Objective: This study aimed to evaluate the effectiveness of multiparametric prostate magnetic resonance imaging (mpMRI) in detecting extracapsular extension (ECE) and its impact on our preoperative ...surgical plan. Materials and Methods: Overall, 150 patients who had undergone preoperative mpMRI and robot-assisted laparoscopic radical prostatectomy (RALRP) between June 2016 and March 2018 were enrolled. The preoperative International index of Erectile Function (IIEF) score of the patients was 22 or higher. On initial assessment, the patients’ prostate specific antigen levels and digital rectal examination and pathology results of prostate biopsy specimens were evaluated to determine whether neurovascular bundle (NVB)-sparing surgery is feasible and appropriate. On the second evaluation, mpMRI results were considered in addition to the parameters included during the first evaluation to decide whether NVB-sparing surgery should be performed. Results: The mean age of the patients was 65.2 years. The sensitivity, specificity, positive predictive value and negative predictive value of mpMRI were 89.6%, 90.2%, 81.1% and 94.8%, respectively. According to mpMRI findings, the surgical plan at the initial evaluation changed in 35 (23.3%) of the cases. Conclusion: The high rate of detection of ECE with mpMRI prior to RALRP may guide the surgeon to decide for NVB-sparing surgery.
A 69-year-old man with prostate cancer presented to the hospital with 2 weeks' history of fever, abdominal distension, and fatigue. Laboratory findings showed signs of acute liver failure, and marked ...elevation of lactate dehydrogenase and tumor marker levels. Abdominal CT showed hepatomegaly with multiple hypodense lesions in both lobes, suggesting metastases. FDG PET/CT scan shows hypermetabolism unusually in the liver with significantly suppressed heart and brain activity, reminiscent of an FDG hepatic superscan. The hypermetabolic lesions confirmed with Tru-Cut needle biopsy of the liver as metastasis of prostate cancer.
Bladder cancer, which is the 9th most common type of cancer
and the 13th cause of death from cancer, is a worldwide health
problem (1). According to the GLOBOCAN, the highest incidence
rates were in ...Western countries and Western Europe (2). Turkiye
is one of the five countries with the highest age-standardized
death rate (6.6/100.000) (3).
To achieve initial diagnosis, transurethral resection of the
bladder tumor (TURBT) is usually performed (4). Some patients
undergo radical cystectomy, which is the surgical procedure
performed as standard therapy for locally confined, muscleinvasive,
or highly aggressive superficial primary tumors of the
bladder (5). Even though pathologists examine such specimens
vigorously, no tumor can be detected because of several
reasons, and such cases have been reported as pT0 tumor (6). No
residual tumor (pT0) on cystectomy specimens may be related
with completeness of TURBT, time frame of TURBT, neoadjuvant
radio- and chemotherapy, small tumor size, initial misdiagnosis,
and delayed formaldehyde fixation (6). Stage pT0 has been
found to be associated with improved survival (7).
As a general rule, all cystectomy specimens are inked and
immediately opened with Y-shaped incision through anterior
wall when still fresh and fixed in 10% buffered formaldehyde
overnight. Specimens are processed according to the
international gross examination guidelines. Mucosa is inspected
thoroughly and any suspicious area (irregularity, ulceration,
solid or papillary mass, etc.) is described, and measured. After
locating these lesions, already opened and fixed bladder is cut
into horizontal slices of 0.5 cm thickness. Samples are taken
from the determined suspicious areas, and depth of invasion is
recorded if present. Also at least one sample is taken from each
wall of the bladder even no lesion is detected. In histological
examination if no tumor is noted, specimen is reexamined, and the entire suspicious areas including the surrounding walls are
sampled extensively.
Despite the fact that extensive measures are taken, cystectomy
specimens with no residual tumor may still exist. In the
literature, the rate of pT0 cystectomy specimens is found in 5.1-
20.1% of cases (8). While the highest rate (20.1%) was reported
in a dataset of 900 patients, the lowest rate (5.1%) was reported
in a dataset of 4430 patients (9,10). Both of these were multicenter
studies, and patients who received neoadjuvant radioand/
or chemotherapy were excluded (9,10). Different findings
were reported by means of prognosis in pT0 patients. While
these studies stated a relationship with better prognosis, others
found none.
In our institution, 185 robotic radical cystectomy surgeries
were performed between 2014 and 2018. Patients who received
neoadjuvant radio- and/or chemotherapy were 30 in number.
