Cases Of Prostatic Hyperplasia Research Articles

Expression of p63 Protein to Differentiate Benign Prostatic Hyperplasia and Carcinoma of Prostate in Pakistani Population

AbstractBackground: Prostate cancer is the world’s foremost and second cause of cancer associated death typically in males after lung cancer. Histopathological diagnosis of prostatic hyperplasia and prostatic carcinoma can be challenging. The expression of p63 can be used in diagnosis and differentiation of benign pro-static hyperplasia from carcinoma of prostate.Materials and Methods: We studied sixty prostatic biopsies obtained by TURP and radical prostatectomy. For each case, clinical data was collected. The tissue sections were then diagnosed on basis of routine hematoxylin and eosin. Then immunohistochemical (IHC) analysis was performed on routinely processed, forma-lin-fixed, paraffin embedded tissue. We also analyzed P63 expression in regions of benign prostatic hyperplasia and prostatic adenocarcinoma. Moreover, detailed examination of tissue sections was observed with light microscopy.Results: Mean age of patients with adenocarcinoma was 70 ± 12 years however mean age in prostate hyperplasia cases was 66 ± 8 years. With the use of Receiver Operative Characteristic Curve (ROC), the optimal cut point found of PSA was 30.0ng/ml. The results showed that prostate specific antigen (PSA) at this cutoff had a sensitivity of 71.4%, with specificity of 74.4% and accuracy of 73.3%. So PSA could not be considered reliable independently for the diagnosis of carcinoma of prostate. Benign cases in the present study were exclusively positive for immunohistoche-mical expression of p63 while all the cases of prostatic carcinomas expressed negative pattern of staining.Conclusion: Immunostaining with p63 is useful to differentiate benign prostatic hyperplasia from pro-static carcinoma, so it may be used as valuable tool in the diagnosis of prostatic carcinoma.

Efficacy and safety of laparoendoscopic single–site surgery in benign prostatic hyperplasia

Objectives To evaluate the efficacy and safety of laparoendoscopic single–site(LESS) surgery in treatment of benign prostatic hyperplasia. Methods A total of 60 benign prostatic hyperplasia(BPH) cases were equally assigned to 2 groups according to the random number table: control group (Open operation group) and observation group (LESS group). The clinical parameters include blood loss, operation time, international prostate symptoms score (IPSS), maximum urine flow rate(Q max), hospital stays and postoperative complication rate. Results In blood loss and operation time, LESS group was significantly less than control group(P 0.05). Conclusions Compare with traditional open operation , Laparoendoscopic single–site surgery of BPH has advantages in minimally invasive, less blood loss , less operation time and hospital stays, lower postoperative complication rate. It’s worthy for clinical use. Key words: Prostatic Hyperplasia; Urinary Bladder; Laparoscopes

Use of Structural Equation Modeling to Demonstrate the Differential Impact of Storage and Voiding Lower Urinary Tract Symptoms on Symptom Bother and Quality of Life during Treatment for Lower Urinary Tract Symptoms Associated with Benign Prostatic Hyperplasia

Lower urinary tract symptoms associated with benign prostatic hyperplasia typically respond well to medical therapy. While changes in total I-PSS (International Prostate Symptom Score) are generally accepted as measurement for treatment response, I-PSS storage and voiding subscores may not accurately reflect the influence of symptom improvement on patient bother and quality of life. Structural equation modeling was done to evaluate physiological interrelationships measured by I-PSS storage vs voiding subscore questions and measure the magnitude of effects on bother using BII (Benign Prostatic Hyperplasia Impact Index) and quality of life on I-PSS quality of life questions. Pooled data from 4 randomized, controlled trials of tadalafil and placebo in 1,462 men with lower urinary tract symptoms/benign prostatic hyperplasia were used to investigate the relationship of storage vs voiding lower urinary tract symptoms on BII and quality of life. The final structural equation model demonstrated a sufficient fit to model interdependence of storage, voiding, bother and quality of life (probability for test of close fit <0.0001). Storage aspects had a twofold greater effect on voiding vs voiding aspects on storage (0.61 vs 0.28, each p <0.0001). The direct effect of storage on bother was twofold greater than voiding on bother (0.64 vs 0.29, each p<0.0001). Bother directly impacted quality of life by the largest magnitude of (-0.83), largely driven by storage lower urinary tract symptoms (p<0.0001). Total I-PSS is a reliable instrument to assess the therapeutic response in lower urinary tract symptoms/benign prostatic hyperplasia cases. However, an improvement in storage lower urinary tract symptoms is mainly responsible for improved bother and quality of life during treatment. Care should be taken when evaluating the accuracy of I-PSS subscores as indicators of the response to medical therapy.

Association of GSTM1T1 genes with COPD and prostate cancer in north Indian population

The glutathione S-transferase (GST) family of enzymes is known to play a pivotal role in phase II of biotransformation of xenobiotics, environmental carcinogens and pharmacological drugs. The objective of the present study was to investigate the role of GSTM1 and GSTT1 null genotypes as risk factors for chronic obstructive pulmonary disease (COPD) and prostate cancer. The subjects appraised were 200 COPD cases, 150 prostate cancer cases, 150 benign prostatic hyperplasia (BPH) cases, 200 age matched controls for COPD and 172 age matched controls for prostate cancer. GSTM1 and GSTT1 null genotype was found to confer 2.5 (OR 2.45; 95% CI 1.56-3.82; P value = 0.00008) and 2.4-fold (OR 2.39; 95% CI 1.36-4.20; P value = 0.002) significant higher risk for prostate cancer. Smoking imparted a 2.2-fold significant risk of prostate cancer cases (OR 2.23; 95% CI 1.36-3.65 P value = 0.001) and twofold risk in BPH (OR 2.09; 95% CI 1.26-3.46; P value = 0.005). In case of COPD only null genotype of GSTT1 has shown 2.1-fold (OR 2.11; 95% CI 1.22-3.62; P value = 0.007) significant increased risk.

