To histologically compare benign prostatic hyperplasia with proslalic adenocarcinoma, a morphometric study was conducted on 20 cases of benign prostatic hyperplasia and 16 cases of prostatic adenocarcinoma. Adenocarcinoma group was divided into two subgroups. well differentiated (9 cases) and poorly differentiated (7 cases), based on the Gleason grading system. By means of computerized image analyzer, about 30 to 40 cells for each case were examined to evaluate mean nuclear area and perimeter, mean standard deviations and mean form factor. Mean form factor, the most prominent parameter in our study, was significantly different among BPH (1.063+/-0.008), well differentiated adenocarcinoma (1.089+/-0.018) and poorly differentiated adenocarcinoma (1.135 +/-0.057 ). Mean standard deviations of mean nuclear area and perimeter were significantly different between benign prostatic hyperplasia and well differentiated prostatic adenocarcinoma. .Morphometry. may provide the pathologists with a helpful technique, allowing them to analyze pathological material accurately. and in a more quantitative and reproducible fashion.
Adenocarcinoma* ; Neoplasm Grading ; Prostatic Hyperplasia*

Cancer is the leading cause of disease and death worldwide and among all cancers,prostate cancer (PCA) is the second most frequently diagnosed cancer of men after lungcancer. Despite the low incidence of prostate cancer, there is a rapid increase of prostate cancer's incidence and mortality in Asian countries due to a more westernized lifestyle and high proportion of advanced stage prostate cancer.
Prostate ; Neoplasm Grading ; Bone Neoplasms

Purpose: We evaluated the variables that may predict the final Gleason score of a radical prostatectomy in the patients showing more than two different Gleason scores in their positive core biopsy specimens. Materials and Methods: We reviewed the pathological data of patients diagnosed with prostate cancer using extended (12 site or more) needle biopsies who underwent a radical retropubic prostatectomy. A total of 73 patients showed more than two different Gleason scores in their biopsy specimen. The following parameters were assessed: highest Gleason score in the biopsy specimen, the Gleason score of the highest tumor percentage in the core and the highest tumor ratio score (Gleason score of highest total tumor length of same Gleason score/total core length of same Gleason score). Concordance of the Gleason scores between the biopsy specimen and prostatectomy was also examined. Results: The highest tumor ratio score showed the highest (64.4%) concordance rate. The concordance rates of the Gleason scores of the highest tumor percentage in the core and the largest linear cancer length were 59 and 58%, respectively. The concordance rate of the highest Gleason score in the biopsy specimens was only 47%. When stratified by grade: well differentiated (Gleason score=6), moderate (7) and poorly differentiated (8-10), the grade concordance rate of the highest tumor ratio score was 73%. The grade concordance rates of the highest and largest linear cancer length Gleason scores were 64.4 and 64.3%, respectively. Conclusions: If a biopsy specimen shows more than two different Gleason scores in positive cores, the highest tumor ratio score may be the most useful variable for predicting the final Gleason score from radical prostatectomy specimens.
Biopsy* ; Biopsy, Needle ; Humans ; Neoplasm Grading* ; Prostatectomy* ; Prostatic Neoplasms

OBJECTIVETo explore the basic features of the prostate carcinoma Gleason grading system of the International Society of Urological Pathology (ISUP).

METHODSWe analyzed the means and proportions of the Gleason score (GS), primary grade (PG), secondary grade (SG) and third grade (TG) of 667 cases of prostate carcinoma.

RESULTSThe means of GS, PG, SG and TG were 7.06 +/- 1.10, 3.53 +/- 0.66, 3.53 +/- 0.72 and 4.30 +/- 0.96, respectively. The cases with GS 5, 6, 7, 8, 9 and 10 accounted for 0.4% (3/677), 37.2% (252/677), 34.4% (233/677), 13.7% (93/677), 12.0% (81/677) and 2.2% (15/677), respectively; those with GS < or = 6 and > or = 7 constituted 37.7% (255/677) and 62.3% (422/677); those with GS3 + 3, 4 + 3 and 3 + 4 made up 37.2% (252/677), 19.2% (130/677) and 15.2% (103/677); and the TG cases held 10.3% (70/677), including 30.0% (21/70) of grade 3, 10% (7/70) of grade 4 and 60.0% (42/70) of grade 5.

CONCLUSIONOur study showed a high proportion of GS, a low proportion of GS < or = 6, and a high proportion of GS > or = 7 in the ISUP prostate carcinoma Gleason grading system. TG of GS needs to be further understood.

