Study on individualized prostate biopsy guided by prostate specific antigen at different ranges

Background: Prostate specific antigen (PSA) is the most commonly used indicator for screening of prostate cancer(PCa), and the studies on PSA in PCa are very extensive at present. How to effectively use this indicator is worth for further study which this article wish to address. Objective: The aim of this study is to explore how PSA in different ranges can better guide the individualized prostate biopsy. Methods: A total of 117 patients with suspected PCa admitted to the Affiliated Hospital of Chengde Medical College from October 2018 to July 2020 were selected as the research subjects. PSA level and ratio of free and total PSA (F/TPSA) value of each patient were measured, and ultrasound-guided transrectal prostate biopsy was conducted for each patient, and then the PSA measurement results were compared with the prostate biopsy results. Results: The result of biopsy was PCa in 40 cases, BPH in 77 cases. The positive expression rates of Group I in BPH and PCa patients were 25.97% and 87.50%, respectively, and the difference was statistically significant (P < 0.05).The positive expression rates of Group II in BPH and PCa patients were 10.39% and 75.00%, respectively, and the difference was statistically significant (P < 0.05). The sensitivity, specificity, positive predictive value and diagnostic coincidence rates of Group I and Group II were 87.50%, 74.03%, 63.63%, 78.63% and 75.00%, 89.61%, 78.94% and 84.62%, respectively. Conclusion: Under different TPSA intervals, F/T < 0.16 has different diagnostic efficacy for PCa. Group I is more sensitive and suitable for early screening. Group II has stronger specificity in the diagnosis of PCa, Higher diagnostic coincidence rate, and has more diagnostic advantages before biopsy. Selecting Group II can help clinicians make more patient-friendly decisions and reduce the incidence of complications related to biopsy. According to patients’ aspiration for biopsy, auxiliary examinations such as magnetic resonance scan of prostate and bone scan should be performed actively for patients who meet the criteria I if they refuse to undergo biopsy. On the premise of not affecting PCa secondary prevention as much as possible, a more individualized biopsy plan was developed for patients.

The recent advances in Vascular endothelial growth factor and metabolic syndrome in prostate cancer

Prostate cancer is one of the most common male malignant tumors in Western countries. In the United States, there are about 170,000 new cases of prostate cancer in 2019, ranking second only to lung cancer.1, 2 In recent years, the incidence of prostate cancer in China is gradually increasing occupying the third place among male urogenital malignancies. The metastasis of prostate cancer mainly depends on blood vessels and lymphatic vessels, and the late discovery and poor prognosis of patients are the main reasons for the high fatality rate.2 Relevant epidemiological studies on immigration have found that the incidence of PCa in The Asian population in the United States is as high as 77.8 / l0000, which is similar to local residents and significantly higher than that in the native population in Asia. This suggests that, in addition to race and family history, different diet and lifestyle in China and the West may play an important role in the development and progression of PCa.3 Epidemiological studies have shown an association between geographic location and prostate cancer risk. In fact, the incidence of prostate cancer in Western men is 15 times higher than in Asian men. This suggests that environmental factors or lifestyle, especially diet and nutrition, may play a key role in the occurrence and development of prostate cancer.4 To some extent, metabolic syndrome reflects the diet and lifestyle of patients and is closely related to the occurrence and development of prostate cancer. In addition, Vascular endothelial growth factor (VEGF) as a kind of multi functional cytokine works through specific role in endothelial cells.It can promote endothelial cell proliferation, migration, and increase Vascular permeability. And VEGF can be induced in the body for blood vessel growth, angiogenesis, is closely related to tumorigenesis and metastasis. Numerous recent studies have shown that VEGF is closely related to the occurrence and development of prostate cancer and metabolic syndrome.5 In this paper, multiple physiological and pathological mechanisms of VEGF and metabolic syndrome associated with prostate cancer are reviewed.

