The Significance of Serum C-Reactive Protein and Neutrophil–Lymphocyte Ratio in Predicting the Diagnostic Outcomes of Renal Mass Biopsy Procedure

This study aimed to investigate the predictive role of serum C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR) on renal mass biopsy outcomes. A total of 71 patients with suspected kidney masses who underwent renal mass biopsy procedure between January 2017 and January 2021 were retrospectively evaluated. Pathological results after the procedure were obtained and pre-procedural serum CRP and NLR levels were extracted from the patients’ data. The patients were grouped into benign and malignant pathology groups according to the histopathology results. The parameters were compared between the groups. Diagnostic role of the parameters in terms of sensitivity, specificity, and positive and negative predictive values was also determined. Additionally, Pearson correlation analysis, and univariate and multivariate cox proportional hazard regression analyses were also performed to investigate the above association with tumor diameter and pathology results, respectively. At the end of the analyses, a total of 60 patients had malignant pathology on histopathological investigations of the mass biopsy specimens, whereas the remaining 11 patients had a benign pathological diagnosis. Significantly higher CRP and NLR levels were detected in the malignant pathology group. The parameters positively correlated with the malignant mass diameter, as well. Serum CRP and NLR determined the malignant masses before the biopsy with sensitivity and specificity of 76.6 and 81.8%, and 88.3 and 45.4%, respectively. Moreover, univariate and multivariate analyses showed that serum CRP level had a significant predictive value for malignant pathology (HR: 0.998, 95% CI: 0.940–0.967, P < 0.001 and HR: 0.951, 95% CI: 0.936–0.966, P < 0.001, respectively). In conclusion, serum CRP and NLR levels were significantly different in patients with malignant pathology after renal mass biopsy compared to the patients with benign pathology. Serum CRP level, in particular, diagnosed malignant pathologies with acceptable sensitivity and specificity values. Additionally, it had a substantial predictive role in determining the malign masses prior the biopsy. Therefore, pre-biopsy serum CRP and NLR levels may be used to predict the diagnostic outcomes of renal mass biopsy in clinical practice. Further studies with larger cohorts can prove our findings in the future

Local anesthesia type affects cancer detection rate in transrectal ultrasound guided prostate biopsy

ABSTRACT Purpose: Studies about the anesthesia techniques during transrectal ultrasound guided prostate biopsy (TRUS-Bx) are usually focused on pain relief. Although patients' tolerance is an important issue in TRUS-Bx, cancer detection rate (CDR) must not be ignored. In this study, we compared the impact of intrarectal lidocaine gel anesthesia (IRLA) and periprostatic nerve blockade (PNB) techniques on CDR. Materials and Methods: A total of 422 patients underwent 10 core-TRUS-Bx because of elevated serum prostate specific antigen (PSA) level (>2.5ng/mL) and/or suspicious digital rectal examination findings. Patients were divided into two groups according to the applied anesthesia technique: IRLA group and PNB group. Age, serum PSA level, prostate volume, visual analogue scale (VAS) score and CDR were recorded and compared statistically with chi square and unpaired t-tests. Results: Of the patients 126/422 (29.9%) underwent TRUS-Bx by using IRLA whereas 296/422 (70.1 %) by PNB technique. The mean, age, serum PSA level and prostate volume were similar between the two groups. CDR was 19.8% and 25.4% in IRLA and PNB groups, respectively (p=0.001). The mean VAS score of the PNB group (1.84±0.89) was significantly lower than that for IRLA group (3.62±1.06) (p=0.001). Conclusions: Our results revealed that PNB is superior to IRLA in terms of CDR. Further studies are required to confirm our findings

Pelvic inflammatory myofibroblastic tumour mimicking scrotal mass: an extremely rare case

Inflammatory myofibroblastic tumour (IMT) is a rare benign mesenchymal tumour. However, IMT may arise from a wide variety of tissues and is very rare in the elderly. IMT may mimic the mass in which it originates. Although IMT has been defined as uncertain behaviour, it is treated surgically. We present a-65-year old man whose mass was diagnosed as IMT extending from scrotum to pelvis. The mass was independent of any surrounding anatomic structures. According to our best knowledge this is the first case in the literature that pelvic IMT was diagnosed in an elderly man and successfully treated surgically with a long term follow-up period. Aetiology of IMT is still unknown, and more studies are needed for exact continuum of IMT

Pelvic inflammatory myofibroblastic tumour mimicking scrotal mass: an extremely rare case

Inflammatory myofibroblastic tumour (IMT) is a rare benign mesenchymal tumour. However, IMT may arise from a wide variety of tissues and is very rare in the elderly. IMT may mimic the mass in which it originates. Although IMT has been defined as uncertain behaviour, it is treated surgically. We present a-65-year old man whose mass was diagnosed as IMT extending from scrotum to pelvis. The mass was independent of any surrounding anatomic structures. According to our best knowledge this is the first case in the literature that pelvic IMT was diagnosed in an elderly man and successfully treated surgically with a long term follow-up period. Aetiology of IMT is still unknown, and more studies are needed for exact continuum of IMT

Identification of microRNAs differentially expressed in prostatic secretions of patients with prostate cancer

Prostate cancer (PCa) is one of the leading causes of cancer deaths in men. Since there are limited treatment options available for the advanced tumors, there is an urgent need for novel diagnostic tools for PCa. Prostate secretion samples (PSS) from 23 PCa and 25 benign prostate hyperplasia (BPH) patients were obtained from Urology Department of Bagcilar Educational and Research Hospital (Istanbul). MicroRNA (miRNA) profiling of eight PSS (four from BPH, four from PCa patients) was performed using microarray. Four of significantly deregulated miRNAs were further confirmed using quantitative reverse-transcription PCR (qRT-PCR). Statistical analysis was performed using Student's t-test. ROC curves were plotted with SPSS-15.0. In this study, we aimed to identify a miRNA expression signature that could be used to distinguish PCa from BPH. MiRNA profiling of four PCa and four BPH patients with microarray revealed that miR-361-3p, miR-133b and miR-221 were significantly downregulated and miR-203 was upregulated in PSS of PCa patients. Further qRT-PCR analysis confirmed the altered expressions of these four miRNAs in PSS of 23 PCa and 25 BPH patients. Four miRNAs, together and individually have much power (AUC; 0.950) than PSA has (AUC; 0.463) to discriminate PCa from BPH patients. We have shown for the first time in the literature the presence of miRNAs in the PSS. We suggest PSS as a powerful non-invasive source for evaluation of prognosis in PCa, since prostate massages can be easily applied during routine examination. Our results showed that certain differentially expressed miRNAs in PSS could be used as diagnostics markers