Carcinoma, Transitional Cell ; pathology ; Humans ; Neoplasm Grading ; Urologic Neoplasms ; pathology

PURPOSE: We applied low-dose-rate brachytherapy for low- and intermediate-risk groups of prostate cancer patients. Our initial experiences were analyzed to assess the result of low-dose-rate brachytherapy for low- and intermediate-risk groups of patients with localized prostate cancer. MATERIALS AND METHODS: A total of 50 consecutive patients have been treated with brachytherapy for 1 year since April 2007. Among them, a total of 24 patients in the low- or intermediate-risk groups were enrolled: 10 of the 24 patients were in the low-risk group (clinical T1a-T2b, Gleason score [GS] of 2-6, PSA<10 ng/ml), and 14 patients were in the intermediate-risk group (clinical T2b-T2c, Gleason score of 7, or PSA 10-20 ng/ml). Implantations were performed by practicing a real-time ultrasound-guided placement including prostatic capsular placement in the intermediate-risk group. All 24 patients were treated with 1 to 3 months of androgen-deprivation therapy. RESULTS: In the low- and intermediate-risk groups, the median patients' ages were 64 and 70 years, respectively. The numbers of patients in the low-risk group according to clinical T stage were 4 cases of T1c and 6 cases of T2a. The intermediate-risk group included 4 patients of stage T2a, 3 patients of stage T2b, and 7 patients of T2c. Five patients with a GS< or =6 and 9 patients with a GS of 7 were classified as being in the intermediate-risk group. Serum PSA levels in the intermediate-risk group were less than 10 ng/ml in 11 patients and 10-20 ng/ml in 3 patients. The median radiation doses delivered to 90% of the prostate in the low-risk and intermediate-risk groups were 257.5 Gy (range, 142.5-357.5 Gy) and 260.0 Gy (range, 147.5-357.5 Gy), respectively. Biochemical failure was not revealed in any case during follow-up. No patients experienced major complications. CONCLUSIONS: We can expect outstanding local control effect with low-dose-rate brachytherapy in low- and intermediate-risk prostate cancer. Our technique of modifying the insertion field in the intermediate-risk group is feasible and tolerable. However, long-term follow-up data are needed for this strategy.
Brachytherapy ; Follow-Up Studies ; Humans ; Neoplasm Grading ; Prostate ; Prostatic Neoplasms

PURPOSE: Survivin, a novel inhibitor of apoptosis(IAP), is expressed in many human cancers, but its potential role in prostate cancer is unknown. The expressions of survivin in benign prostate hyperplasia, localized prostate cancer and metastatic prostate cancer were investigated. MATERIALS AND METHODS: Immunohistochemical staining of paraffin sections by a monoclonal antibody for survivin using the standard avidin- biotin-peroxidase technique was performed in 19, 20 and 30 cases with benign prostate hyperplasia, localized prostate cancer and metastatic prostate cancer, respectively. The relationships between the expression of survivin and the clinicopathological characteristics were analyzed. RESULTS: No survivin expression was found in benign prostate hyperplasia, but not in prostate cancer. The expression of survivin was observed in the cytoplasm of the tumor cells, but not in the neighboring normal tissues. The immunoreactivity of survivin increased from localized prostate cancer (60.0%) to metastatic prostate cancer(76.7%), but did not differ significantly. A statistically significant association was observed between the expression of survivin and the Gleason score(p=0.001). CONCLUSIONS: Survivin is expressed in the majority of Prostate cancers and is related to the Gleason score. Survivin may be a potential target for apoptosis-based therapy.
Apoptosis ; Cytoplasm ; Humans ; Hyperplasia* ; Neoplasm Grading ; Paraffin ; Prostate* ; Prostatic Neoplasms*

