiratory diseases, we aimed to study severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in bladder cancer patients with a history of BCG therapy. In the present study, all bladder cancer survivors with a history of BCG therapy were identified and included in the study according to the data recovered from the UORC (Uro-Oncology Research Center) registry database. These patients were followed up in terms of acquiring coronavirus disease 2019 (COVID-19). Among the studied patients, 102 eligible bladder cancer patients with a history of BCG therapy entered the study. The males constituted the majority of the patients (86.3%), and more than half of the study population (55.9%) were above 65 years old. Among the understudy patients, 12.7% were confirmed for COVID-19. The study results did not show a statistically significant association between the time and number of BCG therapy courses and SARS-CoV-2 infection. Although no statistically significant association was observed between receiving BCG therapy and developing COVID-19, the infection rate in patients who had recently received BCG therapy was lower than those who had received therapy more than a year ago.

The Association of Cell Surface Fibromodulin Expression and Bladder Carcinoma.

BACKGROUND: Fibromodulin (FMOD) is a secretory protein which is considered a major component of extracellular matrix. Its dysregulation in different types of cancer implies it as a promising target for cancer therapy. Within the scope of its rather wide expression in different tumors, we studied expression of FMOD and effect of anti-FMOD antibody in bladder cancer cells in order to identify new target for diagnostic and therapeutic interventions. We report here for the first time the expression of FMOD in bladder cancer cell lines in comparison to the normal cell line and tissues. METHODS: A peptide-based produced anti-FMOD murine monoclonal antibody (mAb) (clone 2C2-A1) was applied for evaluation of FMOD expression in bladder cancer and normal tissues by immunohistochemistry (IHC) staining. Furthermore, the expression of FMOD was examined in human bladder cell lines, 5637 and EJ138, as well as a non-cancerous human cell line, human fetal foreskin fibroblast (HFFF), by immunocytochemistry (ICC) and flow cytometry. The apoptosis induction of anti-FMOD mAb was also evaluated in bladder cancer cells. RESULTS: IHC and ICC analyses revealed that the qualitative expression of FMOD in bladder cancer tissues and cell lines is higher than in normal tissues and cell lines. Flow cytometry analyses revealed that 2C2-A1 mAb could recognize FMOD expression in 84.05 ± 1.85%, 46.1 ± .4% , and 2.56 ± 1.26% of 5637, EJ138, and HFFF cells, respectively. An effective apoptosis induction was detected in 5637 and EJ138 cells with no significant effect on HFFF cell. CONCLUSION: To our knowledge, this is for the first time reporting surface expression of FMOD in bladder cancer. This significant surface expression of FMOD in bladder cancer with no expression in normal bladder tissues and the capacity of inducing apoptosis through directed targeting of FMOD with specific monoclonal antibody might candidates FMOD as a diagnostic marker as well as a potential immunotargeting with monoclonal antibody.

Management of primary Ewing sarcoma of the kidney with inferior vena cava (IVC) tumor thrombosis.

Ewing sarcoma (ES) is an entity which belongs to a spectrum of neoplastic diseases called the Ewing sarcoma family of tumors (EFT). EFTs of the kidney represent less than 1% of all renal tumors. Herein, we presented a case of primary renal ES with tumor thrombosis up to vena cava who underwent radical nephrectomy and IVC tumor thrombectomy followed by adjuvant chemotherapy. Histopathology showed that the tumor composed of small uniform, dark, round cells arranged in sheets, and rosettoid pattern. The diagnosis of ESFT was confirmed by detecting EWS/FLI-1 fusion gene using reverse transcription polymerase chain reaction (RT-PCR).

Human microbiome and prostate cancer development: current insights into the prevention and treatment.

