Comparability of serum prostate-specific antigen measurement between the Roche Diagnostics Elecsys 2010 and the Abbott Architect i2000

Background: Most prostate cancers are characterized by a significant rise in the production of serum prostate-specific antigen (PSA), which is used widely in screening for prostate cancer. Within New Zealand, PSA is measured on automated immunoassay analysers, including models by Abbott Laboratories (Architect i2000) and Roche Diagnostics (Elecsys 2010). These assays produce similar, but not identical, results. Objective: To compare the measurement of PSA between the Elecsys 2010 and the Architect i2000 assay. Methods: We measured PSA concentrations in each of 194 serum samples using both the Roche Elecsys 2010 and the Abbott Architect i2000 and compared the results using various statistical methods. Results: PSA concentrations measured on the Architect i2000 system were less than those on the Elecsys 2010 system, by an average of 11%. Conclusion: Because the results from the two assays are different, reference intervals appropriate to the method of PSA measurement should be used

Demographic and Clinical Factors as Determinants of Serum Levels of Prostate Specific Antigen and its Derivatives

Background: To characterise the association between demographic and clinical factors and levels of total prostate specific antigen (tPSA) and its molecular derivatives [complexed PSA (cPSA), free PSA (fPSA) and the ratio of free to total PSA (%fPSA)] in New Zealand Maori, Pacific Islanders and Europeans, in order to determine whether reported ethnic differences in PSA can be explained by lifestyle and social factors. Materials and Methods: Demographic and clinical factors were examined in relation to tPSA, fPSA and cPSA levels, in 1405 Maori, Pacific Island and New Zealand European men with no clinical evidence of prostate cancer, in the Wellington region of New Zealand. Any associations between levels of PSA and PSA derivatives and body mass index, smoking status, family cancer history, non-steroidal anti-inflammatory/vitamin supplement usage, number of sexual partners, age at first intercourse, previous vasectomy, marital/partnership status, educational level and socioeconomic status were investigated by backwards stepwise regression analysis, correcting for age, ethnicity and urinary symptoms. Results: Not being married/partnered was associated with increased tPSA, fPSA and cPSA. tPSA and cPSA decreased with regular non-steroidal anti-inflammatory use. cPSA was decreased in subjects with a first degree relative with any form of cancer. tPSA and fPSA were decreased if the body mass index was > 34. fPSA and %fPSA were decreased in current and former smokers. Conclusion: Demographic and clinical factors appear to have a significant effect on levels of PSA and its various derivatives and may account for previously observed ethnic differences. It is important that these associations are taken into account when comparing individual PSA results with standard reference ranges

Clinical significance of cancer in radical prostatectomy specimens: analysis from a contemporary series of 2900 men

With prostate specific antigen (PSA) testing, up to 49% of detected tumours are small and in some of these cases there is a possibility that the tumour will remain clinically insignificant during the patient's remaining lifetime. The current study was performed to characterise the extent of cancer in men treated by radical prostatectomy (RP) in a community without population-based PSA screening. Clinical and pathological data of 2900 patients who underwent RP between 2008 and 2012 were analysed. Specimens were entirely embedded and evaluated by routine haematoxylin and eosin staining. Tumours were graded using recent modifications to the International Society of Urological Pathology (ISUP) modified Gleason grading system, and staged according to the ISUP recommendations. Tumours were considered pathologically insignificant if organ confined, with a volume of 3cc and 284 (9.8%) had surgical margin positivity Seminal vesicle involvement was seen in 159 (5.5%) cases. Of 693 patients who had a lymphadenectomy 31 (4.5%) had lymph node metastases. Age

Maori men’s perception and experiences of health seeking for prostate health problems in New Zealand

