OBJECTIVETo investigate the relationship of the histopathologic grade and extent of prostatic inflammation with the level of serum PSA in patients with type IV prostatitis.

METHODSWe performed transrectal ultrasound-guided prostate biopsy for 120 patients suspected of prostate cancer and included in this study only those with benign prostate hyperplasia (BPH) and prostatitis (n = 46), excluding the cases with prostate cancer and those with BPH but no prostatitis. We evaluated the relationship between prostatic inflammation and serum PSA levels based on the three-grade pathohistologic criteria for the extent, location and aggressiveness of prostatic inflammation. The serum tPSA levels, fPSA levels, % fPSA, and PSAD were compared among different groups.

RESULTSAs for the extent of inflammation, 35 of the 46 included cases were grade I (tPSA: [8.46 +/- 4.09] microg/L; fPSA: [1.75 +/- 0.93] microg/L; PSAD: 0.15 +/- 0.11), 7 were grade II (tPSA: [15.26 +/- 5.26] microg/L; fPSA: [2.54 +/- 0.72] microg/L; PSAD: 0.26 +/- 0.07) and 4 were grade III (tPSA: [21.05 +/- 7.58] microg/L; fPSA: [3. 19 +/- 1.13] microg/L; PSAD: 0.42 +/- 0.19), with statistically significant differences among the three groups in the levels of tPSA (P = 0.001), fPSA (P = 0.008) and PSAD (P < 0.001). Regarding the location of inflammation, 19 cases were grade I, 17 were grade II and 10 were grade II, with no significant differences in tPSA, fPSA and %fPSA among the three grades (P > 0.05). As for the aggressiveness of inflammation, 32 cases were grade I (tPSA: [8.37 +/- 4.07] microg/L; fPSA: [1.76 +/- 0.93] microg/L; PSAD: 0.14 +/- 0.11), 10 were grade II (tPSA: [13.30 +/- 5.69] microg/L; fPSA: [3.27 +/- 2.21] microg/L ; PSAD: 0.25 +/- 0.06) and 4 were grade III (tPSA: [21.05 +/- 7.58] microg/L; fPSA: [3.19 +/- 1.13] microg/L; PSAD: 0.42 +/- 0.19), with statistically significant differences among the three grades in the levels of tPSA (P = 0.002), fPSA (P = 0.024) and PSAD (P < 0.001). The extent of inflammation was positively correlated with the levels of tPSA (r = 0.6, P < 0.001), fPSA (r = 0.5, P = 0.001) and PSAD (r = 0.6, P < 0.001), and so was the aggressiveness of inflammation (tPSA: r = 0.5, P < 0.001; fPSA: r = 0.4, P = 0.008; PSAD: r = 0.7, P < 0.001), but a negative correlation was found between the aggressiveness of inflammation and %fPSA (r = -0.4, P = 0.013).

CONCLUSIONThe aggressiveness and extent of prostatic inflammation in asymptomatic prostatitis patients are significantly correlated with the level of serum PSA, which may help pathologists to avoid unnecessary repeated biopsies for patients with high-grade prostatitis.

Aged ; Biopsy ; Humans ; Inflammation ; Male ; Prostate ; pathology ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; blood ; pathology ; Prostatitis ; blood ; pathology ; Serum

Antigens, Surface ; blood ; Diagnosis, Differential ; Glutamate Carboxypeptidase II ; blood ; Humans ; Male ; Neoplasm Staging ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; pathology ; Prostatic Neoplasms ; etiology ; metabolism ; pathology ; Racemases and Epimerases ; analysis

OBJECTIVESTo investigate the pathoanatomize histological and biochemical characteristics of benign prostatic hyperplasia (BPH) by use of old dogs with spontaneous BPH as animal models.

METHODSOld dogs aged 6 to 13 years were recruited after anus check, B-ultrasonic examination by recta spy and measurement under surgical exploration. Ten dogs with notable prostatic hyperplasia were used as models, and 6 with non-hyperplasia prostate as control. Serum testosterone (T), estrogen (E2), ACP and prostatic specific antigen (PSA) were analyzed, and prostates were checked histologically.

