No abstract available.
Carcinoid Tumor/etiology/*pathology/ultrasonography ; Colonoscopy ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Muscles/pathology ; Neoplasm Invasiveness ; Rectal Neoplasms/etiology/*pathology/ultrasonography

No abstract available.
Carcinoid Tumor/*diagnosis/*pathology/ultrasonography ; Colonoscopy ; Cysts/*pathology/surgery ; Humans ; Male ; Middle Aged ; Rectal Neoplasms/*diagnosis/*pathology/ultrasonography ; Synaptophysin/metabolism ; Tomography, X-Ray Computed

BACKGROUNDThere is no consensus regarding the performance for endorectal ultrasonography (ERUS) at every stage of rectal cancer. Thus, the purpose of our study was to further assess the value of ERUS in the preoperative staging of rectal cancer.

METHODSA retrospective study was performed with 44 consecutive patients (mean age: (63.3 ± 10.2) years) who underwent surgical treatment for endorectal carcinoma and were preoperatively evaluated using Biplane ERUS between September 2008 and December 2010. We compared the ERUS staging with the pathological findings based on surgical specimens.

RESULTSERUS staging agreed with the histologic staging in 39 of the 44 (88.6%) patients: the agreement on the depth of transmural invasion was good (κ = 0.73; 95%CI: 0.60 - 0.86, P = 0.000). The detection sensitivities of rectal cancer with ERUS were as follows: T1 85.7%, T2 87.5%, T3 88.9%, and T4 100.0% with specificity values of T1 97.3%, T2 92.9%, T3 96.2%, and T4 97.6%. ERUS correctly staged patients with T1 95.5%, T2 90.9%, T3 70.5%, and T4 97.7%. The positive predictive value of ERUS was lowest for T4 (75%), but highest for T3 (94.1%) followed by T2 (87.5%) and T1 (85.7%); the negative predictive values of ERUS from high to low were ordered as T4 (100%), T1 (97.3%), T2 (92.9%), and T3 (92.6%). The percentage of total over-staged cases was 4.5% and the under-staged cases was 6.8%. The extent of perirectal lymph node metastases was determined with a sensitivity of 68.4% (13/19), specificity of 80.0% (20/25), and diagnostic accuracy of 75.0% (33/44).

CONCLUSIONBiplane ERUS has a high diagnostic accuracy for tumoral invasion of the rectal wall at every T stage, but relatively low diagnostic accuracy for lymph node metastases.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Rectal Neoplasms ; diagnostic imaging ; pathology ; Retrospective Studies ; Ultrasonography

OBJECTIVETo compare the efficacy of endoluminal ultrasonography (EUS) and spiral computed tomography (SCT) in preoperative staging of rectal carcinoma.

METHODSBoth EUS and SCT were performed prior to surgery in 68 patients with rectal carcinoma. After radical surgery, the preoperative findings were compared with histologic findings of the operative specimens, and the efficacy of EUS and SCT in staging the rectal carcinoma were evaluated.

RESULTSFor T stage, EUS accuracy was 86.8%, while SCT was 70.6%. The difference was significant (P<0.05). For N stage, EUS accuracy was 67.6% and SCT was 63.2%. The difference was not significant (P>0.05).

CONCLUSIONEUS is superior to SCT for the judgement of tumor infiltration depth, but neither is able to provide satisfactory assessment of lymph node metastases.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; methods ; Rectal Neoplasms ; diagnostic imaging ; pathology ; Tomography, Spiral Computed ; Ultrasonography, Interventional

A precise knowledge of the depth of invasion of tumor is essential for the planning of treatment of rectal cancer. Transrectal ultrasonography is a new diagnostic modality that has become useful in determining the depth of invasion preoperatively and the presence or absence of metastatic lymph nodes. Transrectal ultrasonography was used in preoperative staging of 36 patients with rectal cancer. Thirty three patients had a radical resection (17 low anterior resection, 15 abdominoperineal resection and 1 pelvic exenteration), one patient had a local excision. Two among these thirty four patients had preoperative radiotherapy. Preoperative transrectal ultrasonographic staging was compared with pathologic findings. In staging depth of invasion, the overall accuracy was 88.8 percent, overstaged in 5.8 percent, understaged in 5.8 percent. Transrectal ultrasonography is the more accurate method than CT in staging of depth of tumor invasion (61.8% vs 88.8%). In staging of lymph nodes, the overall accuracy of transrectal ultrasonography was 85.3 percent, sensitivity was 71.7 percent and specificity was 88.8 percent. Transrectal ultrasonography is a safe, inexpensive and accurate staging method in the assessment of both depth of invasion and nodal status.
Adult ; Aged ; Female ; Human ; Male ; Middle Age ; Neoplasm Staging ; Predictive Value of Tests ; Rectal Neoplasms/pathology/*ultrasonography ; Sensitivity and Specificity

