OBJECTIVE: To explore the application value of joint detection of serum neutrophil-to-lymphocyte ratio (NLR), prostate-specific antigen (PSA) and MMP26 in differentiating prostate cancer (PCa) from benign prostatic hyperplasia (BPH). METHODS: A total of 61 PCa patients (PCa group) and 63 BPH patients (BPH group) who were treated in The Affiliated Huaian Hospital of Xuzhou Medical University from May 2022 to May 2024 were retrospectively included. The relevant clinical data of all subjects were collected with the serum NLR, PSA and MMP26 levels being detected. Multivariate logistic regression analysis was used to analyze the influencing factors in differentiating PCa from BPH. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of serum NLR, PSA and MMP26 in differentiating PCa from BPH. RESULTS: The levels of TC and LDL-C in the PCa group were higher than those in the BPH group. And the level of HDL-C in the PCa group was lower than that in the BPH group (P<0.05). The serum levels of NLR, PSA and MMP26 in the PCa group were higher than those in the BPH group (P<0.05). The results of multivariate logistic regression analysis showed that NLR, PSA and MMP26 were risk factors for the diagnosis of PCa in patients (P<0.05). The ROC results showed that the area under the curve (AUC) of NLR, PSA MMP26 and joint diagnosis in the identification of PCa was 0.804, 0.800, 0.809 and 0.905, respectively. The comparison results of AUC showed that the joint diagnosis was superior to the single diagnosis (Z=2.262, 2.177, 2.002, P<0.05). CONCLUSION The joint detection of serum NLR, PSA and MMP26 has significant application value in the differentiation of PCa and BPH, which is expected to become an effective tool for early screening and diagnosis of PCa.
Humans ; Male ; Prostatic Hyperplasia/blood* ; Prostate-Specific Antigen/blood* ; Diagnosis, Differential ; Prostatic Neoplasms/blood* ; Retrospective Studies ; Neutrophils ; Lymphocytes ; ROC Curve ; Aged ; Middle Aged

OBJECTIVE: To explore the role of prostate health index (PHI) and its derivatives for early screening in patients with PI-RADS score 3 and prostate-specific antigen (PSA) levels of 4－20 μg/L. METHODS: Clinical data of 203 patients with a score of 3 on the PI-RADS v2.1 scoring system who underwent ultrasound-guided transperineal prostate aspiration biopsy from April 2021 to April 2024 from Provincial Hospital of Shandong First Medical University, Qilu Hospital of Shandong University and Weifang People's Hospital were collected. Patients who met the inclusion criteria were divided into prostate cancer (PCa) group (62 cases) and benign prostatic hyperplasia (BPH) group (141 cases). Serum total prostate-specific antigen (tPSA), serum free prostate-specific antigen (fPSA), and PSA isoform 2 (p2PSA) were routinely detected after admission. And prostate-specific antigen density (PSAD), prostate health index (PHI) and prostate health index density (PHID) were calculated with the basic personal information being collected. The efficacy of each parameter in early screening of patients with PI-RADS score of 3 and PSA level of 4－20 μg/L was assessed using ROC curve approach. RESULTS: There was no statistical difference in tPSA, fPSA and fPSA/tPSA between the two groups (P>0.05). There was a statistical difference in p2PSA, PSAD, PHI, PHID and age between the two groups (P<0.05). PHI (AUC=0.783 7, 95% CI: 0.711 3－0.856 1) and PHID (AUC=0.782 3, 95% CI: 0.708 3－0.856 4) showed a good predictive ability in the early screening of prostate cancer. In the clinically significant prostate cancer (csPCa) group, the ROC curve areas of PHI and PHID were 0.823 0 and 0.788 5, respectively, which showed better predictive efficacy of prediction of csPCa. The ROC curves of the combined diagnostic indexes were plotted on the basis of the independent ROC curves, and the area under the curve of PHI combined with age, p2PSA and PHID (AUC=0.843 6) was the largest and had the best predictive ability among all the combined diagnostic indexes. CONCLUSION In patients with PI-RADS score 3 and PSA level between 4 and 20 μg/L, PHI and its derivatives (PHI and PHID) provide a new way for early screening of prostate cancer compared with the traditional index tPSA, which has a high value of application in reducing the over-penetration.
Humans ; Male ; Prostatic Neoplasms/diagnosis* ; Prostate-Specific Antigen/blood* ; Prostatic Hyperplasia/diagnosis* ; Prostate/pathology* ; Early Detection of Cancer ; ROC Curve ; Middle Aged ; Aged

