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Domestication patterns in common bean (Phaseolus vulgaris L.) and the origin of the Mesoamerican and Andean cultivated races.

Chloroplast DNA polymorphisms were studied by PCR sequencing and PCR-restriction fragment length polymorphism in 165 accessions of domesticated landraces of common bean from Latin America and the USA, 23 accessions of weedy beans, and 134 accessions of wild beans covering the entire geographic range of wild Phaseolus vulgaris. Fourteen chloroplast haplotypes were identified in wild beans, only five of which occur also in domesticated beans. The chloroplast data agree with those obtained from analyses based on morphology and isozymes and with other DNA polymorphisms in supporting independent domestications of common bean in Mesoamerica and the Andean region and in demonstrating a founder effect associated with domestication in each region. Andean landraces have been classified into three different racial groups, but all share the same chloroplast haplotype. This suggests that common bean was domesticated once only in South America and that the races diverged post-domestication. The haplotype found in Andean domesticated beans is confined to the southern part of the range of wild beans, so Andean beans were probably domesticated somewhere within this area. Mesoamerican landraces have been classified into four racial groups. Our limited samples of Races Jalisco and Guatemala differ from the more widespread and commercially important Races Mesoamerica and Durango in types and/or frequencies of haplotypes. All four Mesoamerican races share their haplotypes with local wild beans in parts of their ranges. Independent domestications of at least some of the races in Mesoamerica and/or conversion of some locally adapted wild beans to cultigens by hybridization with introduced domesticated beans, followed by introgression of the "domestication syndrome" seem the most plausible explanations of the chloroplast and other molecular data.

Base Sequence↗

Strain-specific and recessive QTLs involved in the control of partial resistance to Fusarium oxysporum f. sp. melonis race 1.2 in a recombinant inbred line population of melon.

Fusarium oxysporum f. sp. melonis (FOM) causes serious economic losses in melon (Cucumis melo L.). Two dominant resistance genes have been identified, Fom-1 and Fom-2, which provide resistance to races 0 and 2 and races 0 and 1, respectively, however FOM race 1.2 overcomes these resistance genes. A partial resistance to FOM race 1.2 that has been found in some Far East accessions is under polygenic control. A genetic map of melon was constructed to tag FOM race 1.2 resistance with DNA markers on a recombinant inbred line population derived from a cross between resistant (Isabelle) and susceptible (cv. Védrantais) lines. Artificial root inoculations on plantlets of this population using two strains, one that causes wilting (FOM 1.2w) and one that causes yellowing (FOM 1.2y), resulted in phenotypic and genotypic data that enabled the identification of nine quantitative trait loci (QTLs). These QTLs were detected on five linkage groups by composite interval mapping and explained between 41.9% and 66.4% of the total variation. Four digenic epistatic interactions involving seven loci were detected and increased the total phenotypic variation that was explained. Co-localizations between QTLs and resistance gene homologs or resistance genes, such as Fom-2 and Vat, were observed. A strain-specific QTL was detected, and some QTLs appeared to be recessive.

Chromosome Mapping↗

Identification of QTLs for Ralstonia solanacearum race 3-phylotype II resistance in tomato.

