Yuchun Zhu

Evaluation of Interleukin-8 in Expressed Prostatic Secretion as a Reliable Biomarker of Inflammation in Benign Prostatic Hyperplasia

OBJECTIVES To evaluate the efficacy of interleukin-8 (IL-8) as a possible biomarker for diagnosis and treatment of benign prostatic hyperplasia (BPH) with chronic prostatitis. Histologic inflammation can be demonstrated in most BPH pathologic specimens. To provide objective parameters of inflammation, this prospective study quantified the IL-8 in expressed prostatic secretion (EPS) from BPH patients with or without histologic inflammation. METHODS White blood cell (WBC) count and enzyme-linked immunosorbent assays of the EPS for IL-8 were done in 44 patients who underwent transurethral prostatic resection because of benign prostatic enlargement before the operations. The correlation between IL-8 and WBC count in EPS; prostatic specific antigen; and International Prostate Symptom Score, irritative, and obstructive subscores was determined by Pearson correlation analysis. RESULTS IL-8 was detectable in all patients (the threshold of detection for IL-8 is 5 pg/mL). Twenty-one (47.7%) BPH patients had chronic prostatitis. The mean level of IL-8 in EPS was higher in BPH with chronic prostatitis than in simple BPH (median +/- SE, 8175 +/- 3789 pg/mL vs 2806 +/- 1009 pg/mL). The catheter and age seemed to have no impact on the level of IL-8 in EPS. Statistically significant correlation was only found between IL-8 and WBC count. The sensitivity and specificity of IL-8 in EPS identifying the BPH with chronic prostatitis from the simple BPH were 85.7% and 91.3% respectively, at a cut-point of 3992 pg/mL. CONCLUSIONS IL-8 is significantly elevated in BPH patients with chronic prostatitis. IL-8 in EPS can serve as a reliable biomarker applicable to identifying BPH with chronic prostatitis from simple BPH.

Is there any prognostic impact of intraductal carcinoma of prostate in initial diagnosed aggressively metastatic prostate cancer

Intraductal carcinoma of prostate (IDC‐P) was usually found to be co‐exist with conventional aggressive prostate adenocarcinoma. The presence of IDC‐P was considered as an adverse pathological factor, which was associated with high Gleason score, large prostate volume and accelerated disease progression. However, no any information is available on the presence of IDC‐P diagnosed by needle biopsy in patients with metastatic prostate cancer. We investigated the incidence and prognostic value of intraductal carcinoma of prostate (IDC‐P) in initial diagnosed metastatic prostate cancer.

Multifocal Brain Metastases in Clear Cell Renal Cell Carcinoma with Complete Response to Sunitinib

We report the case of a 70-year-old man who received sunitinib treatment for brain metastatic clear cell renal cell carcinoma. After 6 months of treatment, brain MRI showed complete disappearance of two brain metastases. To the best of our knowledge, this is the first reported case of multifocal brain metastases in renal cell carcinoma with complete response to sunitinib.

A Retrospective Study: Correlation of Histologic Inflammation in Biopsy Specimens of Chinese Men Undergoing Surgery for Benign Prostatic Hyperplasia With Serum Prostate-specific Antigen

PURPOSE To reveal the correlation between benign prostatic hyperplasia (BPH) histologic inflammation and serum prostate-specific antigen (sPSA) concentrations, and the possible mechanism. PATIENTS AND METHODS Patients underwent surgery at the Urology Department of West China Hospital of Sichuan University were retrospectively studied. Preoperative sPSA and transrectal ultrasonography were measured. According to the histopathological classification system for chronic prostatic inflammation proposed by the Chronic Prostatitis Collaborative Research Network (CPCRN) and the International Prostatitis Collaborative Network (IPCN), we classified the histologic sections of prostatic biopsy into glandular, periglandular, and stromal inflammation by the anatomical location of inflammatory infiltration. The glandular inflammation was graded according to the inflammatory aggressiveness. The periglandular and stromal inflammation were graded according to the inflammatory density. The correlation between histologic inflammation and sPSA was studied by a multiple regression model in conjunction with age and total prostatic volume. RESULTS A total of 454 patients with exclusively BPH were analyzed. The periglandular inflammatory infiltration was the most common pattern (95.6%). Single regression analysis revealed that total prostatic volume, the aggressiveness of glandular inflammation, and the intensity of periglandular and stromal inflammation were correlated with sPSA. However, the multiple regression analysis revealed that only the total prostatic volume and the aggressiveness of glandular inflammation were correlated significantly with sPSA (R = .389, 0.289; P = .000). CONCLUSIONS The aggressiveness of glandular inflammatory infiltration in BPH is a significant contributor to elevated sPSA levels. The theory of leakage may be the most reasonable mechanism to reveal the correlation morphologically. We should take inflammation into consideration when interpreting the abnormal elevating of sPSA levels.

