Biomedical subjects

Hideaki Miyake

Publications and source records attributed to Hideaki Miyake.

107 records · Page 6Linked to original sources

PubMed2002

Optimal timing of radical cystectomy for patients with invasive transitional cell carcinoma of the bladder.

OBJECTIVE: To determine whether the timing of radical cystectomy affects the survival of patients with invasive transitional cell carcinoma (TCC) of the bladder. METHODS: Between January 1985 and June 2000, 167 patients underwent radical cystectomy in our institution. Among them, 50 patients who did not receive any perioperative therapies, including chemotherapy and radiotherapy, were divided into two groups, viz. 28 patients who underwent radical cystectomy within 3 months after the primary diagnosis of invasive bladder cancer (group A) and 22 who underwent radical cystectomy more than 3 months after the primary diagnosis (group B), and we then compared several clinicopathological factors and the survival between these two groups. RESULTS: No significant difference was observed in the patients' clinicopathological characteristics except for age between these two groups. The median follow-up periods for groups A and B were 53 and 48 months, respectively. In groups A and B, an average of 1.2 (range 1-2) and 1.4 (range 1-3) transurethral resections (TURs) of bladder cancer were performed, respectively (p = 0.83). Twenty of 28 patients in group A underwent orthotopic neobladder replacement, whereas only four of 22 underwent neobladder creation (p = 0.001). The recurrence-free, cause-specific and overall survival rates in group A were significantly higher than those in group B (p < 0.05, p < 0.05 and p < 0.05, respectively). Final pathological analysis revealed that the distributions of pathological stage, tumor grade and lymph node metastasis were similar between groups A and B; however, the incidence of vascular involvement in group B was significantly higher than that in group A (p < 0.05), despite the lack of a significant difference in the incidence of vascular involvement in TUR specimens between these two groups. CONCLUSIONS: These findings suggest that radical cystectomy in the early disease process, especially before the occurrence of vascular involvement, may result in the improvement of survival of patients with invasive TCC of the bladder.

Aged↗

PubMed2002

Clinical outcome of surgical resection for renal cell carcinoma.

PURPOSE: To evaluate prognostic factors for patients with renal cell carcinoma (RCC) who had undergone surgical resection. PATIENTS AND METHODS: We analyzed data from 371 patients with RCC who had undergone surgical resection. Prognostic factors were identified from clinical and pathological data using univariate and multivariate analysis. RESULTS: When we analyzed all patients including lymph node metastasis, multivariate analysis showed that only pN factor was an independent prognostic factor. We then analyzed 359 patients without lymph node metastasis, and the presence of symptoms, pT, grade, IFN and venous involvement were considered significant. However, pT (pT1 vs pT2-4), tumor grade and presence of symptom were judged to be independent prognostic factors by multivariate analysis. When the patients were stratified according to the tumor size (2.5, 4, 7 cm), a significant difference in disease specific survival was found by 4 and 7 cm, but not by 2.5 cm. CONCLUSIONS: The current TNM staging accurately predicts patient survival. Tumor grade is also an important prognostic factor for patients with RCC.

Adult↗

PubMed2002

Predicting the extent of prostate cancer using a combination of serum prostate-specific antigen-alpha(1)-antichymotrypsin complex and systematic biopsy.

OBJECTIVE: The objective of the present study was to evaluate the usefulness of the combined systematic biopsy with serum prostate-specific antigen-alpha(1)-antichymotrypsin complex (PSA-ACT) level to predict the extent of prostate cancer. MATERIALS AND METHODS: Sixty-two patients with clinically organ-confined disease who underwent radical prostatectomy were evaluated for serum PSA and PSA-ACT levels, systematic biopsy, and the pathological stage. RESULTS: The incidence of extraprostatic disease in patients with more than half the biopsy cores positive or > or = 8 ng/ml PSA-ACT was significantly higher than those with less than half positive or <8 ng/ml PSA-ACT, respectively, whereas cancer in bilateral lobes or > or = 10 ng/ml PSA could not be used as a predictor of extraprostatic disease. Furthermore, in those with more than half the biopsy cores positive and > or = 8 ng/ml PSA-ACT or those with more than half the biopsy cores positive and > or = 10 ng/ml PSA, extraprostatic disease was significantly more common than in those with less than half positive and <8 ng/ml PSA-ACT or those with less than half positive and <10 ng/ml PSA, respectively. However, the incidence of extraprostatic disease predicted by these three variables was not significantly better than those by the two variables (percentage positive biopsy cores plus serum PSA-ACT or PSA). CONCLUSIONS: The combined systematic biopsy with serum PSA-ACT or PSA could be used as a useful predictor for the extent of prostate cancer. Patients with more than half the biopsy cores positive and > or = 8 ng/ml PSA-ACT or > or = 10 ng/ml PSA could avoid a prostatectomy because there is a high probability that they have extraprostatic disease.

