• 대한비뇨기종양학회지
• /
• 제16권3호
• /
• pp.110-118
• /
• 2018

Purpose: The aim of this study is to confirm the detection rate of transperineal biopsy after multiparametric magnetic resonance imaging (mpMRI) and compared it to that of transrectal biopsy. We also examined the role of mpMRI and the rate of complications for each method. Materials and Methods: In a retrospective study, we analyzed 147 patients who underwent mpMRI before prostate biopsy because of elevated serum prostate-specific antigen and/or abnormal digital rectal examination findings at Korea University Hospital, Seoul, Korea from March 2017 to April 2018. Regions on the mpMRI that were suggestive of prostate cancer were categorized according to the Prostate Imaging-Reporting and Data System (PI-RADS v2). For transperineal biopsy, a 20-core saturation biopsy was performed by MRI-TRUS cognitive or fusion techniques and a 12-core biopsy was performed in transrectal biopsy. Results: Sixty-three and 84 patients were enrolled in transperineal group and transrectal group, respectively. The overall detection rate of prostate cancer in transperineal group was 27% higher than that in transrectal group. Classification according to PI-RADS score revealed a significant increase in detection rate in all patients, as the PI-RADS score increased. Frequency of complications using the Clavien-Dindo classifications revealed no significant differences in the total complications rate, but two patients in transrectal group received intensive care unit care due to urosepsis. Conclusions: Our results confirmed that transperineal biopsy is superior to transrectal biopsy for the detection of prostate cancer. From the complication point of view, this study confirmed that there were fewer severe complications in transperineal biopsy.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권13호
• /
• pp.5261-5264
• /
• 2015

Purpose: To examine the effectiveness of serum free-to-total prostate specific antigen ratio (%fPSA) for the detection of prostate cancer (PCa) in men with different serum total PSA (tPSA) categories. Materials and Methods: From January 2010 to December 2013, a total of 225 patients with lower urinary tract symptoms (LUTS) underwent tPSA and %fPSA measurements. Histological examination with calculation of Gleason score and whole body bone scans were performed in identified cases of PCa. Results: PCa was diagnosed in 44 (19.6%) patients and the remaining 181 patients had benign prostate disease. PCa was detected in 5 (23.8%), 13 (8.7%) and 26 (47.3%) cases with tPSA level ranges ${\leq}4ng/ml$, 4 to 10 ng/ml and >10 ng/ml, respectively. The average Gleason score was $7.2{\pm}0.2$. Some 6 (13.6%) out of 44 PCa patients had bone metastases. The sensitivity was 80% and specificity was 81.3% at the cut-off %fPSA of 15% in PCa patients with a tPSA level below 4 ng/mL. A lower %fPSA was associated with PCa patients with Gleason score ${\geq}7$ than those with Gleason score ${\leq}6$ ($11.7{\pm}0.98$ vs. $16.5{\pm}2.25%$, P=0.029). No obvious relation of %fPSA to the incidence of bone metastasis was apparent in this study. Conclusions: The clinical application of %fPSA could help to discriminate PCa from benign prostate disease in men with a tPSA concentration below 4 ng/mL.

• Journal of Yeungnam Medical Science
• /
• 제22권2호
• /
• pp.199-210
• /
• 2005

전 세계적으로 비만 인구의 급격한 증가와 이로 인한 다양한 만성질환의 증가가 중요한 건강 문제로 대두되고 있으며, 최근 여러 종류의 암들도 비만과 연관성이 있을 것이라는 연구들이 많이 이루어지고 있다. 비만과 암과의 연관성에 대한 정확한 기전은 아직 밝혀지지 않았으나 다양한 스테로이드와 펩타이드 호르몬 그리고 성장인자가 중요한 역할을 할 것으로 생각되어지며, 전립선암 역시 호르몬 의존성의 종양이므로 남성 비만 환자에서의 증가된 혈청 에스트로겐 농도와 교감 신경계의 활성화 등 비만과 관련된 호르몬의 변화는 전립선암과도 상당한 연관이 있을 것으로 추정된다. 그러나, 지금까지의 비만과 전립선암과의 연관성에 대한 임상연구들은 대부분 서구인을 대상으로 시행되었으며 그 결과 또한 서로 상반되게 발표되고 있어 명확한 연관성을 밝히지 못하고 있는 실정이다. 이에 본 저자들은 한국인을 대상으로 비만과 전립선암과의 연관성을 알아보고자 2000년 1월부터 2005년 6월까지 영남대학교 의과대학 부속병원 비뇨기과에서 임상적으로 전립선암이 의심되어 경직장초음파유도하 전립선생검(transrectal ultrasound guided prostate biopsy)을 시행한 286명을 대상으로 환자들의 의무기록을 후향적으로 분석하여, 환자의 나이, 키, 몸무게, BMI, PSA, DRE, TRUS, 경직장초음파유도하 전립선생검, Gleason 점수, 임상적 병기 등을 비교, 분석하였다. 본 연구 결과에서는 BMI와 전립선암 발병률과는 연관성을 확인 할 수 없었으며, BMI와 임상적 병기와는 다소 연관성이 있는 것으로 나타났으나 통계적 유의성은 없었다. 이러한 비만 환자를 대상으로 한 연구에서는 비만의 기준에 따라서 큰 차이가 유발될 수 있으며, 비만 환자의 경우 전립선암 진단 및 치료 방법 등에 있어서 다양한 편견 및 오류가 작용할 수 있을 것으로 생각된다. 따라서, 비만과 전립선암과의 명확한 연관성을 확인하기 위해서는 향후 비만에 영향을 미칠 수 있는 다양한 인자와 호르몬 측정 및 BMI 이외의 여러 가지 비만 지수 등의 측정을 포함한 대규모 임상연구가 필요하리라 생각된다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권6호
• /
• pp.2693-2697
• /
• 2014

