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PubMed1988

Observations on the number, size and localization of nucleoli in hyperplastic and neoplastic prostatic disease.

Specimens of prostate obtained for histopathological and cytological examination by urethral resection and 'punch' biopsies showing carcinoma, atypical and typical hyperplasia were re-examined with regard to the number, size and localization of nucleoli. With increasing degrees of malignancy the number and size of the nucleoli increased and the position of the nucleolus shifted to the periphery of the nucleus. In the cells in typical and slightly atypical prostatic hyperplasia there were few nucleoli which were localized to the centre of the nucleus. In moderately atypical hyperplasia there were intermediate locations, while in severe atypical hyperplasia and 'borderline' malignant cases there was a distinct shift towards the periphery of the nucleus as well as an increase in the number of nucleoli in each nucleus. It is suggested that careful analysis of the number and localization of nucleoli can be helpful in the analysis of the differential diagnosis between carcinoma and atypical hyperplasia of the prostate, which can be difficult in histopathological and cytopathological material.

Cell Nucleolus↗
PubMed2007

Antibody array profiling reveals serum TSP-1 as a marker to distinguish benign from malignant prostatic disease.

BACKGROUND: Blood protein markers that provide more accurate or earlier diagnosis of prostate cancer should have a positive impact on prostate cancer treatment and management. METHODS: Serum samples from control subjects and patients with benign or malignant prostatic disease were analyzed on antibody arrays targeting multiple candidate prostate cancer markers and detected with two-color, rolling-circle amplification (TC-RCA). The measurements of certain antibodies were validated using immunoblots, immunoprecipitation/mass spectrometry, and sandwich immunoassays. RESULTS: Several potential disease-associated protein alterations were uncovered. The most significant was thrombospondin-1, which was strongly elevated in patients with benign prostatic disease and repressed in patients with prostate cancer. Thrombospondin-1 levels did not correlate with prostate-specific antigen (PSA) levels and differentiated benign from malignant disease with 79% sensitivity and 81% specificity. CONCLUSIONS: The measurement of thrombospondin-1 could be used to assist the decision to obtain a biopsy in men with suspected prostate cancer, which could lead to a reduction in the number of unnecessary prostatic biopsies.

Adult↗
PubMed1989

[Comparison of transabdominal and intrarectal ultrasonic studies in prostatic diseases].

Following a great number of transabdominal and intrarectal ultrasonographies the authors analyse the significance of the method int the diagnostics of the prostatic diseases. The technique and conditions of the performance of both examinations are described. The ultrasonic signs of different prostatic diseases are discussed in details and the value of intrarectal ultrasonography in the recognition and diagnostics of the prostatic cancer is analysed. The attention is drawn to the fact that the data of ultrasonography alone are not sufficient for making the correct diagnosis, results of the traditional diagnostic techniques (manual examination, cytology, histology, cystoscopy) must also be taken into consideration.

Abdomen↗
PubMed1995

Surgical treatments for prostatic diseases in dogs.

Successful prostatic surgery requires aggressive perioperative animal patient management, accurate identification of the disease process, and proper surgical techniques. Overcoming the complications associated with urinary incontinence, sepsis, and neoplasia will help reduce animal patient morbidity and mortality.

Animals↗
PubMed1983

Computed tomography and transrectal ultrasound in the diagnosis of prostatic disease--a comparative study.

Computed tomography (CT) and transrectal ultrasound were performed in 88 patients with clinically and histologically proven prostatic disease. An ultrasound diagnosis of prostatic cancer was suggested in 49 of 54 patients with proven disease, whereas CT identified only 21 of those patients. There were no specific features of confined prostatic malignancy on CT and the most reliable feature of an unconfined tumour was infiltration of the posterior aspect of the bladder base. It was not possible on ultrasound to differentiate between prostatic inflammatory disease and a confined carcinoma but ultrasound was accurate in detecting defects in the prostatic capsule, the hallmark of unconfined prostatic malignancy.

Adult↗
PubMed1998

Relationship among age, prostate-specific antigen, and prostate volume in men with lower urinary tract symptoms (LUTS) and in different groups of men with and without benign and malignant prostate diseases.