The huge communities of microorganisms that symbiotically colonize humans are recognized as significant players in health and disease. The human microbiome may influence prostate cancer development. To date, several studies have focused on the effect of prostate infections as well as the composition of the human microbiome in relation to prostate cancer risk. Current studies suggest that the microbiota of men with prostate cancer significantly differs from that of healthy men, demonstrating that certain bacteria could be associated with cancer development as well as altered responses to treatment. In healthy individuals, the microbiome plays a crucial role in the maintenance of homeostasis of body metabolism. Dysbiosis may contribute to the emergence of health problems, including malignancy through affecting systemic immune responses and creating systemic inflammation, and changing serum hormone levels. In this review, we discuss recent data about how the microbes colonizing different parts of the human body including urinary tract, gastrointestinal tract, oral cavity, and skin might affect the risk of developing prostate cancer. Furthermore, we discuss strategies to target the microbiome for risk assessment, prevention, and treatment of prostate cancer.

Association of human papilloma virus (HPV) infection with oncological outcomes in urothelial bladder cancer.

BACKGROUND: Bladder cancer is one of the leading causes of cancer death in adults worldwide. There are various risk factors described for the bladder cancer development including genetic background as well as environmental exposure. Currently, infectious agents such as human papilloma virus (HPV) has also been linked to bladder cancer risk. The current study aimed to evaluate the potential correlation between HPV infection and the oncological outcome in urothelial bladder cancer. METHODS: Totally 106 tissue samples of histopathologically confirmed transitional cell carcinoma (TCC) of the urinary bladder were included in this study. The presence of high risk (types 16 and 18) and low risk (types 11 and 6) types of HPV was evaluated using polymerase chain reaction (PCR) followed by in situ hybridization. RESULTS: Out of 106 bladder cancer patients, a total of 24 cases (22.6%) were positive HPV infection. The most common type of HPV detected was type 16 followed by types 11 and 18, and 6. According to independent T-test results, there was a significant association between mean age and HPV infection (P = 0.015). Moreover, our findings showed a significant relation between infection with HPV and tumor stage, tumor grade, muscle invasion of the tumor, as well as tumor recurrence. The results of Chi-square Test indicated that there is significant statistical association between types of HPV and tumor grade (P-Value = 0.044). CONCLUSION: Our findings indicated that a family history of cancer and HPV infection can be potential independent predictive factors for tumor recurrence in bladder cancer. Overall, the results of this study strongly indicate a significant relationship between HPV infection and an aggravated outcome of the disease and a higher risk of recurrence in patients with bladder cancer.

Autolysin (lytA) recombinant protein: a potential target for developing vaccines against pneumococcal infections.

PURPOSE: N-acetylmuramoyl-l-alanine amidase known as lytA, is an immunogenic protein that plays an important role in the pathogenesis of Streptococcus pneumoniae. It is highly conserved among S. pneumoniae strains and is absent among other Streptococcus species. In the present study, the level of antibodies against the lytA recombinant protein was evaluated in healthy individuals' sera. MATERIALS AND METHODS: DNA was extracted from S. pneumoniae ATCC 49619 to amplify lytA gene by polymerase chain reaction assay. The lytA amplicon and pET28a vector were separately double digested using Nde-1 and Xho1 restriction enzymes and then ligated together with ligase enzyme. The recombinant plasmid was expressed in Escherichia coli BL21 strain and the lytA recombinant protein purified using nickel-nitrilotriacetic acid affinity chromatography. Western blot was carried to detect lytA recombinant protein. Sixty healthy individual's sera (at three age groups: group 1, <2; group 2, 2-40; and group 3, 60-90 years old) were collected and the titers of anti-lytA antibodies were determined. RESULTS: The lytA gene was highly expressed in E. coli BL21 host. The recombinant lytA protein was purified and confirmed by western blotting. Tukey test analysis showed that there were no significant differences among the age groups considering the anti-lytA titer of 10. However, at the anti-lytA titer of 60, significant differences were observed between group 1 vs. group 2 (p<0.001); group 1 vs. group 3 (p=0.003), and group 2 vs. group 3 (p=0.024). CONCLUSION: The lytA protein seems to be a highly immunogenic antigen and a potential target for developing vaccines against pneumococcal infections.

