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Xu S, Guo T, Zhang J, Zhang J, Zhang Z, Huang Y, Hu C, Zhang H, Song Z, Wang C, Ouyang J. Exophytic benign prostatic hyperplasia presenting as a polycystic pelvic mass. Urol Case Rep 2023; 51:102582. [PMID: 37869527 PMCID: PMC10587704 DOI: 10.1016/j.eucr.2023.102582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 10/12/2023] [Indexed: 10/24/2023] Open
Abstract
We report a case of an exophytic benign prostatic hyperplasia presenting as a polycystic pelvic mass. A 69-year-old man presented with an incidental finding of a pelvic mass of over 18 years. Digital rectal examination revealed a mass on the right anterior rectal wall 8 cm from the anal opening. His current prostate-specific antigen was 3.187 ng/mL. Enhanced computed tomography and magnetic resonance imaging demonstrated an occupancy in the right pelvis. A laparoscopic resection of the pelvic tumor was performed and pathologists identified it as an exophytic benign prostatic hyperplasia nodule. No significant recurrence was found at the 6-month follow-up.
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Affiliation(s)
| | | | - Jianglei Zhang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Jun Zhang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Zhiyu Zhang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Yuhua Huang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Can Hu
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Haoyang Zhang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Zhen Song
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Chao Wang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Jun Ouyang
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
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2
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Wahlstedt E, Zhou C, Strup S, Kyung Kim J, Strup SE, Yenwong L, Allison DB, Hensley PJ. Locally advanced solitary fibrous tumour of the prostate. BMJ Case Rep 2023; 16:e257666. [PMID: 37848277 PMCID: PMC10583110 DOI: 10.1136/bcr-2023-257666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023] Open
Abstract
Solitary fibrous tumours (SFTs) are rare mesenchymal neoplasms composed of spindle cells, most often occurring in the pleura. SFTs arising from the prostate are exceptionally rare, with only around 40 cases reported in literature to date. We report a man in his 60s who was referred to our clinic for elevated prostate-specific antigen and presented with mild obstructive lower urinary tract and defecatory symptoms. Prostate needle-core biopsy revealed neoplastic spindle cells that strongly expressed CD34. Cross-sectional imaging demonstrated a 12βcm locally advanced heterogeneous prostate mass with intravesical extension and mass effect on the anterior rectum. Radical cystoprostatectomy with orthotopic neobladder reconstruction was performed, and the diagnosis of primary prostatic SFT was made based on histological characteristics and immunophenotyping. We present diagnostic, clinical management and prognostic considerations in patients with primary prostatic SFT.
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Affiliation(s)
- Eric Wahlstedt
- Department of Urology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Christopher Zhou
- School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Sydney Strup
- Department of Urology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Joon Kyung Kim
- Department of Pathology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Stephen E Strup
- Department of Urology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Leonard Yenwong
- Department of Pathology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Derek B Allison
- Department of Urology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
- Department of Pathology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
| | - Patrick J Hensley
- Department of Urology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
- Department of Pathology, University of Kentucky College of Medicine, Lexington, Kentucky, USA
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3
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Mougola Bissiengou P, Montcho Comlan JG, Atsame Ebang G, Sylla Niang M, Djoba Siawaya JF. Prostate malignant tumor and benign prostatic hyperplasia microenvironments in black African men: Limited infiltration of CD8+ T lymphocytes, NK-cells, and high frequency of CD73+ stromal cells. Cancer Rep (Hoboken) 2023; 6 Suppl 1:e1817. [PMID: 37092584 PMCID: PMC10440842 DOI: 10.1002/cnr2.1817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 03/17/2023] [Accepted: 03/27/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Anti-cancerous immunology has yet to be investigated in the African black population, despite being the dawn of precision medicine. AIM Here we investigated the tumor microenvironment of prostate cancer and benign prostatic hyperplasia (BPH) in black Africans. METHODS Through immunohistochemistry analysis of prostate cancer and BPH patients' biopsies, we investigated the expression and distribution of CD73, CCD8 T-lymphocytes, and natural killer cells. In addition, we looked at tumor-infiltrating features CD8 T-lymphocytes and natural killer cells. RESULTS We show for the first time in black Africans a high expression of CD73 in epithelial-stromal cells and virtually no infiltration of CD8 T lymphocytes and natural killer cells in the tumoral area. In addition, CD73 was seven (7) times more likely to be expressed in prostate cancer stromal tissues than in benign prostatic hyperplasia tissues (odds ratioβ=β7.2; Ο2 β=β21; pβ<β.0001). In addition, PSA concentration was significantly higher in prostate cancer patients than in BPH patients (pβ<β.001). Also, the PSA-based ROC. analysis showed an area under the curve of 0.87 (pβ<β.0001). CONCLUSION CD73 expression is more likely expressed in prostate cancer stromal tissues than in benign prostatic hyperplasia tissues. The features of prostate cancer in Black Africans suggest CD73 expression as a possible target for immunotherapy in this population.
