diagnosis with all diseases were significant.CONCLUSION: Our complete enumeration of the Korean Pca population shows that ADT is not associated with increased risks of cardiovascular disease.]]>
Antineoplastic Agents ; Cardiovascular Diseases ; Cohort Studies ; Comorbidity ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; Humans ; Incidence ; Male ; Morinda ; Multivariate Analysis ; Myocardial Ischemia ; National Health Programs ; Observational Study ; Passive Cutaneous Anaphylaxis ; Prostate ; Prostatic Neoplasms ; Social Class

PURPOSE: The purpose of this study was to estimate the clinical utilization of radiation therapy (RT) in Korea between 2011 and 2015. MATERIALS AND METHODS: We analyzed the claims data from the Health Insurance Review and Assessment Service to estimate the clinical utilization of RT. The source population consisted of all patients who had any of the International Classification of Diseases 10th revision cancer diagnoses (C00-C97) and those with diagnostic codes D00-D48, who were also associated with at least one of the procedure codes related to RT. RESULTS: The total number of patients who received RT in 2011, 2012, 2013, 2014, and 2015 were 54,810, 59,435, 61,839, 64,062, and 66,183, respectively. Among them, the total numbers of male and female patients were 24,946/29,864 in 2011, 27,211/32,224 in 2012, 28,111/33,728 in 2013, 29,312/34,750 in 2014, and 30,266/35,917 in 2015. The utilization rate of RT in cancer patients has also increased steadily over the same period from 25% to 30%. The five cancers that were most frequently treated with RT between 2011 and 2012 were breast, lung, colorectal, liver, and uterine cervical cancers. However, the fifth most common cancer treated with RT that replaced uterine cervical cancer in 2013 was prostate cancer. More than half of cancer patients (64%) were treated with RT in the capital area (Seoul, Gyeonggi, and Incheon). CONCLUSION: The total number of patients who underwent RT increased steadily from 2011 to 2015 in Korea. The utilization rate of RT in cancer patients is also increasing.
Breast ; Diagnosis ; Female ; Gyeonggi-do ; Humans ; Insurance, Health ; International Classification of Diseases ; Korea* ; Liver ; Lung ; Male ; Prostatic Neoplasms ; Radiotherapy ; Uterine Cervical Neoplasms

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

PURPOSE: MicroRNAs (miRNAs) in biological fluids are potential biomarkers for the diagnosis and assessment of urological diseases such as benign prostatic hyperplasia (BPH) and prostate cancer (PCa). The aim of the study was to identify and validate urinary cell-free miRNAs that can segregate patients with PCa from those with BPH. METHODS: In total, 1,052 urine, 150 serum, and 150 prostate tissue samples from patients with PCa or BPH were used in the study. A urine-based miRNA microarray analysis suggested the presence of differentially expressed urinary miRNAs in patients with PCa, and these were further validated in three independent PCa cohorts, using a quantitative reverse transcriptionpolymerase chain reaction analysis. RESULTS: The expression levels of hsa-miR-615-3p, hsv1-miR-H18, hsv2-miR-H9-5p, and hsa-miR-4316 were significantly higher in urine samples of patients with PCa than in those of BPH controls. In particular, herpes simplex virus (hsv)-derived hsv1-miR-H18 and hsv2-miR-H9-5p showed better diagnostic performance than did the serum prostate-specific antigen (PSA) test for patients in the PSA gray zone. Furthermore, a combination of urinary hsv2-miR-H9-5p with serum PSA showed high sensitivity and specificity, providing a potential clinical benefit by reducing unnecessary biopsies. CONCLUSIONS: Our findings showed that hsv-encoded hsv1-miR-H18 and hsv2-miR-H9-5p are significantly associated with PCa and can facilitate early diagnosis of PCa for patients within the serum PSA gray zone.
Biomarkers ; Biopsy ; Cohort Studies ; Diagnosis ; Early Diagnosis ; Herpes Simplex ; Humans ; Microarray Analysis ; MicroRNAs* ; Passive Cutaneous Anaphylaxis ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms* ; Sensitivity and Specificity ; Simplexvirus ; Urologic Diseases