A Review on Currently Available Potential Therapeutic Options for COVID-19.

A series of unexplained pneumonia cases currently were first reported in December 2019 in Wuhan, China. Official names have been announced for the virus responsible, previously known as "2019 novel coronavirus" and the diseases it causes are, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease (COVID-19), respectively. Despite great efforts worldwide to control SARS-CoV-2, the spread of the virus has reached a pandemic. Infection prevention and control of this virus is the primary concern of public health officials and professionals. Currently, several therapeutic options for COVID-19 are proposed and vaccine development has been initiated for prevention purposes. In this review, we will discuss the most recent evidence about the current potential treatment options including anti-inflammatory drugs, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, nucleoside analogs, protease inhibitors, monoclonal antibodies, and convalescent plasma therapy. Some other agents such as vitamin D and melatonin, which were recommended as potential adjuvant treatments for COVID-19 infection are also presented. Moreover, the potential use of convalescent plasma for treatment of COVID-19 infection was described. Furthermore, in the next part of the current review, various vaccination approaches against COVID-19 including whole virus vaccines, recombinant subunit vaccine, DNA vaccines, and mRNA vaccines are discussed.

Monoclonal Antibody Against ROR1 Induces Apoptosis in Human Bladder Carcinoma Cells.

BACKGROUND: Receptor tyrosine kinase-like Orphan Receptor 1 (ROR1) is one of the promising cell surface antigens for targeting cancer cells. The aim of this study was to evaluate ROR1 cell surface expression in bladder cancer cells using a murine anti-ROR1 monoclonal antibody (mAb) called 5F1-B10 as well as investigate its potential in apoptosis induction. METHODS: Expression of ROR1 in two human bladder cell lines, 5637 and EJ138, as well as a non-cancerous human cell line, Human Fetal Foreskin Fibroblast (HFFF), was examined by flow cytometry and immunocytochemistry. Immunohistochemical staining of cancer and normal bladder tissues was also performed. RESULTS: The flow cytometry results showed that 5F1-B10 mAb could recognize ROR1 molecules in 86.1% and 45.6% of 5637 and EJ138 cells, respectively. The expression level of ROR1 was 5.49% in HFFF cells. The immunocytochemistry and immunohistochemistry staining results also confirmed the presence of ROR1 on the surface of both bladder cancer cells and tissues, respectively. The obtained data from apoptosis assay demonstrated that 5F1-B10 mAb could induce apoptosis in both 5637 and EJ138 cell lines. CONCLUSION: Taken together, our finding indicates the role of ROR1 in bladder cancer cell survival and suggests this receptor might be a promising target for developing novel therapeutic agents against bladder carcinoma.

Molecular Epidemiology of Carbapenemase-Producing Pseudomonas aeruginosa Isolated from an Iranian University Hospital: Evidence for Spread of High-Risk Clones.

PURPOSE: Given the importance of treatment failure due to multidrug-resistant (MDR) strains, studies on population structure of these organisms are necessary to improve control strategies. Accordingly, the current study aimed to determine the prevalence of carbapenem-resistant P. aeruginosa (CRPA) at a teaching referral hospital in Iran and to analyz their molecular clonality by multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) for epidemiological purposes. METHODS: In this study, modified Hodge test (MHT) and double-disk synergy test (DDST) were used for carbapenemase production and metallo-ß-lactamases (MBLs) screening, respectively. All P. aeruginosa isolates were tested for antimicrobial resistance. Moreover, MBL genes (blaIMP, blaVIM, blaSPM, blaNDM) were detected by multiplex PCR assay. RESULTS: Among 68 P. aeruginosa clinical isolates, 38 (55.88%) isolates were CRPA. Antibiotic susceptibility testing revealed that most of these isolates were MDR. PFGE analyses showed 5 common types and 27 single types among CRPA isolates. MLST analysis revealed three major clusters (MLST-sequence types (STs): 235, 357, and 861) among them. The 30 non-CRPA isolates corresponded mainly to MLST-STs 253, 360, and 446. CONCLUSION: Our results showed that internationally distributed MLST-STs with widely genomic diversity have spread in our hospital, and clonal expansion of MDR strains of P. aeruginosa was described as well.