Aged↗

PubMed2002

An evaluation of quality of life in patients who underwent orthotopic bladder replacement after cystectomy: comparison of ileal neobladder versus colon neobladder.

OBJECTIVE: The objective of this study was to determine whether the quality of life (QOL) in patients who underwent orthotopic bladder replacement after radical cystectomy was affected by the intestinal segment used for the creation of a neobladder. MATERIALS AND METHODS: A total of 52 patients who underwent radical cystectomy for bladder cancer were included in this study; i.e., 24 patients with an ileal neobladder and 28 patients with a sigmoid neobladder. QOL was evaluated using the SF-36 health-related QOL survey and a questionnaire designed to evaluate the continent status. RESULTS: The mean follow-up periods for patients with an ileal and a sigmoid neobladder was 40.2 and 43.1 months, respectively. The SF-36 survey revealed that patients with colon neobladder had a significantly higher score for role-emotional functioning than those with ileal neobladder, while there was no significant difference in the remaining seven scores between patients with ileal and colon neobladders; however, general health and social functioning in patients with both types of neobladder appeared to be significantly lower than those in the general population in the United States. The results of the questionnaire analyzing the continent status were also similar between these two groups, including the desire to urinate, the incidence of both day- and nighttime urinary leakage, the frequency of pad exchange, and the concern of urine odor. CONCLUSIONS: Six of the eight scales concerning health-related QOL were favorable with both patients with ileal and colon neobladders, and the health-related QOL in orthotopic neobladder patients except for role-emotional functioning was not affected by the segment of the intestine used for neobladder construction. Moreover, no significant differences were observed in the QOL associated with continent status between these two groups. Therefore, patients with both types of orthotopic neobladder were generally satisfied with their health-related as well as disease-specific QOL.

Adaptation, Physiological↗

PubMed2002

Over expression of CD44V8-10 in urinary exfoliated cells as an independent prognostic predictor in patients with urothelial cancer.

PURPOSE: CD44 is a widely expressed cell surface adhesion molecule, of which various isoforms arise from alternative RNA splicing mechanisms. Over expression of specific CD44 splice variants, namely CD44v8-10, is evident in various malignant tumors and is considered to be associated with disease progression. In this study, we investigated whether the transcriptional level of CD44v8-10 relative to that of the standard CD44 isoform would predict the extent and prognosis of urothelial cancer. MATERIALS AND METHODS: The CD44v8-10- to -standard CD44 ratio was measured in the tissue (40 urothelial cancer specimens and corresponding normal urinary tissue) and spontaneously voided urine samples of 150 patients with urothelial cancer and 50 with benign urological disease by reverse transcriptase-polymerase chain reaction using the set of primers capable of amplifying all CD44 splice variant isoforms. RESULTS: Initially any CD44 variant isoforms were barely detectable in normal urinary tissues, whereas CD44v8-10 was predominantly expressed in most urothelial cancer specimens. Furthermore, the CD44v8-10- to -standard CD44 ratio in urothelial cancer was closely associated with tumor progression. We then compared the ratio in urothelial cancer tissue and urinary exfoliated cells, and noted a linear and significant correlation of these 2 values in the same patients. Therefore, we investigated whether the CD44v8-10- to -standard CD44 ratio in urinary exfoliated cells would predict the prognosis and disease progression. The mean ratio in the urinary exfoliated cells of patients with invasive urothelial cancer was significantly higher than in those with superficial urothelial cancer. Of the patients with superficial bladder cancer disease-free survival rate of those with an elevated versus a normal ratio was significantly lower. Moreover, of the patients with advanced urothelial carcinoma who underwent complete resection disease-free survival of those with an elevated CD44v8-10- to -standard CD44 ratio was significantly lower than that of patients with a normal ratio. CONCLUSIONS: These results indicate that CD44v8-10 is strongly expressed in tumor tissue and evident at high levels in urinary exfoliated cells of patients with invasive versus superficial urothelial cancer. An elevated CD44v8-10- to -standard CD44 ratio in urinary exfoliated cells may serve as a novel prognostic predictor and indicator of disease extent in patients with urothelial cancer.