Adenocarcinoma ; metabolism ; pathology ; Atrophy ; Biomarkers ; metabolism ; Diagnosis, Differential ; Humans ; Male ; Prostate ; pathology ; Prostatic Diseases ; metabolism ; pathology ; Prostatic Hyperplasia ; metabolism ; pathology ; Prostatic Neoplasms ; metabolism ; pathology ; Prostatitis ; metabolism ; pathology ; Xanthomatosis ; metabolism ; pathology

PURPOSE: We are often confronted with patients in the "gray zone" (prostate-specific antigen [PSA]<10 ng/mL) whose biopsies reveal no malignancy but only inflammation. We investigated the relationship between histological inflammation and total PSA (tPSA), free PSA (fPSA), and percentage of free PSA (f/tPSA) levels in patients without prostate cancer (PC). MATERIALS AND METHODS: We studied 106 men with tPSA<10 ng/mL who had undergone biopsy that was negative for PC and who had no clinical prostatitis. Inflammation observed at biopsies was scored for inflammation type in each biopsy core by use of a four-point scale and was then correlated with tPSA, fPSA, and f/tPSA. RESULTS: Different patterns of inflammation were found in each set of biopsies. Regression factor analysis was used to form two groups according to inflammation type: more chronic and more acute. Median tPSA, fPSA, and f/tPSA levels in the more chronic and more acute inflammation groups were 6.4 ng/mL, 1.09 ng/mL, and 15%, and 7.3 ng/mL, 0.79 ng/mL, and l2%, respectively. A significant difference was found in fPSA (p=0.003) and f/tPSA (p<0.001), whereas the difference in tPSA was not significant (p=0.200). Total PSA correlated with fPSA (r=0.4, p<0.001) but not with inflammation type (r=0.12, p>0.010). A correlation existed between inflammation type and fPSA (r=-0.31, p=0.001) and f/tPSA (r=-0.43, p<0.001) in that the fPSA and f/tPSA were lower in the group with more acute inflammation. CONCLUSIONS: Subclinical inflammation has a significant influence on fPSA in patients with tPSA<10 ng/mL but without PC or clinical prostatitis. Subclinical inflammation is not characterized by elevated tPSA alone but also by a decreased fPSA, a tendency similar to that in PC.
Acute Disease ; Aged ; Aged, 80 and over ; Asymptomatic Diseases ; Biopsy, Large-Core Needle ; Chronic Disease ; Diagnosis, Differential ; Humans ; Kallikreins/*blood ; Male ; Middle Aged ; Prostate/pathology ; Prostate-Specific Antigen/*blood ; Prostatic Neoplasms/blood/diagnosis ; Prostatitis/*blood/diagnosis/pathology

OBJECTIVETo develop a nomogram for predicting the probability of prostate cancer at transrectal ultrasound-guided repeat prostate biopsy in Chinese men.

METHODSWe performed repeat biopsy for 170 patients with benign prostate diseases diagnosed on the first biopsy, and analyzed the correlation of positive repeat biopsy with age, prostate volume, PSA, free-to-total PSA (f-PSA/t-PSA), PSA velocity, PSA density, results of digital rectal examination (DRE) and previous histology. We entered the variables stepwise into logistic regression models, and established a nomogram for the risk score on the probability of positive repeat biopsy, whose predictive value was assessed by receiver operating characteristic (ROC) analysis.

RESULTSProstate cancer was detected in 31.8% of the repeat biopsies (54/170). The most accurate predictive nomogram comprised age, PSA, f-PSA/t-PSA, PSA velocity, prostate volume, DRE and previous prostatic intraepithelial neoplasia (PIN) findings. The nomogram exhibited a high predictive value, with the area under the ROC curve (AUC) of 82.4%, significantly greater than that of the prediction based on PSA density (AUC: 66.9%), prostate volume (AUC: 72.6%), PSA velocity (AUC: 69.6%), f-PSA/t-PSA (AUC: 69.3%), or DRE (AUC: 58.5% ) alone.

CONCLUSIONThe nomogram is an accurate multi-variable predicting tool to determine the probability of positive repeat prostate biopsy.