Background: Isoflavones, which are included in soybeans, have been suggested to protect against prostate cancer. Equol, one of isoflavones, is an intestinally derived bacterial metabolite of daidzein. A newly identified equol-producing bacterium, Slackia sp. strain NATTS, with a high equol-producing activity was isolated from human feces in Japanese adults. Counts of Slackia sp. strain NATTS in intestinal flora have not been assessed with regard to prostate cancer risk. In this study, we investigated the association of serum isoflavones and counts of Slackia sp. strain NATTS with prostate cancer risk in a case-control study. Materials and Methods: Concentrations of isoflavones and counts of Slackia sp. strain NATTS in feces were measured from 44 patients with prostate cancer and 28 hospital controls. The risk of prostate cancer was evaluated in terms of odds ratios (ORs) and 95% confidence intervals (CIs) by the logistic regression analysis. Results: The detection proportions of Slackia sp. strain NATTS in cases and controls were 34.1% and 25.0%, respectively. Counts of Slackia sp. strain NATTS were significantly correlated with serum concentrations of equol both in cases and controls (Spearman correlation coefficients, $r_s$=0.639 and $r_s$=0.572, p<0.01, respectively). Serum concentrations of genistein, daidzein, glycitein, and equol were not significantly associated with risk of prostate cancer. Conclusions: This study found that counts of Slackia sp. strain NATTS correlated with serum concentrations of equol both in prostate cancer cases and controls, but serum isoflavone concentrations were not associated with risk of prostate cancer in our patients.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권11호
• /
• pp.4863-4865
• /
• 2016

Background: Prostatic adenocarcinoma by Prosate cancer (PCa) is the most prevalent cancer and the second cause of cancer-related death among men in the Western world. Human papilloma virus (HPV) may be considered as a preventable risk factor. In this study, we assessed the frequencies of HPV infection in prostatic adenocarcinoma and benign prostatic hyperplasia (BPH) cases in Northeast Mexico. Materials and Methods: A total of 87 paraffin-embedded blocks (from 25 and 62 patients with definite diagnoses of BPH and adenocarcinoma, respectively) were selected and subjected to INNOLiPA HPV Genotyping to detect 28 high- and low-risk HPV types. The rates of infection were compared in the two studied groups. Results: INNOLiPA HPV demonstrated great sensitivity for HPV detection on paraffin-embedded tissue. Global prevalence was 14.9% (13/87). HPV infection was positive in 19.4% (12/62) of patients with adenocarcinoma and 4.0% (1/25) of patients with BPH. HPV-11, which is considered to be low risk, was more prevalent. Interestingly, one patient with BPH and six with prostate cancer showed examples considered to be high risk (HPV-18, -51, -52, and -66). Conclusion: A higher rate of HPV infection among Mexican patients with prostatic carcinoma than among those with BPH was observed. HPV infections may thus contribute to the risk of prostate cancer. Further studies are required to elucidate any roles of HPV infection in prostate disease in Mexico and the effect of prevention and treatment of HPV infection on prostatic adenocarcinoma.

• 대한방사성의약품학회지
• /
• 제8권2호
• /
• pp.129-137
• /
• 2022

Bombesin has a high binding affinity to gastrin-releasing peptide receptor (GRPR) and can be used as a targeting ligand in GRPR-related cancers. Because GRPR is overexpressed in prostate cancer, bombesin analogues have been investigated extensively for diagnosis and treatment of prostate cancer. In nuclear medicine, bombesin derivatives labeled with radiometals such as ^55/57Co, ⁶⁴Cu, ⁶⁸Ga, ^99mTc, and ¹⁷⁷Lu or radiohalogen such as ¹³¹I and ²¹¹At were developed as markers for early detection of tumors and theragnostic tool for cancer treatment. This review focuses on the introduction of bombesin-based radiopharmaceuticals that are studied in pre-clinical or clinical research.

