Cases Of Benign Prostatic Hyperplasia Research Articles

PD16-11 TRANS-ETHNIC GENOME-WIDE ASSOCIATION STUDY REVEALS NEW THERAPEUTIC TARGETS FOR BENIGN PROSTATIC HYPERPLASIA

You have accessJournal of UrologyCME1 May 2022PD16-11 TRANS-ETHNIC GENOME-WIDE ASSOCIATION STUDY REVEALS NEW THERAPEUTIC TARGETS FOR BENIGN PROSTATIC HYPERPLASIA Michael Ng, Koichi Matsuda, Chizu Tanikawa, Chikashi Terao, Yoichiro Kamatani, Wei Wang, Adam Auton, 23andme Research Team, Benjamin Turney, Richard Bryant, and Dominic Furniss Michael NgMichael Ng More articles by this author , Koichi MatsudaKoichi Matsuda More articles by this author , Chizu TanikawaChizu Tanikawa More articles by this author , Chikashi TeraoChikashi Terao More articles by this author , Yoichiro KamataniYoichiro Kamatani More articles by this author , Wei WangWei Wang More articles by this author , Adam AutonAdam Auton More articles by this author , 23andme Research Team More articles by this author , Benjamin TurneyBenjamin Turney More articles by this author , Richard BryantRichard Bryant More articles by this author , and Dominic FurnissDominic Furniss More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002548.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Benign prostatic hyperplasia (BPH) is a common condition affecting men in and beyond middle age, causing significant morbidity. Medical treatments comprise a small number of pharmacological agents, and patients often progress to require surgery. There is an unmet clinical need to identify genomic drivers of BPH progression requiring surgery, and to identify novel targets for pharmacological intervention. METHODS: We performed a large genome-wide association study of BPH in 126,082 subjects from UK Biobank, with replication in 44,093 subjects from the RIKEN Japanese biobank, and 756,878 subjects from 23andMe (total 110,916 BPH cases and 816,137 controls). We investigated candidate genes using differential expression between single cell subtypes in samples from BPH versus normal prostate. A genetic risk score for BPH was constructed to assess its use for prognostication. Therapeutic targets were identified from the Open Targets platform. RESULTS: We identified 17 BPH-associated loci. Two loci were only associated with this condition in men of Western European or Japanese origin, and represent ethnicity-specific risk alleles. We demonstrated differential expression of associated genes in cells derived from BPH compared to normal prostate. For example, we provide evidence that the homeobox gene NKX3.1 specifically plays a role in BPH in basal epithelial cells. Patients with BPH managed with surgery had a higher genetic risk score than those managed conservatively or with non-surgical treatment. Several genes implicated in our genetic analysis are tractable to therapeutic targeting or drug repurposing, and represent attractive targets for new therapeutic development. CONCLUSIONS: These results point to important genes driving the pathophysiology of BPH, and reveal promising candidates for future therapeutic development. Our proof-of-principle that the genetic risk score correlates with the severity of BPH, and the need for surgery, provides a first step towards personalised medicine in the management of this common condition. Source of Funding: This work was co-funded by co-funded by the John Black Foundation and the Rosetrees Trust, with funding administered by The Urology Foundation. The BioBank Japan project was supported by the Ministry of Education, Culture, Sports, Sciences and Technology Japan and the Japan Agency for Medical Research and Development. The funders had no role in the design of the study, the collection, analysis or interpretation of data, the writing of the manuscript, or the decision to publish the results. We would like to thank the research participants and employees of 23andMe for making this work possible © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e272 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Ng More articles by this author Koichi Matsuda More articles by this author Chizu Tanikawa More articles by this author Chikashi Terao More articles by this author Yoichiro Kamatani More articles by this author Wei Wang More articles by this author Adam Auton More articles by this author 23andme Research Team More articles by this author Benjamin Turney More articles by this author Richard Bryant More articles by this author Dominic Furniss More articles by this author Expand All Advertisement PDF DownloadLoading ...

