scholarly journals Incidence of Carcinoma Prostate in Transurethral Resection Specimen in a Teaching Hospital of Nepal

2016 ◽  
Vol 4 (2) ◽  
pp. 77
Author(s):  
Neeraj Thapa ◽  
Sachin Shris ◽  
Nabin Pokharel ◽  
Yashwant Gajanan Tambay ◽  
Yeshwant Ramakrishan Kher ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Clinical Symptoms ◽  
Tertiary Care ◽  
Histopathological Analysis ◽  
Carcinoma Prostate ◽  
High Prevalence ◽  
Resection Specimen ◽  
Tertiary Care Institution ◽  
Poorly Differentiated

Introduction: As suggested through several autopsy studies there is a high prevalence of latent prostate  cancer in the population. A much smaller proportion of prostate  cancer is detected because of clinical symptoms. This study was done to identify the rates of incidentally detected prostate cancer in patients undergoing surgical management of Benign Prostatic Hyperplasia (BPH) in our centre.   Methods: A retrospective review was done on all transurethral resections of the prostate (TURP)  cases from May 2014 to May 2015 at a single tertiary care institution. One hundred and three men, aged 40 to 88 year, underwent TURP and their specimens were sent for the  histopathological analysis.   Results: Five (4.85%) patients were diagnosed with the prostate  cancer. All the five patients had Gleason score of seven or more. Two patients had moderately differentiated adenocarcinoma  with Gleason score of seven. Three patients had poorly differentiated adenocarcinoma with Gleason score of eight or above. The Prostate cancer was seen only  in the age group above 65 years but it was not statistically significant.   Conclusion: Our series demonstrated that 4.85% of patients had latent prostate  cancer. It occurs mainly in men above 65 years of age though this was not statistically significant.

scholarly journals Can mean ADC value and ADC ratio of benign prostate tissue to prostate cancer assist in the prediction of clinically significant prostate cancer within the PI-RADSv2 scoring system?

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Samar Ramzy Ragheb ◽  
Reem Hassan Bassiouny
Keyword(s):  
Prostate Cancer ◽  
Sensitivity And Specificity ◽  
Gleason Score ◽  
Treatment Strategies ◽  
Serum Levels ◽  
Prostatic Tissue ◽  
Histopathological Analysis ◽  
Adc Value ◽  
The Mean ◽  
Clinically Significant

Abstract Background The aim of this study is to investigate whether quantitative DW metrics can provide additive value to the reliable categorization of lesions within existing PI-RADSv2 guidelines. Fifty-eight patients with clinically suspicious prostate cancer who underwent PR examination, PSA serum levels, sextant TRUS-guided biopsies, and bi-parametric MR imaging were included in the study. Results Sixty-six lesions were detected by histopathological analysis of surgical specimens. The mean ADC values were significantly lower in tumor than non-tumor tissue. The mean ADC value inversely correlated with Gleason score of tumors with a significant p value < 0.001.Conversely, a positive relationship was found between the ADC ratio (ADC of benign prostatic tissue to prostate cancer) and the pathologic Gleason score with a significant elevation of the ADC ratio along with an increase of the pathologic Gleason score (p < 0.001). ROC curves constructed for the tumor ADC and ADC ratio helped to distinguish pathologically aggressive (Gleason score ≥ 7) from non-aggressive (Gleason score ≤ 6) tumors and to correlate it with PIRADSv2 scoring to predict the presence of clinically significant PCA (PIRADSv2 DW ≥ 4). The ability of the tumor ADC and ADC ratio to predict highly aggressive tumors (GS> 7) was high (AUC for ADC and ADC ratio, 0.946 and 0.897; p = 0.014 and 0.039, respectively). The ADC cut-off value for GS ≥ 7 was < 0.7725 and for GS ≤ 6 was > 0.8620 with sensitivity and specificity 97 and 94%. The cutoff ADC ratio for predicting (GS > 7) was 1.42 and for GS ≤ 6 was > 1.320 with sensitivity and specificity 97 and 92%. By applying this ADC ratio cut-off value the sensitivity and specificity of reader 1 for correct categorization of PIRADSv2 DW > 4 increased from 90 and 68% to 95 and 90% and that of reader 2 increased from 94 and 88% to 97 and 92%, respectively. Conclusion Estimation of DW metrics (ADC and ADC ratio between benign prostatic tissue and prostate cancer) allow the non-invasive assessment of biological aggressiveness of prostate cancer and allow reliable application of the PIRADSv2 scoring to determine clinically significant cancer (DW score > 4) which may contribute in planning initial treatment strategies.