Role of Chronic Inflammation as a Predictor of Upstaging/Upgrading in Prostate Cancer: Finding a New Group Eligible for Active Surveillance.

PURPOSE: We aimed to investigate the correlation between presence of inflammation and pathology upgrading/upstaging in patients with prostate cancer. MATERIALS AND METHODS: A retrospective study was accomplished on 315 patients with prostate cancer, eligible for active surveillance except prostate-specific antigen (PSA) level (PSA<30ng/dL), who underwent radical prostatectomy between 2005 and 2015. Patients were divided into two groups based on needle biopsy: A; with evidence of inflammation (chronic prostatitis) and B; without inflammation. The frequency of upstaging and upgrading in both groups was compared in different ranges of PSA level (<10, 10-20 and 20-30ng/dL). Upgrading/Upstaging was defined as increase from one prognostic grade group to another. Statistical analyses were performed to investigate the relation between inflammation and upgrading/upstaging. RESULTS: The mean age of the patients was 68.2 years and the mean PSA level was 10.2 ng/mL. Chronic prostatitis was identified in 82 of 315 cases therefore upgrading/upstaging were seen in only three patients (3.7%) while 39 of 233 (16.7%) patients without inflammation had upgrading/upstaging in final pathology (P = 0.003). Other variables including the patient's PSA before surgery, PSA density, and the presence of hypoechoic areas in ultrasound had a significant relationship with the incidence of postoperative upgrading/upstaging. Among studied variables, presence of inflammation in biopsies was found to be the most important predictor of upstaging/upgrading (OR: 0.205). CONCLUSION: Our data demonstrated that patients with concurrent prostatitis and PCa may have a better prognosis even if the PSA level is higher than 10ng/mL.

Preemptive Analgesia with a Second Dose of Pregabalin, Acetaminophen, Naproxen, and Dextromethorphan: A Comparative Clinical Trial in Major Surgeries.

BACKGROUND: Postoperative pain management can improve patients' quality of life and decrease hospitalization rates. Preemptive analgesia may provide an effective approach for both pain control and opioid consumption decrease. A common approach for pain management after surgery is to relieve the pain that has already occurred. OBJECTIVES: The aim of this clinical trial was to compare the preemptive analgesic effect of single-dose versus two-dose administration of pregabalin, acetaminophen, naproxen, and dextromethorphan (PAND) combination. METHODS: This study involved 60 patients who had undergone one surgery (including nephrectomy, cystectomy, prostatectomy, colectomy, Whipple, and RPLND). They were randomly divided into two groups: The first group received a single dose of PAND, while the other group received a second dose within 6 hours after discharge from recovery. Pain intensity was assessed by the Universal Pain Assessment Tool (UPAT) in both groups 2, 4, 6, 8, 12, 24, and 48 hours postoperatively. The postoperative morphine dose in both groups was also recorded. Data were analyzed using SPSS version 25. RESULTS: Mean pain scores were significantly different between the two groups at 2, 12, 24, and 48 hours after surgery (P < 0.05). There was a statistically significant difference between the two groups in terms of opioid consumption (P < 0.001). The total opioid consumption in the second group (with the second administration of PAND) was lower than the first group. CONCLUSIONS: Preemptive analgesia with a second dose of PAND is an effective method for reducing pain and morphine consumption after surgery.

Molecular Characteristics of Methicillin-Resistant Staphylococcus aureus (MRSA) Isolated from Diabetic Foot Infection.