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Affiliation(s)
- PΓ©lagie Mougola Bissiengou
- Service d'Immunologie, DΓ©partement des Sciences Fondamentales, FacultΓ© de MΓ©decineUniversitΓ© des Sciences de la SantΓ©LibrevilleGabon
- Service d'Immunologie, DΓ©partement des Sciences Biologiques et Pharmaceutiques AppliquΓ©es, FacultΓ© de MΓ©decine, de Pharmacie et d'OdontostomatologieUniversitΓ© Cheikh Anta DiopDakarSenegal
| | - JΓ©rΓ΄me Gaston Montcho Comlan
- Service d'Immunologie, DΓ©partement des Sciences Biologiques et Pharmaceutiques AppliquΓ©es, FacultΓ© de MΓ©decine, de Pharmacie et d'OdontostomatologieUniversitΓ© Cheikh Anta DiopDakarSenegal
| | - Gabrielle Atsame Ebang
- UnitΓ© d'anatomieβCytologieβPathologieCentre Hospitalier Universitaire de LibrevilleLibrevilleGabon
| | - Maguette Sylla Niang
- Service d'Immunologie, DΓ©partement des Sciences Biologiques et Pharmaceutiques AppliquΓ©es, FacultΓ© de MΓ©decine, de Pharmacie et d'OdontostomatologieUniversitΓ© Cheikh Anta DiopDakarSenegal
| | - Joel Fleury Djoba Siawaya
- Service LaboratoireCentre Hospitalier Universitaire MΓ¨reβEnfant Fondation Jeanne EBORILibrevilleGabon
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4
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Nepal A, Sharma P, Bhattarai S, Mahajan Z, Sharma A, Sapkota A, Sharma A. Extremely Elevated Prostate-Specific Antigen in Acute Prostatitis: A Case Report. Cureus 2023; 15:e43730. [PMID: 37727194 PMCID: PMC10505831 DOI: 10.7759/cureus.43730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 09/21/2023] Open
Abstract
Elevated prostate-specific antigenΒ (PSA) levels are mostly suggestive of prostate cancer, but they are elevated in non-cancerous prostatic conditions as well. However, extreme levels of PSA as reported here have not been observed in cases other than prostatic cancer so far. Our patient had a significantly elevated PSA of 1,398 ng/mL in acute prostatitis.Β The purpose of this case report is to review the patient's atypical and rare presentation of extremely high PSA in acute prostatitis in the background of benign prostatic hyperplasia (BPH) and chronic prostatitis.
