Diagnostic value of serum prostate-specific antigen in hemodialysis patients

BACKGROUND: The value of serum prostate-specific antigen (PSA) screening was examined to detect prostate cancer in men receiving hemodialysis. METHODS: Forty-one male patients age 60-95 (median age, 70 years) receiving hemodialysis were investigated for PSA levels. We set the cut-off point at 4 ng/mL (the usual reference range). Digital rectal examination (DRE) and transrectal ultrasonography (TRUS) of the prostate were performed in patients whose PSA was more than 4 ng/mL and/or who expected further examination of the prostate. When prostate cancer was suspected, biopsy of the prostate was performed. In patients with prostate cancer, magnetic resonance imaging, computed tomography and bone scintigraphy were performed to diagnose the clinical stage. RESULTS: The mean serum level of PSA was 2.10 +/- 0.49 ng/mL. In this screening study, four of 41 men required further examinations for prostate cancer. Two of four refused further examinations. The other two were diagnosed with prostate cancer. The incidence of prostate cancer was at least 5% in our hemodialysis patients. One man, whose clinical stage was T2aN0M0, was treated with radical retropubic prostatectomy. Another man, whose clinical stage was T2bN0M0, was treated with luteinizing hormone-releasing hormone analogue. CONCLUSION: In our preliminary study, prostate cancer screening with PSA was useful for the early detection of prostate cancer in hemodialysis patients. If possible, DRE and TRUS should be performed in conjunction with PSA tests.     

Hp相关胃炎患者血清表皮生长因子（ECG）和β2—微球蛋白（β2—MG）水平研究

目的探索EGF和β2-MG在CSG -CAG -GC演变模式中的变化规律 ,探讨Hp对EGF和β2-MG有无影响。方法应用尿素酶试验法、血清学试验法和组织学诊断法 ,进行Hp检查 ,应用放射免疫法检测血清EGF及β2-MG水平。结果(一)EGF水平(μg/L) :(1)按CSG -CAG -GC逐渐升高 ,依次为0.3229±0.225 ,0.8823±0.2549,1.3999±0.8935,GC组高于CSG组 (P<0.01) ,也高于CAG组 (P<0.05) ,CAG组高于CSG组 (P<0.01)。(2)CSG患者Hp(+)组 (0.2404±0.1103)低于Hp( -)组 (0 .4492±0.2931) (P<0.01) ;CAG患者Hp(+)组 (0 .8119±0.279)低于Hp(- )组(1.0056±0.1704) ,GC患者Hp(+)组 (1.159±0 .9229)低于Hp(- )组(1 .4963±0 .9127) ,均无统计学差异 (P>0.05)。(二 ) β2-MG水平 (mg/l) :(1)按CSG -CAG -GC顺序增高 ,依次为 :1.659±0.4321 ,1 .9661±1 .0802,2.3431±0 .5951 ,GC组高于CSG组 (P<0.01),CAG组高于CSG组 ,GC组高于CAG组 ,均无统计学意义 (P>0.05)。(2)同一胃病Hp( +)组与Hp( -)组比较血清β2-MG水平均无明显差异 (P>0.05)。结论按CSG -CAG -GC ,EGF水平逐渐升高 ,β2-MG有此种趋势。Hp有降低EGF的作用 ,Hp对β2-MG水平无明显影响     

Anatomic basis of the liver for the development of a perihepatic prosthesis

We studied specimens from 50 cadavers (27 men and 23 women) to obtain anatomical data concerning the liver and its attachments. The results allowed us to develop a polyglactin perihepatic prosthesis for compression of the injured liver. The falciform ligament and a narrowing of the hepatic parenchyma at this level allow attachment of the prosthesis. Separate prostheses were designed for each lobe. Clinical use has demonstrated that our prosthesis can be used to achieve effective control of haemorrhage and bile leakage.

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Etude anatomique du foie. Développement d'une prothèse péri-hépatique

Résumé Sur une série de 50 pièces anatomiques d'adultes (27 hommes, 23 femmes), l'étude morphométrique du foie, de ses attaches dorsales et leurs variations a permis la confection d'une prothèse périhépatique en polyglactine adaptable à chaque lobe et fixée grâce à des artifices anatomiques. Celle-ci assure une compression efficace du parenchyme lésé et donc une hémostase et une bilistase correctes. Le ligament falciforme et le rétrecissement du parenchyme hépatique à son niveau assurent le maintien de la prothèse. Un exemplaire a été réalisé pour chaque lobe.

     

Benign liver lesions: implications of detection in cancer patients

A review of liver sonograms obtained for cancer patients (excluding primary liver cancers) over a 12 year period found 829 benign lesions: non-parasitic cysts (427 cases), hemangiomas (216 cases), solitary calcifications (79 cases), focal fatty infiltration (62 cases), and miscellaneous lesions (45 cases). These benign pathologies represented 41.8% of the focal hepatic lesions observed during this period in this population; hepatic metastases accounted for the remaining 58.2%. Marked female predilection was noted for the nonparasitic cysts, hemangiomas, and focal fatty infiltration; 63–78.7% of these lesions were solitary, and first-line imaging by US was sufficient for diagnosis of 66.1–98.2% of cases. Analysis of lesion evolution over more than 5 years revealed modifications in 17% of hemangiomas, 23.9% of nonparasitic cysts, and 75% of cases of focal fatty infiltration. Systematic pretherapy liver sonography can be proposed owing to the high frequency of benign liver lesions that can create diagnostic problems during follow-up of cancer patients. Correspondence to: J. N. Bruneton     

