Benign Prostatic Hyperplasia Procedures in Patients with Prostate Cancer:: What Do We Know?

Prostate Specific Antigen and Human Glandular Kallikrein 2 in Early Detection of Prostate Cancer

Society of Interventional Radiology Research Reporting Standards for Prostatic Artery Embolization

Critical Appraisal of Prostate-specific Antigen in Prostate Cancer Screening: 20 Years Later

PD41-01 TRENDS IN THE DIAGNOSTIC AND SURGICAL MANAGEMENT OF BENIGN PROSTATIC HYPERPLASIA (BPH) IN THE UNITED STATES: ANNUAL CHANGES IN THE SELECTION OF TREATMENT OPTIONS AND AVERAGE COSTS DIFFERENTIAL FOR DIAGNOSTIC/SURGICAL TECHNIQUE

Purpose: We assessed the quality of information available to patients on benign prostatic hyperplasia (BPH) and prostate cancer on the Korean internet web sites. Materials and Methods: This research was undertaken by surfing the internet on the world wide web sites, including naver, nate, daum, yahoo and empas. The key words for the search were 'BPH' and 'prostate cancer'. We evaluated two main themes, and these were aspect of the contents and the technical contents. The aspects of the contents were the content and authorship, and the technical aspects were related to design and efficiency. Results: We evaluated 45 web sites that focused on BPH and 24 web sites that focused on prostate cancer. From among the web sites, 27 (60%) of the 45 BPH sites and 16 (67%) of the 24 sites gave medical information. Only 14 (31%) of the 27 BPH sites and 12 (50%) of the 24 prostate cancer sites dealt with full information. The average score of these 43 web sites was only 34.5±13.6 of a perfect score of 100. The mean score of the content was 10±5.1 of 40 points, authorship was 4.3±3.3 of 20 points, design was 10.4±3.3 of 20 points and efficiency was 9.8±4.6 of 20 points. A total of 28 (65%) out of the 43 providers of information were urologists and 23 (82%) out of the 28 were general practitioners. The rate of research on prostatic disease was lower than that for 'hypertension', 'diabetes', 'stroke' and 'hepatitis'. Conclusions: There is need for more accurate information on prostatic diseases on the Korean internet. It is essential to set up an institution for qualifying the medical information on web sites & evaluating the web sites on the Korean internet. (Korean J Urol 2008;49:404-410) 󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏󰠏

ACR Appropriateness Criteria® on Obstructive Voiding Symptoms Secondary to Prostate Disease

91 Background: Patients with a history of procedures for BPH experience worse urinary toxicity following interstitial brachytherapy for localized prostate cancer. This retrospective study sought to evaluate the rates of urinary toxicity following SBRT in men with a history of procedures for BPH. Methods: Localized prostate cancer patients, treated with SBRT from August 2009 to February 2015 and a minimum follow up of 2 years, with a history of at least 1 procedure for BPH associated with a prostatic defect identified on the treatment planning MRI were evaluated. Radiotherapy was delivered in 5 fractions to a dose of 35 or 36.25 Gy using the CyberKnife system with fiducial tracking. Urinary QOL was assessed pre- and post-treatment using the International Prostate Symptom Score (IPSS) and the Expanded Prostate Cancer Index Composite (EPIC-26). Cystoscopy findings were retrospectively reviewed. Toxicities were scored using the CTCAE v4. Results: Thirty nine men with a median age of 72 years, 7 with a history of more than 1 procedure for BPH, were treated with a median follow up of 49 months. Grade 1, grade 2, and grade 3 urinary toxicity occurred in 11, 24, and 3 men, respectively; there were no grade 4 or 5 toxicities. Overall, 22 men experienced hematuria; the median time to the onset hematuria from the start of SBRT was 13 months (range 1-70). Cystoscopy was performed on 12 of these patients and bladder neck/prostatic urethra hyperemia were found in a majority of cases. Active bleeding from the bladder neck or prostatic urethra was found in 4 men. A mean baseline IPSS score of 9 did not significantly change at any point during follow up. A mean baseline EPIC-26 obstructive/irritative score of 84 significantly decreased to 76 at 1 month (p = 0.023). There was no significant change from the mean baseline EPIC-26 urinary incontinence score at any point during follow up. Conclusions: A history of procedures for BPH may lead to worse urinary quality of life and high rates of hematuria following SBRT for localized prostate cancer. Stricter urethra/bladder neck dose constraints or an alternative fractionation schedule may be required to decrease the risk of urinary toxicity.