BACKGROUND: In order to enhance prostate-specific antigen (PSA) as a predictor of prostate cancer, it is necessary to understand the characteristics of this tumor marker in a population of men without evidence of prostate cancer but who are at risk for developing the condition. METHODS: In an age-stratified population of 328 men with lower urinary tract symptoms (LUTS), we analyzed the distribution of PSA levels as a function of age and prostate volume, and we analyzed the percentage of age-related variance in PSA that can be explained by the age-related variance in prostate volume. RESULTS: Classifying the 328 cases with LUTS according to four age groups, a correlation was found between PSA and prostate volume, becoming stronger from the younger (correlation coefficient, -0.1265) to the older group (correlation coefficient, 0.6044). Serum PSA variance per milliliter of prostate volume also increased from the younger (not significant, P > 0.1) to the older age decades (7.3% in men age 70 years or over). Moreover, the results of the regression analysis suggest that 10% of the variance in PSA with age can be accounted for by prostate volume in men under age 50 years, reaching 37% in men age 70 years or more. CONCLUSIONS: These data confirm that the serum PSA concentration increases with advancing age in the absence of clinically evident prostatic malignancy. In younger patients with LUTS, serum PSA variance with age seems to be less dependent upon the age-related variance in prostate volume.

Adult↗
PubMed2002

Analytical accuracy and reliability of commonly used nutritional supplements in prostate disease.

PURPOSE: We determine the analytical accuracy and reliability of commonly used nutritional supplements for prostate disease by comparing the amounts of active ingredients of several brands of vitamin E, vitamin D, selenium, lycopene and saw palmetto. We also compared the amounts of active compound in different lots of the same brand to determine the consistency of the manufacturing process. MATERIALS AND METHODS: Samples purchased at pharmacies and specialty stores were sent for independent chemical analysis. The measured dose was compared to the stated dose on the product label. Analysis of variance was performed to test for significance in interlot reliability. RESULTS: Vitamin E (7 samples) and selenium (5) were within a range of -41% to +57% and -19% to +23% of the stated dosage, respectively. All vitamin D brands (4 samples) were within 15% of the stated dose. Saw palmetto (6 samples) were within a range -97% to +140% of the stated dosages with 3 containing less than 20% of the stated dosages. Lycopene brands were between -38% and +143% of stated dosages. Among the reliability assays 1 of 3 brands of vitamin E, 1 of 2 brands of selenium and 1 of 2 brands of saw palmetto demonstrated statistical differences in interlot dosage (p <0.0055, approximate 20% to 25% differences in dose). The 1 assayed form of vitamin D was reliable between lots. CONCLUSIONS: Commonly used nutritional supplements for prostate disease vary widely in measured dose. Saw palmetto demonstrated tremendous variability with some samples containing virtually no active ingredients. In contrast, the more regulated substances we measured, such as vitamins and minerals, demonstrated less variation.

Capsules↗
PubMed1983

Perspectives on serum acid phosphatase in prostatic disease. An evaluation of two methods.

Acid phosphatase in serum was measured in 116 patients with prostatic disease, benign in 59 and malignant in 57 cases. Comparisons were made between radioimmunoassay (RIA) and an enzymatic method. The correlation coefficient between the respective values was 0.96 in patients with untreated prostatic cancer, indicating that no significant difference between results with the two methods was to be expected. The correlation coefficient between RIA values and cancer stage was 0.48, and between catalytic activity and cancer stage it was 0.50. The validity of the two methods consequently was equal. RIA, however, was the more sensitive method, giving elevated values in 10 of 11 patients with untreated stage III or stage IV prostatic cancer, as compared with only 4 of the same 11 in the enzymatic assay. This seeming paradox most probably was attributable to differing intrinsic properties of the methods when the upper limits of normal range were established. Neither RIA nor enzymatic analysis discriminated early prostatic cancer (stages I and II) from benign lesions.

Acid Phosphatase↗
PubMed2006

Botulinum-A toxin: an exciting new treatment option for prostatic disease.

Recently, botulinum neurotoxin type A (BoNT-A) application in the lower urinary tract has been extended to prostate disorders and we would like to review the literature on the mechanisms of action and clinical efficacy of BoNT-A treatment in the prostate. The information was gathered from MEDLINE, abstracts from recent urological meetings and from personal experience. BoNT has demonstrated promising preliminary results for male prostatic disease and translational research suggests a novel mechanism of action of BoNT in the prostate. It is important to remember that the application of BoNT in the prostate is not approved by the regulatory agencies and caution should be applied until larger randomised clinical studies are completed.

Antineoplastic Agents↗
PubMed1989

Structure and per-rectal ultrasonography of prostatic disease using cadaver specimens.