MP04-09 TRENDS IN HOLMIUM LASER ENUCLEATION OF THE PROSTATE FOR TREATMENT OF BENIGN PROSTATIC HYPERPLASIA

You have accessJournal of UrologyCME1 May 2022MP04-09 TRENDS IN HOLMIUM LASER ENUCLEATION OF THE PROSTATE FOR TREATMENT OF BENIGN PROSTATIC HYPERPLASIA Tenny R. Zhang, Mary O. Strasser, Samantha L. Thorogood, Christina Sze, Bilal Chughtai, Alexis Te, Richard K. Lee, and Jim C. Hu Tenny R. ZhangTenny R. Zhang More articles by this author , Mary O. StrasserMary O. Strasser More articles by this author , Samantha L. ThorogoodSamantha L. Thorogood More articles by this author , Christina SzeChristina Sze More articles by this author , Bilal ChughtaiBilal Chughtai More articles by this author , Alexis TeAlexis Te More articles by this author , Richard K. LeeRichard K. Lee More articles by this author , and Jim C. HuJim C. Hu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002521.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Compared to traditional treatment options for benign prostatic hyperplasia (BPH), holmium laser enucleation of the prostate (HoLEP) has demonstrated improved outcomes in hemostasis, urinary symptoms, and immediate complication rates. We investigated practice patterns associated with the use of HoLEP. METHODS: We obtained de-identified, self-reported American Board of Urology (ABU) certification/recertification case log data from 2008-2021. We identified 6,632 urologists who performed 73,884 surgeries with an indication for BPH. Current Procedural Terminology (CPT) codes distinguished HoLEP, transurethral resection of prostate (TURP), laser TURP, simple prostatectomy, prostatic urethral lift, transurethral incision of the prostate, and microwave and radiofrequency ablation. We identified 548 urologists (8.3%) who performed 7,386 HoLEP surgeries. Forty-three urologists (0.7%) performed HOLEP exclusively (no other BPH surgical approaches). A logistic regression model was used to determine factors independently associated with using HoLEP. RESULTS: The annual number of HoLEP procedures performed ranged from 3 to 1276, comprising 0.06% to 17.3% of total BPH surgeries annually. Highest HoLEP volumes were logged in 2019, representing 17.3% of total BPH cases. In adjusted analyses (table) factors associated with lower odds of performing HoLEP include surgeon age (odds ratio [OR] 0.93); government (OR 0.06), private practice group (OR 0.44), managed care (OR 0.14), salaried hospital (OR 0.38) vs. academic employment; and Mid-Atlantic (OR 0.28) and New England (0.45) regions vs. South Central (referent). Factors associated with higher odds of performing HoLEP include higher BPH surgical volume (OR 1.02) and endourology (OR 2.41) vs. general urology subspecialty. CONCLUSIONS: HoLEP is more likely to be performed by younger urologists, urologists in academic practice, endourology subspecialists, and those with higher BPH volume. HoLEP was less likely to be performed in Mid-Atlantic and New England regions. Additional studies are needed to elucidate practice pattern variations. Despite evidence demonstrating improved perioperative outcomes compared to competing BPH surgical approaches, HoLEP dissemination over time has been limited, possibly due to prolonged learning curve. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e60 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tenny R. Zhang More articles by this author Mary O. Strasser More articles by this author Samantha L. Thorogood More articles by this author Christina Sze More articles by this author Bilal Chughtai More articles by this author Alexis Te More articles by this author Richard K. Lee More articles by this author Jim C. Hu More articles by this author Expand All Advertisement PDF DownloadLoading ...

Current Status of Calculation of Continence Care Fee for Out-Patients at Kurosawa Hospital

The continence self-management programme fee (CSPF) for hospitalized patients was revised in 2020 to include those receiving consistent care on an out-patient basis. We extracted candidate patients for CSPF on an out-patient basis (out-patient candidates hereafter) from those for whom-CSPF had been calculated during hospitalization at our hospital, and defined those who had undergone a medical examination related to continence care as out-patient calculation candidates. Of the 956 patients for whom CSPF had been calculated during hospitalization, 482 patients (50%) were out-patient candidates ; 275 (54%) and 169 (33%) of whom were seen in the urology and neurosurgery departments, respectively. Of the 482 out-patient candidates, 238 (49%) were out-patient calculation candidates ; 197 (83%) and 14 (6%) of whom were seen in the urology and neurosurgery departments, respectively. Forty-two and 41 of the calculation candidates were cases of benign prostatic hyperplasia and bladder cancer, respectively. The CSPF was actually processed 93 times for 78 of the 482 out-patient candidates (16%). There were various obstacles in the current system of calculating the fees to realize consistent care from hospitalization to out-patient care.