Efficacy of maximal androgen blockade versus castration alone in the treatment of advanced prostate cancer: a retrospective clinical experience from a Chinese medical centre.

In this retrospective study, we evaluated and compared the efficacy and toxicities of maximal androgen blockade (MAB) versus castration alone in Chinese patients with advanced prostate cancer. From 1996 to 2004, 608 patients with advanced prostate cancer were included in the study. Patients were retrospectively divided into two groups according to different therapeutic regimens. Of the 608 patients, 300 patients were treated with MAB (castration plus nonsteroidal antiandrogens) and the remaining 308 were treated with castration alone. The 2- and 5-year overall survival rates of these patients were 73.7% and 56%, respectively. Multivariate analysis showed that, in patients with metastatic prostate cancer, MAB was associated with not only the improvement of progression-free survival (PFS) (increased by 10 months) but also a 20.6% reduction in mortality risk compared with castration alone. In contrast, the efficacy of MAB was not superior to castration alone for patients with nonmetastatic prostate cancer. Interestingly, among patients with MAB, those using bicalutamide had a longer PFS than those using flutamide; this was especially so in patients with metastatic prostate cancer. Almost all of the toxicities due to the hormone therapy were mild to moderate and manageable. To conclude, in China, hormone therapies, including MAB and castration alone, have been standard treatments for advanced prostate cancer. For patients with nonmetastatic prostate cancer, castration alone might be adequately practical and efficient. In patients with metastatic prostate cancer, however, MAB has superior efficacy over castration alone. It is clear that MAB should be considered the first-line standard treatment for patients with metastatic prostate cancer.

Antibiotics may not decrease prostate-specific antigen levels or prevent unnecessary prostate biopsy in patients with moderately increased prostate-specific antigen levels: A meta-analysis

OBJECTIVES To evaluate the effect of empiric antibiotics on decreasing prostate-specific antigen (PSA) levels and the possibility of avoiding unnecessary prostate biopsies (PBs). MATERIALS AND METHODS A systematic search of PubMed, Embase, and the Cochrane Library was performed to identify all randomized controlled trials (RCTs) that compared effects of empiric antibiotics with no treatment or placebo on lowering PSA levels and minimizing unnecessary PBs in patients with moderately increased PSA levels. The Cochrane Collaboration Review Manager software (RevMan 5.1.4) was used for statistical analysis. RESULTS The inclusion criteria for the study were met by 6 RCTs (1 placebo controlled and 5 no treatment controlled) involving 656 patients. The synthesized data from these RCTs indicated that there were no significant differences between the antibiotic and control groups in the PSA levels after treatment (mean difference [MD] = 0.15, 95% CI:-0.50 to 0.81, P = 0.65], number of patients with decreased PSA levels after treatment (relative risk [RR] = 1.22, 95% CI: 0.90-1.65, P = 0.20], prostate-specific antigen density levels after treatment (MD =-0.04, 95% CI:-0.15 to 0.07, P = 0.47), f/t% PSA after treatment (MD =-1.47, 95% CI:-4.65 to 1.71, P = 0.37), number of patients with responsive PSA (RR = 1.02, 95% CI: 0.58-1.81, P = 0.94), and individual Pca-positiverate in these patients (RR = 1.07, 95% CI: 0.53-2.16, P = 0.86), and Pca-positiverates (RR = 0.85, 95% CI: 0.48-1.50, P = 0.57). However, the antibiotic group had a significant change in the net PSA decrease after treatment compared with the control group (MD = 1.44, 95% CI: 0.70-2.17, P = 0.0001). CONCLUSION The use of empiric antibiotics may not significantly decrease PSA levels or avoid unnecessary PBs.