RESULTSProstate volume of the BPH group was significantly bigger than those of the control group, (14.7 +/- 2.3) and (13.8 +/- 1.9) cm3 vs (8.4 +/- 1.0) and (8.4 +/- 1.9) cm3, P < 0.01. Serum T [(14.3 +/- 2.9) vs (16.4 +/- 4.0) nmol/L] and E2 [(137.6 +/- 70.8) vs (164.4 +/- 82.0) pmol/L] were not different between the two groups (P > 0.05). ACP of the BPH group was higher than that of the control group [(6.63 +/- 2.76) vs (4.92 +/- 2.19) U/L], but the difference was not statistically significant (P > 0.05). There was significant difference between the BPH group and the control group in PSA level [(5.6 +/- 0.78) vs (3.1 +/- 0.54) microgram/L, P < 0.01]. The tissue slides of the BPH prostates showed hyperplasia with raised height of epithelium, and many long and offsetting mammillae in the gland cavity due to epithelium hyperplasia.

CONCLUSIONOld dogs with spontaneous BPH are useful animal models for the etiological and pharmacological researches of human BPH.

Animals ; Disease Models, Animal ; Dog Diseases ; pathology ; Dogs ; Male ; Prostate ; pathology ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; pathology ; veterinary

OBJECTIVETo determine the effect of obesity on prostate specific antigen (PSA) in men with benign prostatic hyperplasia (BPH) and develop a PSA-related parameter that can eliminate the effect of obesity.

METHODSWe reviewed the clinical data of 706 patients with BPH. Two PSA-related parameters, namely PSA mass (total circulating PSA protein) and PSA mass ratio (total circulation PSA protein per prostate volume), were calculated for all the patients and the association of BMI with PSA, PSA mass, and PSA mass ratio was assessed.

RESULTSA higher BMI was significantly associated with a greater plasma volume and prostate volume (P<0.05). Linear regression analysis revealed a greater adjusted R2 of BMI versus plasma volume than of BMI PSA (0.569 vs 0.027). PSA was positively associated with the prostate volume and negatively with BMI and plasma volume (P<0.05). PSA mass was positively associated with prostate volume (P<0.05) but was not associated with BMI or plasma volume (P>0.05). PSA mass ratio was not associated with prostate volume (P>0.05) but negatively associated with BMI and plasma volume. Plasma volume and prostate volume, PSA, and PSA mass ratio (P<0.05), but not PSA mass (P>0.05), differed significantly among normal-weight, overweight, and obese patients.

CONCLUSIONA higher BMI is associated with a greater plasma volume in BPH patients. In obese patients with BPH, a lower PSA concentration may result from hemodilution caused by a greater plasma volume, and PSA mass can eliminate the effect of obesity on PSA.

Body Mass Index ; Hemodilution ; Humans ; Male ; Obesity ; pathology ; Organ Size ; Overweight ; pathology ; Prostate ; pathology ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; diagnosis ; Prostatic Neoplasms ; diagnosis

OBJECTIVETo find sensitive and specific micro-metastic markers for prostate cancer.

METHODSUsing nested reverse transcription-PCR, we examined the expression of PSA, hK2 and PSMA mRNA in peripheral blood mononuclear cells of 51 patients with prostate cancer, 33 patients with benign prostate hyperplasia (BPH) and 32 normal young people.

RESULTSThe expression rates of PSA, hK2 and PSMA mRNA were 52.9%, 43.1% and 64.7%, respectively in prostate cancer group, and 6.2%, 7.7% and 4.6%, respectively in control group (BPH patients and normal young people) with statistical significance (P < 0.01). Although the expression rate of PSA and hK2 mRNA increased with cancer progression, there was no statistical significance among patients in different stages. The expression rate of PSMA mRNA was higher than that of PSA and hK2 mRNA in each clinical stage.

CONCLUSIONPSMA mRNA expression detected by nested RT-PCR is of greater value for the diagnosis, therapy choice and prognostic evaluation of prostate cancer patients.