Resistance against a Ralstonia solanacearum race 3-phylotype II strain JT516 was assessed in a F(2:3) and a population of inbred lines (RIL), both derived from a cross between L. esculentum cv. Hawaii 7996 (partially resistant) and L. pimpinellifolium WVa700 (susceptible). Resistance criteria used were the percentage of wilted plants to calculate the AUDPC value, and bacterial colonization scores in roots and stem (hypocotyl and epicotyl) assessed in two independent greenhouse experiments conducted during the cool and hot seasons in Réunion Island, France. Symptoms were more severe during the cool season trials. Heritability estimates in individual seasons ranged from 0.82 to 0.88, depending on resistance criterion. A set of 76 molecular markers was used for quantitative trait loci (QTL) mapping using the single- and composite- interval mapping methods, as well as ANOVA. Four QTLs, named Bwr- followed by a number indicating their map location, were identified. They explained from 3.2 to 29.8% of the phenotypic variation, depending on the resistance criterion and the season. A major QTL, Bwr-6, and a minor one, Bwr-3, were detected in each season for all resistance criteria. Both QTLs showed stronger effects in the hot season than in the cool one. Their role in resistance to R. solanacearum race 3-phylotype II was subsequently confirmed in the RIL population derived from the same cross. Two other QTLs, Bwr-4 and Bwr-8, with intermediate and minor effects, respectively, were only detected in the hot season, demonstrating that environmental factors may strongly influence the expression of resistance against the race 3-phylotype II strain JT516. These QTLs were compared with those detected in the RIL population against race 1-phylotype I strain JT519 as well as those detected in other previous studies in the same genetic background against other race 1-phylotype I and II strains. This comparison revealed the possible occurrence of some phylotype-specific resistance QTLs in Hawaii 7996.

Chromosome Mapping↗

Grouping of accessions of Mexican races of maize revisited with SSR markers.

Mexican races of maize (Zea mays L.) represent a valuable genetic resource for breeding and genetic surveys. We applied simple sequence repeat (SSR) markers to characterize 25 accessions of races of maize from Mexico. Our objectives were to (1) study the molecular genetic diversity within and among these accessions and (2) examine their relationships as assumed previously on the basis of morphological data. A total of 497 individuals were fingerprinted with 25 SSR markers. We observed a high total number of alleles (7.84 alleles per locus) and total gene diversity (0.61), confirming the broad genetic base of the maize races from Mexico. In addition, the accessions were grouped into distinct racial complexes on the basis of a model-based clustering approach. The principal coordinate analyses of the four Modern Incipient hybrids corroborated the proposed parental races of Chalqueño, Cónico Norteño, Celaya, and Bolita on the basis of the morphological data. Consequently, for some of the accessions, hybridizations provide a clue that can further be used to explain the associations among the Mexican races of maize.

Alleles↗

Hematologic and biochemical laboratory parameters before and after a marathon race.

Marathon racing is a strenuous exercise that has a profound effect on many laboratory parameters. Participants in marathon races may require abstinence of exercise and the performance of laboratory assays several days after the event. The aim of this study was to evaluate the possible changes in blood cell count and biochemical parameters observed in participants in a marathon 3 days before and 3 days after and before and immediately after a cardiopulmonary exercise test. Incremental cycle ergometry up to maximal capacity was performed in 7 marathon runners, 3 days before and 3 days after the race. The % peak oxygen consumption (peak %VO(2)) achieved was statistically significantly lower after than before the race ( p = 0.02). No statistically significant differences were observed in cardiac frequency ( p = 0.148) or blood cell count ( p = 0.501). Also, the concentration of sodium, potassium, calcium, magnesium, lactate dehydrogenase (LDH), phosphocreatine kinase (CPK) and glucose, measured before and immediately after the pulmonary exercise test, did not differ significantly ( p < 0.5). A significant percentage of the laboratory results were outside the standard reference rates. According to our data, exercise performance, as expressed by peak %VO(2), continued to be decreased in marathon runners 3 days after the race. The blood cell count and biochemical parameters did not differ significantly but many marathon runners were outside the standard reference rates. Unfortunately, only 7 subjects were available for this study. Further studies with larger samples and with samples obtained at multiple times during and after exercise are needed to clarify the effects of long-distance running.

Blood Cell Count↗

Effect of a 24-h continuous walking race on cardiac autonomic control.