Observations on the treatment of 37 cases of senile prostate hyperplasia with acupuncture

Objective: To investigate the curative effect of acupuncture on senile benign prostate hyperplasia. Methods: The patients were given acupuncture treatment for 10–30 times; International prostate symptom score (IPSS) and quality of life index (QOL) were used to assess IPSS and QOL scores of the patients before and after treatment. Results: Before treatment IPSS and QOL of the patients were 22.1±6.7 and 4.5±0.6 respectively, and after treatment were 9.1±4.3 and 1.9±1.1 respectively, there were very significant differences in IPSS and QOL between pre-treatment and post-treatment (P<0.01). Conclusion: Acupuncture can relieve the clinical symptoms of prostate hyperplasia and raise the patients' quality of life.

The distribution of S-100 protein in hyperplastic and neoplastic prostatic epithelium.

Specimens from 30 cases of benign prostatic hyperplasia and 75 cases of prostatic carcinoma obtained during suprapubic prostatectomy, transurethal resection of the prostate and radical prostatectomy, were stained immunohistochemically for S-100 protein, prostatic acid phosphatase (PAP), prostatic specific antigen (PSA), neuron specific enolase (NSE) and polyclonal keratin. S-100 protein was positive in 9.3% of prostatic carcinomas and negative in all cases of prostatic hyperplasia. PAP and PSA were positive in all cases, while NSE was positive in 16% of the carcinoma cases. Polyclonal keratin was positive in both cell layers of the double layered hyperplastic prostatic epithelium with a more intense staining pattern in the outer cell layer. The authors believe that the S-100 protein immunoreactivity observed in some prostatic carcinomas, reflecting the change in the functional status of the neoplastic cells, might be of prognostic significance. They also emphasize the non-myoepithelial nature of the outer cell layer of the double layered prostatic epithelium.

Longitudinal Evaluation of Prostate-Specific Antigen Levels in a Case-Control Study

BACKGROUND: Over the last period--late 1970 to early 1990--the incidence of prostate carcinoma has nearly doubled, even though many more patients die with prostate cancer rather than of it. This finding, together with the slow growth of this tumor and the absence of a controlled trial, makes early diagnosis for this pathology quite questionable. On the other hand, it is well known that prostatic carcinoma is curable as long as it is intracapsular and that there is an ever increasing encouragement for early detection in all diseases. Since prostatic pathology increases its incidence as age advances, the first step in early diagnosis is to be able to discriminate between healthy, benign prostatic hyperplasia and cancer cases with a well-accepted and easily understandable method. The problem is to find the best method to do it. METHODS: We measured serum prostate-specific antigen (PSA) levels in 435 men participating in an epidemiological study, at first in 1987 and again in 1992. Men with PSA levels above 4 ng/ml (in 1992) were invited to undergo other diagnostic tests (digital rectal examination, transrectal ultrasonography, biopsy) in sequence on the basis of the results of the previous tests. The pathological findings from biopsies were the reference test to determine the presence or absence of prostate cancer (2.5% of the population). RESULTS: We divided PSA concentrations into three categories, according to the most used cutoffs ( 10 ng/ml); in the meantime, we took into account the change rate in PSA concentration in time, defined as delta PSA. By the comparison between PSA categories and delta PSA, we found out that the first one does not discriminate between benign and malignant pathologies, while the use of delta PSA strongly discriminates them (p < 0.001). CONCLUSION: On the basis of our results, we think that delta PSA might be the best parameter to indicate the presence of prostate cancer cases in an asymptomatic population.

Binding of soybean agglutinin lectin to prostatic hyperplasia and adenocarcinoma

The binding of soybean agglutinin (SBA) lectin to routinely processed surgical pathology material from cases of prostatic hyperplasia, atypical hyperplasia, and adenocarcinoma was studied using an immunoperoxidase technique. Positive staining was obtained in eight of eight cases of nodular hyperplasia, eight of eight cases of atypical hyperplasia, and ten of 11 cases of adenocarcinoma. This report indicates that this lectin is not useful in distinguishing prostatic hyperplasia from adenocarcinoma.

Significance of PSA and PAP in Patients With or Without Prostatic Cancer

Coupled prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) measurements (using the radioimmunoassay method) were carried out on 220 controls, 33 patients with prostatic hyperplasia, and 71 with carcinoma. The mean PSA value was 3.70 +/- 3.31 ng in the controls. A level of 10 ng was adopted as the upper limit of normal. Four of the eight cases of prostatic hyperplasia with a high PSA level (between 10 and 25 ng) underwent surgery. Histological tests confirmed benign hyperplasia. In the localized cancers, the PSA level was normal. In the metastatic cancers, PSA proved to be more sensitive than PAP. Thus, PSA is of little use in the early diagnosis of cancer; its systematic measurement as a means of cancer screening for the general public may even be misleading.

Relationship between Echogram and Histology of Benign Prostatic Hyperplasia

Echograms of benign hyperplastic prostates by means of transrectal ultrasonography were evaluated according to their ability to distinguish between internal and external glands. Of the 112 benign prostatic hyperplasia (BPH) cases, we could distinguish between internal and external glands in 43 cases (38.4%). In 24 of all BPH cases, their preoperative echograms and postoperative histologies were compared. The result was that it was difficult to distinguish between internal and external glands in the many chronic-inflammatory infiltrates.