A cross-sectional study was conducted to estimate the age-stratified normal levels and age-related changes in the risk predictors of benign prostatic hyperplasia (BPH) progression. A total of 4706 male participants aged 40 years or older in Zhengzhou (China) were enrolled. The values of the International Prostate Symptom Score (IPSS), prostate-specific antigen (PSA), prostate volume (PV), and postvoid residual urine volume (PVR) significantly increased with age. Nonlinear relationships between age and IPSS scores ≥8 (P for nonlinearity = 0.046), PSA level ≥1.6 ng ml^-1, PV ≥31 ml, or PVR ≥39 ml (all P for nonlinearity <0.001) were observed. After the age of 61 years, the risk indicators related to BPH progression were positively correlated with age (odds ratio [OR] >1), regardless of the predictors of the IPSS score, PSA level, PV, or PVR; and the OR values increased gradually. Therefore, after the age of 61 years, the risk predictors related to BPH progression were positively correlated with age.
Humans ; Male ; Prostatic Hyperplasia/diagnosis* ; Prostate-Specific Antigen ; Cross-Sectional Studies ; East Asian People ; Risk Factors

PURPOSE: The purpose of this study was to determine whether histologic inflammation (HI) in initial and repeat prostate biopsy specimens was significantly associated with the detection of prostate cancer. MATERIALS AND METHODS: Between 2005 and 2017, the clinicopathological records of patients with high prostate-specific antigen (PSA) levels who underwent initial and repeat prostate biopsies were retrospectively reviewed. The presence of HI and its degree in each biopsied specimen were interpreted by one uropathologist with 20 years of experience. The association between HI and cancer diagnosis was statistically assessed, with p < 0.05 considered significant, and the cancer and non-cancer groups were compared. RESULTS: Among the 522 patients with a median PSA levels of 6.5 ng/dL, including 258 (49.4%) whose cancer was diagnosed following repeat biopsy, the median degrees of HI in the initial and repeat biopsies were 25.0% and 41.7%, respectively. Furthermore, 211 (40.4%) and 247 (47.3%) patients had HI (> 0%) on biopsied specimens, respectively. Comparison of the cancer and noncancer groups revealed that a greater rate of HI specimens in the initial biopsy was associated with fewer prostate cancer diagnoses following repeat biopsy (p < 0.001). Other comparisons between the cancer and non-cancer groups showed that the cancer group had a significantly higher rate of hypertension, whereas those non-cancer group had a significantly higher rate of benign prostatic hyperplasia and prostatitis (p < 0.05). CONCLUSION: A finding of a lesser degree of HI in the initial and a greater degree of HI in the repeat biopsied specimens was associated with the higher probability of cancer diagnosis in patients with high PSA levels.
Biopsy ; Diagnosis ; Humans ; Hypertension ; Inflammation ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Prostatitis ; Retrospective Studies

Prostate cancer (CaP) is the most common cancer diagnosed among men in the United States and the fifth most common cancer among men in Korea. Unfortunately, the early stages of CaP may have no symptoms. Thus, early detection is very important and physicians managing voiding dysfunction must have awareness about CaP. The traditional tests used for early detection of CaP are the prostate-specific antigen (PSA) blood test and digital rectal examination. However, a high PSA level is not specific for CaP. Benign prostatic hyperplasia, prostatitis, urinary tract infection, and urinary retention can all cause a high PSA level. Thus, no test shows sufficient accuracy to truly be useful for screening men for CaP. A prostate biopsy is the only method that yields a definitive diagnosis of CaP; however, this test is invasive and uncomfortable. Recently, new biomarkers for CaP detection have been proposed to improve the accuracy of the PSA test. In this review, we summarize our knowledge of various new biomarkers, including PSA-associated biomarkers (the prostate health index and 4Kscore), molecular biomarkers (PCA3, TMPRSS2: ERG fusion gene, and various miRNAs), and proteomics-associated biomarkers, and the ways in which they may improve the detection rate of CaP. Accordingly, this review can raise awareness about CaP to physicians managing voiding dysfunction and be a good reference for them.
Biomarkers ; Biopsy ; Diagnosis ; Digital Rectal Examination ; Discrimination (Psychology) ; Early Detection of Cancer ; Hematologic Tests ; Humans ; Korea ; Male ; Mass Screening ; Methods ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Prostatitis ; United States ; Urinary Retention ; Urinary Tract Infections

