Results of prostatic biopsies in Algerian patients with an elevated PSA and/or suspicious digital rectal examination

Objective: to report on prostatic biopsy results in Algerian patients presenting with a suspicious Digital Rectal Examination (DRE) and\or an elevated total PSA.Methods: data collected on prepared index cards were age, result of DRE, rate of PSA and number of cores, as well as the histological result. The biopsies were performed by two urologist surgeons from Oran city, Algeria.Results: 331 patients had prostatic transrectal ultrasound-guided biopsies, the average (SD) age was 70.4 (8.7) years with a range 33 - 94 years. The most important age bracket was the one with subjects over 60 years. The DRE was suspicious in 41.69% of patients (138 of 331), and 44.20% of the suspect prostates on DRE were malignant. The average PSA was 42.2 ng/ml the rate of PSA >10 ng/ml constituted 72.57%. The number of biopsy cores was 12 for 129 biopsies, 49.2% of the biopsies revealed prostatic adenocarcinoma. The percentage of positive biopsies was 41.66% (21/48) when the PSA was between 4 and 10 ng/ml, and 33.33% (45/135) when the PSA exceeded 10 ng/ml. Among 47 scores of Gleason 59.7% patients had a score 7, 8.6% had a score < 7, and 31.8% had scores >7.Conclusion: 49.2% of 331 biopsies were positive for prostatic adenocarcinoma. Significant associations were found between age and cancer, between digital rectal examination and prostate biopsy results, and between PSA and number of positive cores

Résultats de la biopsie prostatique chez les patients algériens avec un PSA élevé et/ou un toucher rectal suspect

Objectif: Rapporter les résultats de la biopsie prostatique à Oran chez des patients qui présentent un toucher rectal (TR) suspect et/ou une élévation du PSA total. Méthodes: Les données recueillies sur des fiches préétablies sont l’âge, le résultat du TR, le taux de PSA et le nombre de prélèvements, ainsi que le résultat anatomopathologique. Les biopsies ont été réalisées par deux chirurgiens urologues de la ville d'oran. Résultats: 331 patients ont eu des biopsies prostatiques transrectales écho guidées, l’âge moyen (SD) était de 70.4 (8.7) ans avec une limite inférieure de 33 ans et une limite supérieure de 94 ans. La tranche d’âge la plus importante est celle des sujets de plus de 60 ans. Le TR était suspect chez 41.69% (138 sur 331), et 44.20% des prostates suspectes au TR étaient histologiquement malignes, la moyenne du PSA chez les sujets qui ont eu des biopsies de prostate était de 42.2 ng/ml avec un écart type de 68.36 ng/ml, le taux de PSA >10 ng / ml a constitué 72,57%. Le nombre de carottes biopsiques était de 12 pour 129 biopsies. 49.2% des biopsies ont révélés un adénocarcinome de la prostate. Le pourcentage de biopsies positives est de 41.66% (21/48) lorsque le PSA était entre 4 et 10 ng/ml, ce taux est de 33.33% (45/135) lorsque le PSA dépasse 10 ng/ml. Sur les 47 scores de Gleason 59.7% avaient un score 7, 8.6% avaient un score  7. Conclusion: 49.2% des 331 biopsies colligées étaient positives pour adénocarcinome de la prostate. Des associations significatives ont été retrouvées entre l’âge et le cancer, les résultats du Toucher Rectal et la biopsie prostatique, ainsi qu'entre le taux de PSA et le nombre de carottes positives

Association of Hashimoto's thyroiditis with cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) and inducible co-stimulator (ICOS) genes in a Kuwaiti population

Analysing two CTLA-4 markers [exon 1 A49G single nucleotide polymorphism (SNP) and exon 4 3′UTR (AT)n repeat] and the ICOS intron 4 (GT)n marker for their potential association with HT, and exploring the effect of the tested SNPs on the CTLA-4 isoform expression at the mRNA and protein levels. Total of 270 age-gender-ethnically matched subjects were genotyped by fluorescent-labelled restriction fragment length polymorphism, multiplex PCR, and fragment analysis. Sequencing was used to confirm the genotyping results. Expression of the full-length and soluble CTLA-4 mRNAs analysed using real-time PCR. Sera from subjects were screened for sCTLA-4 using ELISA. Tested subjects revealed ten alleles and sixteen genotypes of CTLA-4 3′UTR(AT)n. The 3′UTR(AT)n was significantly associated with HT: allele (AT)15 and genotype 15/15 were found to cause susceptibility to HT (P = 0.004, OR = 2.13, 95 % CI = 1.26-3.58 and P = 0.029, OR = 2.77, 95 % CI = 1.1-6.94, respectively), whereas allele (AT)6 and genotype 6/6 were found to be protective of HT (P = 0.00002, OR = 0.36, 95 % CI = 0.227-0.57 and P = 0.001, OR = 0.357, 95 % CI = 0.1980.64, respectively). SNP A49G and ICOS(GT)n revealed no significant association with HT (P > 0.05). The expression of sCTLA-4 was inversely proportional to the number of 3′UTR(AT)n repeats, with heterozygous and longer (AT)n repeats showing lower levels of sCTLA-4 mRNA than those with shorter alleles in HC and HT (P = 0.001 and P = 0.04, respectively). Significant increase in the serum level of sCTLA-4 was observed in HT patients compared with the HC (P = 0.0007). The novel finding in our study is that the CTLA-4 3′UTR(AT)n proven to be a key player in the pathogenesis of HT