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Affiliation(s)
- Anamika Nepal
- Internal Medicine, Shankarapur Hospital, Kathmandu, NPL
| | - Prabhat Sharma
- Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, USA
| | | | | | - Akhya Sharma
- Neurosciences, Tata Main Hospital, Jamshedpur, IND
- Medicine, Kasturba Medical College, Manipal, IND
- Internal Medicine, MacNeal Hospital, Berwyn, USA
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5
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Gaudiano C, Renzetti B, De Fino C, Corcioni B, Ciccarese F, Bianchi L, Schiavina R, Droghetti M, Giunchi F, Brunocilla E, Fiorentino M. Multiparametric magnetic resonance imaging for the differential diagnosis between granulomatous prostatitis and prostate cancer: a literature review to an intriguing diagnostic challenge. Front Oncol 2023; 13:1178430. [PMID: 37342186 PMCID: PMC10277616 DOI: 10.3389/fonc.2023.1178430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/22/2023] [Indexed: 06/22/2023] Open
Abstract
Multiparametric magnetic resonance imaging (mpMRI) is currently the most effective diagnostic tool for detecting prostate cancer (PCa) and evaluating adenocarcinoma-mimicking lesions of the prostate gland, among which granulomatous prostatitis (GP) represents the most interesting diagnostic challenge. GP consists of a heterogeneous group of chronic inflammatory lesions that can be differentiated into four types: idiopathic, infective, iatrogenic, and associated with systemic granulomatous disease. The incidence of GP is growing due to the increase in endourological surgical interventions and the adoption of intravesical instillation of Bacillus Calmette-Guerin in patients with non-muscle invasive bladder cancer; therefore, the difficulty lies in identifying specific features of GP on mpMRI to avoid the use of transrectal prostate biopsy as much as possible.
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Affiliation(s)
- Caterina Gaudiano
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Benedetta Renzetti
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Cristina De Fino
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Beniamino Corcioni
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Federica Ciccarese
- Department of Radiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Lorenzo Bianchi
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Riccardo Schiavina
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Matteo Droghetti
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Francesca Giunchi
- Department of Pathology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Eugenio Brunocilla
- Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
- Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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6
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Lee ZR, Lai YK, M L, Khor LY, Tay KJ, Law YM. Focal IgG4-related periprostatic "PI-RADS 5" pseudotumor mimicking prostatic adenocarcinoma. Radiol Case Rep 2023; 18:2158-2164. [PMID: 37089972 PMCID: PMC10120361 DOI: 10.1016/j.radcr.2023.02.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 02/23/2023] [Accepted: 02/26/2023] [Indexed: 04/25/2023] Open
Abstract
Immunoglobulin G4-related disease (IgG4-RD) is a systemic fibroinflammatory disease characterized by raised serum IgG4 levels and tumefactive inflammation affecting multiple organ systems, typically involving the pancreas and biliary tree. Though rare, prostatic involvement has been reported in a few cases and is suspected to be an underreported entity. Our patient is a 63-year-old gentleman who has presented with an incidental "PI-RADS 5" (Prostate Imaging Reporting & Data System) prostate lesion and perivascular soft tissue cuffing of the superior rectal vessels on MRI rectum performed for surveillance of rectal neuroendocrine tumor. He had a history of lacrimal gland IgG4-RD. The lentiform prostate lesion subtly indents the prostate capsule, reminiscent of a periprostatic rather than an intraprostatic lesion. Perivascular cuffing of superior rectal vessels suggest inflammatory vasculitis of IgG4-RD. Differential diagnosis of periprostatic inflammatory IgG4-RD was considered, subsequently proven on MRI-ultrasound fusion targeted biopsy. Reported radiological findings of prostate IgG4-RD typically show diffuse chronic inflammation of the prostate, with a minority of the reports describing focal involvement, often mimicking focal prostate adenocarcinoma. Focal periprostatic involvement of IgG4-RD is an unusual manifestation which should be considered in patients with IgG4-RD who present with a periprostatic pseudotumor. IgG4-RD of the prostate usually responds well to steroid treatment without the need for surgery.
