Contrast-enhanced transrectal ultrasonography for the detection of diffuse prostate cancer

AIM

To evaluate the diagnostic accuracy of contrast-enhanced transrectal ultrasonography (CE-TRUS) versus baseline TRUS (combination of grey-scale and colour Doppler imaging) for diffuse prostate cancer.

MATERIALS AND METHODS

Forty-six patients without an obvious focal mass on baseline TRUS (grey-scale and colour Doppler), underwent additional CE-TRUS and TRUS-guided biopsy due to elevated levels of prostate-specific antigen (PSA ≥4 ng/ml) and/or abnormal digital rectal examination (DRE). In all patients, CE-TRUS was performed with intravenous injection of a contrast agent (sulphur hexafluoride microbubble; SonoVue, 2.4 ml) before biopsy. TRUS-guided biopsy targeted suspicious areas detected on CE-TRUS imaging or sampled the outer gland of the normal prostate. The final diagnosis was based on results of the TRUS-guided biopsy. The diagnostic accuracy of baseline TRUS and CE-TRUS for diffuse prostatic lesions was evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTS

Diffuse prostate cancer was present in 32 (69.5%) patients and absent in 14 (30.5%) patients. Nineteen patients had diffuse prostate cancer that was not detected by baseline TRUS, whereas 15 cases were identified using CE-TRUS. Conversely, five patients had benign prostatic hypertrophy (BPH) that was diagnosed as cancer by CE-TRUS, and two of these patients were diagnosed with BPH by baseline TRUS. The combined sensitivity, specificity, and accuracy were 87.5%, 64.2%, and 80.4%, respectively, for CE-TRUS, and 40.6%, 78.5%, and 52.1%, respectively, for baseline TRUS. The area under the ROC curve (AUC) values for the diagnostic accuracy of baseline CE-TRUS versus TRUS for diffuse prostate cancer differed significantly at 0.904 and 0.667, respectively (Z=4.098, p<0.0001).

CONCLUSION

CE-TRUS exhibited greater diagnostic accuracy for diffuse prostate cancer than baseline TRUS. CE-TRUS may improve cancer detection over baseline TRUS imaging for the diagnosis of diffuse prostate cancer in patients with an elevated PSA level. CE-TRUS detects diffuse prostate cancer without an obvious focal mass on routine TRUS or clinical examination, and therefore, may help identify patients who do not need a repeat biopsy or who do not need to undergo systematic 12-core invasive sampling biopsies.

Lack of association between the aryl hydrocarbon receptor rs2066853 polymorphism and breast cancer: A meta-analysis on Ahr polymorphism and breast cancer

Published data regarding the association between aryl hydrocarbon receptor (Ahr) rs2066853 polymorphism and the risk of breast cancer shows conflicting results. We performed a meta-analysis on 2999 patients and 3050 controls from three related case-control studies to estimate the association between Ahr rs2066853 polymorphism and the risk of breast cancer. The protocol was approved by the Institutional Animal Care and Use Committee (IACUC) at the University of Florida (America NIH Publication No. 86-231985 Revision). According to the three eligible populations, the odds ratios (ORs), 95% confidence intervals (CIs) on the risk of breast cancer for the genotypes GA vs GG, AA vs GG, and A vs G were 1.06 (0.81-1.40), 0.96 (0.81-1.13), and 1.02 (0.85-1.22), respectively. The OR (95%CI) for GA + AA vs GG was 1.05 (0.80-1.37). Furthermore, after multi-variates adjustment, the ORs (95%CIs) were 1.05 (0.80-1.38) for GA vs GG, and 0.92 (0.76-1.10) for AA vs GG. This meta-analysis suggests that Ahr (rs2066853) polymorphism would not modify the risk of breast cancer. However, further research should be conducted to provide more evidence.

[Studies on original plant of traditional Chinese drug "bai zhi" (radix Angelicae Dahuricae) and its closely related wild plants. IV. Discussion on original plant and cultivation history of traditional Chinese drug "bai zhi" and evolution of its closely related wild plants]

OBJECTIVE

To confirm the original plant of traditional Chinese drug "Bai Zhi" and to inquire into the cultivation history of "Bai Zhi" and evolution of closely related wild plants of "Bai Zhi".

METHOD

Various research results obtained were synthesized and discussed according to historical and current data.

RESULT

Obtained research results, historical and current data showed almost no difference.

CONCLUSION

1. Angelica dahurica var. formosana must be the original plant of traditional Chinese drug "Bai Zhi". 2. A. porphyrocaulis should be treated as a variety of A. dahurica, named as A. dahurica var. porphyrocaulis. 3. 4 sorts of Chinese traditional drug "Bai Zhi" (Chuang Bai Zhi, Hang Bai Zhi, Qi Bai Zhi and Yu Bai Zhi) should not be taxonomically distinguished. The history of utilization and cultivation of "Bai Zhi", and the evolutional relation of the closely related wild plants of "Bai Zhi" (A. dahurica, A. dahurica var. formosana, and A. dahurica var. porphyrocaulis) were also discussed.

[Studies on original plant of traditional Chinese drug "bai zhi" (radix Angelicae Dahuricae) and its closely related wild plants. II. Karyological and pollen morphological studies on "bai zhi" and closely related wild plants]

OBJECTIVE

To supplement cytobiological and pollen morphological data for confirming the original plant of traditional Chinese drug "Bai Zhi".

METHOD

Karyological study and pollen observation were made on "Bai Zhi" and its closely related wild plants.

RESULT

Similarities and differences of "Bai Zhi" and its closely related wild plants were found.

CONCLUSION

1. 4 cultivated breeds of "Bai Zhi", Angelica dahurica, A. dahurica var. formosana, A. porphyrocaulis are really closely related plants. 2. A. dahurica var. formosana is closer to traditional Chinese drug "Bai Zhi" than others.

[Studies on original plant of traditional Chinese drug "bai zhi" (radix Angelicae Dahuricae) and its closely related wild plants. I. Morphological and anatomical studies on "bai zhi" and closely related wild plants]

OBJECTIVE

To supplement morphological and anatomical data for confirming the original plant of traditional Chinese drug "Bai Zhi" (Radix Angelicae Dahuricae).

METHOD

Morphologocal observation and anatomical study were made on 4 cultivated breeds and closely related wild plants of "Bai Zhi".

RESULT

According to morphological and anatomical characteristics discovered in this paper, 7 samples noted above could be divided into 3 groups: 1. 4 breeds ("Chuan Bai Zhi", "Hang Bai Zhi", "Qi Bai Zhi" and "Yu Bai Zhi") and Angelica dahurica var. formosana; 2. A. dahurica; 3. A. porphyrocaulis.

CONCLUSION

In the morphological and anatomical point of view, A. dahurica var. formosana is closer to traditional Chinese drug "Bai Zhi" than others.