Alternative Splicing↗

PubMed2002

Detection of beta-human chorionic gonadotropin expressing cells by nested reverse transcriptase-polymerase chain reaction in the peripheral blood stem cells of patients with advanced germ cell tumor.

PURPOSE: We investigated whether peripheral blood stem cells (PBSCs) were contaminated by tumor cells. MATERIALS AND METHODS: A total of 13 patients with advanced testicular cancer underwent PBSC transplantation at our institute. Nested reverse transcriptase-polymerase chain reaction using primers specific for beta-human chorionic gonadotropin (beta-HCG) or alpha-fetoprotein (AFP) detected 1 beta-HCG or AFP producing cell in 1 x 10(6) PBSCs. RESULTS: Although AFP messenger (m) RNA was not identified in any of the 13 patients, beta-HCG mRNA was detected in 7. All patients with beta-HCG mRNA in PBSCs had elevated serum beta-HCG before treatment. Three patients with a normal beta-HCG range before treatment did not have beta-HCG mRNA in the PBSCs. The serum beta-HCG level in the patients whose PBSCs were contaminated with tumor cells was significantly higher than in patients whose PBSCs contained no tumor cells. Four of the 7 patients with beta-HCG mRNA in PBSCs eventually died of cancer, whereas those whose PBSCs were not contaminated with tumor cells survived without disease. CONCLUSIONS: Patients with elevated serum beta-HCG levels are likely to have PBSCs contaminated by tumor cells. Moreover, the prognosis of patients with tumor cells in the PBSCs is poor.

Adolescent↗

PubMed2002

Introducing the clusterin gene into human renal cell carcinoma cells enhances their metastatic potential.

PURPOSE: We recently reported a protective role of clusterin expression against apoptosis induced by a wide variety of stimuli in several human cancer models. In the current study we tested the hypothesis that clusterin over expression confers a benefit for the metastasis of renal cell carcinoma through the inhibition of apoptosis induced by the various obstacles the cancer cells may confront after detachment from their primary origin. MATERIALS AND METHODS: We introduced clusterin complementary DNA into human renal cell carcinoma ACHN cells, which do not express detectable level of clusterin expression, and generated the clusterin over expressing cell line ACHN/CL and the control vector only transfected cell line ACHN/C. In vitro anti-cell death activity under anchorage independent conditions among ACHN sublines was examined by limiting dilution assay and cell survival assay in suspension. To investigate the in vivo effects of clusterin over expression on metastatic potentials each cell line was injected into the tail vein or renal subcapsule of nonobese diabetic, severe combined immunodeficient mice and the metastatic features in all abdominal and thoracic organs were evaluated. RESULTS: ACHN/CL showed significantly enhanced growth in limiting dilution cultures compared with ACHN/C. The analysis of cell survival in the floating assay also revealed that ACHN/CL had a powerful survival advantage in suspension compared with ACHN/C. Furthermore, ACHN/CL formed more than 5-fold as many metastatic nodules in the lung after intravenous injection than ACHN/C. Similarly more marked lung metastasis was observed after implanting ACHN/CL cells into the renal subcapsule than after implanting ACHN/C cells. In contrast, there were no significant differences among ACHN sublines in the growth rates in vitro and in vivo, cell motility or invasive ability. CONCLUSIONS: These findings suggest that, if clusterin is over expressed, it prolongs cell survival under unfavorable conditions in the metastatic process, resulting in the enhanced metastatic potential of renal cell carcinoma.