scholarly journals A clinico-epidemiological analysis of subclinical hypothyroidism in a tertiary care health center

2019 ◽  
Vol 6 (4) ◽  
pp. 1079
Author(s):  
Vaibhav Agrawal ◽  
Virendra Patil ◽  
Ashok Kshirsagar
Keyword(s):  
Subclinical Hypothyroidism ◽  
Clinical Symptoms ◽  
Tertiary Care ◽  
Thyroid Stimulating Hormone ◽  
Common Symptom ◽  
Age Group ◽  
Free Triiodothyronine ◽  
High Prevalence ◽  
Care Health ◽  
Serum Tsh

Background: Subclinical hypothyroidism (SCH) is defined by increase in serum thyroid stimulating hormone (TSH) and free thyroxine (FT4) and free triiodothyronine (FT3) levels within normal range, coupled with absence of typical clinical symptoms. The present study was undertaken to analyse the SCH associated comorbidities, especially lipid disturbances, thyroid autoantibodies, etc.Methods: The present study was retrospective observational study, which was carried out at a tertiary health care center.Results: Out of the 100 patients, majority were in the age group 21 to 30 years (31 patients), followed by 26 patients in age group >51 years and least in age group 41 to 50 years. Prevalence showed female predilection, with female: male ratio of 1.9:1. Most common symptom reported was general fatigue, which was encountered in 40 patients, followed by weight gain, menstrual abnormalities, and constipation. 10 patients were asymptomatic. Serum TSH range in the patients was 5 to 21.1 µIU/l, while mean TSH was 10.9 µIU/l. 20 patients were found to have serum TSH>10.Conclusions: Despite high prevalence, detection rate of subclinical hypothyroidism is very low. Carrying out epidemiological study on national scale is need of the hour, as lack of typical clinical features makes the detection less likely and it has numerous complications, if untreated.

The diagnostic utility of brain biopsy procedures in patients with rapidly deteriorating neurological conditions or dementia

2007 ◽  
Vol 106 (1) ◽  
pp. 72-75 ◽  
Author(s):  
S. Andrew Josephson ◽  
Alexander M. Papanastassiou ◽  
Mitchel S. Berger ◽  
Nicholas M. Barbaro ◽  
Michael W. McDermott ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Brain Biopsy ◽  
B Cell Lymphoma ◽  
Clinical Syndrome ◽  
Biopsy Specimens ◽  
Jakob Disease ◽  
Tertiary Care Institution ◽  
Neurological Conditions

Object Obtaining brain biopsy specimens is often the diagnostic test of last resort for patients with unexplained neurological conditions, particularly those with a rapidly deteriorating neurological course. The goals of this analysis were to determine the diagnostic sensitivity of brain biopsy specimens in these types of patients and retrospectively identify features of these disorders that may have enabled an earlier diagnosis, which may prevent the need for diagnostic brain biopsy procedures in the future. Methods The authors reviewed the case records of all brain biopsy procedures that had been performed at a single tertiary care institution between January 1993 and April 2002 in 171 patients. Patients with HIV or nonlymphomatous brain tumors were excluded from this analysis because the utility of brain biopsy specimens for these conditions has been determined from previous studies. A subgroup analysis of this cohort was performed in the 64 patients who had comprehensive medical records and a clinical syndrome involving a progressively deteriorating neurological condition of less than 1 year in duration. The overall sensitivity of brain biopsy procedures for diagnostic purposes in the cohort was 65% (111 of 171 patients). The two most common diagnoses in the subgroup with rapidly deteriorating neurological conditions were primary central nervous system (CNS) B-cell lymphoma in 20.3% (13 patients) and Creutzfeldt–Jakob disease in 15.6% (10 patients), followed by viral encephalitis in 14.1% (nine patients) and CNS vasculitis in 9.4% (six patients). Clinical symptoms and laboratory data were compared among the diagnostic groups. Conclusions These results will help guide the evaluation of patients with neurological conditions that are difficult to diagnose and will provide a foundation for further prospective studies.

scholarly journals Incidence of Prostatic Carcinoma in Transurethral Resection Specimen

2021 ◽  
Vol 5 (2) ◽  
Keyword(s):  
Prostate Cancer ◽  
Cross Section ◽  
Prostatic Carcinoma ◽  
Screening Program ◽  
Prostate Adenocarcinoma ◽  
Prostatic Hyperplasia ◽  
Histopathological Analysis ◽  
High Grade ◽  
Prostatic Enlargement ◽  
Resection Specimen