This study investigated the relationships between walking speed and heart rate (HR) variability (HRV) in eleven subjects during a 24-h race. It was hypothesized that the nycthemeral rhythm on HR is preserved during the race. RR intervals and walking speed were measured. Fast Fourier transform was applied to samples of 1,024 successive RR intervals collected every hour from a HR monitor. Walking speed was averaged every hour and decreased (first lap: 8.8 +/- 0.3 vs. last lap: 7.3 +/- 0.8 km h(-1), P < 0.001) with HR also decreasing (max at 19:00 h: 143 +/- 9 vs. min at 7:00 h: 117 +/- 14 beats min(-1), P < 0.001) following a third order polynomial shape. HRV power spectral components followed distribution patterns similar to the mean RR during the race with a minimum in the early evening (19:00-20:00 h) and a maximum in the morning (5:00-8:00 h). Thus, as for mean RR, spectral components over time are also fitted to a third order polynomial regression. LF/HF ratio increased linearly (min = 0.5 +/- 0.3, max = 2.8 +/- 5.3, P = 0.02). Although mean HF peak did not decrease significantly over time, it was positively correlated with walking speed. In conclusion, this study showed that despite a constant decrease in walking speed, HR circadian rhythm is preserved during a continuous 24-h walking race. The short-term HRV components remain linked to HR whereas the LF/HF ratio increases linearly until the end of the race whatever HR is.

Adult↗

Aerobic and anaerobic energy during a 2-km race simulation in female rowers.

The maximal aerobic power (VO2max) and maximal anaerobic capacity (AODmax) of 16 female rowers were compared to their peak aerobic power (VO2peak) and peak anaerobic capacity (AODpeak, respectively) during a simulated 2-km race on a rowing ergometer. Each subject completed three tests, which included a 2-min maximal effort bout to determine the AODmax, a series of four, 4-min submaximal stages with subsequent progression to VO2max and a simulated 2-km race. Aerobic power was determined using an open-circuit system, and the accumulated oxygen deficit method was used to calculate anaerobic capacities from recorded mechanical power on a rowing ergometer. The average VO2peak (3.58 l min(-1)), which usually occurred during the last minute of the race simulation, was not significantly different (P > 0.05) from the VO2max (3.55 l min(-1)). In addition, the rowers' AODmax (3.40 l) was not significantly different (P > 0.05) from their AODpeak (3.50 1). The average time taken for the rowers to complete the 2-km race simulation was 7.5 min, and the anaerobic system (AODpeak) accounted for 12% of the rowers' total energy production during the race.

Adult↗

The Third Whitbread Round the World Race.

A medical report from the Third Whitbread Round the World Race (1981-1982) is presented by the doctor on board the Swedish entry, who was also the contact doctor for the fleet. The race is the longest ocean race in the world at 27,000 nautical miles. It is divided into four legs with the yachts being offshore for 4-6 weeks on each leg. The medical preparation for the Swedish entry and the organization for the contact between the 28 participating boats are presented. The problems of medical interest during the race, as well as the possible dangers on board and their prevention, are listed and discussed. It is concluded that good medical preparation for the race is of great importance for the results.

Morbidity↗

Effect of age, race, body surface area, heart weight and atherosclerosis on coronary artery dimensions in young males.

Compensatory arterial enlargement in response to atherosclerosis has been demonstrated for the left main coronary artery. Only limited data is available on the interaction of patient characteristics and atherosclerosis with coronary artery dimensions. The purpose of the present study was to evaluate the influence of age, race, body habitus, heart weight and atherosclerosis on coronary artery dimensions of young males. Hearts from 137 young men (age 32 +/- 8 years; 78 black, 59 white) with unnatural deaths (homicide, suicide, accident, drug overdose) were perfusion-fixed, and histologic sections were obtained from the left main, proximal left anterior descending and left circumflex coronary arteries. Computerized planimetry was performed on Movat stained sections. Multiple regression analysis was used to evaluate the relative contribution of plaque size, age, race, heart weight and body surface area on coronary dimensions and compensatory enlargement in response to atherosclerosis. In the left anterior descending and left main coronary arteries, black race, body surface area and age were independent predictors of increased lumen area. In the left circumflex, age was a predictor of lumen area. Plaque area, black race and body surface area independently predicted increased area enclosed by the internal elastic lamina area. There was compensatory enlargement of internal elastic lamina with increasing plaque size in both races in the three arteries, but the percent luminal stenosis was greater in whites due to smaller artery size. Luminal narrowing did not develop until plaques occupied 30% of internal elastic lamina area. Among a population of young men with non-cardiac deaths, blacks have larger lumen and area enclosed by internal elastic lamina than whites. Age and body surface area are major determinants of lumen areas, and compensatory arterial enlargement was seen in all examined arteries in the present study.