Animals↗

PubMed2002

Enhanced radiation sensitivity in prostate cancer by inhibition of the cell survival protein clusterin.

PURPOSE: The purpose of this study is to evaluate the role of the cell survival gene clusterin in radiation-induced cell death in human LNCaP and PC-3 prostate cancer models. EXPERIMENTAL DESIGN: Radiation sensitivities were compared in parental and clusterin-overexpressing LNCaP cells and in PC-3 cells and tumors treated with antisense or mismatch clusterin oligonucleotides. RESULTS: Clusterin-overexpressing LNCaP cells were less sensitive to irradiation with significantly lower cell death rates (23% after 8 Gy) compared with parental LNCaP cells (50% after 8 Gy) 3 days after irradiation. Clusterin expression in PC-3 cells after radiation was found to be up-regulated in a dose-dependent manner in vitro by 70% up to 12 Gy and in vivo by 84% up to 30 Gy. Inhibition of clusterin expression in PC-3 cells using antisense oligonucleotides (ASOs) occurred in a sequence- and dose-dependent manner and significantly enhanced radiation-induced apoptosis and decreased PC-3 cell growth rate and plating efficiency. Compared with mismatch control oligonucleotide treatment, clusterin ASO treatment enhanced radiation therapy and significantly reduced PC-3 tumor volume in vivo by 50% at 9 weeks. In addition, TUNEL staining revealed increased number of apoptotic cells in clusterin ASO-treated and irradiated PC-3 tumors, compared with treatment with mismatch control oligonucleotides plus radiation. CONCLUSIONS: These findings support the hypothesis that clusterin acts as a cell survival protein that mediates radioresistance through the inhibition of apoptosis. In vivo results further suggest that inactivation of clusterin using ASO technology might offer a novel strategy to improve results of radiation therapy for prostate cancer patients.

Animals↗

PubMedDate not supplied

Clinical symptoms in localized renal cell carcinoma reflect its invasive potential: comparative study between incidentally detected and symptomatic diseases.

The objectives of this study were to analyze the association of clinical symptoms with several parameters in patients with organ-confined renal cell carcinoma (RCC), and investigate the difference in biologic characteristics between incidentally detected and symptomatic RCCs. This study included 132 patients who were pathologically diagnosed with organ-confined RCC after radical surgery, and their clinicopathologic features were compared to those in patients with incidentally detected and symptomatic diseases. In this series, 91 patients were incidentally diagnosed with RCC, while the remaining 41 had some clinical symptoms. The cause-specific survival in patients with incidental RCC was significantly higher than that in patients with symptomatic RCC, and the presence of clinical symptoms could be an independent predictor of cause-specific survival in these patients. Immunohistochemical staining of resected specimens from these patients were then performed with Ki-67, Bcl-2, matrix metalloproteinase (MMP)-2, MMP-9, and vascular endothelial growth factor antibodies. Despite the lack of differences in Ki-67, Bcl-2, and vascular endothelial growth factor expression between these 2 groups, significantly increased expressions of MMP-2 and MMP-9 in symptomatic RCCs were observed compared with those in incidental RCCs. Moreover, the presence of clinical symptoms in organ-confined RCC was significantly correlated with immunoreactivities of MMP-2 and MMP-9. These findings suggest that clinical symptoms have a significant impact on the prognosis of patients with organ-confined RCC and that the appearance of clinical symptoms may reflect the increased invasive potentials characterized by overexpression of MMPs.

Adenocarcinoma, Clear Cell↗

PubMedDate not supplied

Serum cathepsin D and its density in men with prostate cancer as new predictors of disease progression.