Objective: This study done to identify the rates of incidentally detected prostate cancer in patients undergoing surgical management of Benign Prostatic Hyperplasia (BPH). Methods: This cross section study was done on all transurethral resections of the prostate (TURP) cases. One hundred and eighty one men, aged 45 to 94 year, underwent TURP and their specimens were sent for the histopathological analysis. Those with a known diagnosis of prostate cancer prior to TURP were excluded (𝑛 = 5) from the analysis. Results: Hundred eighty-one patients had prostatic enlargement; fifteen patients (8.29%) patients were found to have prostate adenocarcinoma. Grade of disease ranged from Gleason score 7 to 10. Majority of them (fourteen patients) aged 65 year or above. Conclusion: Prostate carcinoma is showing high grade at the diagnosis and widely frequent (8.29%) in TURP, especially in-patient above 65 years (11.0%) and therefore a screening program advised.

scholarly journals Incidental Prostate Cancer in Transurethral Resection of the Prostate Specimens in the Modern Era

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Brandon Otto ◽  
Christopher Barbieri ◽  
Richard Lee ◽  
Alexis E. Te ◽  
Steven A. Kaplan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Tertiary Care ◽  
Cancer Detection Rate ◽  
Incidental Prostate Cancer ◽  
Prostate Cancer Detection ◽  
Benign Pathology ◽  
Tertiary Care Institution ◽  
Modern Era ◽  
Pathology Specimen

Objectives.To identify rates of incidentally detected prostate cancer in patients undergoing surgical management of benign prostatic hyperplasia (BPH).Materials and Methods.A retrospective review was performed on all transurethral resections of the prostate (TURP) regardless of technique from 2006 to 2011 at a single tertiary care institution. 793 men (ages 45–90) were identified by pathology specimen. Those with a known diagnosis of prostate cancer prior to TURP were excluded (n=22) from the analysis.Results.760 patients had benign pathology; eleven (1.4%) patients were found to have prostate cancer. Grade of disease ranged from Gleason3+3=6to Gleason3+4=7. Nine patients had cT1a disease and two had cT1b disease. Seven patients were managed by active surveillance with no further events, one patient underwent radiation, and three patients underwent radical prostatectomy.Conclusions.Our series demonstrates that 1.4% of patients were found to have prostate cancer, of these 0.5% required treatment. Given the low incidental prostate cancer detection rate, the value of pathologic review of TURP specimens may be limited depending on the patient population.

Duration of androgen deprivation therapy for high-risk prostate cancer: Application of randomized trial data in a tertiary referral cancer center.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 33-33
Author(s):  
Vinayak Muralidhar ◽  
Meredith M. Regan ◽  
Lillian Werner ◽  
Mari Nakabayashi ◽  
Carolyn Evan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Side Effects ◽  
High Risk ◽  
Androgen Deprivation Therapy ◽  
Gleason Score ◽  
Cox Regression ◽  
Tertiary Care ◽  
Androgen Deprivation ◽  
High Risk Prostate Cancer ◽  
Risk Prostate Cancer

33 Background: We wished to evaluate the incidence and predictors of the use of long-term (2-3 years) vs. shorter-term androgen deprivation therapy (ADT) in radiation-treated men with high-risk prostate cancer. Methods: We identified 302 patients from the Dana-Farber Cancer Institute patient registry diagnosed with high-risk prostate cancer (T3a or PSA > 20 ng/mL or Gleason score 8-10) between 1993 and 2015. We assessed the intended duration of ADT and used multivariable Cox regression to evaluate predictors of receiving shorter-course ADT than recommended by guidelines (< 2 years). Results: The course of ADT intended by physicians increased following the 2009 publication of trials showing the superiority of 2-3 years versus 4-6 months of ADT, with 43.5% intending ≥ 2 years before vs. 61.4% after (p=0.014). Starting in 2010, 49.4% of patients actually received less than 2 years of ADT. The most common reasons for receipt of shorter-course ADT were intolerance of ADT side effects, patient comorbidity/age, the presence of T3a on MRI only as the sole high-risk feature, or participation in a clinical trial. ACE-27 moderate to severe comorbidity (adjusted hazard ratio [AHR]=2.94), Gleason score less than 8 (AHR=5.66), and PSA < 20 ng/mL (AHR=4.19) all predicted receipt of shorter-course ADT (p<0.05 in all cases). Conclusions: In a tertiary-care setting, rates of long-course ADT for high-risk disease have increased since the 2008/2009 trials supporting its use. However, approximately half of patients continued to receive shorter-course ADT, often due to intolerance of side effects, underlying comorbidity, or physician judgment about the aggressiveness of the disease.

scholarly journals EXPRESSION OF CD10 IN CARCINOMA PROSTATE AND ITS CORRELATION WITH VARIOUS CLINICOPATHOLOGICAL PARAMETERS.