Aged ; Aged, 80 and over ; Area Under Curve ; Asian Continental Ancestry Group ; Biopsy, Needle ; methods ; Humans ; Logistic Models ; Male ; Middle Aged ; Nomograms ; Predictive Value of Tests ; Prostate ; pathology ; Prostatic Diseases ; pathology ; Prostatic Neoplasms ; diagnosis ; diagnostic imaging ; ROC Curve ; Ultrasonography

Prostate cancer is the most frequently diagnosed solid organ cancer in men and is the second leading cause of cancer-related deaths in men in the United Kingdom. Commonly, it metastasizes to bones and lymph nodes, however, in advanced hormonerefractory disease it may involve the skull base leading to associated cranial nerve palsies. Cranial nerve palsy as the presenting feature of advanced hormone-sensitive prostate cancer is extremely rare. To the best of our knowledge, we report the first case of solitary hypoglossal nerve palsy as the presenting feature of advanced prostate cancer. Neurologists, neurosurgeons and otolaryngologists may be the first clinicians to see such a patient; therefore, prostate cancer should be amongst the differential diagnoses considered in middle-aged and elderly men presenting with a cranial neuropathy and evidence of skull metastasis.
Aged ; Atrophy ; Cranial Nerve Diseases ; Diagnosis, Differential ; Great Britain ; Humans ; Hypoglossal Nerve Diseases ; Lymph Nodes ; Male ; Neoplasm Metastasis ; Prostate ; Prostatic Neoplasms ; Skull ; Skull Base ; Tongue

BACKGROUND: The prostate-specific antigen (PSA) is considered the most useful among tumor markers currently used. However, its quantitative results are interpreted only qualitatively for the diagnosis of prostate cancer. The recently introduced information theory enables the information of the quantitative results transformed into Shannon's entropy (S) that represents uncertainties and then "1-S" representing diagnostic certainty. METHODS: The 882 urological patients enrolled were categorized into 2 groups: a patient group comprising 233 patients with prostate cancer and a disease control group comprising 649 patients with benign prostate disease. The level of PSA in all the patients was tested and was found to be > or =2 ng/mL. The variables like PSA level and age were modeled on logistic regression analysis to predict the probability of prostate cancer and the diagnostic certainty. RESULTS: The mean (SD) of PSA levels in the patient group and the disease control group were 44.5 ng/mL (37.62 ng/mL) and 5.7 ng/mL (3.70 ng/mL), respectively. The logistic regression model fitted well when the age variable was dichotomized at the age of 55 yr. The diagnostic certainty was lowest at a PSA level of 18.90 ng/mL in the <55-yr age group, and 15.45 ng/mL in the >55-yr age group. CONCLUSIONS: The diagnostic certainty (1-S) of whether to diagnose prostate cancer or not at a certain PSA level could be obtained using the information theory. The methodology used in this study may help interpret the results of other quantitative tests.
Age Factors ; Aged ; Entropy ; Humans ; *Information Theory ; Logistic Models ; Male ; Middle Aged ; Prostate-Specific Antigen/*blood ; Prostatic Diseases/diagnosis ; Prostatic Neoplasms/*diagnosis

OBJECTIVETo explore acupuncture-assisted anesthesia in transrectal ultrasound guided prostate biopsy via the perineum.

METHODSOne hundred and five cases of prostate biopsy were randomly divided into two groups. For 51 cases in observation group (group A), the periprostatic nerve plexus block and acupuncture on bilateral Zusanli (ST 36) were applied. For 54 cases in control group (group B), the simple periprostatic nerve plexus block was adopted. Visual Analogue Score (VAS) was used to evaluate the pain extent after biopsy and blood pressure and heart rate were monitored before, during and after operation, separately.

RESULTSVAS scores were 0.9 +/- 0.8 and 2.8 +/- 1.0 in group A and group B, separately, indicating statistical significant difference in comparison (P < 0.01). Additionally, in group B, blood pressure and heart rate during and after operation were higher remarkably than those before operation (all P < 0.05). Moreover, in group B, blood pressure during operation and heart rate during and after operation were all higher apparently than those in group A (all P < 0.05).

CONCLUSIONAcupuncture-assisted anesthesia alleviates apparently pain and discomforts during transrectal ultrasound guided prostate biopsy via the perineum in patients and ensures the stability of blood pressure and heart rate.

Acupuncture Analgesia ; Adult ; Aged ; Aged, 80 and over ; Biopsy ; Humans ; Male ; Middle Aged ; Pain Management ; Perineum ; innervation ; Prostate ; pathology ; Prostatic Diseases ; diagnosis ; pathology