One hundred cadaver prostates were examined by per-rectal ultrasound and the findings correlated with the microradiographic and histopathological features of whole sections taken at the levels of scanning. The normal gland consists of both periurethral muscle and glands. The periurethral muscle has little structure on microradiography and is therefore hypoechoic (low amplitude echoes) on ultrasound scanning. The gland itself, both central and peripheral zones, has a lattice appearance on microradiography (reticular structure) and therefore produces mid-range amplitude echoes on ultrasound. Benign hypertrophy develops at the edge of the periurethral muscle and is microadenomatous in structure. This produces mid-range amplitude echoes which are coarser than in the normal gland. Associated calcification has a characteristic distribution around the adenomas. Cancer produces an amorphous structure resulting in loss of ultrasonic echoes (hypoechoic). In a few cancers irregular calcification is present, resulting in high echoes in the ultrasound scan (hyperechoic) which are not in the typical benign distribution. The internal structure of the prostate was therefore demonstrated in its histopathological states by the technique of microradiography and seen to relate to its representation by ultrasound.

Adolescent↗
PubMed2005

Circulating levels of isoflavones and markers of 5alpha-reductase activity are higher in Japanese compared with New Zealand males: what is the role of circulating steroids in prostate disease?

Epidemiological evidence implicates dietary isoflavone intake as protective against prostate disease. A putative mechanism is attenuated circulating androgen levels in male populations consuming an isoflavone rich diet. We investigated this hypothesis by collecting plasma from 60 Japanese and 60 New Zealand males aged between 21 and 31 years each consuming their traditional diets. We measured plasma testosterone, dihydrotestosterone (DHT), androstenedione, dehydroepiandrosterone sulfate (DHEAS), the combined levels of androsterone sulfate and epiandrosterone sulfate (AoS/epiAoS), sex hormone-binding globulin, and cortisol and corticosteroid-binding globulin as well as the isoflavones genistein and equol. Plasma genistein and equol levels were several times higher in Japanese males as would be expected from an isoflavone rich diet. However, androstenedione, DHEAS, calculated free testosterone and paradoxically markers of 5alpha-reductase, DHT and AoS/epiAoS were all also significantly higher in Japanese rather than the New Zealand male counterparts. All other comparisons were not significant. Plasma DHT and DHEAS correlated positively with plasma equol and plasma AoS/epiAoS correlated positively with genistein levels. Taken together the results suggest that, rather than reduced levels of steroidogenesis, Japanese males may have increased 5alpha-reductase activity and possibly altered 17beta OH steroid dehydrogenase activity. Significantly the positive association between isoflavones levels and 5alpha-steroids is counter-intuitive to isoflavone intake offering prostate protection, unless this is postulated to occur through other mechanisms.

Adult↗
PubMedDate not supplied

The potential significance of aromatase in the etiology and treatment of prostatic disease.

Prior to the present conference on aromatase, reports in the literature on prostatic aromatase have been scattered over time, few in number, and the results have been widely divergent. Moreover, several participants at this conference have reported unpublished data that failed to detect the existence of androgen aromatase in the prostate of man and other species. While papers and posters presented at this conference have added new information to this field, there would still appear to be no consensus as to the biological significance, if any, of the putative androgen aromatase system or the practical importance of inhibitors of prostatic and/or peripheral aromatase as a treatment modality for benign prostatic hyperplasia (BPH). Thus, it would be difficult to predict at this time the ultimate impact which current prostatic aromatase investigations will eventually have on our understanding and treatment of prostatic disease. To summarize the status of our current understanding of aromatase as it relates to prostatic function and disease, it would be safe to note that this field is virtually wide open for researchers to explore, both in terms of the future role that aromatase inhibitors may have in clinical investigations and in terms of the functional significance of aromatase, if any, in the normal prostate as well as in the pathogenesis of BPH and prostate cancer. Clearly, the widely divergent results currently available in the literature must reflect, in part, differences in methodology, anatomy, tissue types, the relative amounts of stroma and epithelium in specimens analyzed, the cellular and tissular (normal, BPH, and carcinomatous) heterogeneity encountered in clinical specimens, and the pharmacologic features of aromatase inhibitors tested.

Aromatase↗
PubMed2006

Detection of pre-neoplastic and neoplastic prostate disease by MALDI profiling of urine.