We examined whether serum levels of cathepsin D (CatD) and its density (CatD-D), which was determined by dividing the serum levels of CatD by the prostate volume, could be used as predictors of the progression and prognosis in patients with prostate cancer. Serum levels of CatD in 40 healthy controls, 70 patients with benign prostatic hypertrophy (BPH) and 80 patients with prostate cancer were measured by a sandwich enzyme immunoassay, and prostate volume was measured using transrectal ultrasonography. The mean levels of CatD and CatD-D in patients with prostate cancer were significantly higher than those in healthy controls and patients with BPH. Furthermore, the CatD and CatD-D levels in prostate cancer patients with metastasis were significantly elevated compared with those in patients without metastasis. Among patients who underwent radical prostatectomy, the levels of CatD and CatD-D in patients with pathologically organ-confined disease were significantly lower than in those with extraprostatic disease. However, the elevated levels of CatD and CatD-D were not significantly associated with the cause-specific survival in prostate cancer patients. These findings suggest that the elevation of CatD or CatD-D could be used as new predictors of disease progression, but not prognosis, in patients with prostate cancer.

Aged↗

PubMedDate not supplied

Resistance to cytotoxic chemotherapy-induced apoptosis in human prostate cancer cells is associated with intracellular clusterin expression.

We recently reported the powerful antiapoptotic activity of clusterin against various apoptotic stimuli in prostate cancer model systems; however, the precise mode of clusterin action in target cells remains largely unknown. In the present study, we therefore investigated whether intracellular or extracellular action of clusterin plays a crucial role in cytotoxic chemotherapy-induced apoptosis in androgen-independent human prostate cancer PC3 cells, which express a high level of clusterin. The sensitivity of PC3 cells to paclitaxel was increased by pretreatment with monoclonal antibody (mAb) to clusterin or antisense (AS) oligodeoxynucleotide (ODN) targeting the clusterin gene in a dose-dependent manner at up to 50 microg/ml or 1 microM, respectively. However, clusterin mAb failed to further enhance the sensitivity to paclitaxel of PC3 cells simultaneously treated with 1 microM AS clusterin ODN, whereas AS clusterin ODN further induced the apoptosis of cells treated with 50 microg/ml clusterin mAb. Moreover, the effects of clusterin mAb and AS clusterin ODN on PC3 cells were not reversed by additional treatment with exogenous recombinant clusterin protein. These findings suggest that the sensitivity of PC3 cells to paclitaxel-induced cytotoxicity may be regulated by the intracellular rather than extracellular level of clusterin.

Antibodies, Monoclonal↗

PubMedDate not supplied

Predicting factors for collection of peripheral blood stem cells in patients with advanced germ cell tumors after cisplatin-based combination chemotherapy.

The objectives of this study were to identify the predictive factors for the mobilization of CD34 positive peripheral blood stem cells (PBSC) and to determine the optimal timing of PBSC harvest in patients with advanced germ cell tumors after cisplatin-based combination chemotherapy. Thirty-eight patients with advanced germ cell tumors were enrolled in this study. We undertook a retrospective analysis of 124 aphereses performed between March, 1994 and December, 1999. The predictive value for the optimal timing of PBSC harvest was determined by the analysis of the correlation factors between the number of harvested CD34 positive cells and several clinicopathological factors. The mean number of CD34 positive cells obtained at a single apheresis was 5.38 x 10(6)/kg, and the mean cumulative number of CD34 positive cells in each patient was 24.07 x 10(6)/kg. The number of CD34 positive cells were significantly correlated to the number of previously performed chemotherapies before PBSC harvest, leukocyte count and the percentage of immature leukocytes (myelocytes plus metamyelocytes) (p=0.0098, p=0.011, and p<0.0001, respectively). Multivariate analysis revealed that the number of chemotherapies and the percentage of immature leukocytes were independent predictors for the number of harvested CD34 positive cells (p=0.012 and p=0.016, respectively). The present findings suggest that PBSC harvest should be performed during first-line chemotherapy, and that the monitoring of the percentage of immature leukocytes could be a useful predictor for determining the optimal timing of PBSC harvest.

Adolescent↗

PubMedDate not supplied

Long-term cryopreservation of peripheral blood stem cells in patients with advanced germ cell tumors using the dump-freezing method at -80 degrees C.