Aged ; Antigens, Surface ; blood ; Biomarkers, Tumor ; blood ; Glutamate Carboxypeptidase II ; blood ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; blood ; pathology ; Prostatic Neoplasms ; blood ; pathology ; Tissue Kallikreins ; blood

OBJECTIVETo investigate relationship between benign prostatic hyperplasia (BPH) and hyperlipemia, and to clear out possible factors related to BPH etiology.

METHODSA total of 462 cases of BPH diagnosed by pathological examination were studied retrospectively.

RESULTSOf 462 cases, BPH with hyperlipemia was noted in 232 cases (50.22%). In comparison with the data of simple BPH, both prostate volume (P = 0.029) and residual urine (P = 0.03) were significantly increased in the BPH patients with hyperlipemia. Statistical analysis regarding the effects of different components of serum lipid on BPH clinical factors showed that the level of high density lipoprotein was significantly associated with both the enlargement of prostate volume (P < 0.05) and increasing of serum PSA (P < 0.05) Further study indicated that hypertension was demonstrated in 39.2% patients of BPH with hyperlipemia. Hyperlipemia accompanied with hypertension in BPH patients was significantly related to increased IPSS (P = 0.004).

CONCLUSIONThe situation of BPH with hyperlipemia is frequently noted in clinics, and the decreased level of high-density lipoprotein is significantly associated with the enlargement of prostate volume. Co-existence of hypertension with hyperlipemia in BPH patients greatly worsens the lower urinary tract symptoms (LUTS) of BPH. Hyperlipemia may be one of the risk factors in the processes of BPH growth and progression.

Aged ; Humans ; Hyperlipidemias ; blood ; complications ; Hypertension ; complications ; Lipoproteins, HDL ; blood ; Male ; Middle Aged ; Prostate ; pathology ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; blood ; complications ; pathology ; Retrospective Studies

OBJECTIVETo report our experience of ultrasound guided transperineal 6-core prostate biopsy (UG6CPB) in the diagnosis of prostate cancer (PCa).

METHODSIn a prospective study, we performed UG6CPB in 104 suspected PCa patients with tPSA more than 4 microg/L and analysed the positive rate and complications of the diagnostic approach.

RESULTSPCa was detected in 24 of the 104 patients (23%), with low grade Gleason 2 to 4 in 3 cases (12.5%), intermediate grade Gleason 5 to 7 in 15 (62.5%) and high grade Gleason 8 to 10 in the remaining 6 (25%). Complications included temporary hematuria in 5 patients (4.8%), mild postbiopsy perineal discomfort in 5 (4.8%) and fever in 4 (3.8%). TPSA > or =10 microg/L, fPSA > or = 2 microg/L, fPSA/tPSA < 0.16, PSAD > or = 0.2 and prostate volume < 40 ml were the significant influencing factors of biopsy positive rate (P < 0.05).

CONCLUSIONUG6CPB is an exact and a safe way of detecting PCa.

Biopsy, Needle ; methods ; Humans ; Male ; Perineum ; Prospective Studies ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; diagnostic imaging ; pathology ; Prostatic Neoplasms ; diagnostic imaging ; pathology ; Ultrasonography

OBJECTIVETo investigate the expression of follistatin-like protein 1 (FSTL-1) in bone metastasis of prostate cancer (BMPC), the correlation of serum FSTL-1 with the chronic inflammatory factor interleukin-6 (IL-6) and bone morphogenetic protein 6 (BMP6) , and the clinical application value of serum FSTL-1 in BMPC.

METHODSUsing ELISA, we measured the expression levels of serum FSTL-1, IL-6, and BMP6 in 35 patients with BMPC and another 30 with benign prostatic hyperplasia (BPH) and performed correlation analysis on the data obtained.

RESULTSCompared with the BPH controls, the BMPC patients showed a significantly decreased expression of serum FSTL-1 ([34.45 ± 12.35] μg/L vs [20.23 ± 8.69] μg/L, P < 0.01) and increased levels of IL-6 ([11.21 ± 8.62] μg/L vs [23.56 ± 20.12] μg/L, P < 0.05) and BMP6 ([293.50 ± 39.72] μg/L vs [428.30 ± 178.40] μg/L, P < 0.05). There was a significant negative correlation between the level of serum FSTL-1 and those of IL-6 and BMP6 in the BMPC patients, with correlation coefficients of -0.971 and -0.972, respectively (P < 0.05).

