Misleading skeletal surveys of prostatic carcinoma.

Bone sclerosis can be a manifestation of regressing metastatic bone disease of carcinoma of the prostate and should not be misconstrued as further dissemination. In eight of our patients the skeletal survey radiographs were misleading, whereas the bone scan provided an accurate assessment of metastatic activity.     

Staging of prostatic carcinoma. Accuracy of magnetic resonance

Twenty-nine prostatic cancer patients were evaluated for staging purpose by Magnetic Resonance (MR). MR findings were correlated with the pathologic examination in 18/29 patients who underwent radical prostatectomy. Four MR staging parameters were evaluated individually: periprostatic fat; periprostatic venous plexus; seminal vesicles and pelvic adenopathy. MR correctly staged 16/18 patients, with one case of overstaging and one case of understaging. The diagnostic accuracy of MR in differentiating intracapsular stage B from extracapsular stage C was 87%, with a sensitivity of 90% and a specificity of 87%. MR and CT results agreed in 4 of the 7 operated patients who were examined with both techniques; in 3 cases there was disagreement, and MR was correct.     

Dose estimation in strontium-89 radiotherapy of metastatic prostatic carcinoma.

Strontium-89 radiotherapy is becoming an important treatment in the palliation of bone pain from osteoblastic metastases. The absorbed dose delivered to bone metastases during 89Sr radiotherapy has been estimated in four patients with metastatic prostatic carcinoma. Patients were injected with a tracer dose of 85Sr-chloride. Blood and urine samples were obtained during the week following injection. Strontium-85 scintigrams of metastases and normal bone were obtained up to 8 wk postinjection. Half of the patients showed elevated whole-body retention; plasma-strontium concentrations were decreased from normal values. Uptake of strontium in metastases was 2-25 times that in normal bone but rates of washout of strontium from metastases were similar to those from normal bone. Absorbed doses delivered in infinite time to the metastases by 89Sr ranged from 21 +/- 4 to 231 +/- 56 cGy/MBq with a median value of 68 cGy/MBq. Doses to red marrow were less by a factor of 2 to 50. These absorbed doses are sufficiently large to be expected to produce a therapeutic benefit.     

前列腺癌生物标志物的研究进展

前列腺癌(Prostate cancer,CaP)是男性最常见的恶性肿瘤之一,是导致癌死亡的第二位原因.据报道,在6个男性中即有一个存在CaP诊断的终生危险因素,其中有3.4%可能死于CaP[1].由于CaP临床表现的复杂性,当前早期诊断CaP是困难的,研究的焦点集中于建立廉价高效的试验方法,以检测血中循环蛋白质类生物标志物.     

Venous drainage of the femoral neck in various stages of activity in Perthes' disease.

The venous drainage of the femoral neck in 73 children with Perthes' disease was analyzed from intraosseous venography films. 55 contralater symptomless hips were used as controls. In active stages of Perthes' disease, i.e. initial and fragmentation stage, the venous drainage was pathological in 46/55 hips (82%). In the restitution stage the finding was pathological in 7/18 (39%) and in healed Perthes' the venous drainage was normal in all six cases. Two out of the 55 symptomless hips showed pathological venous drainage. The disturbances in the venous drainage of the femoral neck seem to correlate with the stage of activity of Perthes' disease. Along with clinical and radiological signs of restitution the venous drainage seems to return to normal.     

MR characteristics of prostatic carcinoma and benign prostatic hyperplasia at 1.5 T

Sixty-one patients with histologically proven disorders of the prostate [prostatic carcinoma (PC), 41; benign prostatic hyperplasia (BPH), 9; PC and BPH, 11] underwent magnetic resonance imaging at 1.5 T. Using single [spin echo (SE) 400/30] and dual (SE 1,600/30, 90) SE sequences, multislice contiguous scans were obtained in transverse, sagittal, and coronal planes through the prostate. In 27 patients (PC 14, BPH 6, PC and BPH 7) multiecho sequences with eight echoes (SE 1,600/30, 60, 90, 120, 150, 180, 210, 240) were acquired and T2 images were calculated in the planes with best depiction of circumscribed prostatic pathology. In these patients the Bhattacharyya coefficient, a quantitative criterion for the discrimination between normal and pathological tissue, derived by means of mathematical decision theory, was applied. This analysis showed the best discrimination between PC and normal prostate with echo time (TE) 90 and 120 ms [error rate (ER) for confusing these tissues 20-30%]. There was no significant difference between the signal intensities of PC and BPH at any parameter setting, but PC could be discriminated from the compressed peripheral glandular regions that often accompany BPH [minimal ER (20-30%) at TE 90 and 120 ms]. This distinction is of clinical value, since PC usually arises in the periphery of the prostate. Calculated T2 images did not show advantages for the detection of PC.     