Out of 155 patients, who did not receive neoadjuvant radioand/
or chemotherapy, 15 were detected as having pT0 (9.6%).
Our pT0 rate (9.6%) is in accordance with the previous reports.
Reporting ‘no residual tumor’ is a distress for the pathologist all
the time because of potential pitfalls, such as delayed fixation,
small tumor size or initial misdiagnosis, although no residual
tumor in cystectomy specimen is a finding which may herald
better prognosis.
To evaluate the role of sex steroid hormone receptors in corneal epithelium in etiopathogenesis of keratoconus (KC).
Thirty patients with KC who were planned for corneal collagen-crosslinking and 20 ...patients who were planned for excimer laser for refractive errors included in this study. Corneal epitheliums were curated mechanically during surgeries. Right eyes were evaluated immunohistochemically and left eyes were evaluated by quantitative polymerase chain reaction (qPCR) to investigate estrogenα, estrogenβ, progesterone and androgen receptors.
Immunohistochemically, staining for progesterone and androgen receptors did not significantly differ between KC and control groups (p > 0.05). None of the cases had staining for estrogenα and estrogenβ receptors. qPCR showed that mRNA expressions of estrogenα and androgen receptors were significantly higher in the KC group (p < 0.001).
A significantly higher rate of estrogenα and androgen receptor expressions in corneal epithelium from patients with KC through qPCR supports a possible relation between KC and sex steroid hormones.
Ubiquitin proteasome system and autophagy mediated by p97/VCP in testicular cancer. Upregulation of p97/VCP promotes autophagosomal protein degradation, thereby decreasing the protein level of p62 ...and LC3B in testicular cancer. p97/VCP works with Jab1/CSN5 as a chaperone proteins in UPS, carrying ubiquitinlated proteins to proteasome. p97/VCP is mediator between autophagosome and lysosome in autophagic pathway.
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•p97/VCP, Ubiquitin and Jab1/CSN5 are up-regulated in testicular tumors compared to cancer adjacent normal testis tissues.•p62, LC3B and Beclin 1 are down-regulated testicular tumors compared to cancer adjacent normal testis tissues.•p97/VCP and autophagy markers are negatively correlated in different type of testicular tumors.
Ubiquitin proteasome sytem (UPS) and autophagy govern protein quality control by degradation and clearance of damaged proteins. Many proteins working in these pathways such as p97/VCP, Ubiquitin (Ub), Jab1/CSN5, p62, LC3B and Beclin 1 are known to be essential for different pathological conditions, especially in cancer, but their expression in human testicular tumors has not been characterized yet. In the present study, we aimed to investigate the expression of UPS (p97/VCP, Ubiquitin, Jab1/CSN5) and autophagic (p62, LC3B, Beclin 1) proteins in human testicular tumors and cancer adjacent normal testicular tissues. We used an immunohistochemical staining technique. 120 cases of testicular germ and non-germ cell tumors, which are 42 seminomas, 31 embryonal carcinomas, 11 yolk sac tumors, 25 intratubular germ cell neoplasms, 6 Leydig cell tumors, 5 Sertoli cell tumors, were collected and evaluated on tissue microarray. For the first time, the expression of p97/VCP, Ub, Jab1/CSN5, p62, LC3B and Beclin 1 in different type of human testicular tumors has been confirmed. We found that p97/VCP, Ub and Jab1/CSN5 were frequently expressed at higher levels in testicular tumours. In contrast to UPS markers, p62, LC3B and Beclin 1 showed significantly diminished expressions in testicular tumors. Accordingly, a negative correlation between p97/VCP and autophagic markers (p62 and LC3B) was found, suggesting a relationship between UPS and autophagy in different type of testicular tumors. The current results displayed elevated level of p97/VCP, Ub and Jab1/CSN5 expressions in contrast to the diminished expression of p62, LC3B and Beclin 1 in human testicular tumors, thereby supporting a correlation between p97/VCP and autophagic markers in testicular tumors.
Neurological damage from spinal cord injury (SCI) is a result of primary mechanical injury and secondary damage from oxidative stress and neuroinflammation. Although genistein has been shown to have ...potent antioxidant and anti-inflammatory effects in studies of brain injury, its effect on secondary damage in SCI has remained unknown.
To determine effects of genistein in a model of SCI in rats.