Prostatic calculi often occur in middle-aged and old men. Prostatic calculi are usually classified as primary/endogenous stones or secondary/extrinsic stones. Endogenous stones are commonly caused by obstruction of the prostatic ducts around the enlarged prostate by benign prostatic hyperplasia (BPH) or by chronic inflammation. Extrinsic stones occur mainly around the urethra, because they are caused by urine reflux. The exact prevalence of prostatic calculi is not known, and it has been reported to vary widely, from 7% to 70%. Most cases of prostatic calculi are not accompanied by symptoms. Therefore, most cases are found incidentally during the diagnosis of BPH using transrectal ultrasonography (TRUS). However, prostatic calculi associated with chronic prostatitis may be accompanied by chronic pelvic pain. Rare cases have been reported in which extrinsic prostatic calculi caused by urine reflux have led to voiding difficulty due to their size. More than 80% of prostatic calculi are composed of calcium phosphate. Prostatic calculi can be easily diagnosed using TRUS or computed tomography. Treatment is often unnecessary, but if an individual experiences difficulty in urination or chronic pain, prostatic calculi can be easily removed using a transurethral electroresection loop or holmium laser.
Calcium ; Calculi ; Chronic Pain ; Diagnosis ; Humans ; Inflammation ; Lasers, Solid-State ; Male ; Pelvic Pain ; Prevalence ; Prostate ; Prostatic Hyperplasia ; Prostatitis ; Ultrasonography ; Urethra ; Urination

PURPOSE: To identify factors associated with successful sacral nerve stimulator (SNS) trial after SNS implantation for the treatment of medication refractory overactive bladder (OAB). METHODS: Patients undergoing treatment for OAB at Lahey Hospital and Medical Center between 2004 and 2016 were identified. Patients undergoing SNS placement were identified; SNS success was defined as permanent implantation of the SNS. Demographic, clinical and treatment data were extracted from patient charts; uni- and multivariate analyses were conducted to identify factors associated with SNS treatment success. RESULTS: A total of 128 patients were included. On univariate analysis, male sex, prior diagnosis of benign prostatic hyperplasia, and lower volume at first urge on urodynamics (UDS) were associated with unsuccessful SNS trial. On multivariate analysis, male sex (odds ratio [OR], 0.145; 95% confidence interval [CI], 0.036–0.530) and lower volume at first urge on UDS (OR, 0.982; 95% CI, 0.967–0.995) were associated with unsuccessful SNS trial. A threshold value of 100 mL at first urge during preoperative UDS had a specificity of 0.86 in predicting SNS success in men. CONCLUSIONS: SNS is frequently successful at relieving OAB symptoms. Male patients and those with lower volumes at first urge on UDS, particularly below 100 mL, are more likely to have an unsuccessful SNS trial. Patients in these groups should be counseled on the lower likelihood of SNS success.
Botulinum Toxins ; Diagnosis ; Humans ; Male ; Multivariate Analysis ; Prostatic Hyperplasia ; Sensitivity and Specificity ; Urinary Bladder, Overactive* ; Urinary Incontinence ; Urodynamics

PURPOSE: This study was to identify the quality of life and its related factors in patients with benign prostatic hyperplasia. METHODS: A cross-sectional survey design was utilized. Data were collected using questionnaires from 128 patients with benign prostatic hyperplasia who visited an outpatient department at one general hospital in 2016. Data were analyzed using Mann-Whitney U test, Kruskal Wallis test, Pearson's correlation coefficient and hierarchical multiple regression analysis. RESULTS: Mean age of the participant was 67.81±6.94. Mean years since diagnosis was 6.41±5.20. The mean score of quality of life was 0.82±0.09, indicating that QOL was relatively low. Lower urinary tract symptoms (p=.029), anxiety, depression, Activities of daily living were significantly correlated to with quality of life (p<.001). Activities of daily living accounted for 54% (p<.001) of the variance in quality of life as a result of hierarchical multiple regression analysis. CONCLUSION: The results of the study showed that nursing intervention may improve the quality of life of patients with benign prostatic hyperplasia by increasing their Activities of daily living.
Activities of Daily Living ; Anxiety ; Cross-Sectional Studies ; Depression ; Diagnosis ; Hospitals, General ; Humans ; Lower Urinary Tract Symptoms ; Nursing ; Outpatients ; Prostatic Hyperplasia ; Quality of Life