Sequential brain perfusion abnormalities in various stages of Japanese encephalitis

There is a paucity of regional cerebral blood flow studies on Japanese encephalitis (JE) with none of these studies describing brain perfusion abnormalities in all three stages of the disease. In this communication we report the changes noted in brain perfusion as detected by single photon emission tomography (SPET), in the acute, subacute and chronic stages of JE. Between December 2000 and March 2006, 31 patients, 19 men and 12 women, mean age 49 y, range 6-64 y of various stages of JE underwent brain perfusion SPET. Tauhese patients were at the following stages of the disease: acute stage, five patients, subacute stage 17 and chronic stage nine . The acute stage was considered as up to seven days from the onset of symptoms, the subacute, from seven to 56 days and any duration beyond 56 days was considered as the chronic stage. In the acute stage all five patients demonstrated focal areas of hyperperfusion involving mainly the thalamus. Additionally, bilateral thalami involvement was noted in three, frontal lobe involvement in four and parietotemporal hyperperfusion in three of these patients. In the subacute stage group, hypoperfusion of the thalamus was noted in all patients while frontoparietal hypoperfusion in seven patients. In the chronic stage group, hypoperfusion of thalamus was noted in four, one patient demonstrated additional occipital lobe hypoperfuion whereas normal perfusion was noted in the remaining five patients. In conclusion, the brain perfusion abnormalities observed depended on the stage of the disease. In the acute stage there was focal hyperperfusion to sites of the brain where JE virus is considered to replicate. In the subacute stage focal hypoperfusion was found to be possibly due to virus induced damage of cellular protein synthesis and in the chronic stage perfusion returns to normal due to regeneration of cellular organelles. Our results also confirm the high frequency of thalamic involvement in JE.     

CT evaluation of lymph node status at presentation of prostatic carcinoma.

Computed tomographic (CT) studies performed within a general oncology service in 104 consecutive patients with prostatic carcinoma were reviewed retrospectively to assess the incidence and distribution of lymphadenopathy. All patients were staged with CT at initial presentation, had normal skeletal scintigrams and were candidates for radical radiotherapy. The likelihood of lymphadenopathy was associated with increasing T-stage. 57 of the 92 (62%) patients without lymph node enlargement had local disease confined to the prostate (T2 or less) compared with only two of the 12 (17%) patients with enlarged nodes. Lymph node enlargement was more likely with a primary tumour of poorly differentiated histology. 12 patients (11.5%) had lymphadenopathy by established CT criteria; six with pelvic nodal enlargement alone and six with enlargement of pelvic and retroperitoneal nodes. In all patients pelvic nodal enlargement predominated and no patient had isolated retroperitoneal lymphadenopathy. Our findings indicate that CT staging studies of prostatic cancer do not need to include the retroperitoneum if there is no lymphadenopathy at or below the aortic bifurcation.     

Colloid scintigraphy showing red bone marrow extension in patients with prostatic carcinoma.

In 25 of 30 patients with bone metastases from prostatic carcinoma, red bone marrow extension was observed by scintigraphy of the reticuloendothelial system (RES). The degree of bone marrow extension in the lower extremities increased with increasing number of bone metastases. In 8 patients, 15 peripheral metastases were detected, all located in areas with extended red bone marrow. The distal level of bone marrow extension coincided with that of the most distal metastases. This is of importance for the detection of peripheral metastases at risk for fracture. Bone marrow extension was also seen in 5 of 8 patients with prostatic carcinoma without bone metastases and was interpreted as a paramalignant activation of RES.     

小鼠不同发育阶段脑蛋白质组学初步研究

目的:本研究为国际脑蛋白质组计划(HUPO BPP)的预实验部分,旨在获得可靠的小鼠脑蛋白质组数据库,比较和评估小鼠不同发育阶段的脑蛋白质组,为下一步进行神经系统疾病的蛋白质组学研究奠定基础。方法:样品来源于国际脑蛋白质组委员会所提供的胚胎16 d、出生后7 d及生后60 d等3个发育时期的C57/B l6雌性小鼠脑组织。常规方法提取组织总蛋白,采用固相pH梯度的二维电泳分离和串联质谱分析等进行鉴定,使用M ascot软件搜索Un iProt数据库,鉴定蛋白种类。结果:获得3个不同发育时期小鼠脑组织蛋白质表达谱,完成国际脑蛋白质组计划的预实验所要求的质量控制,鉴定出各发育阶段均有稳定表达的4个蛋白点,包括α烯醇酶、磷蛋白质P19及2个肌动蛋白。经进一步评估后鉴定出随年龄增大而丰度减低的C14orf166同源蛋白、28×103热/酸稳定的磷蛋白、3-巯基丙酮酸硫基转移酶、40S核糖体蛋白S3 a等4个蛋白。其中α烯醇酶及C14orf166同源蛋白曾有文献报道与神经发育及组织发生密切相关。结论:蛋白质组学的方法为脑发育研究提供了有参考价值的数据,其差异蛋白的发现可促进对神经发育机制的了解,并将为后续启动神经系统疾病蛋白质组学研究提供参考。     

Incidental finding of rectal carcinoma during transrectal US for prostatic diseases.