We divided 21 rats evenly into 3 groups, a control group, in which only a laminectomy was performed; a trauma group in which SCI was induced; and a genistein group in which genistein was administered subcutaneously after SCI. The rats were assessed using a Basso-Beattie and Bresnahan functional score at the 12th hour and on the 1st, 3rd, 5th, and 7th days. Biochemical analyses were conducted at the same time points to determine the serum levels of catalase, ischemia-modified albumin (IMA), disulfide (SS), total thiol (TT), native thiol (NT), disulfide/total thiol (SS/TT), and native thiol/total thiol (NT/TT). Total oxidant and antioxidant capacity, and oxidative stress index were determined in spinal cord tissue obtained on the 7th day together with immunohistochemistry for cyclooxygenase-2 levels.
Catalase activity on the 7th day was significantly (
= 0.001) higher in the genistein-treated rats than in other groups, and IMA levels became stable earlier (3rd day) in the genistein group. SS values were significantly (
= 0.004) lower in the genistein group. NT/TT ratio were significantly (
= 0.049) higher in the genistein-treated rats on the 7th day.
Genistein has antioxidant, anti-inflammatory, and protective effects in a model of SCI in rats and warrants further study.
Magnetosomes are specialized organelles arranged in intracellular chains in magnetotactic bacteria. The superparamagnetic property of these magnetite crystals provides potential applications as ...contrast-enhancing agents for magnetic resonance imaging. In this study, we compared two different nanoparticles that are bacterial magnetosome and HSA-coated iron oxide nanoparticles for targeting breast cancer. Both magnetosomes and HSA-coated iron oxide nanoparticles were chemically conjugated to fluorescent-labeled anti-EGFR antibodies. Antibody-conjugated nanoparticles were able to bind the MDA-MB-231 cell line, as assessed by flow cytometry. To compare the cytotoxic effect of nanoparticles, MTT assay was used, and according to the results, HSA-coated iron oxide nanoparticles were less cytotoxic to breast cancer cells than magnetosomes. Magnetosomes were bound with higher rate to breast cancer cells than HSA-coated iron oxide nanoparticles. While 250 μg/ml of magnetosomes was bound 92 ± 0.2%, 250 μg/ml of HSA-coated iron oxide nanoparticles was bound with a rate of 65 ± 5%. In vivo efficiencies of these nanoparticles on breast cancer generated in nude mice were assessed by MRI imaging. Anti-EGFR-modified nanoparticles provide higher resolution images than unmodified nanoparticles. Also, magnetosome with anti-EGFR produced darker image of the tumor tissue in T2-weighted MRI than HSA-coated iron oxide nanoparticles with anti-EGFR. In vivo MR imaging in a mouse breast cancer model shows effective intratumoral distribution of both nanoparticles in the tumor tissue. However, magnetosome demonstrated higher distribution than HSA-coated iron oxide nanoparticles according to fluorescence microscopy evaluation. According to the results of in vitro and in vivo study results, magnetosomes are promising for targeting and therapy applications of the breast cancer cells.
The purpose of this study was to evaluate in a multicenter dataset the performance of an artificial intelligence (AI) detection system with attention mapping compared with multiparametric MRI (mpMRI) ...interpretation in the detection of prostate cancer.
MRI examinations from five institutions were included in this study and were evaluated by nine readers. In the first round, readers evaluated mpMRI studies using the Prostate Imaging Reporting and Data System version 2. After 4 weeks, images were again presented to readers along with the AI-based detection system output. Readers accepted or rejected lesions within four AI-generated attention map boxes. Additional lesions outside of boxes were excluded from detection and categorization. The performances of readers using the mpMRI-only and AI-assisted approaches were compared.
The study population included 152 case patients and 84 control patients with 274 pathologically proven cancer lesions. The lesion-based AUC was 74.9% for MRI and 77.5% for AI with no significant difference (
= 0.095). The sensitivity for overall detection of cancer lesions was higher for AI than for mpMRI but did not reach statistical significance (57.4% vs 53.6%,
= 0.073). However, for transition zone lesions, sensitivity was higher for AI than for MRI (61.8% vs 50.8%,
= 0.001). Reading time was longer for AI than for MRI (4.66 vs 4.03 minutes,
< 0.001). There was moderate interreader agreement for AI and MRI with no significant difference (58.7% vs 58.5%,
= 0.966).
Overall sensitivity was only minimally improved by use of the AI system. Significant improvement was achieved, however, in the detection of transition zone lesions with use of the AI system at the cost of a mean of 40 seconds of additional reading time.
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