2020 ◽  
pp. 1-4
Author(s):  
Raj Kumar Gupta ◽  
Namita Bhutani ◽  
Sunil Arora
Keyword(s):  
Prostate Cancer ◽  
Gleason Score ◽  
Immunohistochemical Analysis ◽  
Initial Therapy ◽  
Clinicopathological Parameters ◽  
Early Event ◽  
Grade Group ◽  
Altered Expression ◽  
Carcinoma Prostate ◽  
Cd10 Expression

Aim: Adenocarcinoma of the prostate is the second most common cause of cancer. Loss of CD10 is a common early event in human prostate cancer and is seen in lower Gleason Score malignancies while increased and altered expression is seen in high Gleason Score tumors, lymph node and bone metastasis. Materials and methods: The present study was a prospective observational study conducted on seventy-five patients suspected of having prostate cancer. Immunohistochemical profile was assessed for PSA, AMACR and CD10 immunostain. The intensity of CD10 expression and pattern of CD10 staining of tumor cells was evaluated. Results: The patients were in age group of 50-90 years with a mean age of 70.97 ± 9.51 years. As the grade group/gleason score increased the number of cases showing negative expression decreased and the pattern of expression changed from membranous to cytoplasmic to both types of expression. As the serum PSA levels increased the intensity of expression changed from focally positive to diffusely positive. The pattern of expression also changed from membranous to cytoplasmic to both ( membranous + cytoplasmic ) types of expression with increase in PSA levels. Conclusion: By immunohistochemical analysis we can identify CD10 positive tumors, which may warrant more aggressive initial therapy. A number of drugs against CD10 are available based on which potential targeted therapies could be formulated.

Association of Plasma Interlukin-6 in Metastatic & Non-Metastatic Prostate Cancer Patients presented to a Tertiary Care Hospital in Lahore Pakistan.

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Munazza Khan ◽  
Zaffar Uddin ◽  
Zarghuna Khan ◽  
Yasir Khan ◽  
Zarsanga Haider ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Gleason Score ◽  
Metastatic Prostate Cancer ◽  
Strong Predictor ◽  
Tertiary Care ◽  
Specific Antigen ◽  
Medical Institute ◽  
Care Hospital ◽  
Significant Difference

Background: Prostate cancer (PC) is a complex, multi-factorial disease. In spite of its high prevalence, the Pathophysiology of thePC progression is poorly understood. Cytokines play important role in immune regulation. Cytokines (IL-6) regulates growth ofmany tumor cells including prostate cancer, therefor it can be used as a marker for PC.Objectives: To measure and compare the levels of IL-6 between metastatic and non- metastatic prostate cancer patients.Material and Methods: This study was a Cross-sectional analytical and was conducted in the Department of physiology FederalPsotgraduate Medical Institute (FPGMI) Lahore with collaboration of Urology department of Sheikh Zayed hospital Lahore.Patients with prostate cancer registered with Urology department, Sheikh Zayed Hospital Lahore were recruited for the study.Patients with inflammatory conditions, auto-immune diseases, obesity and Alzimer's disease were excluded. A standard Elisa kit(Thermo scientific made in USA) was used for estimation of serum IL-6 levels. Data was recorded on a structured checklist, whichcontained basic demographic data along with finding of prostate specific antigen (PSA), prostatic biopsy, bone scan and serum IL-6levels. Data was analyzed through SPSS version 20 for descriptive statistics.Results: A total of 50 (25 metastatic and 25 non-metastatic) prostate cancer patients were being part of the present study. Themean PSA level was 364.42 ± 86.7 among metastatic prostate cancer patients as compared to 30.71 ±23.48 non- metastatic,indicating significant difference (p =0.001). Similarly mean Gleason score was high (7.16±0.85) among metastatic prostate cancerpatients as compared to 6.28±0.54 among non-metastatic one. Significant difference (p=0.014) was observed regarding IL-6. Itwas 25.73±80.48 among metastatic patients in comparison with 1.56±1.38 among non-metastatic patients. There was strongcorrelation between PSA and Gleason score (r= 0.479**, p<0.001). Also positive association was found between IL-6 and PSA, (r=0.285*, p=0.045).Conclusion: Serum IL-6 might be considered as a predictor for metastatic prostate cancer. Along with PSA, serum IL-6 levelscould be a strong predictor for the diagnosis of metastatic condition of prostate cancer.