BACKGROUND & OBJECTIVE: Diabetic foot ulcer (DFU), is one of the most frequent causes for hospitalizations in patients with diabetes. A major problem in the treatment of DFU is the increased-incidence of methicillin-resistant Staphylococcus aureus (MRSA). The aim of this study was to determine the SCCmec types of MRSA isolates and their epidemiology among patients with diabetes. METHODS: This study was carried out on 145 diabetic patients with DFUs. The antibiotic susceptibility tests (ASTs) were performed using the disk diffusion method and E-test technique. SCCmec typing was done by multiplex PCR. Moreover, the presence of virulence toxin genes, including pvl and lukED was detected by PCR assay. RESULTS: In 145 samples from which S. aureus was predominantly isolated, 19.48% were MRSA. Analysis of MRSA isolates revealed that the most prevalent SCCmec type was type IV (46.7%) followed by type III (30.0%) and type V (20.0%). One strain (3.3%) was untypeable. The prevalence of pvl and lukED was 56.7% and 100%, respectively. CONCLUSION: The high prevalence of MRSA in DFUs represents the high levels of antibiotic usage among patients with diabetes. In this study, resistance to other important clinical antibiotics was detected among MRSA isolates. The high proportion of SCCmec type IV and V strains, even in former hospitalized patients, indicates the entrance of these clones to the clinical setting.

Primary upper pole liposarcoma of the kidney with invasion to inferior vena cava: A case report.

Genitourinary tract liposarcoma is considered as the second most commonly reported type of sarcomas. Renal liposarcoma with tumor invasion to inferior vena cava (IVC) is distinctly rare. This tumor has a relatively indolent clinical course with risk of local recurrences (20%-85% rate) after surgery. Angiomyolipomas (AML) are the most important differential diagnosis because both are large fat-containing lesions. Herein, a patient with upper pole kidney liposarcoma with tumor invasion to renal vein and IVC is presented. The optimal management is radical nephrectomy and IVC tumor resection. Chemotherapy and radiotherapy have not shown significant survival benefit.

Toll-like receptors: The role in bladder cancer development, progression and immunotherapy.

Bladder cancer is one of the leading causes of death worldwide. The main immune mechanisms which lead to bladder cancer development or treatment outcomes have yet to be elucidated. Toll-like receptors (TLRs) play key roles against cancer. TLRs are expressed both on immune cells and on tumour cells and drive immune responses in progression as well as treatment of cancer. Identification of signalling pathways via TLRs could revolutionize further improvement of therapeutic strategies against cancers in the future. According to the recent studies, TLRs agonists are effective immunostimulants and have important role in induction of immune responses with immunotherapeutic potential against several diseases including cancer. They play an important role in the bladder urothelium as a part of immune defence against uropathogens. On the other hand, decreased TLRs expression was found in bladder tumours, particularly in non-muscle-invasive ones. Bacillus Calmette-Guerin (BCG) (agonist of TLR2 and TLR4) is approved by US FDA for immunotherapy of bladder cancer. Despite high efficiency, immunotherapy with BCG may cause toxicity and adverse effects. Nowadays, in vitro and in vivo studies have been conducted to find alternative options for non-responder patients. Studies on TLR agonists for bladder cancer treatment have shown promising results. In this review, we discuss recent data about mechanisms played by TLRs in bladder cancer developments as well as therapeutic application of TLR agonists in cancer treatment.

Management of Hepatic Granulomatous Tuberculosis After BCG Therapy for Bladder Cancer.

BCG therapy is used as a treatment in bladder cancer. Intravesical administration of Bacillus Calmette-Guérin is used as a treatment method in superficial bladder cancer. While it is commonly effective, some serious side effects may occur. We hereby report a 65-year-old man who developed granulomatous hepatitis as a complication following BCG therapy. He was treated successfully with antitubercular therapy and prednisolone.

Utilization of PFGE as a Powerful Discriminative Tool for the Investigation of Genetic Diversity among MRSA Strains.