Prognostic Value of Long Noncoding RNA SNHG11 in Patients with Prostate Cancer.

The present study was aimed to explore the prognostic value of long noncoding RNA SNHG11 in prostate cancer, study its expression, and assess its effect on tumor progression. One hundred and twenty prostate cancer patients and 45 cases of benign prostate hyperplasia (BPH) patients were collected. RT-qPCR was used to test the expression of SNHG11 in prostate cancer and BPH tissues, as well as in cell lines. Kaplan-Meier survival analysis and Cox regression assays were introduced to evaluate the prognostic meaning of SNHG11 in prostate cancer. The CCK-8 assays were performed to explore the effect of SNHG11 on prostate cancer cell proliferation, and a Transwell assay was conducted to access the influence of SNHG11 on prostate cancer cell migration and invasion. SNHG11 expression level was upregulated both in prostate cancer tissues and cell lines. Overexpression of SNHG11 was significantly associated with Gleason score, clinical T stage, surgical margin status, and lymph node metastasis. Patients with high SNHG11 expression levels led to a shorter overall survival time and biochemical recurrence-free survival when compared with those of low expression levels. Multivariate Cox regression results suggested that SNHG11 has the potential to act as a prognostic marker for prostate cancer patients. Knockdown of SNHG11 suppressed 22RV1 cell proliferation, migration, and invasion. In conclusion, SNHG11 is upregulated in prostate cancer patients and predicts an unfavorable prognosis for prostate cancer patients. Its knockdown can weaken prostate cancer cell metastasis and growth in vitro.

Clinicopathological correlation of p53 expression in benign prostatic hyperplasia and prostate adenocarcinoma

Prostate adenocarcinoma is the 6 most common carcinoma in men worldwide. It is usually a cancer of the elderly age group. Benign prostatic hyperplasia is a common cause of urinary incontinence and urine flow symptoms, usually seen in the middle along with elderly age group. In this study we have evaluated the expression of p53 immunohistochemistry (IHC) in prostate adenocarcinoma with benign prostatic hyperplasia along with its diagnostic, treatment and prognostic implications.: 1. Assessment of clinical and biochemical parameters in patients with benign prostatic hyperplasia (BPH) and prostate adenocarcinoma. 2. To assess p53(IHC) expression in benign prostatic hyperplasia and prostate adenocarcinoma : The study population comprised of a subset of patients who came to Ramaiah hospital, Bangalore from May 2018 till June 2019, for treatment regarding prostate related symptoms. The clinicodemographic data was collected and prostate biopsies were taken for which histopathological assessment was done. A total of 60 cases comprising of 30 cases of BPH and 30 cases of prostatic adenocarcinoma was subjected to p53 immunohistochemistry. The results were tabulated and statistically analyzed for significance.The present prospective study was conducted on 60 patients with 30 cases (50%) of BPH and 30 cases (50%) of prostatic adenocarcinoma. Based on the tumor differentiation there was 1 case (3.3%) of well differentiated carcinoma, 18 cases(60%) of moderately differentiated carcinoma and 11cases (36.6%) of poorly differentiated carcinomas. We observed an inverse relationship between p53 expression and histological grade. All poorly differentiated carcinoma had higher p53(>50% expression). There was statistically significant difference in expression of p53 between cases of BPH and carcinoma prostate, indicated by P value of <0.05. Among prostate carcinomas p53 had higher expression on those cases with Gleason score 9 and 10.: P53 expression directly correlates with Gleason score, while inversely correlating with tumor differentiation of prostate carcinoma cases. The expression of p53 is low in BPH as compared to that of prostate cancers. Hence it can be used as a good diagnostic and prognostic marker in prostate carcinoma.

Huge median prostatic lobe: a interesting case of BPH

Benign Prostatic Hyperplasia (BPH) refers to the nonmalignant growth or hyperplasia of prostate tissue and is a common cause of lower urinary tract symptoms in men [1].

