Assessment of Utility of Immunohistochemical Marker Prostein for Evaluation of Primary and Metastatic Prostatic Carcinomas

Background: To assess utility of immunohistochemical marker prostein for evaluation of primary and metastatic prostatic carcinomas.Methods:Fifty- six samples of clinically suspected carcinoma prostate was included. Immunohistochemistry (IHC) was performed for assessment of Prostein (P501S). The intensity of positivity was scored from 0 to 3 as follows: score 0 = non-stained; score 1 = weak; score 2 = moderate; and score 3 = strong. The percentage of positively stained cells for each staining intensity was estimated in the respective lesions.Results:Age group 18-28 years comprised of 6 patients, 28-38 years had 12, 38- 48 years had 16 and >48 years had 22 cases. Type of cases were normal prostatic epithelium in 11, benign prostate hyperplasia in 23, HGPIN in 10, primary prostatic adenocarcinoma in 7 and metastatic prostatic adenocarcinoma in 5 cases. Prostein expression was seen in 100% in normal prostatic epithelium with intensity score of 1.8-2.1, benign prostate hyperplasia having 2-2.7, HGPIN with 2-2.3, primary prostatic adenocarcinoma having 1-1.6 and metastatic prostatic adenocarcinoma with 0.8-1.4 intensity score. Conclusion:Prostein is a new prostate specific marker which showed 100% sensitivity and specificity to identify normal and prostatic lesions.

HERV-K and HERV-H env Proteins Induce a Humoral Response in Prostate Cancer Patients

A higher expression of human endogenous retroviruses (HERVs) has been associated with several malignancies, including prostate cancer, implying a possible use as a diagnostic or prognostic cancer biomarker. For this reason, we examined the humoral response against different epitopes obtained from the envelope protein of HERV-K (HERV-K env-su19–37, HERV-K env-su109–126), HERV-H (HERV-H env-su229–241, HERV-H env387–399) and HERV-W (HERV-W env-su93–108, HERV-W env-su248–262) in the plasma of patients affected by prostate cancer (PCa), and compared to that of benign prostate hyperplasia (BPH) and a borderline group of patients with atypical small acinar proliferation (ASAP) and prostate intraepithelial neoplasia (PIN) and healthy controls. A significant antibody response was observed against HERV-K env-su109–126 (p = 0.004) and HERV-H env-su229–241 (p < 0.0001) in PCa patients compared to HCs, BPH and borderline cohorts, whilst no significance difference was found in the antibodies against HERV-W env-su93–108 and HERV-W env-su248–262 in patients with PCa. Our results provided further proof of the association between HERV-K and PCa and added new evidence about the possible involvement of HERV-H in PCa pathogenesis, highlighting their possibility of being used as biomarkers of the disease.

The Values of Systemic Immune-Inflammation Index and Neutrophil–Lymphocyte Ratio in the Localized Prostate Cancer and Benign Prostate Hyperplasia: A Retrospective Clinical Study

PurposeTo evaluate the diagnostic values of systemic immune-inflammation index (SII) and neutrophil–lymphocyte ratio (NLR) in patients with localized prostate cancer (PCa).MethodsBetween January 2014 and December 2019, 117 patients with benign prostate hyperplasia (BPH) and 278 patients with localized PCa who underwent radical prostatectomy (RP) were included in this study. The inflammatory markers including SII, NLR, platelet–lymphocyte ratio (PLR), lymphocyte–monocyte ratio (LMR), lymphocyte ratio (LR), neutrophil ratio (NR), mean platelet volume (MPV), and red cell distribution (RDW) of these two groups were examined and analyzed. ROC curve analysis was performed to assess the discriminative ability of inflammatory markers and their combination with tPSA for PCa. The binary logistic regression model was used to evaluate the association between significant inflammatory markers and risk of PCa.ResultsThe pathological results from RP specimen comprised 72 (25.90%) patients with pT1, 168 (60.43%) patients with pT2, and 38 (13.67%) patients with pT3. According to Student’s t test, patients with PCa had higher NLR (p = 0.034), SII (p = 0.008), and NR (p = 0.004), and lower LR (p = 0.025), MPV (p = 0.003), and TPV (p = 0.022) compared with patients with BPH; the distribution of age, PLR, LMR, RDW, f/t PSA ratio, and BMI did not show any significant differences. The AUC for NLR, SII, NR, and tPSA was 0.697 (p = 0.015), 0.719 (p &lt; 0.001), 0.647 (p = 0.009), and 0.708 (p &lt; 0.001), with threshold values of 1.6, 471.86, 65.15%, and 12.89 ng/ml, respectively. Patients were divided into two groups according to the threshold values, respectively. By using the multivariable logistic regression models, NLR ≥ 1.6 (OR, 2.731; 95% CI, 0.937–7.961, p = 0.042), SII ≥ 471.86 (OR, 1.274; 95% CI 0.473–3.433; p = 0.033), and PSA ≥ 12.89 ng/ml (OR, 1.443; 95% CI, 0.628–3.944; p = 0.014) were independent risk factors associated with PCa. The AUC for combination of NLR, SII, and NR with tPSA was 0.705 (p &lt; 0.001), 0.725 (p &lt; 0.001), and 0.704 (p &lt; 0.001), respectively.ConclusionThis study demonstrated that SII, NLR, and NR were all independent risk factors of PCa. These factors alone could provide better screen methods for PCa before biopsy. In addition, SII is a more powerful tool among these three inflammatory markers associated with PCa. Besides, combination of SII and NLR with tPSA had not much advantage compared with themselves alone.

