Diagnosis and treatment of small cell carcinoma of prostate and a review of literature

Objective To investigate histological features, clinical presentation,treatment and prognosis of small cell carcinoma of prostate. Methods Clinical,pathological and follow-up data of two cases of small cell carcinoma of prostate were respectively analyzed,and trlated literature was reviewed. Results Two cases of small

Study of hypoechoic nodule diagnosis of BPH in outer gland of the prostate by TRUS and autopsy

To investigate the possibility of benign prostatic hyperplasia (BPH) in prostatic outer gland by transrectal ultrasound (TRUS) and autopsy examination.Methods Fifty-nine patients were biopsied by TRUS guided in sagittal and longitudinal sections,respectively,because hypoechoic nodules were found in the outer glands of the prostates.The specimens were stained by HE methods.The whole prostate specimens obtained from 16 men at autopsy were studied.Sonogram of the specimens was investigated by putting them in water.Them the specimens were sliced down perpendicularly to the urethra,histologically processed and stained by HE methods.Results Pathologically,22 of the 59 specimens were of benign prostate hyperplasia (BPH),29 of prostate cancer (PCa),1 of prostatic intraepithelial neoplasia (PIN) and 7 of tuberculosis (TB).A clear-cut interface between inner gland and outer gland,and multiple calculi and cysts were found on sonogram.Pathological diagnosis of BPH of the outer glands was made in all HE-stained autopsied specimens with varying degrees of hyperplasia of the glands,small muscles and stroma.Conclusion It is suggested that hypoechoic nodules in outer gland of the prostate by TRUS on sonogram may be benign hyperplastic nodules besides PCa,PIN,and TB.10 refs,5 figs.

Life-threatening meningitis resulting from transrectal prostate biopsy

After antibiotic prophylaxis with metronidazole and levofloxacin, a transrectal sextant biopsy was performed under the guide of transrectal ultrasonography （TRUS） for a 75-year-old suspicious patient with prostate adenocarcinoma. Although antibiotics were also given after this procedure, the patient still developed fever, anxious, agrypnia and headache. Blood cultures remained negative. Lumbar puncture was performed and was consistent with Escherichia coli bacterial meningitis.

The value of B7-H3 expression in expressed prostatic secretions in differential diagnosis of patients with inflammatory elevation of PSA in t-PSA gray zone

Objective To investigate the value of BT-H3 in expressed prostatic secretions ( EPS) in differential diagnosis of patients with inflammatory elevation of PSA in t - PSA gray zone ( 4 - 10 ng /ml) . Methods One hundred and sixteen patients from ages of 19 to 80 years ( mean,40 years) were studied. In the group there

Transperineal prostate biopsies for diagnosis of prostate cancer are well tolerated： a prospective study using patient-reported outcome measures

We aimed to determine short-term patient-reported outcomes in men having general anesthetic transperineal （TP） prostate biopsies. A prospective cohort study was performed in men having a diagnostic TP biopsy. This was done using a validated and adapted questionnaire immediately post-biopsy and at follow-up of between 7 and 14 days across three tertiary referral hospitals with a response rate of 51.6%. Immediately after biopsy 43/201 （21.4%） of men felt light-headed, syncopal, or suffered syncope. Fifty-three percent of men felt discomfort after biopsy （with 95% scoring 〈5 in a 0-10 scale）. Twelve out of 196 men （6.1%） felt pain immediately after the procedure. Despite a high incidence of symptoms （e.g., up to 75% had some hematuria, 47% suffered some pain）, it was not a moderate or serious problem for most, apart from hemoejaculate which 31 men suffered. Eleven men needed catheterization （5.5%）. There were no inpatient admissions due to complications （hematuria, sepsis）. On repeat questioning at a later time point, only 25/199 （12.6%） of men said repeat biopsy would be a significant problem despite a significant and marked reduction in erectile function after the procedure. From this study, we conclude that TP biopsy is well tolerated with similar side effect profiles and attitudes of men to repeat biopsy to men having TRUS biopsies. These data allow informed counseling of men prior to TP biopsy and a benchmark for tolerability with local anesthetic TP biopsies being developed for clinical use.

Prostate cancer antigen 3 test for prostate biopsy decision： a systematic review and meta analysis

Background The specificity for early interventions of prostate-specific antigen （PSA） in prostate cancer （PCa） is not satisfactory.It is likely that prostate cancer antigen 3 （PCA3） can be used to predict biopsy outcomes more accurately than PSA for the early detection of PCa.We systematically reviewed literatures and subsequently performed a meta-analysis.Methods A bibliographic search in the database of Embase,Medline,Web of Science,NCBI,PubMed,CNKI,and those of health technology assessment agencies published before April 2013 was conducted.The key words used were ＂prostatic neoplasms＂,＂prostate＂,＂‘prostate,＇ ‘carcinoma＇ or ‘cancer＇ or ‘tumor＇,or ‘PCa,＇＂ and free terms of ＂upm3＂,＂pca3＂,＂dd3＂,＂aptimapca 3＂,and ＂prostate cancer antigen 3＂.All patients were adults.The intervention was detecting PCA3 in urine samples for PCa diagnosis.We checked the quality based on the QUADAS criteria,collected data,and developed a meta-analysis to synthesize results.Twenty-four studies of diagnostic tests with moderate to high quality were selected.Results The sensitivity was between 46.9％ and 82.3％; specificity was from 55％ to 92％; positive predictive value had a range of 39.0％-86.0％; and the negative predictive value was 61.0％-89.7％.The meta-analysis has heterogeneity between studies.The global sensitivity value was 0.82 （95％ Cl 0.72-0.90）; specificity was 0.962 （95％ Cl 0.73-0.99）; positive likelihood ratio was 2.39 （95％ Cl 2.10-2.71）; negative likelihood ratio was 0.51 （95％ Cl 0.46-0.86）; diagnostic odds ratio was 4.89 （95％ Cl 3.94-6.06）; and AUC in SROC curve was 0.744 1.Conclusion PCA3 can be used for early diagnosis of PCa and to avoid unnecessary biopsies.

Application of 3-D Sonography in the Diagnosis of Prostatic Diseases.

Transbdominal and transrectal 3-D ultrasonography were carried out simultaneously for 301 cases of prostatic

NOTICE

Transbdominal and transrectal 3-D ultrasonography were carried out simultaneously for 301 cases of prostatic