Chemotherapeutic Evaluation of Ethanol Extract of Chromolaena odorata on Biochemical Aberrations Associated with Experimentally-induced Benign Prostatic Hyperplasia in Male Rats

The sudden rise in benign prostatic hyperplasia (BPH) cases, severe side effects, and the high cost of conventional methods have necessitated the intensive search for alternative BPH management strategies. This study investigated the restorative effects of ethanol leaf extract of Chromolaena odorata (EECO) on testosterone-induced BPH in male albino rats. Thirty male albino rats with a weight range of 150-210 g were randomly distributed into six groups of five rats each. Group 1 was normal rats and not induced. Groups 2-6 were induced via daily subcutaneous injection of testosterone propionate (3 mg/kg) for 28 days. After induction, group 2 received vehicle (carboxyl methylcellulose), group 3 received finasteride (1 mg/kg), while groups 4-6 received 100, 200, and 400 mg/kg of EECO, respectively, for 21 days orally. Prostate and biochemical parameters were determined using standard methods. Treatments with EECO decreased the concentrations of prostate-sensitive antigen, dihydrotestosterone, testosterone, malondialdehyde, cholesterol, low-density cholesterol, and liver enzyme activities compared with BPH-control. Furthermore, there was increased superoxide dismutase, and catalase activities in extract treated groups compared with BPH- control. The findings from this study showed that EECO inhibited testosterone-induced BPH anomalies, making it promising phytotherapy for the management of BPH in males.

Epidemiological trends of urinary tract infections, urolithiasis and benign prostatic hyperplasia in 203 countries and territories from 1990 to 2019

BackgroundUrinary tract infections (UTI), urolithiasis, and benign prostatic hyperplasia (BPH) are three of the most common nonmalignant conditions in urology. However, there is still a lack of comprehensive and updated epidemiological data. This study aimed to investigate the disease burden of UTI, urolithiasis, and BPH in 203 countries and territories from 1990 to 2019.MethodsData were extracted from the Global Burden of Disease 2019, including incident cases, deaths, disability-adjusted life-years (DALYs) and corresponding age-standardized rate (ASR) from 1990 to 2019. Estimated annual percentage changes (EAPC) were calculated to evaluate the trends of ASR. The associations between disease burden and social development degrees were analyzed using a sociodemographic index (SDI).ResultsCompared with 1990, the incident cases of UTI, urolithiasis, and BPH increased by 60.40%, 48.57%, and 105.70% in 2019, respectively. The age-standardized incidence rate (ASIR) of UTI increased (EAPC = 0.08), while urolithiasis (EAPC = − 0.83) and BPH (EAPC = − 0.03) decreased from 1990 to 2019. In 2019, the age-standardized mortality rate (ASMR) of UTI and urolithiasis were 3.13/100,000 and 0.17/100,000, respectively. BPH had the largest increase (110.56%) in DALYs in the past three decades, followed by UTI (68.89%) and urolithiasis (16.95%). The burden of UTI was mainly concentrated in South Asia and Tropical Latin America, while the burden of urolithiasis and BPH was recorded in Asia and Eastern Europe. Moreover, the ASIR and SDI of urolithiasis in high-SDI regions from 1990 to 2019 were negatively correlated, while the opposite trend was seen in low-SDI regions. In 2019, the ASIR of UTI in females was 3.59 times that of males, while the ASIR of urolithiasis in males was 1.96 times higher than that in females. The incidence was highest in the 30–34, 55–59, and 65–69 age groups among the UTI, urolithiasis, and BPH groups, respectively.ConclusionOver the past three decades, the disease burden has increased for UTI but decreased for urolithiasis and BPH. The allocation of medical resources should be based more on the epidemiological characteristics and geographical distribution of diseases.

Analysis of temperament/mizaj of men with benign prostatic hyperplasia: a novel research