Adolescent↗

Race, socioeconomic status, and other prognostic factors for survival from colo-rectal cancer.

Survival data on colo-rectal cancer patients from eleven comprehensive cancer centers were analyzed to examine the effect of race, socioeconomic status and other factors on the probability of survival. Complete data on variables of interest were available for 3617 colon cancer patients (2545 Caucasians and 1072 Blacks) and 1528 rectal cancer patients (1179 Caucasians and 349 Blacks). No significant difference was observed between the races with respect to either the follow-up time or the censoring pattern. For each site, Caucasian patients had a lower risk of death at any time point compared to Black patients, and this difference was maintained within categories of disease stage, sex, age and SES. The race effect was statistically significant in all multivariate models. Moreover, only race was significant in models that considered both race and SES. For either cancer, the racial difference in survival was most prominent for localized disease.

Age Factors↗

Skeletal muscle characteristics of racing reindeer (Rangifer tarandus).

Samples from the middle gluteal muscle of 3-7-year-old racing reindeer were taken before (7 reindeer) and at the end of the racing season (12 reindeer) for determination of fibre type composition, activities of citrate synthase (CS), 3-hydroxyacyl-CoA-dehydrogenase (HAD) and the glycogen content. Muscle samples were also taken from 7 female and 18 male reindeer of same age for histochemical determination of muscle fibre composition. During the racing season the fibre type composition remained unchanged as did the activities of CS and HAD. The high activities of CS and HAD together with the high intensity in the NADH-dehydrogenase stain indicate that the reindeer muscle has a high oxidative capacity. The glycogen content increased during the winter which can explain the increasing tendency in the transverse fibre area. The racing reindeer had a lower percentage of type I fibres and a higher percentage of type IIA fibres than the ordinary male reindeer. The differences in the fibre type composition suggest that the racing reindeer represent a selected reindeer population.

Animals↗

Race and gender influences on the survival of patients with mouth cancer.

Previous studies have shown that race and gender are important correlates of survival among patients with cancer of certain sites. Since race and gender influence the stage of disease at diagnosis and the choice of therapy it has been argued that survival differentials may not be real but instead, they represent secondary associations with clinical variables. Therefore, verification of the true prognostic effects of race and gender requires proper controlling for potential confounders, such as stage and treatment. We have studied the 15-year survival experience of a hospital-based cohort of 4527 patients diagnosed with cancer of the mouth over a 28-year period in Brazil. Race and gender were strong predictors of stage and treatment. The odds ratios for no treatment were 1.35 (95% confidence limits [CL]: 1.09, 1.66) for females and 1.63 (CL: 1.29, 2.06) for non-white patients even after adjustment by stage, presumably a key criterion to define treatment. Survival differentials were found for lip cancer, with respect to race, and for cancers of the gum, floor of mouth, and other oral subsites, with respect to gender. Non-whites experienced 2.1 times the risk of lip cancer recurrence (CL: 1.20, 3.61) and 2.3 times the risk of dying from it (CL: 1.29, 4.09) as compared to whites. However, controlling for stage and treatment modality variables by proportional hazards regression reduced the same risk ratios to 1.01 (CL: 0.57, 1.78) and 1.17 (CL: 0.65, 2.13), respectively. The survival advantage experienced by females (17% lower risk of recurrences and 29% lower risk of cancer deaths) regarding other oral sites was independent from the effect of clinical factors.

Adult↗

Relation of age and race with hospital death after acute myocardial infarction.