PURPOSE: We prospectively evaluated the prostate cancer detection rate and pathologic characteristics of patients with a serum prostate-specific antigen (PSA) level of 3.0 to 4.0ng/ml and we compared this with the patients who had a PSA level in the range of 4.1 to 10.0ng/ml. MATERIALS AND METHODS: We analyzed the data of patients who had PSA levels of 3.0 to 10.0ng/ml, benign findings on digital rectal examination (DRE) and no specific lesion identified on transrectal ultrasound. The clinical characteristics, cancer detection rate and pathologic findings of the biopsy and prostatectomy specimen were compared between the low (3.0 to 4.0ng/ml) and intermediate (4.1 to 10.0ng/ml) PSA groups. RESULTS: A total of 370 patients met our criteria and so they were included in the study. Sixty five and 305 patients had low or intermediate PSA levels, respectively. The mean age and the number of prostate biopsy cores were not different between the two groups. Prostate cancer was diagnosed in 26% of the low PSA group and in 20% of the intermediate PSA group. No significant difference was found between the two groups on the pathologic findings of the biopsy and on the pathology findings of the prostatectomy specimens, including the mean Gleason score, the percentage of patients with a Gleason score 7 or higher, the pathologic stage and the percentage of insignificant prostate cancer. CONCLUSIONS: No statistically significant difference was found in the incidence of prostate cancer or pathological characteristics on comparison between the low and intermediate PSA groups. These results suggest that a lower PSA cutoff should be considered as an indication for a prostate biopsy in the Korean population.
Biopsy ; Digital Rectal Examination ; Humans ; Incidence ; Neoplasm Grading ; Pathology ; Prospective Studies ; Prostate* ; Prostate-Specific Antigen ; Prostatectomy ; Prostatic Neoplasms* ; Ultrasonography

We report a case of prenatally diagnosed congenital perineal mass which was combined with anorectal malformation. The mass was successfully treated with posterior sagittal anorectoplasty postnatally. On ultrasound examination at a gestational age of 23 weeks the fetal perineal mass were found on the right side. Any other defects were not visible on ultrasonography during whole gestation. Amniocentesis was performed to evaluate the fetal karyotyping and acetylcholinesterase which were also normal. As the fetus grew up, the mass size was slowly increased more and more. At birth, a female neonate had a perineal mass on the right side as expected. During operation, the anal sphincteric displacement was found near the mass and reconstructed through posterior sagittal incision. This is the first reported case of prenatally diagnosed congenital perineal mass, after birth which was diagnosed as lipoblastoma and even combined with anorectal malformation. This case shows that it can be of clinical importance to be aware of this rare fetal perineal mass in prenatal diagnosis and counseling.
Adult ; Amniocentesis ; *Anal Canal/abnormalities/pathology/ultrasonography ; *Digestive System Abnormalities/diagnosis/pathology/ultrasonography ; Female ; Gestational Age ; Humans ; Infant, Newborn ; *Lipoma/diagnosis/pathology/ultrasonography ; Male ; *Perineum/pathology/ultrasonography ; Pregnancy ; Prenatal Diagnosis ; *Rectal Neoplasms/diagnosis/pathology/ultrasonography ; *Rectum/abnormalities/pathology/ultrasonography ; Ultrasonography, Prenatal/*methods

OBJECTIVETo evaluate the accuracy of endorectal ultrasonography in preoperative staging of rectal carcinoma.

METHODSThe 319 patients with rectal adenocarcinoma underwent endorectal ultrasonography evaluation from January 2007 to March 2010. There were 175 males and 144 females, and the age of patients were 22-82 year old (median 59 years). According their visiting time, 319 patients were divided into 3 groups (period A: January to December 2007; period B: January to December 2008; and period C: January 2009 to March 2010). All patients underwent endorectal ultrasonography, and the 3 doctors had finished evaluations with 272 cases (Doctor 1, 2, 3 had finished evaluations with 162, 64 and 46 cases respectively). The endorectal ultrasonography staging was compared with the pathology findings based on the surgical specimens in 319 patients who had surgery.