Background: Benign prostatic hyperplasia (BPH) is a commonest health disorder affecting elderly men characterized by lower urinary tract symptoms (LUTS). It is a non-malignant neoplasm of men with an incidence of approximately 20% in their 40s and reaches up to 90% in their 80s. Androgens play a vital role in its development. In Unani system of medicine, BPH can be traced under the headings of waram-i-unuq al-mathāna (swelling at the bladder neck) and insidād majrā-i-mathāna (bladder outlet obstruction). As per the basic fundamentals of the said system of medicine, a disease arises due to the humoral imbalance or distemperament. Knowing the temperament of men having LUTS associated with BPH will help in appropriate selection of herbs and other Unani medicinal remedies for its treatment and productive research. It might prove a breakthrough in managing BPH and decreasing burden on conventional medicines and their side-effects.Methods: The current study was based on a questionnaire and examination of sixty (60) diagnosed cases of BPH, as per the standard temperament chart recommended in Unani literature.Results: The study revealed that 73.3% of BPH patients were having phlegmatic temperament (balghami al-mizaj), 20% having sanguine (damwi al-mizaj) and 6.7% were of bilious temperament (safrawi al-mizaj).Conclusions: BPH was found to be more prevalent among men with phlegmatic temperament (balghami al-mizaj) and hence is likely a phlegmatic disorder (marad-i-balghami) or in other words phlegmatic distemperament (su-e-mizaj balghami).

SNPs of Metabolic Syndrome are Associated with Benign Prostatic Hyperplasia Development and Progression in Chinese Population

Objective: Benign Prostatic Hyperplasia (BPH) is a common disease prevalent in elderly men, but the genetic determinants of BPH still remain unclear. Since metabolic syndrome, especially diabetes, may influence the progression of benign prostatic hyperplasia, we investigated whether susceptibility loci for diabetes would increase the risk of BPH development and progression in elderly Chinese men. Material and Methods: Fifteen SNPs associated with the diabetes risk in a Chinese population were genotyped in 377 BPH cases (152 aggressive and 225 non-aggressive BPH cases) and 1,008 controls. The association between the SNPs and the risk of BPH development was evaluated through logistic regression. Additionally, the effects of the 15 SNPs on BPH related clinical parameters, including Body Mass Index (BMI) International Prostate Symptom Score (IPSS), Quality of Life (QoL) and Prostate Volume (PV) were also evaluated. Results: SNP rs9864104 in IGF2BP2 at 3q27 (OR=1.24, P =0.0148) was significantly associated with BPH development. In addition, SNP rs9863780, rs9864104, rs10229583 and rs17727841 were significantly associated with baseline clinical parameters in BPH patients. Moreover, the risk allele of rs6763887 (C) and rs17727841 (C) was significantly associated with the change of storage score and voiding score after treatment. No SNPs were associated with the risk of BPH progression. Conclusions: This is a systematic investigation of the contributions of diabetes susceptibility loci to the risk of BPH development and progression. Our findings advance the understanding of the genetic basis of BPH and provide new insights into the genetic determinants shared between BPH and metabolic syndrome.

Management of lower urinary tract symptoms in benign prostatic hyperplasia with individualised homoeopathic medicines: Case reports

Benign prostatic hyperplasia (BPH) is a common condition in elderly men and has a significant impact on their quality of life. Surgical procedures in the management of BPH have been associated with more adverse effects on patients. This retrospective study aims at management of BPH symptomatically by using the International Prostatic Symptom Score (IPSS). The article comprises three cases of BPH where there was considerable alleviation of symptoms following homoeopathic intervention.

Ultrasonographic Features of Hypertrophic Interureteral Cristae in Transabdominal and Transrectal Ultrasonography.

The aim of this study was to determine the value of transrectal ultrasound in the definitive diagnosis of hypertrophic interureteral cristae and to provide a definitive diagnostic basis for clinical treatment. When the patient's bladder fills moderately, the ultrasound physician uses the transabdominal ultrasound probe to examine the patient's bladder and prostate carefully, focusing on bilateral ureterovesical portals, a cord-like hyperechoic structure visible between the bilateral ureterovesical portals. For further detailed observation, transrectal probe was used to measure the size of Hypertrophic Interureteral Cristae and describe the shape and internal echo. After the examination, the residual urine volume of bladder was measured after one-time urination. Hypertrophic interureteral cristae was a trilinear structure with a "high-low-high" echo. All the 33 patients had bladder wall thickening. In 9 cases of overfilling of bladder, there were slightly dilated ureterovesical portals at both ends of hypertrophic interureteral cristae. Thirty cases of benign prostatic hyperplasia, 11 patients who had undergone prostate hyperplasia surgery, 26 cases with different degrees trabecular and reticular hyperplasia of bladder wall, there were 9 cases with bladder diverticulum and 23 cases with mild hydronephrosis. Transrectal ultrasound can confirm the diagnosis of Hypertrophic Interureteral Cristae.

