Objective To investigate the source of the elevated serum prostatic specific antigen(PAS) in prostate hyperplasia patients with large volume prostate. Methods Open surgery (ie,suprapubic prostatectomy) was performed in 27 patients who had a preoperative PSA between 8.1 and 75.1 ng/ml and the volume measured by ultrasonography over 50 ml,DER≥Ⅲ? size,but without symptoms and signs of prostate cancer (PCa).The 27 patients were post operatively followed up to measure the serum PSA,to analyze the change in PSA and the source of pre operative elevated PSA. Results The post operative gross examination showed that the average weight of the prostate enucleated was 82.7 g (40 to 185 g).Pathological evaluation of the surgical specimen revealed that no prostate cancer lesion was found in 25 patients;however,PCa lesions were found in 2.Within 1 month the PSA rapidly dropped down to normal in 26 patients;however,in the remaining one with pathologically proven PCa,PSA increased.24 patients were followed up between 17 and 57 months after surgery.The average PSA level was 1.16 ng/ml(0.08 to 2.39 ng/ml). Conclusions In BPH patients with large volume prostate the increased PSA originates from hyperplastic gland (transition zone),not from the peripheral zone.

Objective To measure the expression of SFRP1 in bladder cancer and explore the corresponding mechanism,in order to study the roles of SFRP1 in the pathogenesis of bladder cancer.Methods SFRP1 mRNA was detected by RT-PCR.Methylation status of SFRP1 was detected by methylation specific PCR.SFRP1 protein was determined by Western blotting.Results SFRP1 was methylated in bladder cancer cell lines T24 and 5637,not in SCaBER.SFRP1 mRNA and protein were detected in SCaBER,but not in T24 and 5637.Six hours after treating T24 and 5637 with 5'-aza-deoxycytidine,both T24 and 5637 expressed SFRP1 mRNA and protein.In 45 bladder cancers,methylation of SFRP1 was detected in 28 (62.2％).In matched cancer adjacent tissues,6 (13.3％) were found with SFRP1 methylation.The methylation rate in bladder cancers was significant higher than that in matched cancer adjacent tissues (P ＜ 0.01).Conclusions SFRP1 is downregulated in some bladder cancers due to methylation.SFRP1 methylation and aberrant expression may be involved in the pathogenesis of bladder cancers.

ObjectiveTo investigate the expression of Snail in bladder urothelial carcinoma and evaluate its relationship with E-cadherin and a subset of T cell groups.MethodsImmunohistochemical method was used to detect the expression of Snail and E-cadherin proteins in tissue from 156 cases of bladder urothelial carcinoma and 80 cases of the para-cancerous mucosa. The proteins expression status was analyzed with clinico-pathological data. Meanwhile, correlations with Snail and CD4+, CD8+, CD4+/CD8+ were analyzed.ResultsThe positive rate of Snail in bladder urothelial carcinoma was 65.4％ , which was significantly higher than that in para-cancerous mucosa (48.8％). The expression of Snail was significantly correlated with the clinical stage, pathological grade, tumor quantity, distant metastasis and tumor recurrence.There was negative correlation between the expression of Snail and E-cadherin in bladder urothelial carcinoma. Positive expression of Snail had a negative correlation with the number of CD4+ and CD4+/CD8+ , whereas it had no significant correlation with the number of CD8+.ConclusionsBy inhibition of the E-cadherin expression and inducing local immunosuppression, Snail might play an important role in the process of the invasion and metastasis of bladder urothelial carcinoma.

Objective To summarize the diagnosis,treatment and prevention of dysuria within 6 months after the suprapubic transvesical prostatectomy. Methods Twenty-four cases were retrospectively reviewed,including the data on the diagnosis, treatment and prognosis. Results Twenty-one of the 24 cases had received surgery. There were 9 cases with bladder neck stricture,9 cases with posterior urethra stricture and 3 cases with of remnant glands. Nine cases received transurethral bladder neck incision, 9 received open surgery ( bladder neck,posterior urethral incision) and 3 received transurethral resection of the prostate (TURP) plus bladder neck incision. The other 3 diagnosed as detrusor weakness were conservatively treated by indwelling catheter and they were improved one months later. None of these patients was readmitted into hospital for dysuria within 6 months after treatment. Conclusion The recurrence of dysuria post prostatectomy mostly ( 75% ) occurred within 6 months after surgery. A majority of these patients need a second surgery. To avoid a second surgery for postoperative dysuria, much attention should be paid to the operating technique and postoperative management.