The objectives of this study were to evaluate the hematopoietic activity of peripheral blood stem cells (PBSCs) harvested from patients with advanced germ cell tumors after long-term cryopreservation in a mechanical freezer at -80 degrees C. Forty-one patients with advanced tumors were enrolled in this study. Flow cytometric analysis was performed to determine the total cell viability and the viability of CD34 positive cells of PBSCs stored between January 1995 and December 2001. The 41 patients were divided into two groups according to the duration of cryopreservation. In the 21 patients in whom the duration of storage was greater than 5 years, the total cell number did not change significantly before and after long-term cryopreservation (p=0.75). The percentage of viable cells and the total number of viable cells was significantly decreased after long-term cryopreservation (p<0.001 and p<0.05, respectively). However, the percentage of CD34 positive cells was significantly increased to 2.34% from 1.85% (p<0.05), resulting in non-statistically significant change in the total viable CD34 positive cells (p=0.98). A similar relation was found in the 20 patients whose storage duration was less than 2 years, although a significant change was found only in the percentage of viable cells. Moreover, pre-PBSCH factors, including age, cumulative dosage of cisplatin and the International Germ Cell Cancer Collaborative Group classification at the diagnosis did not affect the viable CD34 positive cell count after long-term cryopreservation. In conclusion, the present results suggest that CD34 positive cells could be successfully cryopreserved in a mechanical freezer at -80 degrees C for more than 5 years with no relation to pre-PBSCH factors and efficacy of PBSCH itself.

Adolescent↗

PubMedDate not supplied

Serum level of cathepsin B and its density in men with prostate cancer as novel markers of disease progression.

BACKGROUND: Cathepsin B has been shown to play an important role in invasion and metastasis of prostate cancer. The objective of this study was to determine whether serum levels of cathepsin B and its density (cathepsin B-D) could be used as predictors of disease extension as well as prognosis in patients with prostate cancer. MATERIALS AND METHODS: Serum levels of cathepsin B in 60 healthy controls, 80 patients with benign prostatic hypertrophy (BPH) and 120 patients with prostate cancer were measured by a sandwich enzyme immunoassay. Cathepsin B-D was calculated by dividing the serum levels of cathepsin B by the prostate volume, which was measured using transrectal ultrasonography. We subsequently analyzed the association between these two factors and several clinicopathological factors. RESULTS: The mean values of cathepsin B and cathepsin B-D in patients with prostate cancer were significantly higher than those in healthy controls and BPH patients. Moreover, the cathepsin B and cathepsin B-D levels in patients with metastasis were significantly elevated compared with those in patients without metastasis. Among patients undergoing radical prostatectomy, the levels of cathepsin B and cathepsin B-D in those with pathologically confirmed extraprostatic disease were significantly higher than in patients with organ-confined disease. However, there was no significant association between the elevation of cathepsin B and cathepsin B-D levels and cause-specific survival in prostate cancer patients. CONCLUSION: These findings indicate that the elevation of serum cathepsin B and cathepsin B-D could be used as novel predictors of disease extension, but not survival, in patients with prostate cancer.

Aged↗

PubMedDate not supplied

Urinary levels of vascular endothelial growth factor in patients with prostate cancer as a predictor of disease progression.

BACKGROUND: The objectives of this study were to investigate the association between urinary levels of vascular endothelial growth factor (VEGF) and the progression of prostate cancer, and to evaluate changes in urinary VEGF levels before and after initial treatment. MATERIALS AND METHODS: A total of 97 patients with prostate cancer were included in this study. Of these 97, 52 underwent radical prostatectomy and the remaining 45 received hormonal therapy as initial treatment. Urinary VEGF levels were measured using a sandwich enzyme immunoassay, and the results were analyzed with respect to several clinicopathological factors. RESULTS: The mean urinary level of VEGF in patients with prostate cancer was significantly higher than that in healthy controls. The urinary level of VEGF in prostate cancer patients with metastasis was significantly elevated compared with that in those without metastasis. Among 52 patients who underwent radical prostatectomy, the urinary levels of VEGF in patients with pathologically organ-confined disease were significantly lower than that in those with extraprostatic disease. Furthermore, the urinary VEGF level in 52 patients after radical prostatectomy was significantly lower than that before radical prostatectomy, while there was no significant difference in urinary VEGF level in 45 patients before and after hormonal therapy. CONCLUSION: These findings suggest that the elevation of urinary VEGF could be a useful predictor of disease progression in prostate cancer, and that the urinary levels of VEGF reflect the therapeutic effect of radical prostatectomy, but not that of hormonal therapy.