Joint effect between bisphenol A and alcohol consumption on benign prostatic hyperplasia: A case-control study in Hong Kong Chinese males.

Whether bisphenol A (BPA) exposure is a contributing factor to benign prostatic hyperplasia (BPH) remains unclear. This study evaluated the association between chronic BPA exposure and BPH risk, and explored whether this association was modified by alcohol drinking. This study included a total of 650 BPH cases and 650 controls recruited from the same hospital in Hong Kong during 2011-2016. Chronic BPA exposure level was estimated by a validated cumulative BPA exposure index (CBPAI). We performed unconditional logistic regression model to examine the association of BPH risk with potential sources of BPA exposure via oral intake and CBPAI. We further tested the interactions between CBPAI and alcohol consumption habits on BPH risk. A positive exposure-response relationship was observed between CBPAI and BPH risk. Frequent BPA exposure via oral intake of foods heated in a plastic box/bag (odds ratio [OR] = 3.52, 95% confidence interval [CI]: 1.51-8.22), cooling water in a plastic bottle (OR = 2.65, 95% CI: 1.33-5.27), or using a plastic cup to contain hot water (OR = 4.14, 95% CI: 1.02-16.89), was significantly associated with increased BPH risk. Compared with nonalcohol drinkers, alcohol drinkers was insignificantly associated with BPH risk (OR = 1.10, 95% CI: 0.77-1.57), but it demonstrated a more remarkable positive gradient between CBPAI exposure and BPH risk among alcohol drinkers, indicating an additive interaction between CBPAI and alcohol on BPH risk (synergy index = 4.24, 95% CI: 1.21-14.94). Chronic oral BPA exposure increased BPH risk with a positive exposure-response relationship among Hong Kong Chinese, and alcohol drinking amplified the effect of BPA on BPH. Hence, minimizations of containing food or water/beverage in plastic containers and drinking alcohol are recommended in the community to mitigate BPH risk. Future larger and designated studies are warranted.

Comparative study of diagnostic value between IVIM and DWI for prostate cancer at 3.0\xa0T magnetic resonance

ObjectiveTo quantitatively compare the diagnostic and differential diagnostic value of intra-voxel incoherent motion imaging (IVIM) and diffusion weighted imaging (DWI) for prostate cancer (PCa) and benign prostatic hyperplasia (BPH).Methods68 cases of prostate confirmed by pathology, including 33 cases of PCa and 35 cases of BPH were analyzed retrospectively. All patients were underwent T1WI, T2WI, DWI and IVIM sequences to obtain the apparent diffusion coefficient (ADC), pure apparent diffusion coefficient (Pure-ADC/D), standard apparent diffusion coefficient (standard-ADC/Ds), fast apparent diffusion coefficient (fast-ADC/D*), fraction of fast apparent diffusion coefficient (f) values. All the multiple parameters were statistically analyzed for the differential diagnosis of BPH and PCa. P < 0.05 was considered as statistically significant.ResultsThe differences in D, Ds, f and ADC values between BPH and PCa groups were statistically significant (all P values < 0.001), respectively. Among them, D value in the IVIM model had the highest diagnostic efficiency for PCa, the area under the curve (AUC) was 0.967, and the AUC combined with the ADC value and D value reaches 0.973.ConclusionThe diagnostic efficacy of multiple parameters in the IVIM model for PCa was higher than the ADC value of the quantitative parameter of DWI. D value had the highest diagnostic efficiency. The combined diagnosis of ADC and D value was more effective, more advantageous in the diagnosis and differential diagnosis of PCa.

Transmembrane and Tetratricopeptide Repeat Containing 4 Is a Novel Diagnostic Marker for Prostate Cancer with High Specificity and Sensitivity.