• 대한영상의학회지
• /
• 제84권6호
• /
• pp.1220-1232
• /
• 2023

전립선암의 진단은 전립선을 10-12구역으로 나눠서 무작위로 조직을 얻는 체계적 생검 방식이 표준적으로 사용되어 왔다. 그러나 종괴의 위치나 유무와 상관없이 조직의 획득이 이루어지기 때문에 일부 전립선암을 놓치거나 임상적으로 중요하지 않은 암을 과도하게 발견한다는 점에서 비판을 받고 있다. 이를 보완하기 위해 자기공명영상 기반 전립선 표적 생검이 제안되었으며 이는 자기공명영상에서 의심 병변을 발견 후 이를 토대로 초음파 유도 혹은 MRI 유도하에 표적 생검을 하는 방식이다. 본 종설에서는 자기공명영상 기반 표적 생검의 방식에 대해서 살펴보고 최근 전립선암 진단에 있어서의 가이드라인과 최근 동향에 대해 다루고자 한다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권18호
• /
• pp.8387-8390
• /
• 2016

Background: Treatment of biochemical failure after radical prostatectomy for prostate cancer is largely empirically based. The use of PSA kinetics has been used as a guide to determine local or systemic treatment of biochemical failure. We here compared PSA kinetics with detection of bone marrow micrometastasis as methods to determine local or systemic relapse. Materials and Methods: A transversal study was conducted of men with biochemical failure, defined as a serum PSA >0.2ng/ml after radical prostatectomy. Consecutive patients having undergone radical prostatectomy and with biochemical failure were enrolled and clinical and pathological details were recorded. Bone marrow biopsies were obtained from the iliac crest and touch prints made, micrometastasis (mM) being detected using anti-PSA. The clinical parameters of total serum PSA, PSA velocity, PSA doubling time and time to biochemical failure, age, Gleason score and pathological stage were registered. Results: A total of 147 men, mean age $71.6{\pm}8.2years$, with a median time to biochemical failure of 5.5 years (IQR 1.0-6.3 years) participated in the study. Bone marrow samples were positive for micrometastasis in 98/147 (67%) of patients at the time of biochemical failure. The results of bone marrow micrometastasis detected by immunocytochemistry were not concordant with local relapse as defined by PSA velocity, time to biochemical failure or Gleason score. In men with a PSA doubling time of < six months or a total serum PSA of >2,5ng/ml at the time of biochemical failure the detection of bone marrow micrometastasis was significantly higher. Conclusions: The detection of bone marrow micrometastasis could be useful in defining systemic relapse, this minimally invasive procedure warranting further studies with a larger group of patients.

• Korean Journal of Radiology
• /
• 제21권6호
• /
• pp.684-694
• /
• 2020

Objective: The purpose was to review the diagnostic performance of the length of tumor capsular contact (LCC) on magnetic resonance imaging (MRI) for detecting prostate cancer extraprostatic extension (EPE). Materials and Methods: PubMed and EMBASE databases were searched up to March 24, 2019. We included diagnostic accuracy studies that evaluated LCC on MRI for EPE detection using radical prostatectomy specimen histopathology as the reference standard. Quality of studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Sensitivity and specificity were pooled and graphically presented using hierarchical summary receiver operating characteristic (HSROC) plots. Meta-regression and subgroup analyses were conducted to explore heterogeneity. Results: Thirteen articles with 2136 patients were included. Study quality was generally good. Summary sensitivity and specificity were 0.79 (95% confidence interval [CI] 0.73-0.83) and 0.67 (95% CI 0.60-0.74), respectively. Area under the HSROC was 0.81 (95% CI 0.77-0.84). Substantial heterogeneity was present among the included studies according to Cochran's Q-test (p < 0.01) and Higgins I² (62% and 86% for sensitivity and specificity, respectively). In terms of heterogeneity, measurement method (curvilinear vs. linear), prevalence of Gleason score ≥ 7, MRI readers' experience, and endorectal coils were significant factors (p ≤ 0.01), whereas method to determine the LCC threshold, cutoff value, magnet strength, and publication year were not (p = 0.14-0.93). Diagnostic test accuracy estimates were comparable across all assessed MRI sequences. Conclusion: Greater LCC on MRI is associated with a higher probability of prostate cancer EPE. Due to heterogeneity among the studies, further investigation is needed to establish the optimal cutoff value for each clinical setting.

• Investigative Magnetic Resonance Imaging
• /
• 제21권3호
• /
• pp.139-147
• /
• 2017

Purpose: To evaluate differences in staging accuracy of prostate cancer according to the extent of hemorrhage on multiparametric MRI performed after biopsy. Materials and Methods: We enrolled 71 consecutive patients with biopsy-proven prostate cancer. Patients underwent MRI followed by a prostatectomy at our institution in 2014. Two radiologists reviewed the MRI to determine the tumor stage. Correlation between biopsy-MRI interval and extent of hemorrhage was evaluated. Regression analyses were used to determine factors associated with accuracy of tumor staging. Results: The mean interval between biopsy and MRI was $17.4{\pm}10.2days$ (range, 0-73 days). The interval between prostate biopsy and MRI and the extent of hemorrhage were not significantly correlated (P = 0.880). There was no significant difference in the accuracy rate of staging between the small and large hemorrhage groups. Conclusion: Biopsy-induced hemorrhage in the prostate gland is not sufficiently absorbed over time. The extent of hemorrhage and the short interval between biopsy and MRI may not impair tumor detection or staging on multiparametric MRI.