RESULTSOverall accuracy in assessing the level of rectal wall invasion was 67%. The accuracy of uT2 and uT3 were 43% and 81% respectively, and the difference was statistically significant (χ(2) = 30.54, P < 0.01), and the accuracy of uT4a was 59%, which was lower than uT3 (81%,χ(2) = 13.77, P < 0.01). Overall accuracy in assessing nodal involvement in the 311 patients treated with radical surgery was 66%. Staging accuracy tends to improve with experience, the accuracy with Doctor 1 in period C(staging accuracy of T and N were 84% and 81% respectively) were higher than period A(staging accuracy of T and N were 55% and 41% respectively) (χ(2) = 6.65 and 13.27, P < 0.01).

CONCLUSIONSTransrectal ultrasound for preoperative staging of rectal has higher accuracy with mastered ultrasound doctor.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Rectal Neoplasms ; diagnostic imaging ; pathology ; surgery ; Rectum ; diagnostic imaging ; Sensitivity and Specificity ; Ultrasonography ; Young Adult

Mucosa-associated lymphoid tissue (MALT) lymphoma is a typical primary gastrointestinal lymphoma, particularly in the stomach. Although primary rectal lymphoma is rare, it may present as a subepithelial tumor. Several techniques have been proposed for a tissue diagnosis in subepithelial tumor, including endoscopic ultrasonography (EUS)-guided fine needle aspiration (EUS-FNA), EUS-guided trucut biopsy (EUS-TCB), and tacked biopsy. However the diagnostic efficacy of these techniques appears to be limited. The unroofing technique involves removal of the overlying mucosa, thereby exposing the subepithelial lesion. It was originally reported as a method for endoscopic treatment of colorectal lymphangioma. In this case, a subepithelial tumor of the rectum was diagnosed using the endoscopic unroofing technique. This is a useful modality for the diagnosis of subepithelial tumor, because it provides histologic results in a safe and rapid manner.
Adult ; Antigens, CD20/metabolism ; Colonoscopy ; Humans ; Immunohistochemistry ; Intestinal Mucosa/surgery ; Lymphoma, B-Cell, Marginal Zone/*diagnosis/pathology/ultrasonography ; Male ; Rectal Neoplasms/*diagnosis/pathology/ultrasonography ; Tomography Scanners, X-Ray Computed

OBJECTIVETo identify the predictors of the positive results of transrectal ultrasound (TRUS)-guided biopsy for prostate cancer.

METHODSWe performed univariate and multivariate logistic regression analyses on the relevant data on 385 male patients that underwent TRUS-guided biopsy for prostate cancer, including such potential predictors as age, body mass index (BMI), symptoms, results of digital rectal examination (DRE), tPSA, fPSA, free/total PSA ratio (f/tPSA), prostate volume (PV), and PSA density (PSAD) for identification of the risk factors related to the positive rate of biopsy. Then we constructed a scoring system as a tool for predicting prostate cancer in repeat biopsies and determined the sensitivity of the system by calculating the false positive rate using the receiver operating characteristic curve.

RESULTSAmong the 385 patients, 139 (36.1%) were diagnosed with prostate cancer. On multivariate analysis, age (P < 0.01), DRE (P < 0.01), tPSA (P < 0.01), fPSA (P < 0.01), f/tPSA (P < 0.01), PV (P < 0.01), and PSAD (P < 0.01) were all significant predictors of prostate cancer. Multivariate logistic regression analysis showed age, tPSA, f/tPSA, PV, and PSAD to be independent predictors, with ORs and 95% CIs of 1.07 (1.05-1.16), 1.05 (1.02-1.15), 0.97 (0.86-0.99), 0.98 (0.87-0.96), and 1.79 (1.48-2.06), respectively. Moreover, patients with the risk score of 3-5 had a significantly higher rate of prostate cancer than those with 0-2 (64% vs 11%, P < 0.001).

CONCLUSIONThe scoring system on the key predictors of prostate cancer can help urologists to identify the men in need of prostatic biopsy.

Aged ; Digital Rectal Examination ; Humans ; Image-Guided Biopsy ; methods ; Logistic Models ; Male ; Middle Aged ; Prostate ; pathology ; Prostate-Specific Antigen ; analysis ; Prostatic Neoplasms ; chemistry ; pathology ; ROC Curve ; Risk Factors ; Ultrasonography, Interventional ; methods