Jin Sato

Diagnostic Significance of Prostate Specific Antigen and the Development of Mass Screening System for Prostate Cancer

PURPOSE The significance of prostate specific antigen (PSA) in the mass screening for prostate cancer was investigated. MATERIALS AND METHODS A total of 4,375 PSA, digital rectal and transrectal ultrasonographic examinations was performed on 3,526 subjects. RESULTS Among the 3 modalities, PSA had the highest sensitivity (80.4%) and positive predictive value (45.1%). We established age-specific reference PSA ranges for normal Japanese men, and demonstrated the significance of PSA density and PSA velocity. CONCLUSIONS The significance of PSA as a prostate cancer screening modality should be evaluated across multiple age ranges and in combination with previous PSA data and/or prostate volume.

EPIDEMIOLOGICAL CHARACTERISTICS OF PROSTATE CANCER IN GUNMA PREFECTURE, JAPAN

Background Prostate cancer is rare in Asia, but the number of patients is increasing in Japan. We conducted an epidemiological study of prostate cancer in Gunma Prefecture, Japan, to investigate the trends and characteristics of the disease.

The Significance of Erythrocyte Sedimentation Rate as a Prognostic Factor for Patients with Prostate Cancer: Gunma Urological Oncology Study Group Investigation

The Gunma Urological Oncology Study Group has performed a multivariate statistical analysis of prognostic factors based on 353 patients with prostate cancer diagnosed between 1974 and 1984. This paper discusses the prognostic significance of erythrocyte sedimentation rate (ESR) in these patients with prostate cancer. Based on three ranges (<20, >20‐ <50, >50 mm/h) of ESR, a significant difference of survival rates among the patients was found by means of univariate analysis. ESR apparently includes components which represent anemia or infection. Hemoglobin, frequently used as a prognostic factor, was compared with ESR by means of multivariate analysis, and ESR was found to be a more useful prognostic factor than hemoglobin. Moreover ESR showed the highest partial coefficient value among the items studied (clinical stage, pathological differentiation, age, acid phosphatase, gait disturbance). It seems that ESR includes not only anemia and infection components but also provides a clue to the degree of bone metastasis or the degree of prostate cancer progression.

Analysis of Multiple Primary Cancers in Patients with Urologic Cancer

BackgroundThe study of the clinical features of multiple primary cancers (MPC) may provide insight into the pathogenesis of specific cancers, as well as the issue of treatment-related induction of second tumors.MethodsBetween 1972 and 1995, 94 of 765 patients with urologic cancer treated at our hospital had MPC. We retrospectively analyzed the clinical features of these patients, and compared them with those of the 671 patients with single primary cancers (SPC).ResultsThe frequency of MPC among all 765 patients was 12.3%. The average age at diagnosis of urologic cancer in the male patients was significantly higher in the MPC group than in the SPC group. In the MPC group, the organs most commonly involved were the bladder and prostate (urologic cancers), and the stomach and lung (nonurologic cancers). Adenocarcinoma was the most common tumor in the MPC group. The interval between the first and second cancer diagnoses was significantly longer in female patients with MPC than in male patients. No significant difference between the MPC and SPC groups was observed in the distribution of ABO blood groups or in the frequency of history of tobacco or alcohol use. Four MPC patients had second cancers considered to have been induced by the treatment for the first cancer. The prognoses were significantly poorer for the patients with MPC. The rate of death due to urologic cancer was much lower in the patients with MPC than in those with SPC.ConclusionsWe found that more than 10% of the 765 patients with urologic cancer whose cases we reviewed had another primary cancer. Because the number of cases of MPC is increasing, it is important to be aware of the possibility of the development of MPC and to therefore carefully follow up cancer patients.