Objective: To investigate the correlation between the syndrome types of traditional Chinese medicine (TCM) and clinical symptoms of benign prostatic hyperplasia (BPH) with chronic prostatitis (BPH-CP). METHODS: We selected 150 cases of BPH-CP in this study and divided them into 7 TCM syndrome types. Using univariate and multivariate logistic regression analyses, we studied the correlation of each TCM syndrome type with the age, disease course, prostate volume, postvoid residual urine volume (PVR), prostate-specific antigen (PSA) level, maximum urinary flow rate (Qmax), and International Prostate Symptoms Score (IPSS). RESULTS: Kidney-yin deficiency was correlated positively with the prostate volume but negatively with Qmax and IPSS; kidney-yang deficiency positively with the age and prostate volume but negatively with IPSS; the damp heat syndrome positively with the PSA level but negatively with the disease course, prostate volume and Qmax; the spleen-qi deficiency syndrome positively with the prostate volume but negatively with the disease course; liver-qi stagnation positively with the disease course but negatively with the age, prostate volume and PVR; the syndrome of qi stagnation and blood stasis positively with the disease course and IPSS but negatively with PVR; the syndrome of lung-heat and qi blockage positively with the age, Qmax and IPSS but negatively with the disease course. CONCLUSIONS The TCM syndrome types of BPH-CP are closely correlated to their clinical symptoms. The analysis of the clinical objective indexes of BPH-CP can provide some reliable evidence for accurate identification of the TCM syndrome type of the disease.
Age Factors ; Chronic Disease ; Disease Progression ; Humans ; Kidney Diseases ; diagnosis ; Liver Diseases ; diagnosis ; Male ; Medicine, Chinese Traditional ; Organ Size ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; classification ; diagnosis ; Prostatitis ; classification ; diagnosis ; Qi ; Regression Analysis ; Splenic Diseases ; diagnosis ; Symptom Assessment ; classification ; methods ; Urination ; Yang Deficiency ; diagnosis ; Yin Deficiency ; diagnosis

Objective: To investigate the expressions of interleukin-17 (IL-17) and interleukin-8 (IL-8) in benign prostatic hyperplasia (BPH) and BPH complicated with histological inflammation and their significance. METHODS: According to the results of HE staining, we divided 60 cases of BPH treated by transurethral resection of the prostate (TURP) into a BPH group (n = 23) and a BPH with inflammation group (n = 37). We analyzed the clinical data of the patients and determined the mRNA and protein expressions of IL-17 and IL-8 by immunohistochemistry, real-time fluorescence quantitative PCR, and Western blot, respectively. RESULTS: Compared with the BPH patients complicated with inflammation, the BPH group showed significantly lower International Prostate Symptom Score (IPSS) (29.1 ± 6.2 vs 21.6 ± 3.7), quality of life score (QoL) (5.4 ± 1.3 vs 4.4 ± 1.6), postvoid residual urine volume (RUV) (［198.6 ± 15.5］ vs ［98.2 ± 19.3］ ml), prostate volume (［69.2 ± 24.1］ vs ［49.8 ± 16.5］ ml), PSA level (［7.4 ± 1.9］ vs ［2.8 ± 0.8］ μg/L) and serum c-reactive protein content (CRP) (［5.1±2.0］ vs ［1.5±0.6］ mg/L), but a higher maximum urine flow rate (Qmax) (［4.7 ± 2.1］ vs ［8.2 ± 1.8］ ml/s) (all P<0.05). The former group had a significantly higher incidence rate of urinary retention than the latter (32.4% ［12/37］ vs 8.69% ［2/23］), mRNA expressions of IL-17 (0.303 ± 0.076 vs 0.042 ± 0.019) and IL-8 (0.536 ± 0.059 vs 0.108 ± 0.025), and protein expressions of IL-17 (0.88 ± 0.10 vs 0.34 ± 0.05) and IL-8 (1.07 ± 0.08 vs 0.43 ± 0.04) (all P<0.05). CONCLUSIONS The expressions of IL-17 and IL-8 are upregulated in the prostatic tissue of the BPH patients with inflammation, which may play a significant role in the development and progression of BPH.
Disease Progression ; Humans ; Inflammation ; metabolism ; Interleukin-17 ; metabolism ; Interleukin-8 ; metabolism ; Male ; Organ Size ; Prostate ; pathology ; Prostatic Hyperplasia ; complications ; metabolism ; Quality of Life ; RNA, Messenger ; metabolism ; Transurethral Resection of Prostate ; Treatment Outcome ; Urinary Retention ; diagnosis ; etiology