Study on Esculetin to reduce cardiotoxicity induced by Doxorubicin

Objective: To investigate the protective effects and mechanisms of esculetin(Esc) on H9C2 cells injury induced by doxorubicin (DOX). Methods: H9C2 cells were cultured and divided into control group, model (DOX) group and intervention (ESC + DOX) group. Flow cytometry was used to detect apoptosis of H9C2 cells and reactive oxygen (ROS) level in H9C2 cells; Western blotting to detect the cleaved Caspase-3, cleaved PARP, bid and Bcl-2 protein expression in H9C2 cells. Results: The number of apoptosis and ROS level of H9C2 cells in the model group, the expression of cleaved Caspase-3, cleaved PARP and Bid protein in the model group were obviously higher than control group; and the Bcl-2 protein expression was obviously lower (P < 0.05).The number of apoptosis and ROS level, cleaved Caspase-3, cleaved PARP and Bid protein expression in H9C2 cells in intervention group were obviously lower than model group;the Bcl-2 protein expression was obviously higher (P< 0.05). Conclusion: Esculetin can reduce the cardiotoxicity induced by doxorubicin by reducing apoptosis and ROS level.

Malignant Melanoma of Anal Canal

Anal melanoma (AM) is a rare and highly aggressive mucosal melanocytic malignancy. We report a case of 70 year old male presented with chief complaints of anal pain and intermittent rectal bleeding with clinical diagnosis of Polyp or Carcinoma. On histopathology examination malignant melanoma was suggested which was further confirmed by immunohistochemistry (S100 and HMB 45 strongly positive). Anal melanoma is rare neoplastic condition with catastrophic outcome.

Correlation of Imprint and Crush cytology with Bronchoscopic biopsy in the diagnosis of Bronchogenic carcinoma

Introduction: Lung carcinoma is the most common cancer with 2.1 million (11.6%) newly diagnosed cases in 2018. Over the years, many cytotechniques have been developed but their combination with histology is still an area of controversy. Imprint and crush cytology are considered simple, rapid and cost effective for a low resource setting in the early diagnosis and management of lung cancer. Here, we aimed to assess the diagnostic accuracy of imprint and crush cytology and compare them with histopathology. Method: A prospective study was conducted from May 2017 to April 2018 at the Pulmonary medicine unit and Department of Pathology at National Academy of Medical Sciences (NAMS), Bir Hospital. A total of 53 patients were enrolled in the study who showed visible mass on bronchoscopy. Three to five bits of tissue were obtained, imprint and crush smear were prepared from them and the tissue were then sent for histopathological examination. The level of significance selected was p < 0.005. Results: The most common age group affected was 60-69 years. 91% cases were smokers, with a male predominance. The most common location of endobronchial growth was left upper lobe. 43 cases were malignant in biopsy. The sensitivity, specificity, accuracy and positive predictive value of imprint cytology was 71.05%, 87.50%, 73.91% and 96.43% respectively while that for crush cytology was 74.36%, 75%, 74.47% and 93.55% respectively. The diagnostic yield of imprint, crush smear and forceps biopsy were 52.8%, 58.4% and 81.1% respectively. Squamous cell carcinoma was the most common carcinoma in this study. Conclusion: Imprint and crush cytology yield additional information that can be complementary to endobronchial biopsy. They are convenient, do not burden the patients and thus can be carried out wherever possible during bronchoscopy.

Pseudomyxoma peritonei: unusual origin from teratoma associated mucinous cystadenoma of ovary

Pseudomyxoma peritonei is an extremely rare clinical syndrome with incidence of approximately two per 10000 laparotomies. Approximately 44% of women with PMP have ovarian mucinous tumor. It is generally accepted that the ovarian involvement is secondary; PMP is nearly always gastrointestinal origin, usually from mucinous adenoma of the appendix1. Exception to this, we report a 35 years lady who presented with the complaint of abdominal pain and abdominal distention for two months, clinically and radiologically gross mucinous ascites with large abdominopelvic mass was evident. Final histopathology was reported as mucinous cystadenoma, with mature teratoma components, appendix was normal.