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Affiliation(s)
- Zhuyi Rebekah Lee
- Singapore General Hospital Department of Diagnostic Radiology, 31 Third Hospital Ave, Singapore 168753, Singapore
- Corresponding author.
| | - Yusheng Keefe Lai
- Singapore General Hospital Department of Diagnostic Radiology, 31 Third Hospital Ave, Singapore 168753, Singapore
| | - Logaswari M
- Singapore General Hospital Department of Anatomical Pathology, 20 College Rd, Academia, Singapore 169856, Singapore
| | - Li Yan Khor
- Singapore General Hospital Department of Anatomical Pathology, 20 College Rd, Academia, Singapore 169856, Singapore
| | - Kae Jack Tay
- Singapore General Hospital Department of Urology, 31 Third Hospital Ave, Singapore 168753, Singapore
| | - Yan Mee Law
- Singapore General Hospital Department of Diagnostic Radiology, 31 Third Hospital Ave, Singapore 168753, Singapore
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7
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Dev ID, Puranik AD, Sahay A, Purandare NC, Agrawal A, Shah S, Rangarajan V. Primary Neuroendocrine Tumor of Prostate in a Case of Metastatic Adenocarcinoma of Lung: Rare Entity with Histopathological and Gallium 68 DOTANOC Positron Emission Tomography Correlation. Indian J Nucl Med 2023; 38:154-156. [PMID: 37456183 PMCID: PMC10348502 DOI: 10.4103/ijnm.ijnm_193_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/07/2022] [Accepted: 12/24/2022] [Indexed: 07/18/2023] Open
Abstract
Neuroendocrine tumor (NET) of the prostate is an extremely rare entity which represents <1% of the prostatic cancers, but with increasing incidence. Its spectrum encompasses several histological variants ranging from well-differentiated tumor which are often indolent in nature; to aggressive neuroendocrine carcinoma which portends aggressive management. Hence, such rare entities are to be characterized and treated accordingly. We report an unusual case of well-differentiated NET of prostate which was flagged on fluorodeoxyglucose positron emission tomography computed tomography (PET/CT) performed for other indication and confirmed on Gallium-68 DOTANOC PET/CT. Histopathology and immunohistochemistry confirmed the findings subsequently.
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Affiliation(s)
- Indraja D. Dev
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Ameya D. Puranik
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Ayushi Sahay
- Department of Pathology, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Nilendu C. Purandare
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Archi Agrawal
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Sneha Shah
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Venkatesh Rangarajan
- Department of Nuclear Medicine and Molecular Imaging, Tata Memorial Center, Homi Bhabha National Institute, Mumbai, Maharashtra, India
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8
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Muacevic A, Adler JR. Prostate Tuberculosis Masquerading as Prostate Carcinoma: A Rare Case Report. Cureus 2022; 14:e30978. [PMID: 36465223 PMCID: PMC9711908 DOI: 10.7759/cureus.30978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2022] [Indexed: 01/25/2023] Open
Abstract
Genitourinary tuberculosis (GUTB), the second most frequent type of extrapulmonary tuberculosis (TB) in endemic regions, was initially described by Wildbolz in 1973. The prostate and epididymis are the first sites of male genital tuberculosis, followed by the seminal vesicles and the testicles. Here, we describe a case of a 65-year-old male who presented with obstructive lower urinary tract symptoms (LUTS) for the previous six weeks. The digital rectal examination revealed prostatic enlargement with a firm and nodular surface. A high prostate-specific antigen level (88 ng/ml) was found in serum analysis. There was a suspicion of prostate cancer on the basis of clinical, radiological, and serological examination. In view of the suspicion of carcinoma, a prostate biopsy was performed, which revealed the proliferation of prostatic glandular and stromal elements with interspersed granulomas, necrosis, and aggregates of mature lymphoid cells. The histopathology findings were indicative of benign prostatic hyperplasia with granulomatous prostatitis. Ziehl-Neelsen (ZN) stain was negative for acid-fast bacilli. The cartridge-based nucleic acid amplification test (CBNAAT) for Mycobacterium tuberculosis was ordered on theΒ prostate biopsy tissue bits, which showed positive results. On the basis of histopathology and nucleic acid amplification test, the diagnosis of prostate tuberculosis was considered. There are no specific clinical and radiological findings related to prostate tuberculosis; hence, the diagnosis canΒ be established only after histopathological examination and tissue-based cartridge-based nucleic acid amplification test. Clinicians should have a high index of suspicion for tuberculosis, especially in patients from endemic countries who present with symptoms of the lower urinary tract, especially if there is granulomatous inflammation coupled with necrosis.
