Анализ результатов биопсий предстательной железы, выполненных с 10-летним интервалом

Introduction and objective: the authors compared the results of biopsies performed in 1994 and 2004, respectively.The analysis of the results of prostate biopsy obtained in 1994 and 2004 was carried out. Prostate cancer is the most common malignant tumor in males; its diagnostic algorithm and therapy were analyzed. The aim of the study was to compare data from the prostate biopsies performed in 1994 with those of 2004. During this decade, 4.5 fold increase of the number of prostate biopsies has been observed. In 1994, 36.2%, while in 2004, 47.5% of the biopsies proved to be a cancer. The mean age of the patients undergoing biopsy decreased from 69.7 to 62.3 years; however, the mean age of patients who were suffering from prostate cancer remained constant (70.8 vs. 71.3 years).Conclusions: Whereas in 1994 only the total level of PSA was estimated, in 2004 the diagnostic algorithm included additional measurements of free-PSA and PSA-density. Prostate biopsy was performed by a trans-rectal ultrasound guided technique unlike the blind or trans-perineal methods which were only available previously. Although the effectiveness of the prostate biopsy is improved, the diagnosis and identification of prostate cancer at a younger age remains to be a challenge. The Gleason score marking the aggressiveness of the prostate cancers was lower; therefore, more patients were found suitable for curative surgery. However, the increased mean value of PSA level indicated that patients were still rather of a more advanced stage in majority, which could only be treated by palliative therapy.

Ki67 index is an independent prognostic factor in epithelioid but not in non-epithelioid malignant pleural mesothelioma: a multicenter study

BACKGROUND: Estimating the prognosis in malignant pleural mesothelioma (MPM) remains challenging. Thus, the prognostic relevance of Ki67 was studied in MPM. METHODS: Ki67 index was determined in a test cohort of 187 cases from three centres. The percentage of Ki67-positive tumour cells was correlated with clinical variables and overall survival (OS). The prognostic power of Ki67 index was compared with other prognostic factors and re-evaluated in an independent cohort (n=98). RESULTS: Patients with Ki67 higher than median (>15%) had significantly (P<0.001) shorter median OS (7.5 months) than those with low Ki67 (19.1 months). After multivariate survival analyses, Ki67 proved to be-beside histology and treatment-an independent prognostic marker in MPM (hazard ratio (HR): 2.1, P<0.001). Interestingly, Ki67 was prognostic exclusively in epithelioid (P<0.001) but not in non-epithelioid subtype. Furthermore, Ki67 index was significantly lower in post-chemotherapy samples when compared with chemo-naive cases. The prognostic power was comparable to other recently published prognostic factors (CRP, fibrinogen, neutrophil-to-leukocyte ratio (NLR) and nuclear grading score) and was recapitulated in the validation cohort (P=0.048). CONCLUSION: This multicentre study demonstrates that Ki67 is an independent and reproducible prognostic factor in epithelioid but not in non-epithelioid MPM and suggests that induction chemotherapy decreases the proliferative capacity of MPM

Analysis of the results of prostate cancer biopsies performed after a 10-year interval

Introduction and objective: the authors compared the results of biopsies performed in 1994 and 2004, respectively.The analysis of the results of prostate biopsy obtained in 1994 and 2004 was carried out. Prostate cancer is the most common malignant tumor in males; its diagnostic algorithm and therapy were analyzed. The aim of the study was to compare data from the prostate biopsies performed in 1994 with those of 2004. During this decade, 4.5 fold increase of the number of prostate biopsies has been observed. In 1994, 36.2%, while in 2004, 47.5% of the biopsies proved to be a cancer. The mean age of the patients undergoing biopsy decreased from 69.7 to 62.3 years; however, the mean age of patients who were suffering from prostate cancer remained constant (70.8 vs. 71.3 years).Conclusions: Whereas in 1994 only the total level of PSA was estimated, in 2004 the diagnostic algorithm included additional measurements of free-PSA and PSA-density. Prostate biopsy was performed by a trans-rectal ultrasound guided technique unlike the blind or trans-perineal methods which were only available previously. Although the effectiveness of the prostate biopsy is improved, the diagnosis and identification of prostate cancer at a younger age remains to be a challenge. The Gleason score marking the aggressiveness of the prostate cancers was lower; therefore, more patients were found suitable for curative surgery. However, the increased mean value of PSA level indicated that patients were still rather of a more advanced stage in majority, which could only be treated by palliative therapy

Advances in vascular medicine

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Region specific differences of claudin-5 expression in pediatric intracranial ependymomas: Potential prognostic role in supratentorial cases

Ependymomas are common pediatric brain tumors that originate from the ependyma and characterized by poor prognosis due to frequent recurrence. However, the current WHO grading system fails to accurately predict outcome. In a retrospective study, we analyzed 54 intracranial pediatric ependymomas and found a significantly higher overall survival in supratentorial cases when compared to infratentorial tumors. Next we performed region-specific immunohistochemical analysis of the ependyma in neonatal and adult ependyma from the central canal of spinal cord to the choroid plexus of lateral ventricles for components of cell-cell junctions including cadherins, claudins and occludin. We found robust claudin-5 expression in the choroid plexus epithelia but not in other compartments of the ependyma. Ultrastructural studies demonstrated distinct regional differences in cell-cell junction organization. Surprisingly, we found that 9 out of 20 supratentorial but not infratentorial ependymomas expressed high levels of the brain endothelial tight junction component claudin-5 in tumor cells. Importantly, we observed an increased overall survival in claudin-5 expressing supratentorial ependymoma. Our data indicates that claudin-5 expressing ependymomas may follow a distinct course of disease. The assessment of claudin-5 expression in ependymoma has the potential to become a useful prognostic marker in this pediatric malignancy