scholarly journals Correlation between serum PSA, gleason score and histopathological grading of adenocarcinoma of prostate in patients undergoing TRUS guided prostatic biopsy in a tertiary care centre of Southern India

2021 ◽  
pp. 42-47
Author(s):  
Pogula Veda Murthy Reddy ◽  
Omkaram Karthikesh ◽  
Galeti Ershad Hussain ◽  
Kanchi V Bhargava Reddy
Keyword(s):  
Gleason Score ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Gleason Grade ◽  
Tertiary Care Centre ◽  
Prostatic Biopsy ◽  
Carcinoma Of The Prostate ◽  
Carcinoma Prostate ◽  
Number Of Patients ◽  
Grade Groups

Background Prostate cancer is the second most common cancer and the fifth leading cause of cancer deaths worldwide. Serum psa, a glycoprotein and a serine protease, which is increased in all prostatic diseases but markedly elevated levels are indicative of carcinoma prostate. The present study was done to evaluate the histopathologyof carcinoma of prostate in trus guided prostatic biopsy specimens and correlate serum psa levels with gleason score and grade groups. Methods A hundred patients presented with luts and suspicious of carcinoma prostate underwent trus guided 16 core prostatic biopsy. Histopathological examination, gleason scores and grades of biopsies were obtained. Based on the gleason scores, patients with carcinoma of the prostate were divided into five-grade groups. Mean serum psa levels were calculated and correlated with gleason score and grade groups. Results Malignancy was found in 69 per cent of cases, of which 68 patients were found to have adenocarcinoma of the prostate, one patient found to have undifferentiated carcinoma of the prostate. The total number of patients in each gleason grade groups were obtained, and the mean serum psa levels of these patients in each group were calculated. Mean serum psa levels in each group are group 1 (21.3 ng/ml), group 2 (58.4 ng/ml), group 3 (73.6 ng/ml), group 4 (118.4 ng/ml), group 5 (96.3 ng/ml). Conclusion Serum psa is a highly sensitive tumour marker with low specificity, and its levels are increased in many benign and iatrogenic conditions. Psa has a high negative predictive value which is essential in ruling out malignancy. In our study, higher serum psa levels were correlated with higher gleason score and grades.

scholarly journals Adenocarcinoma of the prostate with small cell component and low levels of prostate specific antigen

2020 ◽  
Vol 77 (10) ◽  
pp. 1101-1103
Author(s):  
Sasa Vojinov ◽  
Mladen Popov ◽  
Ivan Levakov ◽  
Aleksandra Levakov-Fejsa ◽  
Dimitrije Jeremic ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cell Carcinoma ◽  
Prostate Specific Antigen ◽  
Small Cell Carcinoma ◽  
Specific Antigen ◽  
Small Cell ◽  
Histopathological Analysis ◽  
Poorly Differentiated Adenocarcinoma ◽  
Adenocarcinoma Of The Prostate ◽  
Poorly Differentiated

Introduction. Prostate cancer is one of the most common malignancies in men. The most common type is acinar adenocarcinoma. Small cell prostate cancer (SCPC) usually occurs together with coexisting prostate adenocarcinoma. Case report. A 72-years-old patient with voiding simptoms is presented. Initial level of prostate specific antigen (PSA) was 2.87 ng/mL. Twelve prostate biopsies were taken and in six of them neoplastic tissue was detected. The viewed tissue was most convenient to ?small cell carcinoma?. Bone scintigraphy did not demonstrate dissemination of the cancer into the skeletal system. Multislice computed tomography (MSCT) of the pelvis did not reveal any special pathological changes. The patient underwent surgery ? radical retropubical prostatectomy. Histopathological analysis revealed a poorly differentiated adenocarcinoma of the prostate with small cell carcinoma zones [Gleason score 5+5 (10), grade III, pT3bN1, stage IV]. Conclusion. Poorly differentiated adenocarcinoma of the prostate, especially in combination with SCPC, is an aggressive malignancy with most cases presenting with the extensive disease dissemination on diagnosis and poor prognosis. Small cell carcinomas of the prostate are extremely rare tumors of the neuroendocrine origin. Patients with mixed prostate cancer, compared to pure SCPC, have a better prognosis and greater survival rate. There is a lack of the evidence guiding treatment for SCPC.

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