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9
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A comprehensive prostate biopsy standardization system according to quantitative multiparametric MRI and PSA value: P.R.O.S.T score. World J Urol 2022; 40:2245-2253. [DOI: 10.1007/s00345-022-04102-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/08/2022] [Indexed: 10/17/2022] Open
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10
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Sasidharan S, KP S, Bhaumik A, Kanti Das S, Nair J H. Administration of Caesalpinia bonduc Seed Extracts Ameliorates Testosterone-Induced Benign Prostatic Hyperplasia (BPH) in Male Wistar Rats. Res Rep Urol 2022; 14:225-239. [PMID: 35651598 PMCID: PMC9150786 DOI: 10.2147/rru.s365598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 05/07/2022] [Indexed: 12/17/2022] Open
Abstract
Introduction Benign prostatic hyperplasia (BPH) is a major chronic disease affecting men, and the therapeutic agents currently used to manage it have significant side effects. As a result, an alternative medicine with improved therapeutic properties with no side effects is desperately needed. The current investigation aims to study whether the Caesalpinia bonduc seed extracts (ethanolic-A, hydroalcoholic-B, and aqueous-C) have inhibitory potential on testosterone propionate (TP)-induced BPH in Wistar rats. Methods Wistar rats (male) were randomly allocated to one of five groups: control, BPH (TP-3 mg/kg, subcutaneously daily), low dose (TP + C. bonduc seed extracts β 200 mg/kg body weight), high dose (TP + C. bonduc seed extracts β 400 mg/kg body weight), and standard drug (TP + finasteride β 10 mg/kg body weight). At the end of drug treatment, the rats were sacrificed and their serum and prostates were taken for biochemical and histological studies. Results C. bonduc seed extracts treatment significantly decreased prostate weight and prostatic index in rats with TP-induced BPH. The seed extracts exhibited a potent inhibitory effect on dihydrotestosterone (DHT) in serum and prostate. In addition, the PSA level in the serum showed a noteworthy decrease in comparison with the BPH group. Histopathological examination also indicated that extracts improved the tissue morphology of the prostate significantly. Out of three extracts tested, ethanolic and hydroalcoholic extract recorded significant effect. Finally, liquid chromatography quadrupole time-of-flight mass spectrometry (LC/MS-QTOF) analysis showed that the major compounds present in the extracts were tocopherols, fucosterol, linoleic acid, Ξ²-amyrin, Ξ²-sitosterol, campesterol, cassane furanoditerpene, norcassane furanoditerpene and other diterpenes. Conclusion Thus, C. bonduc seed extracts could be a potential source for the formulation of new drug for managing BPH. To the best of our knowledge, this is the first scientific animal investigation into the use of C. bonduc seed extract for the management of BPH.
