Biomedical subjects
JE Tomaszewski
Publications and source records attributed to JE Tomaszewski.
Endorectal coil magnetic resonance imaging and clinicopathologic findings in T1c adenocarcinoma of the prostate.
Stage T1c prostate cancer has become the most commonly diagnosed clinical stage of localized prostate cancer. Endorectal coil magnetic resonance imaging (erMRI) can be used in the staging of such patients. The purpose of this study was to correlate the preoperative erMRI findings with the pathologic characteristics of the surgical specimens. A database review of 355 radical prostatectomy specimens revealed 130 patients with T1c disease. Of these patients, 124 were clinically staged with erMRI. Standard sensitivity analysis and multivariable analysis was then applied to determine the utility of erMRI in the staging of patients with T1c prostate cancer. The mean prostate specific antigen (PSA) value was 8.3 (1.0-33.6). Most patients had Gleason score of 5 or 6 (51.6%) or 7 (33.1%), with fewer patients having Gleason scores between 2 and 4 (7.2%) or 8 and 10 (8.1%). The positive predictive value of erMRI for extracapsular disease was 38.7%, negative predictive value was 75.3%, and accuracy was 79%. Multivariable regression analysis demonstrated that erMRI and preoperative PSA were predictive for seminal vesicle involvement. However, erMRI was not predictive in multivariable or univariable analysis for extracapsular extension or margin positivity. Previous investigators demonstrated the utility and independent significance of preoperative erMRI for a select subset of patients. However, it is not a useful staging modality for patients with T1c cancer as a whole. Further stratification of the T1c patients would be necessary to identify patients within this group who may benefit from staging with erMRI.
Expression of Transforming Growth Factor-beta Receptors and Related Cell-Cycle Components in Transitional-Cell Carcinoma of the Bladder.
Exogenous transforming growth factor-beta (TGF-beta) is a potent inhibitor of normal epithelial cell growth but does not generally inhibit the growth of cell lines of transitional-cell carcinoma (TCC) of the bladder. In addition, a lack of the TGF-beta2 transcript and a marked reduction of the TGF-beta1 transcript have been reported in some high-stage TCCs. The purpose of this investigation was to examine the steady-state expression of TGF-beta receptor I and TGF-beta receptor II and a downstream target, p27(KIP1), as well as cyclin E in normal bladder and superficial and invasive TCC in order to better understand the role of TGF-beta downstream targets in TCC insensitivity to TGF-beta. Quantitative RT-PCR was employed to study the expression of TGF-beta receptor I and receptor II. p27(KIP1), and cyclin E in normal bladder and superficial and invasive TCC lesions. Steady-state levels of p27(KIP1), TGF-beta receptors, and cyclin E mRNAs were similar in superficial TCC samples and normal bladder mucosa. There was a significant decrease in p27(KIP1) and TGF-beta receptor II mRNA expression in invasive lesions compared with superficial tumors (P < 0.004; P < 0.02). In contrast, there was no significant difference in the expression of TGF-beta receptor I mRNA between normal bladder and superficial and invasive TCC. There was a significant increase in the expression of cyclin E mRNA in invasive TCC compared with superficial TCC or normal bladder (P < 0.015). These results suggest that aberrant expression of these genes contributes to the phenotype of invasive bladder cancer.