Thymidine labeling index in breast tumors

The relationship between primary tumor proliferative activity and clinical and pathologic characteristics was analyzed in relation to menopausal status in 32 patients with malignant or benign breast disease. The thymidine labeling index (TLI) showed significantly higher median values in the cancer patients (3.48 per cent) than in the patients with benign diseases (1.02 per cent). TLI was not significantly affected by delayed incubation at room temperature for about 1 hour. In the breast cancer patients, TLI did not significantly correlate to tumor size, the presence of axillary lymph node metastasis or pathologic nuclear grading. The only significant difference was limited to the breast cancer patients without axillary lymph node metastasis in relation to menopausal status; the TLI in the premenopausal patients (5.10 per cent) was significantly higher (p<0.05) than that in the postmenopausal patients (2.28 per cent). These data thus suggest that among premenopausal patients without axillary lymph node metastasis, those with a high TLI could be potential candidates for adjuvant chemotherapy.     

胃癌外科治疗30年回顾

自1958年1月至1987年12月,我院外科共收治胃癌2722例,其中手术2412例(手术率88.6%),切除1720例(切除率71.3%).切除者术后总5年生存率为34.8%.Ⅰa、Ⅰb、Ⅱ、Ⅲa、Ⅲb及Ⅳ期胃癌切除者术后5年生存率分别为98.7%、80.2%、65.7%、44.8%、23.1%及10.8%.随病期趋晚,生存率逐步降低,且各期间差异显著,说明国际胃癌TNM分期法能较好地体现分期与预后理应具备的一致性.若将全组分两个阶段进行分析,则近期组(1984～1987年)5年生存率为41.4%.既往组(1958～1983年)为32.6%.分析还显示5年生存率的提高主要为早、中期病例相对增多所致, 说明早期诊治是提高胃癌生存率的关键.近期组根治性切除术后5年生存率已达61.2%.比较不同根治切除范围(D_1、D_2及D_3术)对各期胃癌的疗效,提示应根据癌肿的部位、分期及生物学特性来制定每一胃癌病例的具体手术方案.     

Flow cytometric analysis of localized adenocarcinoma of the prostate: the use of archival DNA analysis in conjunction with pathological grading to predict clinical outcome following radical retropubic prostatectomy

Fifty-four specimens from patients undergoing radical prostatectomy for clinically confined prostate cancer between 1983 and 1987 were reviewed to determine the potential for flow cytometric (FCM) analysis of DNA ploidy and replication rate to predict disease recurrence. Each specimen was deparaffinized for FCM analysis and the pathology slides were reviewed by a single pathologist. FCM characteristics were correlated with pathological grade and stage, and both were correlated with disease status. In this series of patients, routine FCM analysis of DNA ploidy and replication rate failed to significantly enhance the ability of standard histopathological grading to predict disease recurrence in patients having clinically localized prostate cancer. Aneuploid tumors pathologically confined to the prostate did not appear to negatively affect prognosis.     

Asbestos disease in sheet metal workers: proportional mortality update

This paper, updating the findings of an earlier study, provides additional evidence that sheet metal workers in the construction trades are at increased risk for asbestos-related disease. A proportional analysis of cause of death among 331 New York sheet metal workers found a significantly elevated PMR for lung cancer (PMR = 186). In addition, there were six deaths attributable to mesothelioma (three classified as lung cancer deaths) and three death certificates mentioned asbestosis or pulmonary fibrosis, although none of these three deaths were attributed to these diseases.     

Morphometrically estimated variation in nuclear size

Summary At present there are several grading systems for prostatic carcinoma. Most are difficult to reproduce. An objective method of grading seems to be necessary and could make comparisons between various groups of patients easier and grading more reliable.In the present study morphometrically estimated nuclear size and variation in nuclear size are matched with the survival rates of 207 patients who underwent total perineal prostatetomy for cancer. On the basis of morphometrically estimated variation in nuclear size the patients could be divided into two groups with significantly differing survival rates. In this way it was possible to split the group of patients with grade 2 carcinoma (Mostofi's grading system) into two groups of patients with significantly different survival rates. The survival rates in these two groups did not differ significantly from those in the patients with Grade 1 and Grade 3 tumors respectively.The results are discussed in the light of the recent literature on the subject. Morphometry seems to be a valuable tool in grading prostatic cancer.     

Prognostic role of immunosuppressive acidic protein in advanced ovarian cancer

OBJECTIVE: Our purpose was to investigate immunosuppressive acidic protein in the prognostic characterization of advanced ovarian cancer. STUDY DESIGN: Serum levels of immunosuppressive protein were prospectively measured in 80 patients with untreated ovarian carcinoma. To evaluate the prognostic significance of immunosuppressive acidic protein levels, cutoff points were studied every 50 μg/ml between 450 and 1350 μg/ml. RESULTS: Pretreatment immunosuppressive acidic protein levels were not significantly associated with stage, histotype, grade of differentiation, postoperative residual tumor, and response to chemotherapy. The most significant association with survival was observed at a cutoff value of 1100 μg/ml (p = 0.0089). In the univariate analysis for overall survival, International Federation of Gynecology and Obstetrics stage and immunosuppressive acidic protein status were found to have a role in predicting ovarian cancer prognosis. In the multivariate analysis only immunosuppressive acidic protein status was significantly associated with survival. A statistical correlation was found between serum levels and overall survival (p = 0.0104, χ² 6.56), including immunosuppressive acidic protein as a continuous variable. CONCLUSION: Our data suggest that immunosuppressive acidic protein assay is a potentially useful tool in the prognostic characterization of advanced ovarian cancer. (Am J Obstet Gynecol 1996;175:1606-10.)