During transrectal ultrasound (TRUS), rectal carcinoma was an incidental finding in seven patients among a series of 5,000 TRUS examinations. TRUS was performed in seven patients with symptoms characteristic of prostatic diseases. All seven patients underwent examination by at least one physician before TRUS and, except for abnormal prostatic findings, no tumors were detected during digital rectal examination (DRE). The tumors were clearly visualized with TRUS and were easily palpated during DREs performed after TRUS. They were large and were located mainly along the posterior and lateral walls of the rectum. All the tumors were diagnosed by means of proctoscopy; the biopsy findings were positive, and the pathologic staging indicated advanced disease: adenocarcinoma of the rectum with a minimum grade of Dukes C. It is recommended that, in addition to evaluation of scans obtained in the transverse plane, the multiplane transducer be used to evaluate the longitudinal plane of the rectum for detection of possible undiscovered tumors.     

Positron tomographic assessment of androgen receptors in prostatic carcinoma

Purpose The purpose of this study was to evaluate the feasibility of androgen receptor (AR) imaging with 16-[¹⁸F]fluoro-5-dihydrotestosterone (FDHT) by positron emission tomography (PET) and to assess the binding selectivity of FDHT to AR in patients with prostate cancer.Methods Twenty men (age range 56–87 years) with advanced prostate cancer were studied. All except one had metastatic disease confirmed by biopsy and/or radiological studies. One patient who had radiological findings suggesting a single hepatic metastasis was found to have focal fatty infiltration on biopsy obtained after FDHT-PET and was excluded from further data analysis. FDHT uptake was assessed semiquantitatively by determination of the standardized uptake value (SUV) and tumor-to-muscle ratio (T/M). Additionally, to assess the AR binding selectivity of FDHT, patients with one or more foci of abnormally increased FDHT accumulation were studied after administration of an AR antagonist (flutamide).Results Conventional imaging demonstrated innumerable lesions in two patients and 43 lesions in the remaining 17 patients with advanced prostate cancer. FDHT-PET was positive in 12 of 19 patients (sensitivity of 63%), including the two patients with innumerable lesions. FDHT-PET detected 24 of 28 known lesions (86%) in the remaining ten patients. In addition, FDHT-PET detected 17 unsuspected lesions in five of these ten patients. All 12 patients with positive FDHT-PET underwent a repeat PET study after receiving flutamide for 1 day (250 mg t.i.d.). In all of these patients, there was a decrease in tumor FDHT uptake after flutamide; the mean (± standard deviation) SUV and T/M decreased from 7.0±4.7 and 6.9±3.9, respectively, to 3.0±1.5 and 3.0±1.6, respectively (p=0.002). The mean PSA in patients with positive FDHT-PET was significantly higher than that in patients with negative FDHT-PET (p=0.006).Conclusion Our results document the feasibility of PET imaging of prostate cancer with FDHT and suggest that tumor uptake of FDHT is a receptor-mediated process. Positive PET studies were associated with higher PSA levels and thus, presumably, with greater tumor burden.     

Expression of nuclear Ki-67 antigen in prostatic high grade intraepithelial neoplasia and prostatic carcinoma

BACKGROUND/AIM: Prostatic intraepithelial high grade neoplasia (PINHG) is accepted as preneoplastic lesion in prostatic carcinoma. One of the fundamental events in early oncogenesis is the disruption of proliferative activity. One of the numerous regulatory proteins is Ki-67 expressed in all proliferating cells. Index Ki-67 is considered to have prognostic significance. The aim of the study was to compare the level of proliferation in hyperplastic epithelium, prostatic carcinoma (Gleason score > 6) and PINHG. METHODS: Micromorphological examination was done in 85 patients. Pathohistological analysis was performed on standard histologic specimens with the estimation of Gleason score and the presence of PINHG in its surroundings. Nuclear proliferative activity was analyzed immunohistochemically in 19 cases, using a monoclonal anti-Ki-67 antibody. RESULTS: PINHG was found in prostatic carcinoma surrounding in 30% of the patients. In hyperplastic epithelia Ki-67 proliferative activity was 1,08, in PINHG 2,25 (p < 0,05), while in prostatic cancer, Ki-67 index was 17,64. Proliferative activity in prostatic carcinoma was significantly higher than in PINHG (p < 0,001) and hyperplasia (p < 0,001). CONCLUSION: This study confirmed that high grade PIN lesion predominately appears in the surrounding of poor or moderately differentiated prostate carcinoma, and that it represents progressive disorder of proliferation in preneoplastic and neoplastic prostatic epithelium.