Circumcision with "no-flip Shang Ring" and "Dorsal Slit" methods for adult males: a single-centered, prospective, clinical study

This paper was aimed to compare the clinical effectiveness and safety of adult male circumcision using the Shang Ring™ (SR) with the no-flip technique compared with Dorsal Slit (DS) surgical method. A single-centered, prospective study was conducted at the West China Hospital, where patients were circumcised using the no-flip SR (n = 408) or the DS (n = 94) procedure. The adverse events (AEs) and satisfaction were recorded for both groups, and ring-removal time and percentage of delayed removals were recorded for the SR group. Finally, complete follow-up data were collected for 76.1% of patients (SR: n = 306; DS: n = 76). The average ring-removal time for the SR group was 17.62 ± 6.30 days. The operation time (P < 0.001), pain scores during the procedure (P < 0.001) and at 24 h postoperatively (P < 0.001), bleeding (P = 0.001), infection (P = 0.034), and satisfaction with penile appearance (P < 0.001) in the SR group were superior to those in the DS group. After two postoperative weeks, the percentage of patients with edema in the SR group (P = 0.029) was higher but no differences were found at 4 weeks (P = 0.185) between the two groups. In conclusions, the no-flip SR method was found to be superior to the DS method for its short operation time (<5 min), involving less pain, bleeding, infection, and resulting in a satisfactory appearance. However, the time for recovery from edema took longer, and patients may wear device for 2-3 weeks after the procedure.

Intra-abdominal pulmonary sequestration: a case report and literature review.

Pulmonary sequestration is a rare congenital malformation mostly located in the thorax, while intra-abdominal pulmonary sequestration is an extremely rare type of pulmonary sequestration usually diagnosed during the first 6 months of life. Only 1 case of intra-abdominal pulmonary sequestration in a patient older than 60 years has been reported in the current literature. It is difficult to differentiate an intra-abdominal pulmonary sequestration from other retroperitoneal tumors. A definitive diagnosis is always made by histologi- cal examination. Intra-abdominal pulmonary sequestration commonly responds well to surgical resection and is associated with excellent results and prognosis. The authors present the case of a 74-year-old asymptomatic man with a retroperitoneal mass which was completely excised and revealed by histopathological study to be an intra-abdominal pulmonary sequestration.

Vesical Paragonimiasis Diagnosed by Histopathology: A Case Report

Vesical paragonimiasis is an extremely rare form of ectopic infestation caused by Paragonimus spp. We reported a case of vesical paragonimiasis associated with urinary symptoms but without history of respiratory symptoms or cercarial dermatitis. The diagnosis was made by histopathological examination of the surgical specimens of the vesical masses. Identification of the species by morphometric analysis of the fluke body sections indicated that the vesical lesion was caused by Paragonimus. Postsurgical medication with the antiparasitic drug praziquantel was applied regularly, and the patient experienced a stable recovery.

Paraneoplastic Cerebellar Degeneration Associated with Pelvic Liposarcoma: A Rare Case Report

Paraneoplastic cerebellar degeneration (PCD) is one of the most common paraneoplastic neurological syndromes characterized by the rapid development of severe cerebellar ataxia. In this report, a 23-year-old female with noticeable dizziness and gait instability was described. The enhanced CT scanning suggested the presence of a pelvic tumor. Then, PCD was established. Postoperative pathological result defined it as a liposarcoma (LS) with dedifferentiation. Interestingly, clinical symptoms disappeared after the surgical removal of the pelvic tumor. To our knowledge, this was the first case report with PCD due to LS.