Antineoplastic Agents, Hormonal↗

PubMedDate not supplied

Enhanced expression of heat shock protein 27 following neoadjuvant hormonal therapy is associated with poor clinical outcome in patients undergoing radical prostatectomy for prostate cancer.

BACKGROUND: The objectives of this study were to characterize changes in the expression of heat shock protein 27 (HSP27) in prostate cancer before and after androgen withdrawal therapy and to assess the prognostic significance of HSP27 expression in patients undergoing radical prostatectomy (RP) following neoadjuvant hormonal therapy (NHT). MATERIALS AND METHODS: This study included 97 patients with clinically localized prostate cancer who received NHT followed by RP. Paired needle biopsy and corresponding RP specimens obtained from these patients were analyzed for expression of the HSP27 protein by immunohistochemical staining. These findings were evaluated with respect to several clinicopathological factors. RESULTS: HSP27 expression in the RP specimens following NHT was significantly up-regulated compared with that in the corresponding needle biopsy specimens. The expression level of HSP27 in the biopsy specimens was significantly associated with the biopsy Gleason score, but not with other factors available before RP. HSP27 expression in the RP specimens was significantly correlated with the pre-operative value of serum prostate-specific antigen and pathological stage, but not with other pathological factors. Biochemical recurrence-free survival in patients with strong HSP27 expression in the RP specimens was significantly lower than that in those with weak HSP27 expression; however, the expression level of HSP27 was not an independent predictor of biochemical recurrence. CONCLUSION: Despite the lack of independent significance, the expression level of HSP27 in prostate cancer tissue after NHT, which may inversely reflect the therapeutic effect of NHT, could be a useful parameter predicting biochemical recurrence in patients undergoing RP.

Aged↗

PubMedDate not supplied

Stable hematopoietic recovery after peripheral blood stem cell transplantation in patients receiving high-dose chemotherapy for advanced germ cell tumors.

AIM: The objective of this study was to evaluate the utility of CD34-positive peripheral blood stem cell transplantation (PBSCT) in the hematopoietic recovery, in patients receiving high-dose chemotherapy (HDCT), for advanced germ cell tumor (GCT). MATERIALS AND METHODS: This study included 41 patients with advanced GCT, who were treated with HTCT combined with PBSCT. PBSCs were harvested after conditioning chemotherapy followed by the administration of granulocyte colony-stimulating factor. A retrospective analysis of a total of 86 PBSCTs was carried out focusing on the effects of several factors, including age (<35 years versus > or = 35 years), CD34-positive cell dose (<5.0 x10(6)/kg versus > or =5.0 x10(6)/kg), indication of HDCT (first-line versus salvage) and previous history of HDCT before PBSCT (with versus without), on hematopoietic recovery after PBSCT. RESULTS: The median number of CD34-positive PBSCs collected during a single apheresis and the median cumulative number of CD34-positive PBSCs from each patient were 8.3x10(6)/kg and 23.2x10(6)/kg, respectively. The median number of PBSCT performed in each patient was two and the median number of CD34-positive cells transplanted during a single course was 5.7x10(6)/kg. The median recovery times to white blood cells (WBC) greater than 500/microl, 1000/microl and 2000/microl were 8, 9 and 10 days, respectively, following PBSCT, while that to neutrophils greater than 500/microl and that to platelets greater than 50000/microl were 9 and 13 days, respectively, following PBSCT Only the recovery time to platelet count greater than 50000/microl was significantly affected by age; however, there were no significant differences in the recovery of WBC, neutrophils and platelets in relation to several parameters examined. CONCLUSION: These findings suggest that CD34-positive PBSCT may facilitate stable hematopoietic recovery after HDCT in patients with advanced GCT, and that HDCT, if combined with PBSCT, could be performed with comparative safety in such patients, irrespective of their individual characteristics.

Adolescent↗