BACKGROUND: Prior studies have suggested that young blacks with acute myocardial infarction (AMI) may have higher hospital mortality rates than whites of similar age. However, the influence of age and race on short-term death has not been explored in detail. We examined the relation of age and race on short-term death in a large AMI population and ascertained the factors that may have contributed to differences in mortality rates. METHODS: We compared the crude and adjusted hospital mortality rates stratified by age among 40,903 blacks and 501,995 whites with AMI enrolled in the National Registry of Myocardial Infarction-2 in 1482 participating US hospitals from June 1994 through March 1998. RESULTS: Overall crude mortality was lower among blacks compared with whites (10.9% vs 12.0%, P <.0001). However, blacks had a significantly higher crude mortality rate compared with the whites in the age groups <65 years (<45 years, and 5-year age groups between 45 and 64 years). There was a statistically significant interaction between age and black race on hospital death (P value for interaction <.001). Each 5-year decrement in age from 85 years was associated with 7.2% higher odds of death in blacks compared with whites (95% CI, 5.7% to 7.6%). After adjusting for differences in the baseline, clinical presentation, early treatment, and hospital characteristics, 5-year decrements in age was still associated with increases in the odds for death in blacks compared with whites (5.4%; 95% CI, 3.6% to 7.2%). This interaction between age and black race was present in both sexes but was stronger among men. CONCLUSIONS: Blacks younger than 65 years had higher hospital mortality rates compared with whites hospitalized for AMI, and decreasing age was associated with progressively higher risk of hospital death for blacks. Differences in the clinical presentation, early treatment, and hospital characteristics could only partly explain this age-race interaction.

Age Factors↗

Neither race nor gender influences the usefulness of amino-terminal pro-brain natriuretic peptide testing in dyspneic subjects: a ProBNP Investigation of Dyspnea in the Emergency Department (PRIDE) substudy.

BACKGROUND: Amino-terminal pro-brain natriuretic peptide (NT-proBNP) is useful for the diagnosis and exclusion of congestive heart failure (HF). Little is known about the effect of race on NT-proBNP concentrations. Also, NT-proBNP levels may be higher in apparently well women, but the effect of gender on NT-proBNP concentrations in dyspneic patients is not known. METHODS AND RESULTS: NT-proBNP (Elecsys proBNP, Roche, Indianapolis, IN) was measured in 599 dyspneic patients in a prospective study. Of these, 44 were African American; 295 were female. NT-proBNP levels were examined according to race and gender in patients with and without acute HF using analysis of covariance. Receiver operating characteristic (ROC) curves assessed NT-proBNP by race and gender. Cutpoints for diagnosis (450, 900, and 1800 pg/mL for ages < 50, 50 to 75, and > 75 years) and exclusion (300 pg/mL) were examined in African-American and female subjects. There was no difference in the rates of acute HF between African-American and non-African-American (30% versus 35%, P = .44) or male and female (35% versus 35%, P = .86) subjects. In subjects with HF, there was no difference in median NT-proBNP concentrations between African American and non-African American (6196 versus 3597 pg/mL, P = .37). In subjects without HF, unadjusted NT-proBNP levels were lower in African-American subjects than in non-African-American subjects (68 versus 148 pg/mL, P < .03); however, when adjusted for factors known to influence NT-proBNP concentrations (age, prior HF, creatinine clearance, atrial fibrillation, and body mass index), race no longer significantly affected NT-proBNP concentrations. There was no statistical difference in median NT-proBNP concentrations between male and female subjects with (4686 versus 3622 pg/mL, P = .53) or without HF (116 pg/mL versus 150 pg/mL, P = .62). Among African Americans, NT-proBNP had an area under the ROC for acute HF of 0.96 (P < .0001), and at optimal cutpoints, had a sensitivity of 100% and a specificity of 90%. Among females, NT-proBNP had an area under the ROC for acute HF of 0.95 (P < .0001), and had a sensitivity of 89% and a specificity of 88%; 300 pg/mL had negative predictive value of 100% in African Americans and females. CONCLUSION: NT-proBNP is useful for the diagnosis and exclusion of acute HF in dyspneic subjects, irrespective of race or gender.

Adult↗

A system of microcalcifications detection and evaluation of the radiologist: comparative study of the three main races in Malaysia.