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Affiliation(s)
- Shan Sasidharan
- Department of Pharmacy, Lincoln University College, Petaling Jaya, Malaysia
- Small Animal Research Centre, Department of Toxicology and Pharmacology, CARe KERALA, Thrissur, Kerala, India
- Correspondence: Shan Sasidharan, Department of Pharmacy Lincoln University College, Petaling Jaya, Malaysia, Email
| | - Srinivasakumar KP
- Department of Pharmacy, Lincoln University College, Petaling Jaya, Malaysia
| | - Amiya Bhaumik
- Department of Pharmacy, Lincoln University College, Petaling Jaya, Malaysia
| | - Sreemoy Kanti Das
- Department of Pharmacy, Lincoln University College, Petaling Jaya, Malaysia
| | - Hareebndran Nair J
- Department of R&D, Pankajakasthuri Herbal Research Foundation, Thiruvananthapuram, Kerala, India
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Mehralivand S, Yang D, Harmon SA, Xu D, Xu Z, Roth H, Masoudi S, Kesani D, Lay N, Merino MJ, Wood BJ, Pinto PA, Choyke PL, Turkbey B. Deep learning-based artificial intelligence for prostate cancer detection at biparametric MRI. Abdom Radiol (NY) 2022; 47:1425-1434. [PMID: 35099572 PMCID: PMC10506420 DOI: 10.1007/s00261-022-03419-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 01/09/2022] [Accepted: 01/10/2022] [Indexed: 11/01/2022]
Abstract
PURPOSE To present fully automated DL-based prostate cancer detection system for prostate MRI. METHODS MRI scans from two institutions, were used for algorithm training, validation, testing. MRI-visible lesions were contoured by an experienced radiologist. All lesions were biopsied using MRI-TRUS-guidance. Lesions masks, histopathological results were used as ground truth labels to train UNet, AH-Net architectures for prostate cancer lesion detection, segmentation. Algorithm was trained to detect any prostate cancerββ₯βISUP1. Detection sensitivity, positive predictive values, mean number of false positive lesions per patient were used as performance metrics. RESULTS 525 patients were included for training, validation, testing of the algorithm. Dataset was split into training (nβ=β368, 70%), validation (nβ=β79, 15%), test (nβ=β78, 15%) cohorts. Dice coefficients in training, validation sets were 0.403, 0.307, respectively, for AHNet model compared to 0.372, 0.287, respectively, for UNet model. In validation set, detection sensitivity was 70.9%, PPV was 35.5%, mean number of false positive lesions/patient was 1.41 (range 0-6) for UNet model compared to 74.4% detection sensitivity, 47.8% PPV, mean number of false positive lesions/patient was 0.87 (range 0-5) for AHNet model. In test set, detection sensitivity for UNet was 72.8% compared to 63.0% for AHNet, mean number of false positive lesions/patient was 1.90 (range 0-7), 1.40 (range 0-6) in UNet, AHNet models, respectively. CONCLUSION We developed a DL-based AI approach which predicts prostate cancer lesions at biparametric MRI with reasonable performance metrics. While false positive lesion calls remain as a challenge of AI-assisted detection algorithms, this system can be utilized as an adjunct tool by radiologists.
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Affiliation(s)
| | - Dong Yang
- NVIDIA Corporation, Santa Clara, CA, USA
| | | | - Daguang Xu
- NVIDIA Corporation, Santa Clara, CA, USA
| | - Ziyue Xu
- NVIDIA Corporation, Santa Clara, CA, USA
| | | | | | - Deepak Kesani
- Molecular Imaging Branch, NCI, NIH, Bethesda, MD, USA
| | - Nathan Lay
- Molecular Imaging Branch, NCI, NIH, Bethesda, MD, USA
| | | | - Bradford J Wood
- Center for Interventional Oncology, NCI, NIH, Bethesda, MD, USA
- Department of Radiology, Clinical Center, NIH, Bethesda, MD, USA
| | - Peter A Pinto
- Urologic Oncology Branch, NCI, NIH, Bethesda, MD, USA
| | | | - Baris Turkbey
- Molecular Imaging Branch, NCI, NIH, Bethesda, MD, USA.
- Molecular Imaging Branch, National Cancer Institute, 10 Center Dr., MSC 1182, Building 10, Room B3B85, Bethesda, MD, 20892-1088, USA.