OBJECTIVE: This study concernes the usefulness of 11C-methyl-L-and D-methionine(Met)-positron emission tomography(PET) for gliomagrading and detection of recurrence in gliomas, compared with fluorine-18, 2-fluoro-deoxyglucose(FDG)-PET. METHODS: Eighty patients underwent Met-PET study for evaluation of glioma: 37 astrocytomas (WHO grade II, 3; III, 8; IV, 26), 27 oligodendrogliomas (WHO grade II, 16; III, 11), and 12 suspicious recurrent gliomas. All images were taken within 2 weeks before operation. For suspicious recurrent cases on magnetic resonance images, both FDG-PET and Met-PET were performed. RESULTS: In astrocytoma, Mean maximum standard uptake value(SUV) of region of interest(ROI) was not different between WHO grades (p=0.108), but ROI/normal contralateral tissue SUV (T/N) ratio was statistically different between WHO grades (p=0.002). T/N ratio was more closely related to visual scale than maximum SUV of ROI (p<0.001 and p=0.107 respectively). In oligodendroglioma, there was no statistical difference between WHO grades in view of maximum SUV and T/N ratio. For recurrent gliomas, sensitivity of FDG-PET and Met-PET was 25% and 100%, while specificity of FDG-PET and Met-PET were 100% and 80%, respectively. CONCLUSION: Met-PET might be an appropriate tool for tumor grading in astrocytom a and be more sensitive for detection of recurrence in gliomas than FDG-PET.
Astrocytoma ; Glioma* ; Humans ; Methionine ; Neoplasm Grading ; Oligodendroglioma ; Recurrence* ; Sensitivity and Specificity

PURPOSE: We investigate the impact of tumor multifocality on the biochemical recurrence rate after radical prostatectomy. MATERIALS AND METHODS: Data was collected from 525 patients who underwent radical prostatectomy for clinically localized prostate cancer from 2003 to 2007. We evaluated the potential associations of multifocality with various clinical and pathologic factors. The ability to predict extra-capsular extension(ECE) was tested by logistic regression models, whereas biochemical recurrence(BCR) was assessed via Kaplan-Meier analyses and Cox-hazard regression models. The BCR was defined as a level of serum prostate-specific antigen(PSA) of 0.2ng/ml or greater on consecutive evaluations. RESULTS: Multifocality was observed to be significantly associated with the presence of a high grade Gleason pattern(p=0.014), the pT stage(p< 0.001), ECE(p=0.005) and a positive surgical margin(PSM)(p=0.019). Moreover, it was the independent predictor of ECE on multivariate logistic regression analyses(p=0.039). However, although multifocality had a significant influence on biochemical recurrence on the Kaplan-Meier analyses (log rank test, p=0.019), only the PSA level and the Gleason score were significant predictors of BCR on the multivariated Cox-hazard analyses. CONCLUSIONS: Although multifocality was associated with adverse pathologic features, it had no significant effect on biochemical recurrence on the multivariated cox-hazard analyses.
Humans ; Logistic Models ; Neoplasm Grading ; Prostatectomy ; Prostatic Neoplasms ; Recurrence

PURPOSE: Proteins encoded by bcl-2 family as regulators of apoptosis appear to have significant cellular effects such that when abnormally expressed, they may render certain cells more susceptible to aberrant proliferation. The ratio of anti-apoptotic to pro-apoptotic bcl-2 family proteins appears to control the relative sensitivity or resistance of cells to apoptotic stimuli. The primary goal of this study is to determine the expression pattern of bcl-2 and bax in prostate carcinoma and to correlate them with Gleason score, T stage, and PSA to determine their prognostic potential. MATERIALS AND METHODS: We examined the cellular expression of bcl-2 and bax proteins using immunohistochemical metod in a total 35 patients with untreated prostatic carcinoma. All tissues were scored for overall tissue expression as follows: bcl-2(0,<1%; 1+, 1-25%; 2+, 26-50%; 3+, >50%), bax(1+,<50%; 2+, 51-75%; 3+, >75%). RESULTS: Of the 35 cases, 16(45.7%) contained at least 1% bcl-2 positive tumor cells. The bcl-2 positive cases included 1(7.7%) Gleason 2 to 4 grade tumors, 8(66.7%) Gleason 5 to 7 tumors, 7(70.0%) Gleason 8 to 10 tumors. bcl-2 protein expressed more frequently in higher grade(p<0.05) and in higher PSA level(p<0.05) of tumors. bax immunostaining was positive for all 35(100%) and 1+ was 16(45.7%), 2+ was 14(40.0%), 3+ was 5(14.3%). But statistically significant differences in bax expression among grade, T stage, and PSA were not observed. The bcl-2 protein was present mainly in the basal cells, but bax was in both basal and secretory cells of prostate. CONCLUSIONS: bcl-2 protein have some potential role in progression of prostate carcinoma. Therefore, studies that evaluate the expression of these bcl-2 family genes in varoius time during progression of tumors correlate with the state of hormone dependency, response to therapy and duration of response are needed.
Apoptosis ; bcl-2-Associated X Protein ; Humans ; Neoplasm Grading ; Prostate*