This paper uses wavelets in the detection comparison of breast cancer among the three main races in Malaysia: Chinese, Malays, and Indians followed by a system that evaluates the radiologist's findings over a period of time to gauge the radiologist's skills in confirming breast cancer cases. The db4 wavelet has been utilized to detect microcalcifications in mammogram-digitized images obtained from Malaysian women sample. The wavelet filter's detection evaluation was done by visual inspection by an expert radiologist to confirm the detection results of those pixels that corresponded to microcalcifications. Detection was counted if the wavelet-detected pixels corresponded to the radiologist's identified microcalcification pixels. After the radiologist's detection confirmation a new client-server radiologist recording and evaluation system is designed to evaluate the findings of the radiologist over some period of cancer detection working time. It is a system that records the findings of the Malaysian radiologist for the presence of breast cancer in Malaysian patients and provides a way of registering the progress of detecting breast cancer of the radiologist by tracking certain metric values such as the sensitivity, specificity, and receiver operator curve (ROC). The initial findings suggest that no single race mammograms are easier for wavelets' detections of microcalcifications and for the radiologist confirmation even though for this study the Chinese race samples detection average were a few percentages less than the other two races, namely the Malay and Indian races.

Breast Neoplasms↗

Race, gender, and clinical risk index for babies (CRIB) score as predictors of severe retinopathy of prematurity.

PURPOSE: To determine whether race, gender, and the Clinical Risk Index for Babies (CRIB) illness severity score are predictors of threshold or severe prethreshold retinopathy of prematurity warranting surgery (ROP warranting surgery) and whether racial and gender differences in ROP are correlated with racial and gender differences in illness severity. METHODS: This was a retrospective analysis of premature infants 401-1250 g at birth that were admitted to the University Hospital of Cincinnati (January 1998 to May 2003). Birth weight, gestational age, multiple birth, birth in the study hospital or elsewhere, race, gender, CRIB score, and eye findings were abstracted. The outcome variable was ROP warranting surgery. RESULTS: Of 299 patients (596 eyes) with adequate eye and CRIB data, 35 patients (11.7%) [66 eyes; 11.1%] developed ROP warranting surgery. Multiple logistic regression analysis showed that higher CRIB score (P < 0.0001; odds ratio [OR] 1.21), male gender (P < 0.005; OR: 2.68), nonblack race (P < 0.0005; OR: 4.32), lower gestational age, and multiple birth are predictive factors for ROP warranting surgery. Because birth weight and gestational age comprise 2 of the 6 components of the CRIB score, a CRIB subscore (CRIBSUB) consisting of the remaining 4 components was tested and remained a significant predictor (P < 0.00001). Birth weight was a significant predictor when CRIBSUB was in the model but not when the CRIB score was used. The CRIB score was a predictor of neonatal mortality, but race and gender did not predict the CRIB score or neonatal mortality. CONCLUSIONS: Nonblack race, male gender, and higher CRIB illness severity scores are predictors of ROP warranting surgery. In our population, there were no racial or gender differences in neonatal mortality or CRIB scores to explain the racial and gender differences in severity of ROP.

Birth Weight↗

Insurance status and race represent independent predictors of undergoing laparoscopic surgery for appendicitis: secondary data analysis of 145,546 patients.

