1,721,540 research outputs found
Considerations on current and future issues related to reproducibility and accuracy in prostate cancer grading
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Morphological assessment of radical prostatectomy specimens. A protocol with clinical relevance.
No full textThe increase in prostate cancer detection has induced a sharp increase in the number of radical prostatectomies Proper examination of radical prostatectomy (RP) specimens by pathologists is critical in determining the need for adjuvant treatment and prediction of patient outcome. The pathology report should include relevant clinical information as well as provide prognostically useful information derived from the macroscopic examination and microscopic evaluation of the RP specimen
Effectiveness and cost-effectiveness of prognostic markers in prostate cancer.
Full text linkThis paper demonstrates how economic modelling can be used to derive estimates of the cost-effectiveness of prognostic markers in the management of clinically localised and moderately graded prostate cancer. The model uses a Markov process and is populated using published evidence and local data. The robustness of the results has been tested using sensitivity analysis. Three treatment policies of 'monitoring' (observation), radical prostatectomy, or a selection-based management policy using DNA-ploidy as an experimental marker, have been evaluated. Modelling indicates that a policy of managing these tumours utilising experimental markers has an estimated cost per quality-adjusted life year (QALY) of pound 12 068. Sensitivity analysis shows the results to be relatively sensitive to quality-of-life variables. If novel and experimental markers can achieve specificity in excess of 80%, then a policy of radical surgery for those identified as being at high risk and conservative treatment for the remainder would be both better for patients and cost-effective. The analysis suggests that a radical prostatectomy treatment policy for the moderately graded tumours (Gleason grades -7) modelled in this paper may be inferior to a conservative approach in the absence of reliable prognostic markers, being both more costly and yielding fewer QALYs
Nodular hyperplasia of the prostate: quantitative evaluation of secretrory cell changes after treatment with finasteride.
No full textSTUDY DESIGN: Secretory cell nuclear and nucleolar measurements were performed with an image analyzer in hematoxylin-and-eosin-stained sections of 20 untreated and 20 finasteride-treated cases of nodular hyperplasia. An immunoperoxidase method was used to stain the secretory cells with a monoclonal antibody-directed, anti-prostate specific antigen (PSA). The size of prostates was determined by transrectal ultrasound. For both groups the serum PSA values were determined.
RESULTS: After six months of treatment with finasteride, the prostates shrank by approximately 20% with the therapeutic regimen (as determined by transrectal ultrasound), whereas the serum PSA values decreased by 30% (before therapy, < 4.00 ng/mL). The secretory cells appeared smaller than those from the untreated group of patients, and the cytoplasm staining of the PSA marker was slightly diminished. Karyometric analyses showed that the nuclear and nucleolar size were smaller in comparison with the controls. In particular, the mean nuclear and nucleolar area in the treated group were, respectively, 34.12 and 1.424 micron 2, whereas in the untreated group the values were 40.46 and 2.261.
CONCLUSION: Reduced androgen stimulation after treatment with finasteride induces involution of secretory cells. This may be responsible for the decrease in the serum PSA level and may contribute to the reduction in prostate size
Conceptual analogies between multi-scale feeding and feedback cycles in supermassive black hole and cancer environments
Full text linkAdopting three physically-motivated scales ("micro" - "meso" - "macro", which refer to mpc - kpc - Mpc, respectively) is paramount for achieving a unified theory of multiphase active galactic nuclei feeding and feedback, and it represents a keystone for astrophysical simulations and observations in the upcoming years. In order to promote this multi-scale idea, we have decided to adopt an interdisciplinary approach, exploring the possible conceptual similarities between supermassive black hole feeding and feedback cycles and the dynamics occurring in human cancer microenvironment
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