IS THERE A SCIENTIFIC BASIS FOR THE THERAPEUTIC EFFECTS OF SERENOA REPENS IN BENIGN PROSTATIC HYPERPLASIA? MECHANISMS OF ACTION

Objective: In this study aimed to determine the diagnostic efficiency of miR-21 and miR-34a serum levels in the discrimination of benign prostatic hyperplasia, chronic prostatitis, and prostate cancer. Materials and Methods: Blood samples were taken from 70 patients (25 benign prostatic hyperplasias, 10 chronic prostatitides, and 35 prostate cancer) who underwent prostate needle biopsy. After obtaining serum under suitable conditions, RNA isolation, cDNA synthesis, and qRT-PCR analysis were performed using Qiagen brand kits on Rotor-Gene® Q (Qiagen, Germany) device. -∆Ct values ​​were calculated using RNU6 as a reference gene for normalization. -∆Ct values ​​were used in all statistical calculations. Results: It was observed that miR-21 serum levels were upregulated in chronic prostatitis and cancer groups compared to benign prostatic hyperplasia and the difference between the groups was statistically significant (p = 0.021 and p = 0.001, respectively). The specificity and sensitivity of miR-21 and miR-21/miR-34a combination was calculated as 56% and 86%; 84% and 71% in discriminating benign prostatic hyperplasia and prostate cancer groups, respectively. Conclusion: In this study, it has been shown that miR-21 and miR-21/miR-34a combination has diagnostic performance that can be a biomarker candidate in diagnosing prostate cancer. In addition, the presence of a gradual increase in chronic prostatitis and prostate cancer at miR-21 levels compared to benign prostatic hyperplasia suggests that inflammation and cancer transformation processes taking place at the molecular level are also reflected in the circulating microRNA profile. Keywords: Prostate cancer, Prostatitis, Benign prostatic hyperplasia, MicroRNA, Diagnostic efficiency

BENIGN PROSTATIC HYPERPLASIA CELL LINE VIABILITY AND MODULATION OF JM-27 BY DOXAZOSIN AND IBUPROFEN

Postoperative PSA and PSA Velocity Identify Presence of Prostate Cancer After Various Surgical Interventions for Benign Prostatic Hyperplasia