To discover Maori men's perceptions and experiences of health seeking for prostate health problems. A qualitative research design was sued with semi-structured interviews being the primary data source. From January 2000 to February 2002 a total of 357 Maori men were recruited into the Wellington Region Community Prostate Study, Wellington School of Medicine and Health Sciences, New Zealand. 20 men were interviewed in total, including 16 who were symptomatic of prostate disease and four who were non-symptomatic. A number of barriers were described for not seeking prostate health care, and the majority of these were related to the health system not dealing appropriately with cultural issues. Additionally, a lack of prostate knowledge, due to unavailability of appropriate information and societal pressure of being male, were implicated. Solutions offered by participants were also largely culturally related, for example, whanau (family), te reo Maori (Maori language), rongoa (traditional Maori medicine) and more Maori health professionals. Results re-affirm the need for attention to be paid to the establishment of culturally safe health care and access to appropriate prostate health information. Findings could have implications beyond prostate disease and New Zealand, to countries with indigenous populations who share similar health experiences to Maori

Mucinous adenocarcinoma of prostate and prostatic adenocarcinoma with mucinous components: a clinicopathological analysis of 143 cases

Aim: The clinical significance of mucinous prostatic adenocarcinoma (PCa) remains uncertain

Pleomorphic giant cell carcinoma of the urinary bladder: an extreme form of tumour de-differentiation

Vesical pleomorphic giant cell carcinoma (PGCC) is a variant of urothelial carcinoma (UC) characterized by highly pleomorphic tumour with giant cells. Fewer than 10 cases have been reported, and our aim was to determine the clinical and pathological features of a series of tumours from a specialized uropathology laboratory.Thirteen cases of PGCC of the bladder were identified. There were nine males and four females, ranging in age from 53 to 92\ua0years (mean 72\ua0years). Associated conventional high-grade UC was seen in eight cases, while three cases also had micropapillary UC and one plasmacytoid UC. UC in\ua0situ (CIS) was present in five cases and occasional bizarre cells were seen in both UC and CIS. The proportion of PGCC present varied from 40% to 100% of tumour. Immunostaining performed on 10\ua0cases showed uniform positivity for CK 8/18 and AE1/AE3, while most tumours were positive for CK7, CK20, uroplakin III and GATA binding protein 3 (GATA3). β-human chorionic gonadotrophin (β-hCG) was negative. Of 10 patients with follow-up, five died within 1\ua0year and four are alive with tumour.The association of PGCC with UC and an overlap in immunoexpression suggests that PGCC represents an extreme form of UC de-differentiation

Dataset for the reporting of renal biopsy for tumour:recommendations from the international collaboration on cancer reporting (ICCR)

The International Collaboration on Cancer Reporting (ICCR) has developed a suite of detailed datasets for international implementation. These datasets are based on the reporting protocols developed by the Royal College of Pathologists (UK), The Royal College of Pathologists of Australasia and the College of American Pathologists, with modifications undertaken by international expert groups appointed according to ICCR protocols. The dataset for the reporting of renal biopsy for tumour is designed to provide a structured reporting template containing minimum data recording key elements suitable for international use. In formulating the dataset, the ICCR panel incorporated recommendations from the 2012 Vancouver Consensus Conference of the International Society of Urological Pathology (ISUP) and the 2016 edition of the WHO Bluebook on tumours of the urinary and male genital systems. Reporting elements were divided into Required (Core) and Recommended (Non-core) components of the report. Required elements are as follows: specimen laterality, histological tumour type, WHO/ISUP histological tumour grade, sarcomatoid morphology, rhabdoid morphology, necrosis, lymphovascular invasion and coexisting pathology in non-neoplastic kidney. Recommended reporting elements are as follows: operative procedure, tumour site(s), histological tumour subtype and details of ancillary studies. In particular, it is noted that fluorescence in situ hybridisation studies may assist in diagnosing translocation renal cell carcinoma (RCC) and in distinguishing oncocytoma and eosinophilic chromophobe RCC. It is anticipated that the implementation of this dataset into routine clinical practice will facilitate uniformity of pathology reporting worldwide. This, in turn, should have a positive impact on patient treatment and the quality of demographic information held by cancer registries