The histopathologic diagnosis of prostate cancer (PCa) from biopsies is a current challenge if double or triple staining is needed. Therefore, there is an urgent need for development of a new reliable biomarker to diagnose PCa patients. We aimed to explore and compare the expression of TMTC4 in PCa cells and tissue specimens and evaluate its sensitivity and specificity. The expression of TMTC4 in PCa and normal prostate epithelial cells was determined by real-time PCR and Western blot analyses. Immunohistochemical (IHC) staining of TMTC4 was performed on tissues collected from PCa and benign prostatic hyperplasia (BPH). Our results show a high expression of TMTC4 on mRNA and protein levels in PCa versus BPH1 and normal cells (p < 0.05). IHC results show strong cytoplasmic expressions in PCa cases (p < 0.001) as compared to BPH cases. The overall accuracy as measured by the AUC was 1.0 (p < 0.001). The sensitivity and specificity of the protein were 100% and 96.6%, respectively. Taken together, we report a high TMTC4 expression in PCa cells and tissues and its ability to differentiate between PCa and BPH with high sensitivity and specificity. This finding can be carried over to clinical practice after its confirmation by further studies.

Postoperative antibiotic therapy patterns in Benign Prostatic Hyperplasia (BPH) patients

Benign Prostatic Hyperplasia (BPH) is an enlarged prostate disease benign or a condition when the cells are present the prostate gland has an increased proliferation rate. There are several treatment options, including conservative (watchful waiting), medical, and surgery. Antibiotics in BPH cases can be prophylactic antibiotics or empiric antibiotics. This study was an observational study. The samples were BPH patients who received antibiotics for period January - November 2019. The pattern of prophylactic antibiotic use shows that most of the patients received ceftriaxone therapy. Operation on BPH patients is TURP which is an operation classified into surgery with a clean-contaminated category so that prophylactic antibiotics are required. There are two patterns of use for empiric antibiotics in BPH patients: single (88%) and combination (12%). The pattern of single or combined use is given to patients depending on the complications of the disease and the patient's clinical condition. BPH cases occur in men mostly occurs at the age of 60-74 years. Prophylactic antibiotic therapy in BPH patients, namely ceftriaxone 1 gr IV once daily was 48 patients (90.6%), a broad spectrum. Meanwhile, the most use of empirical antibiotics with a single pattern is Ceftriaxone 1 gr IV twice daily (35.6%).

Association of Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Lymphocyte-to-Monocyte Ratio with Benign Prostatic Hyperplasia: A Propensity Score-Matched Analysis

Introduction: The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) have recently been proposed as easily accessible inflammatory biomarkers and as surrogate markers for metabolic disease, cardiovascular disease, and malignancies, including prostate cancer. However, scant studies have investigated the association of NLR, PLR, and LMR with benign prostatic hyperplasia (BPH). Methods: Data from 8,727 middle-aged men who had participated in a health checkup were analyzed. BPH was defined as prostate volume ≥30 mL, International Prostate Symptom Score > 7, and maximal flow rate <15 mL/s. Propensity score matching was considered for 269 men with BPH (cases), and 7,136 men with no BPH (controls), but ultimately, propensity scores were matched at a 2:1 ratio of controls to cases (538 men in the control group and 269 men in the case group). Results: After propensity score matching, age, International Index of Erectile Function-5, testosterone, and number of metabolic syndrome component variables were evenly distributed and did not differ significantly between the groups. After matching, PLR and LMR were not significantly different between the 2 groups. However, NLR was significantly higher in the case group than in the control group (median [interquartile range]: 1.4 [1.1; 1.8] vs. 1.5 [1.2; 1.9]; p = 0.024) after matching. Conclusion: High NLR was significantly associated with the presence of BPH. Our results suggest the possible effect of inflammation on BPH development. A prospective study is needed to investigate the potential role of NLR as a candidate biomarker of BPH.

Utility of Alpha-Methyl Acyl-CoA Racemase Marker in Prostatic Adenocarcinomas

Introduction: Prostatic adenocarcinoma is the second leading cause of cancer related death in men in the western world and its incidence is increasing in Asian countries. Hence, it is of diagnostic challenge for pathologists to report in tissue biopsies especially in small focus of suspicious glands in radical prostatectomies and needle biopsies. Aim: To evaluate the role of Alpha-Methyl Acyl CoA Racemase (AMACR) immunohistochemical marker in diagnosing prostatic adenocarcinomas and in benign conditions of prostate. Materials and Methods: This was a cross-sectional study of 26 cases of prostatic adenocarcinomas, two cases of High Grade Prostatic Intraepithelial Neoplasias (HGPIN), 139 cases of Benign Prostatic Hyperplasia (BPH) and two cases of atypical adenomatous diagnosed on routine Haemotoxylin and Eosin (H&amp;E) stained sections during a period of four years from January 2016 to December 2019 at ASRAM Medical College, Eluru. Immunohistochemistry with AMACR marker was done in all cases. Membranous staining pattern was accepted for prostatic adenocarcinomas. Semiquantitative scoring method was employed and tissue sections were examined at high power magnification (X400) by Olympus light microscope to evaluate AMACR expression. Results: Out of the 26 cases of prostatic adenocarcinomas in the study, majority were Grade group IV according to Gleason scoring system. Majority of the prostatic carcinomas showed strong and diffuse AMACR positivity. All BPH and Atypical Adenomatous Hyperplasia (AAH) were negative to AMACR immunohistochemical marker. Conclusion: The AMACR was found to be important diagnostic immune marker in prostatic adenocarcinomas especially in problematic situations where quantity and quality of tissue is limited.

