[Prostate cancer: Diagnosis and staging]

Ultrasound-guided prostate biopsy: indication, morbidity and outcome at Hopital General Idrissa Pouye

Background

Magnetic resonance imaging (MRI)-guided prostate biopsy has a higher sensitivity than the ultrasound-guided biopsy, but its realization requires a dedicated interventional MRI, specific material, which is not available in our context; hence, ultrasound-guided biopsy remains of great interest. Currently, ultrasound-guided biopsy outside of a clinical trial is the gold standard for the diagnosis of prostate cancer. The objective of our work is to evaluate our practice of transrectal ultrasound-guided prostate biopsy using an endorectal probe by describing the technique and evaluating the morbidity and results.

Methods

This is a descriptive study of ultrasound-guided prostatic biopsies performed over a 2-year period. The parameters studied were frequency of the procedure, age, rectal examination findings, total PSA level, prostate biopsy morbidities and results. Descriptive statistics were performed, and comparison of qualitative variables was made by the Chi-square test with statistical significance set for α < 5%

Results

Two hundred and thirty-one patients were included over a two-year period. The mean age of our patients was 65 ± 8.2 years. Rectal examination finding was suspicious in 36.9% and the median total PSA was 19.8 ng/ml (0.1-5936 ng/ml). Seventy-seven percent of patients reported their pathology results. Prostatic adenocarcinoma was the most common finding accounting for 53.7% of results. Complications were observed in 16 patients (6.9%) with a predominance of initial hematuria, voiding pain and fever.

Conclusion

In our series, the cancer detection rate was significant and the complications rate was acceptable at 6.9%.

Potential Cross-Talk between Alternative and Classical NF-κB Pathways in Prostate Cancer Tissues as Measured by a Multi-Staining Immunofluorescence Co-Localization Assay

Background

While the classical NF-κB/p65 pathway is known to be involved in prostate cancer progression and is associated with poor patient outcome, the role of the NF-κB /RelB alternative protein is not well defined. Here we analyzed the activation of both NF-κB pathways in prostate cancer tissues and correlate this activation with clinical features of the disease.

Methods

A multiple immunofluorescence technique was employed to concomitantly and quantitatively visualize the nuclear localization of p65 and RelB in 200 paraffin embedded samples. Epithelia were defined using appropriate fluorochrome markers and the resulting immunofluorescent signals were quantified with an automated scoring system.

Results

The nuclear frequency of p65 was found to be significantly increased in tumor tissues as compared with normal adjacent tissue, whereas the frequency for RelB was decreased (p < 0.001, Wilcoxon test). As previously reported, p65 nuclear frequency was associated with a risk of biochemical recurrence. Although, RelB nuclear frequency alone did not predict recurrence, the presence of activated RelB reduced the risk of recurrence associated with the activation of p65.

Conclusion

For the first time p65/RelB co-distribution was assessed in prostate cancer tissues and suggested a negative crosstalk between the two NF-κB pathways in prostate cancer progression.

Bombesin functionalized gold nanoparticles show in vitro and in vivo cancer receptor specificity

Development of cancer receptor-specific gold nanoparticles will allow efficient targeting/optimum retention of engineered gold nanoparticles within tumors and thus provide synergistic advantages in oncology as it relates to molecular imaging and therapy. Bombesin (BBN) peptides have demonstrated high affinity toward gastrin-releasing peptide (GRP) receptors in vivo that are overexpressed in prostate, breast, and small-cell lung carcinoma. We have synthesized a library of GRP receptor-avid nanoplatforms by conjugating gold nanoparticles (AuNPs) with BBN peptides. Cellular interactions and binding affinities (IC(50)) of AuNP-BBN conjugates toward GRP receptors on human prostate cancer cells have been investigated in detail. In vivo studies using AuNP-BBN and its radiolabeled surrogate (198)AuNP-BBN, exhibiting high binding affinity (IC(50) in microgram ranges), provide unequivocal evidence that AuNP-BBN constructs are GRP-receptor-specific showing accumulation with high selectivity in GRP-receptor-rich pancreatic acne in normal mice and also in tumors in prostate-tumor-bearing, severe combined immunodeficient mice. The i.p. mode of delivery has been found to be efficient as AuNP-BBN conjugates showed reduced RES organ uptake with concomitant increase in uptake at tumor targets. The selective uptake of this new generation of GRP-receptor-specific AuNP-BBN peptide analogs has demonstrated realistic clinical potential in molecular imaging via x-ray computed tomography techniques as the contrast numbers in prostate tumor sites are severalfold higher as compared to the pretreatment group (Hounsfield unit = 150).