The Predictive Factor for Favorable Outcome after Surgical Treatment of Benign Prostate Hyperplasia Performed by Young Urologist: Is Surgical Modality Important in Beginner Urologists?

Objective: To identify predictive factors for favorable outcomes after surgical treatments that were performed by beginner urologists in patients with benign prostate hyperplasia (BPH), we retrospectively evaluated outcomes after holmium laser enucleation of the prostate (HoLEP) and transurethral resection of prostate (TURP) that were performed by two young urologists.Methods: Of 80 patients who were treated with HoLEP or TURP, 31 (HoLEP) and 36 (TURP) patients who were followed up for 3 months were enrolled in this study. Preoperative and perioperative variables were evaluated to identify predictive factors for favorable outcome after surgical treatment for BPH.Results: At 3 months postoperative after HoLEP or TURP, the median decrease in International Prostate Symptom Score (IPSS) was 13.0. Patients whose IPSS decreased by over 13 points were categorized into a favorable response group after HoLEP or TURP. Univariate and multivariate logistic regression analyses were performed to identify predictors of favorable outcomes at 3 months after HoLEP or TURP, and the preoperative IPSS was identified as an independent predictor for favorable outcomes.Conclusion: When young urologists plan to perform surgical treatment for BPH, they should consider that the severity of symptoms is the most important factor for favorable outcomes. The type of surgical modality for managing BPH is less important.

The Risk of Prostate Cancer Associated With Common Mutations of AR Gene in Iranian Population: a Perspective Study of Personalized Treatment

Background: Prostate cancer (PC) is one of the most common cancers among men. Genetic predisposition is emerging as a risk factor for PC development. The Androgen receptor (AR) gene is associated with the development and prognosis of PC. Understanding the AR mutations is very important in the precision treatment of PC-resistant patients to androgen deprivation therapy. In this study, we investigate any association between common AR mutations with the risk of PC.Methods and results: In this case-control study, blood samples were collected from 121 radical prostatectomy (RP) patients who were pathologically diagnosed with PC and 120 benign prostate hyperplasia (BPH) subjects as a control group. The targeted area of the AR gene was amplified by PCR and confirmed by the Sanger sequencing method. The target area of the AR gene screened for 124 alterations in intron 7, 44 mutations in exon 8, and 52 variants in the 3'UTR region. rs113528927 DelIns AC>ACACACCAC had the most frequent mutant alleles between case and control groups, but this genotype distribution among the two recruited groups was not significant. Only one mutation, c.2644C>A, was observed in exon 8 in BPH subjects, and six alterations were detected in 3'UTR.Conclusions: For the first time in the Iranian population, AR common mutations were screened in PC patients, and our results indicate no relationship with the risk of PC, which means that other potential molecular risk factors may be engaged for PC in our population.

Super-selective prostatic arteries embolization in patients with benign prostate hyperplasia: prevention and treatment of complications

Introduction. Super-selective prostatic arteries embolization (PAE) is a modern minimally invasive surgical method for the treatment of benign prostatic hyperplasia (BPH). PAE is included in the Russian clinical guidelines for the BPH treatment and approved for use in the United States and European countries.Purpose of the study. To analyze the most common PAE-associated complications and to develop preventive arrangements.Materials and methods. During the period from 2013 to 2020, PAE as the main method of BPH treatment was used in 168 patients with an average age of 69.3 ± 8.1 (53-82) years. All patients underwent two-day antibiotic prophylaxis before the operation and lasted 7-10 days. For catheterization of the prostatic arteries, 2.0-2.8 Fr microcatheters and 4-5 Fr microconductors were used. For embolization, hydrogel microspheres with a diameter of 100-300 µm and 300-500 µm were used, as well as poly polyvinyl alcohol (PVA) microparticles with a diameter of 100-500 µm.Results. Bilateral PAE was successfully performed in 146 cases; unilateral PAE was performed in 22 patients due to anatomical features. Seventeen (10.1%) PAE from the orifice, super-selective PAE was performed in 67 (39.9%) cases, the PErFecTED embolization was performed in 84 (50.0%) patients. The most common complication was acute urinary retention (AUR) in 28 (16.6%) patients: trocar cystostomy was required in 11 (6.5%) patients, AUR was resolved using conservative therapy in 17 (10.2%) patients. In 23 (14.2%) cases, complications associated with unintentional embolization of the anastomoses of the prostate arteries were identified: rectal pain and/or the appearance of blood in the stool in 19 (11.3%) patients, the appearance of trophic ulcers on the glans penis in 5 (2.8%) patients. In addition, several adverse events that were not complications were noted: postembolization syndrome in 50 (29.7%) patients, and worsening of LUTS in 41 (24.4%) patients. Seven (4.1%) patients had acute epididymitis; 4 (2.4%) patients had a hematoma at the puncture site.Conclusion. PAE can cause a limited number of complications. It is necessary to unify the system for reporting PAE complications. Antibiotic prophylaxis is recommended. The use of visualization and X-ray navigation methods make it possible to make the PAE safer. The PErFecTED technique in combination with small particle sizes increases the risk of complications. The surgeon's experience and proficiency in special surgical techniques are essential. The transradial approach is promising, but further observation and an increase in patient samples are required. The question of choosing the optimal embolization drug continues to be relevant.