Utility of Alpha-Methyl Acyl-CoA Racemase Marker in Prostatic Adenocarcinomas

Introduction: Prostatic adenocarcinoma is the second leading cause of cancer related death in men in the western world and its incidence is increasing in Asian countries. Hence, it is of diagnostic challenge for pathologists to report in tissue biopsies especially in small focus of suspicious glands in radical prostatectomies and needle biopsies. Aim: To evaluate the role of Alpha-Methyl Acyl CoA Racemase (AMACR) immunohistochemical marker in diagnosing prostatic adenocarcinomas and in benign conditions of prostate. Materials and Methods: This was a cross-sectional study of 26 cases of prostatic adenocarcinomas, two cases of High Grade Prostatic Intraepithelial Neoplasias (HGPIN), 139 cases of Benign Prostatic Hyperplasia (BPH) and two cases of atypical adenomatous diagnosed on routine Haemotoxylin and Eosin (H&amp;E) stained sections during a period of four years from January 2016 to December 2019 at ASRAM Medical College, Eluru. Immunohistochemistry with AMACR marker was done in all cases. Membranous staining pattern was accepted for prostatic adenocarcinomas. Semiquantitative scoring method was employed and tissue sections were examined at high power magnification (X400) by Olympus light microscope to evaluate AMACR expression. Results: Out of the 26 cases of prostatic adenocarcinomas in the study, majority were Grade group IV according to Gleason scoring system. Majority of the prostatic carcinomas showed strong and diffuse AMACR positivity. All BPH and Atypical Adenomatous Hyperplasia (AAH) were negative to AMACR immunohistochemical marker. Conclusion: The AMACR was found to be important diagnostic immune marker in prostatic adenocarcinomas especially in problematic situations where quantity and quality of tissue is limited.

CD44 expression in Prostatic lesions: A prognostic guide

BACKGROUND AND AIMS: The cell surface glycoprotein CD44 plays an important role in mediating cell to cell and cell to matrix interaction, hence promoting the maintenance of tissue integrity and inhibiting tumour metastasis. The present study is aimed to evaluate the expression of CD44 by immunohistochemistry in prostatic core biopsies and transurethral resection of prostate (TURP) specimens in prostatic lesions. METHODS: A total of 63 prostatic samples were enrolled in the study which included cases of benign prostatic hyperplasia, prostatic intraepithelial neoplasia and prostatic adenocarcinoma. Immunohistochemical expression of CD44 was studied to assess its association with histopathological findings and clinical data in the aforementioned samples. RESULTS: CD44 expression was strongly expressed in inflammatory and non-neoplastic cells as compared to neoplastic cells. Within the later, intensity of CD44 expression was stronger in well-differentiated than in poorly differentiated tumours. Loss of CD44 expression was associated with greater tumour aggressiveness. The positive expression of CD44 expression on immunohistochemistry was strongly associated with lower S. PSA levels, Gleason’s scores & grades. Consequently, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of negative CD44 expression for the diagnosis of prostatic adenocarcinoma were 93.3%,79.3%,82.4%,92% and 86.4% respectively. CONCLUSION: There is a great requirement for markers that distinguish slowly progressive from rapidly progressive prostate cancers in paraffin-embedded tissues. CD44 promotes the maintenance of tissue integrity and its expression in prostate cancer is associated with reduced tumour aggressiveness. The up-regulation of the expression of CD44 by certain microRNAs can be utilized as a novel therapeutic agent against prostatic adenocarcinoma.