Inhibitory effect of matrine on the expression of PSA and AR in prostate cancer cell line LNCaP

In order to investigate the inhibitory effect of matrine on the expression of prostate specific antigen (PSA) and androgen receptor (AR) in prostate cancer cell line LNCaP in vitro, LNCaP cells were treated with matrine at different concentrations (0.5, 1.0, 1.5, 2.0 g/L) for 12-36 h. The growth activities of cancer cells were determined by MTT colorimetric assay. The AR level was measured by Western blotting. The expression of PSA was detected by using AXSYM system-chemical luciferase methods. The results showed that matrine could effectively inhibit the growth of androgen-dependent prostate cancer cell line LNCaP in vitro in a time- and dose-dependent manner (P<0.05). It could obviously decrease the level of AR (P<0.01) and inhibit the expression of PSA in a dose-dependent manner (P<0.05) in LNCaP cells. It was concluded that matrine could significantly suppress the growth of LNCaP cells and inhibit the expression of PSA and AR of prostate cancer cells.

[Epidemiology and histopronostic of prostatic cancer in Togo: about 202 cases diagnosed at the laboratory of pathology of the Tokoin teaching hospital of Lome]

OBJECTIVES

Describe the epidemiological and histological aspects of the prostate cancer in Togo.

METHODS

It was a retrospective descriptive study relating to 202 cases diagnosed between 1984 and 2003 at the Laboratory of Pathology of the Tokoin teaching hospital of Lome. The parameters studied were: frequency, age, circumstances of discovery, PSA value and histological type.

RESULTS

The frequency of prostate cancer was 10 cases on average. The average age of patients was 70 years (45 to 95 years). The circumstances of discovery were dominated by voiding disorders and the average PSA was 88.5 ng/ml (7.8 to 560.4). Histologically, it was adenocarcinoma in 97.5% of cases and squamous cell carcinoma in 1.9% of cases.

CONCLUSION

The prostate cancer although uncommon in Togo remains a public health problem because of the weak accessibility of the population to the diagnosis. So, a national program of screening is needed.

Presence of prostate cancer metastasis correlates with lower lymph node reactivity

BACKGROUND

Several reports suggest that the dissemination of neoplastic cells and cancer progression are associated with the generation of an immunosuppressive environment.

METHODS

In this report, we investigated immunological effects of prostate cancer by comparing metastastic and non-metastatic pelvic lymph nodes (LNs) from 25 patients with carcinomatous involvement of LNs to the non-metastatic LNs from 26 control patients with no metastatic involvement by immunohistochemistry and histological analyses.

RESULTS

Our results showed a decreased abundance of CD20+ B lymphocytes (P = 0.031), CD38+ activated lymphocytes (P = 0.038), and CD68+ macrophages (P < 0.001), and less evidence of follicular hyperplasia (P = 0.014), sinus hyperplasia (P < 0.001), and fibrosis (P=0.028) in metastatic LNs comparatively to control LNs. Finally, we observed that metastatic LNs were significantly smaller than control LNs (P = 0.005).

CONCLUSIONS

Our results suggest that the development of prostate cancer LN metastasis is accompanied with smaller LN size and decreased LN reactivity suggesting the development of an immununosuppressive microenvironment.

[Localized prostate cancer. What to say to the patient?]

The first medical consultation with the urologist is the occasion to explain to the patient the importance of the initial PSA value, the periodic PSA measurements and the need of prostate biopsy for definitive confirmation. The next consults will focus on basic facts concerning the cancer of the prostate in general and the tumor of the patient in particular, and to present to the patient in a clear and objective way the main advantages and drawbacks of the various therapeutic options. These medical consults are key elements for the quality of physician-patient relationships, as each of them will be an opportunity to provide the best possible information to a patient which is often anxious.

Efficacy of 1-day prophylaxis medication with fluoroquinolone for prostate biopsy

A prospective, randomized trial in which 236 patients received oral levofloxacin, either at 600 mg/day for 1 day (n = 124) or 300 mg/day for 3 days (n = 112). Urinalysis, plasma white blood cell count (WBC) (per mm3), and C reactive protein (CRP) (mg/dl) levels were checked before prostate biopsy (PBX), on the day after PBX, and on the seventh day after PBX. Two patients (1.61%) who received 600 mg for 1 day and 2 patients (1.79%) who received 300 mg for 3 days had febrile infectious complications. There was no statistically significant difference between levofloxacin at 600 mg for 1 day and levofloxacin at 300 mg for 3 days regarding the elevation of WBC and CRP. We can perform PBX safely with levofloxacin at 600 mg for 1 day as prophylaxis and recommend this method from the point of view of the decrease of antibiotic-resistant strains.