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12
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He M, Wang L, Wang H, Liu F, Li M, Chong T, Xue L. A preliminary study on the diagnostic value of PSADR, DPC and TSRP in the distinction of prostatitis and prostate cancer. BMC Cancer 2022; 22:348. [PMID: 35361156 PMCID: PMC8969284 DOI: 10.1186/s12885-022-09445-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/23/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate the ability of differential diagnosis of prostate specific antigen decline rate (PSADR) per week, degree of prostatic collapse (DPC) and tissue signal rate of prostate (TSRP) between prostatitis and prostate cancer. METHODS The clinical data of 92 patients [prostate specific antigen (PSA)β>β10Β ng/mL] who underwent prostate biopsy in the Department of Urology, the Second Affiliated Hospital of Xi 'an Jiaotong University from May 2017 to April 2020 were reviewed retrospectively. They were divided into two groups, prostatitis group (nβ=β42) and prostate cancer (PCa) group (nβ=β50), according to pathological results. Parameters, like patient characteristics, PSADR, DPC, TSRP and infectious indicators, were compared and analyzed by t test or non-parametric test to identify if there were significant differences. The thresholds of parameters were determined by the receiver operating characteristic curve (ROC), and the data were analyzed to investigate the diagnostic value in distinguishing of prostatitis and prostate cancer. RESULTS There were statistical differences in age, PSADR, DPC, TSRP, neutrophil percentage in serum, white blood cell (WBC) in urine and prostate volume between prostatitis group and PCa group (Pβ<β0.001,β<β0.001,β=β0.001, 0.001, 0.024, 0.014,β<β0.001 respectively). There was no statistical difference in serum WBC count, serum neutrophil count, monocyte percentage and urine bacterial count between two groups (Pβ=β0.089, 0.087, 0.248, 0.119, respectively). Determined by ROC curve, when the thresholds of PSADR per week as 3.175Β ng/mL/week, DPC as 1.113, TSRP as 2.708 were cutoffs of distinguishing prostatitis and prostate cancer. When combining these three indexes to diagnose, the accuracy rate of diagnosis of prostatitis was 78.85%, the accuracy rate of diagnosis of prostate cancer was 97.50%. Univariate analysis suggested that PSADR, DPC and TSRP played an important role in differentiating prostate cancer from prostatitis (Pβ<β0.05), multivariate analysis suggested PSADRβ>β3.175 might be good indicators when distinguishing prostate disease with prostatitis (ORβ=β14.305, 95%CIβ=β3.779β~β54.147), while DPCβ>β1.113 and TSRPβ>β2.708 might be associated with a higher risk of prostate cancer (ORβ=β0.151, 95%CIβ=β0.039β~β0.588; ORβ=β0.012, 95%CIβ=β0.005β~β0.524, respectively). CONCLUSION The combination of PSADR per week, DPC, and TSRP might be helpful to distinguish prostate cancer and prostatitis, and can reduce unnecessary invasive and histological procedure.
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Affiliation(s)
- Minxin He
- Department of Urology, The Second Affiliated Hospital of Xi'an Jiaotong University, No.157 Xiwu Road, Xincheng District, Xi'an, 710004, Shaanxi, China
| | - Li Wang
- Department of Urology, The Second Affiliated Hospital of Xi'an Jiaotong University, No.157 Xiwu Road, Xincheng District, Xi'an, 710004, Shaanxi, China
| | - Hong Wang
- Department of Urology, The Second Affiliated Hospital of Xi'an Jiaotong University, No.157 Xiwu Road, Xincheng District, Xi'an, 710004, Shaanxi, China
| | - Fang Liu
- Department of Urology, The Second Affiliated Hospital of Xi'an Jiaotong University, No.157 Xiwu Road, Xincheng District, Xi'an, 710004, Shaanxi, China
| | - Mingrui Li
- Department of Urology, The Second Affiliated Hospital of Xi'an Jiaotong University, No.157 Xiwu Road, Xincheng District, Xi'an, 710004, Shaanxi, China
| | - Tie Chong
- Department of Urology, The Second Affiliated Hospital of Xi'an Jiaotong University, No.157 Xiwu Road, Xincheng District, Xi'an, 710004, Shaanxi, China
| | - Li Xue
- Department of Urology, The Second Affiliated Hospital of Xi'an Jiaotong University, No.157 Xiwu Road, Xincheng District, Xi'an, 710004, Shaanxi, China.
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