The heterogeneous progression to the development of prostate cancer (PCa) has precluded effective early detection screens. Existing prostate cancer screening paradigms have relatively poor specificity for cancer relative to other prostate diseases, commonly benign prostatic hyperplasia (BPH). A method for discrimination of BPH, HGPIN, and PCa urine proteome was developed through testing 407 patient samples using matrix assisted laser desorption-mass spectrometry time of flight (MALDI-TOF). Urine samples were adsorbed to reverse phase resin, washed, and the eluant spotted directly for MALDI-TOF analysis of peptides. The processing resolved over 130 verifiable signals of a mass range of 1000-5000 m/z to suggest 71.2% specificity and 67.4% sensitivity in discriminating PCa vs. BPH. Comparing BPH and HGPIN resulted in 73.6% specificity and 69.2% sensitivity. Comparing PCa and HGPIN resulted in 80.8% specificity and 81.0% sensitivity. The high throughput, low-cost assay method developed is amenable for large patient numbers required for supporting biomarker identification.

Aged↗
PubMed1984

[Problems in mass screening program for prostatic diseases].

We developed transrectal ultrasonotomography for practical use in 1967 and started a model trial mass screening program for prostatic diseases with the method in 1975. A mobile unit "Dolphin" for mass screening, in which two sets of special chair-type scanner for the method was loaded, was developed successfully in 1980. Up to March, 1983, 2394 males over the age of 55 were submitted to the primary study. Among them, 12 cases (0.5%) of prostatic cancer (PC) and 755 cases (31.5%) of benign prostatic hypertrophy (BPH) were finally detected in the secondary study. Thus the prevalence of BPH was significant and even the detection rate of PC was still remarkably higher than that in mass screening for other malignancies. The diagnostic accuracy in transrectal ultrasonotomography in PC was calculated from the results of patients visiting our out-patient clinic during 7 years until March, 1983. The sensitivity was 96.5% and the specificity was 84.6%. On the other hand, the sensitivity of digital examination in the same series was 80.7%. We concluded from this study that the efficacy of digital examination was thought to be insufficient for the screening of PC. The cost-benefit balance in our mass screening system was estimated from the above mentioned results. We needed yen 2,000,000 to find out each case of early PC in the system. In our clinic, patients with early PC paid yen 2,000,000 in average for treatments including radical surgery and were cured. On the contrary, patients with advanced PC paid yen 5,000,000 approximately yen 8,000,000 and died eventually. The minimum difference of treatment fee between early and advanced PC was yen 3,000,000, accordingly. Since the cost of detecting each early PC in mass screening was yen 2,000,000, we are contributing approximately yen 1,000,000 to the national finance on each time when we pick up one case of early PC. This doesn't include benefits from detecting BPH and from life prolongation. Thus the balance seems to be sufficiently positive. In conclusion, a mass screening program for prostatic diseases is promising because it can detect the diseases accurately by transrectal ultrasonotomography with a good cost-benefit balance. The only remaining problem is how to transfer this to national political measures.

Aged↗
PubMed1993

Benign prostatic disease. A growing challenge in the 1990s.

All of your male patients may one day be concerned with the prospect of prostatic disease. How can you as a primary care physician best approach evaluation and treatment of these disorders? Drs Daneshgari and Crawford provide the information you need to know about recognition and management of benign prostatic hyperplasia and common types of prostatitis.

Aged↗
PubMed1983

Correlation of transrectal sonographic findings in patients with suspected and unsuspected prostatic disease.

Previous reports describing the diagnostic accuracy of transrectal sonography have not documented the specificity of differentiating abnormal internal echoes of the prostate. To determine the specificity of the examination, a prospective study was designed to correlate sonographic findings with histological diagnoses. Gray scale transrectal sonography was performed on 228 patients and the scans were reviewed without clinical information. The sensitivity (true positive rate) was confirmed by histological evaluation in 121 cases to be 90 per cent. The specificity (true negative rate) was determined by histological evaluation as well as subsequent clinical followup to be 60 per cent. Our experience is similar to that of others showing transrectal sonography as a sensitive diagnostic tool. The relatively low specificity demonstrates the difficulty in differentiating the abnormal internal echoes of the prostate, representing malignant and nonmalignant prostatic disease processes.

Adult↗
PubMedDate not supplied

[Nuclear magnetic resonance tomography in the diagnosis of prostatic diseases].

In diagnosis of prostatic disorders the authors used as an adjuvant method NMR tomography employed after previous morphologic verification of the diagnosis. The authors describe most common tomographic characteristics of chronic prostatitis, adenoma and cancer of the prostate. It is concluded that NMR tomography is most beneficial in complicated diagnostic cases when none of the standard procedures can specify pathological process, in cases of noncoincidence of clinical symptoms and histological findings.

Adolescent↗