BACKGROUND: Studies have shown that racial and socioeconomic differences lead to inequality in access to health care. It is unknown whether insurance status and race affect the choice of surgical treatment for patients presenting with appendicitis. STUDY DESIGN: Patients with primary ICD-9 procedure codes for laparoscopic and open appendectomy were selected from the 1998, 1999, and 2000 Nationwide (US) Inpatient Samples. The primary predictor variables were insurance status (private, Medicare, Medicaid, other) and race (Caucasian, African American, Hispanic, other). Multiple logistic regression models were used to assess whether insurance status and race are associated with the choice of surgical procedure for patients presenting with appendicitis. RESULTS: Discharge abstracts of 145,546 patients were used for our analyses. There were 32,407 patients (22.3%) who underwent laparoscopic appendectomy and 113,139 patients (77.7%) who had open appendectomy. Although 24.2% of privately insured patients underwent laparoscopic appendectomy, only 16.9% of Medicare patients, 17.4% of Medicaid patients, and 19.6% of patients in the "other" insurance category were treated using the laparoscopic procedure (p < 0.001). Caucasian patients underwent laparoscopic surgery in 24.8%, African Americans in 18.6%, Hispanics in 19.6%, and other ethnicities in 18.8% of patients (p < 0.001). Compared with the Medicaid subset, and after adjusting for potential confounders such as age, gender, race, patient comorbidity, median ZIP code income, hospital location and teaching status, and presence of abscess or perforation, privately insured patients (odds ratio [OR] = 1.26, 95% [CI [1.20, 1.33], p < 0.001) and Medicare patients (OR = 1.17, 95% CI [1.05, 1.30], p = 0.004) were significantly more likely to undergo laparoscopic surgery. Caucasian patients (OR = 1.42, 95% CI [1.33, 1.51], p < 0.001) and Hispanics (OR = 1.12, 95% CI [1.04, 1.20], p = 0.002) were significantly more likely to have laparoscopic appendectomy, compared with African Americans, even after adjusting for the previously mentioned confounders and insurance status. CONCLUSIONS: Even after adjusting for potential confounders, insurance status and race are marked independent predictors of having laparoscopic surgery in patients treated for appendicitis in this sample.

Adult↗

Is race a positive predictor of cancer on repeat prostate biopsy?

PURPOSE: High grade intraepithelial neoplasia and atypical small acinar proliferation increase the probability of cancer on a subsequent prostate biopsy. We investigated whether race is prognostic for detecting cancer in patients undergoing repeat prostate biopsies. MATERIALS AND METHODS: At a single institution 416 men underwent 2 or more prostate biopsies from January 1993 through June 2003 for a total of 1,023 biopsies. We retrospectively examined multiple factors, including patient age, race, total number of biopsy cores total number of previously negative biopsy cores, prostate specific antigen, prostate specific antigen slope, digital rectal examination and family history of prostate cancer. Previous high grade intraepithelial neoplasia, atypical small acinar proliferation and Gleason score in positive biopsies were recorded from the histopathology review. Clinical variables were compared between black and white men using the Wilcoxon rank sum and Fisher exact tests. The Cox proportional hazards model was used for multivariate analysis. RESULTS: Of the 416 men 216 (51.9%) were black, 174 (41.8%) were white and 26 (6.3%) were another race. The average number of biopsy sessions in black and white men was 2.41 and 2.51, respectively. The cancer detection rate was 35.1% at the second biopsy, 34.6% at the third biopsy and 32.0% at the fourth biopsy. Cancer was diagnosed in 43.5% of black men compared to 25.9% of white men (p = 0.0004). When clinical and pathological variables were compared between the racial groups, black men had significantly higher prostate specific antigen (p = 0.02). There was no statistically significant difference in patient age, total number of cores, number of previous negative cores, prostate specific antigen slope, abnormal digital rectal examination, family history, or previous high grade intraepithelial neoplasia or atypical small acinar proliferation. Multivariate analysis showed that race approached but did not achieve statistical significance as a predictor of prostate cancer on repeat biopsy (p = 0.09). Previous high grade intraepithelial neoplasia (p = 0.0025), previous atypical small acinar proliferation (p = 0.0049), digital rectal examination (p = 0.0076) and prostate specific antigen slope (p = 0.0005) were independent predictors of prostate cancer on repeat biopsy. Of patients with previous atypical small acinar proliferation black men had a significantly higher rate of cancer detection on repeat biopsy. CONCLUSIONS: Previous high grade intraepithelial neoplasia, atypical small acinar proliferation, digital rectal examination and prostate specific antigen slope were independent predictors of prostate cancer on repeat biopsy. Race approached but did not attain significance after adjusting for disease features.

Aged↗