Chemical and Medicinal Properties of Rauwolfia vomitoria (AFZEL) Harvested from the South Eastern Nigeria

Aim: This work was carried out to evaluate the chemical constituents of the leaf of Rauwolfia vomitoria and to determine the activities of the extract on some selected human pathogens Study Design: The study was designed to characterize the compounds in the extract and to determine their medicinal applications Place and Duration of Study: The work was done at the Department of Chemistry Federal University of Technology Owerri Methodology: Standard assay technique was used to evaluate the phytochemical content of the sample. GC-MS analysis was carried out on the chloroform extract of the sample. The anti microbial activities were determines using the well agar diffusion method Results: The analysis of the components of the leaf extract of Rauwolfia vomitoria Afzel revealed the presence of 34 compounds with their molecular masses molecular weights and structures, all elucidated. The initial phytochemical screening revealed the presence of alkaloids 1.92%, saponins 1.12% , flavonoids 1.15% and cardiac glycosides, the extract showed marked inhibition of the growth of certain human pathogens with inhibition diameters recorded against Klebsiella pnuemonia, 22 mm, Pseudomonas aeruginosa 18 mm,Aspergillis niger 24 mm and Mucor specie 9 mm but was resistant to Streptococcus specie.The extract contain anti cancer,anti-tumuor antioxidant, anti-inflammatory ,cardioprotectives compounds which inludes phytol, Vitamin E, Campestrol, sistosterol, squalene, lupeol and vaccenic acid. Conclusion: Owing to the identified properties of the sample ,Rauwofia vomitoria leaf is excellent ingredient for the treatment of diaeases related to Klebsiella pnuemonia, Pseudomonas aeruginosa Aspergillis niger and Mucor specie and also for the treatment cancer, tumuor, inflammation, arthritis,beingn prostate hyperplasia, fibromyalgia, allergies, coronary heart.

Literature Review : Pengaruh Tekhnik Relaksasi Benson Terhadap Nyeri Pada Pasien Post Operasi Benigna Prostat Hyperplasia

Benign Prostatic Hyperplasia (BPH) is a progressive enlargement of the prostate gland that can be treated surgery, As a result of the surgery, the patient will usually feel pain. To overcome it, Benson’s relaxation technique could be applied. This relaxation is an action to free mentally and physically from tension and stress so that it can increase tolerance to pain. This study aims to examine the effect of Benson’s relaxation technique on pain in patients with postoperative benign prostate hyperplasia. Since it is a literature review, it has reviewed three articles taken from Google scholar with Benson’s relaxation, pain, and postoperative BPH as the keywords. Those articles are full-text, published in 2010-2020. The result stated the average vaule of pain scalee was 6,24 before the treatment and it reduced into 2,07 after it, with the p-value 0,000. It proved the therapy has effectively reduced oain in patients with postoperative benign prostate hyperplasia. Thus, nurses suggested applying this therapy as an alternative to reduce the problem.Keywords: Benson’s relaxation, pain, postoperative benign prostate hyperplasia AbstrakBenigna Prostat Hyperplasia (BPH) adalah pembesaran progresif dari kelenjar prostat yang dapat diatasi dengan tindakan pembedahan. Akibat dari pembedahan dapat menimbulkan nyeri. Pananganan nyeri salah satunya dengan relaksasi benson. Relaksasi Benson merupakan suatu tindakan untuk membebaskan mental dan fisik dari ketegangan dan stress sehingga dapat meningkatkan toleransi terhadap nyeri. Penelitian ini bertujuan untuk menggambarkan pengaruh teknik relaksasi benson terhadap penurunan nyeri post operasi BPH berdasarkan literature review. Desain karya tulis ilmiah berupa literature review dengan jumlah tiga artikel yang diambil dari laman google scholar dengan kata kunci “relaksasi benson, nyeri, post operasi BPH,” berupa artikel fulltex, terbit tahun 2010-2020. Hasil dari tiga artikel menujukkan nilai rata-rata skala nyeri sebelum intervensi 6,24 setelah intervensi 2,07 dengan p-value 0,000. Simpulan Terapi Relaksasi Benson efektif untuk menurunkan nyeri pasien post operasi BPH. Saran kepada perawat diharapkan dapat memberikan Teknik Relaksasi Benson sebagai alternatif untuk menurunkan nyeri pada pasien post operasi BPH.Kata kunci: Relaksasi Benson, Nyeri, Post Operasi BPH.