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant challenge to the burn patient. The implementation of proper monitoring programs and prompt identification of epidemic MRSA strains are critical to consequently control and eradicate potential outbreaks. This study aimed to define the genetic relatedness of MRSA strains isolated from burn patients by analyzing the large fragments of DNA. METHODS: In this cross-sectional study, 126 pus/wound swabs from skin and soft tissue infections (SSTIs) were collected from inpatients of Shahid Motahari Burn Center (Tehran, Iran) in 2013. Then, molecular typing of MRSA was achieved by Pulsed-Field Gel Electrophoresis (PFGE). RESULTS: The PFGE analysis of MRSA indicated 31 single types and 5 common types. There was a significant diversity in the chromosomal digestion pattern of the MRSA strains explained by the acquisition of MRSA from various sources. CONCLUSION: The permanent import of novel types of MRSA strains despite the rigorous infection control measures carried out within the center. The importance of PFGE in understanding the epidemiology of MRSA may serve as a basis for the development of rational control strategies.

Molecular characterization and antimicrobial susceptibility of the CA-MRSA isolated from healthcare workers, Tehran, Iran.

INTRODUCTION: Methicillin resistant Staphylococcus aureus (MRSA) has become as a nosocomial pathogen worldwide. Considering the importance of MRSA typing for understanding the evolution and dissemination of these strains, we studied the molecular characteristics of MRSA colonized healthcare workers (HCWs). METHODOLOGY: All MRSA isolated from HCWs, were genotyped using staphylococcal cassette chromosome mec (SCCmec) with multiplex PCR assay, multilocus sequence typing (MLST) and spa typing. Then antibiotic susceptibility pattern and presence of pvl genes were evaluated in MRSA isolates. RESULTS: Cluster analysis by eBURSTv3 showed that MRSA isolates belonged to two major clonal complexes (CC); CC88 (ST88, ST825, ST859) and CC30 (ST39, ST2, ST24) and five singletons. The most prevalent SCCmec type was type IV (70.59%) followed by type V (29.41%). Totally 11 different spa types were discriminated among which type t186 was predominant. All of the MRSA tested (100%) were susceptible to teicoplanin, linezolid and fusidic acid. Totally 52.94% of isolates were positive for pvl genes. CONCLUSIONS: The ST88-MRSA-IV accounted for most colonized MRSA isolates. We documented a different molecular epidemiology of MRSA nasal colonization in hospitals under studied, due to the introduction of epidemic clones (ST88, ST39, ST2235, ST80, ST813, ST398, ST825, ST24, ST22, ST859 and ST2).

Prostate-Specific Antigen Density and Gleason Score Predict Adverse Pathologic Features in Patients with Clinically Localized Prostate Cancer.

BACKGROUND: According to recent studies, prostate cancer is the second most common cancer among Iranian men. Radical prostatectomy has been considered the gold standard treatment in patients with clinically localized prostate cancer. Gleason score, PSA density, and PSA velocity are some of the parameters used to predict adverse pathologic features. OBJECTIVES: The aim of this study was to evaluate the prognostic value of PSA density and Gleason score in predicting adverse pathologic features in patients with localized prostate cancer who undergo radical prostatectomy. METHODS: We conducted a cross-sectional study of 105 patients with localized prostate cancer who underwent radical prostatectomy between 2006 and 2013. We recorded Gleason scores and PSA levels, in addition to the results of pathological evaluations after radical prostatectomy, including prostate volume, stage, LNI (lymph node involvement), SVI (seminal vesicle invasion), and extraprostatic extension (EPE). Data were analyzed using SPSS version 21. RESULTS: Mean PSA density was 0.27 (0.17 SD). The frequencies of EPE, SVI, and LNI were 21.9, 16.2, and 2.9, respectively. The Mann-Whitney U-test demonstrated a significant correlation between PSA density and adverse pathologic features (EPE, SVI, and LNI). CONCLUSIONS: PSA, PSA density, and Gleason score should be considered together in order to more accurately predict the adverse pathologic features of prostate cancer.