Hepatoblastoma in a 14-months old child

In children, commonest liver tumor is hepatoblastoma. We present a 14-month-old male child who presented with abdominal distension and loose stool. Radiological imaging revealed solid hepatic mass. Hematological investigations revealed anemia, thrombocytosis and high Serum alpha fetoprotein (AFP) level. Ultrasound (USG) guided FNAC confirmed the mass to be hepatoblastoma. CT scan revealed hepatoblastoma PRETEXT stage III. The patient underwent 6 cycles of neoadjuvant chemotherapy and responded to POSTTEXT stage II. Left hemi-hepatectomy was done with clear resectin margins. Complete surgical excision of the mass after preoperative chemotherapy remains the mainstay of the treatment of locally advanced hepatoblastoma.

Patient with False Negative RT-PCR for COVID-19 referred to Cancer Hospital for Lung Cancer Screening

Background: To describe the characteristics and outcomes of patients with a clinical diagnosis of COVID-19 and false-negative SARS-CoV-2 reverse transcription-PCR (RT-PCR), and develop and internally validate a diagnostic risk score to predict risk of COVID-19 (including RT-PCR-negative COVID-19) among medical treatment. Case presentation: Herein, we report a 42-year-old male patient from myagdi district Nepal presenting with high grade fever, dry cough, headache and dizziness on the August 10, 2021 during second phase of COVID-19 pandemic. There is no history of hypertension and diabetes. He went for RT-PCR test at local COVID-19 screening center and reported as negative for RT-PCR test. After that he referred to Lumbini Zonal hospital for further evaluation. RT-PCT swab test was performed again and reported negative. On the chest X-Ray, there was opacity on both lungs and the patient was referred to cancer hospital for lung cancer screening. The patient underwent for HRCT chest and biochemical laboratory tests for further evaluation. The chest High Resolution Computed Tomography (HRCT) indicated ground grass opacity (GGO) with crazy paving a typical COVID-19 interstitial pneumonia. In the biochemical laboratory test, there were elevation in Leukocyte (Total WBC count), Neutrophil, Glucose, Bilirubin Direct, Bilirubin Total, SGOT/AST, SGPT/ALT and Lactate Dehydrogenase (LDH). There was low count found in Lymphocyte, Eosinophil and Monocyte. These laboratory parameters findings are typical sign of COVID-19 patients. Then patient was isolated and treatment of given according to COVID-19 treatment guidelines. On September 12, 2021, all diagnostic tests showed that patient recovered from COVID-19. Conclusion: It is safe to suggest that a symptomatic patient with typical chest HRCT and lab findings for COVID-19 should be quarantined or isolated even with 2 negative RT-PCR tests.

Incorporating Surgery in treatment of Stage IIIA – N2 Non- Small Cell Lung Cancer

Stage IIIA-N2 Non-small cell lung cancer includes heterogenous group of patients with a poor 5-year survival ranging from 13% to 36% with surgery alone. Various randomized controlled trials established the role of multimodality treatment either including or excluding surgical resection. In a select group of non-bulky/ single station N2 disease, the better results have been achieved with induction chemotherapy or chemo-radiotherapy followed by surgery.

The correlation between vascular endothelial growth factor and prostate cancer with and without metabolic syndrome

Objective: To investigate the relationship between vascular endothelial growth factor (VEGF), metabolic syndrome and its components and degree of differentiation of prostate cancer. Methods: The clinical data of 49 PCa cases treated during October, 2018 to February, 2021 were retrospectively analyzed, including patients’ height, weight, body mass index (BMI), age, blood pressure (BP), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), vascular endothelial growth factor (VEGF) and Gleason score. Results: Compared with simple PCa group, BMI, the MS group had higher BMI, diastolic blood pressure (DBP, FGB, TG) and VEGF (P<0.05), and higher Gleason score (P<0.05). MS group had a higher degree of malignancy (Gleason≥8). Conclusion: This suggests that MS may promote the progression of PCa, and the increase of VEGF level can indicate the presence of MS in PCa patients, reflecting the progression of PCa to a certain extent.