Objectives: Prostate cancer (PCA) is a leading cause of cancer related-death in men. Immunotherapy may provide alternative therapy for patients with castration-resistant PCA. Immunosuppressive mechanisms in benign prostatic hyperplasia (BPH) and PCA patients are not fully clarified. We analyzed homeostatic cytokines gene expression in tissue from patients bearing either PCA or BPH. CD8+ T cells exhaustion was assessed by evaluating Programmed Death-1 (PD-1) and its ligand PD-L1 expression in freshly isolated tissue infiltrating and peripheral blood CD8+ T cells. Methods: 78 BPH, 93 PCA patients were enrolled. Gene expression was evaluated by Real-Time-PCR. Protein expressions were assessed by flow cytometry. Results: IL-6, IL-7 and IL-15 gene expression were significantly increased in PCA tissues as compared to BPH (p=0.0077; p=0.0244 and p=0.0316, respectively). No significant differences were observed in IL-2, IL-17 and IL-21 gene expression. A majority of CD8+ T cells infiltrating BPH or PCA tissues were PD-1+ (82.78±7.33% and 87.63±6.41%, respectively), whereas PD-L1 was expressed in 50.71±14.42% and 36.97±14.95% of tissue infiltrating CD8+ T cells in BPH and PCA, respectively. PD-L2 was expressed in 10.15±5.97% and 13.70±7.66% of tissue infiltrating CD8+ T cells in BPH and PCA, respectively. In peripheral blood CD8+ T cells, PD-1, -L1 and -L2 expressions were similar in BPH (26.36±2.81%, 23.74±4.78% and 1.41±0.26%; respectively) and PCA patients (26.29±2.80, 26.56±3.23 and 4.40±1.84; respectively). CD8+PD-1+ cells were in majority effector memory and effector cells in both groups, while CD8+PD-L1+ cells were mainly effector and naïve cells. In peripheral blood CD8+ T cells from BPH and PCA patients, %CD8+PD-L1+ cells was correlating with %CD8+CD25+ cells (p=0.011 and r=0.790, p=0.044 and r=0.646; respectively). Percentages of CD8+PD-1+ cells from patients bearing either BPH or PCA were significantly increasing upon culture with IL-7 and IL-15. In addition, the basal level of Stat5 phosphorylation in peripheral blood CD8+ T cells from PCA patients was significantly higher as compared to BPH (p=0.045), and Stat5 activation was similarly increased upon culture with homeostatic cytokines in the both groups. Conclusion: We demonstrated that tissues from patients bearing BPH and PCA are expressing inflammatory homeostatic cytokine genes. Percentages of tissue infiltrating and peripheral blood CD8+ T cells from both groups expressing PD-1 and ligands are high. In addition, homeostatic cytokines are able to up-regulate in vitro expression of these exhaustion molecules in peripheral blood CD8+ T cells from patients bearing either BPH or PCA. Cytokine rich tumour environment might lead to T cell exhaustion rather than activation, thus raising the issue of the role of T cells exhaustion in PCA. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3658. doi:10.1158/1538-7445.AM2011-3658

Background:Benign prostatic hyperplasia (BPH) and prostate cancer are the most common prostate diseases. The possible role of the immune system in the pathogenesis of BPH and prostate cancer in recent years has begun to be widely studied. Although many studies have focused on T lymphocytes on the development of BPH and prostate cancer, the role of regulatory T-cells in the pathogenesis of BPH and prostate cancer is still not well known.Objective:To determine the amount of regulatory T-cells in prostate cancer and BPH so that it can contribute to the concept of understanding the pathogenesis of prostate cancer and BPH.Methods:This study used cross-sectional design study. Total samples were 24 patients, with 13 subjects prostate cancer group, and 11 subjects BPH group. Furthermore, peripheral blood samples are taken and then the amount of regulatory T-cells is calculated. After obtaining data on the amount of CD4+ CD25+ Foxp3+ regulatory T-cells in the blood, data analysis was performed between groups of patients diagnosed with prostate cancer and benign prostatic hyperplasia.Results:The average amount of regulatory T-cells in the CRPC group was 53.44±29.43, prostate cancer group was 57.02±22.49 and the BPH group 89.71±9.31. One Way ANOVA test results showed that the average amount of regulatory T-cells between treatment groups gave a significant difference in regulatory T-cells with a p-value (0,003) <0.05. It can be concluded that there are differences in the average amount of regulatory T-cells, so we continued the testing with Tukey test. We continue to Pearson correlation study and resulted in significantly correlated with p value = 0.011 (P<0.05) and r = 0.414.Conclusions:It can be concluded there was significant difference between the average number of regulator T-cells in the BPH group compared with prostate cancer and CRPC patient. Further research is needed regarding the number of regulator T-cells CD4 + CD25 + FOXP3 + in prostate cancer patients (grouped according to Gleason score) and benign prostatic hyperplasia before and after therapy with bigger samples.

SERUM PROSTATE SPECIFIC ANTIGEN IS A STRONG PREDICTOR OF FUTURE PROSTATE GROWTH IN MEN WITH BENIGN PROSTATIC HYPERPLASIA

Managing benign prostatic hyperplasia and prostate cancer – the challenges today