CONCLUSIONThe expression of serum FSTL-1 decreases in patients with bone metastasis of prostate cancer, and it is correlated with the levels of inflammatory factor and cell transformation factor. This finding offers a novel biological marker for the development and progression of prostate cancer as well as a new biological target factor for its intervention.

Aged ; Biomarkers, Tumor ; blood ; Bone Morphogenetic Protein 6 ; blood ; Bone Neoplasms ; blood ; secondary ; Disease Progression ; Follistatin-Related Proteins ; blood ; Humans ; Interleukin-6 ; blood ; Male ; Prostatic Hyperplasia ; blood ; Prostatic Neoplasms ; blood ; pathology

OBJECTIVETo investigate the influence of histological prostatitis (HP) on the clinical features of benign prostatic hyperplasia (BPH) and prostate cancer (PCa) and its clinical significance.

METHODSWe retrospectively studied the data of 273 cases of BPH and 240 cases of PCa, including age, prostate volume, total prostatic special antigen (tPSA), prostatic special antigen density (PSAD), maximum urinary flow rate (MFR) and acute urinary retention (AUR).

RESULTSTotally, 186 cases of BPH (68.13%) and 45 cases of PCa (18.75%) were complicated by HP, with statistically significant difference between the two groups (P < 0.05). Compared with the patients with BPH only, those complicated by HP showed significantly elevated tPSA, PSAD and total prostate volume (all P < 0.05), decreased MFR (P < 0.05) and increased risk of AUR (P < 0.05). There was no significant difference in the patients' age between the two groups (P > 0.05). The levels of tPSA and PSAD were remarkably higher in the PCa patients complicated by HP than in those with PCa only (all P < 0.05), but no significant differences were found in the other indexes between the two groups (P > 0.05).

CONCLUSIONHP may play a certain role in the progenesis and progression of HP and PCa, but HP is associated more closely with BPH.

Aged ; Disease Progression ; Humans ; Male ; Organ Size ; Prostate ; pathology ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; etiology ; Prostatic Neoplasms ; complications ; Prostatitis ; complications ; Retrospective Studies ; Urinary Retention ; etiology

OBJECTIVETo investigate the expression of the LC3A protein in prostate cancer (PCa) and its clinicopathological significance. We detected the expression of the LC3A protein by immunohistochemistry in 54 cases of PCa and 14 cases of benign prostatic hyperplasia (BPH), and analyzed the correlation between the LC3A expression and the clinicopathological parameters in PCa. The positive signals of the LC3A protein were located in the cytoplasm and/or cell nuclei. The rate of its strongly positive expression was 90.7% in PCa, significantly higher than 14.3% in BPH (P < 0.01). The LC3A expression was also found in the cell nuclei of 22 cases of PCa, with no significant correlation to that in the cytoplasm (P > 0.05). The expression of LC3A was significantly correlated with Gleason scores (r = 0.297, P = 0.029 in cytoplasm; r = 0.288, P = 0.034 in cell nuclei), but not with the clinical stage, patient's age, androgen receptor (AR) level and preoperative levels of serum PSA and cPSA (all P > 0.05). LC3A was also expressed in the fibrocytes and smooth muscle cells in PCa and BPH. The positive rate of AR was 74.1% (40/54) in PCa and 64.3% (9/14) in BPH, with no significant difference between the two groups (P > 0.05).

CONCLUSIONThe expression of the LC3A protein might be involved in the development, differentiation, and prognosis of prostate cancer.

Aged ; Aged, 80 and over ; Humans ; Immunohistochemistry ; Male ; Microtubule-Associated Proteins ; metabolism ; Middle Aged ; Prognosis ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; metabolism ; Prostatic Neoplasms ; metabolism ; pathology ; Receptors, Androgen ; metabolism