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Go Kimura

Publications and source records attributed to Go Kimura.

11 recordsLinked to original sources
PubMed2006

Significance of noninvasive diagnosis of prostate cancer with cytologic examination of prostatic fluid.

OBJECTIVES: While reassessing the value of exfoliative cytologic examination of prostatic fluid (PF) for the diagnosis of prostate cancer, we found that PF is easily obtained with transrectal ultrasonography during prostate biopsy and that cytologic examination of PF is useful for the diagnosis of prostate cancer. METHODS: The cohort included 53 consecutive patients who underwent transrectal prostate biopsy from May through September 2005. Patient age was 66.7 +/- 7.24 years, and the mean concentration of prostate-specific antigen (PSA) was 15.1 +/- 25.8 ng/ml. The PF for cytologic examination was obtained before biopsy, and Papanicolaou's staining was performed. The results of cytologic examination are expressed as class 1 to 5. Results of cytologic examination and prostate tissue pathologic examination were analyzed. Patient age, PSA levels, total prostate volume (TPV), and PF volume were compared with cytologic class by means of analysis of variance. RESULTS: The mean PF volume was 378.4 +/- 245.3 microl, and the mean TPV was 38.0 +/- 18.8 ml. The numbers of patient in classes 1 to 5 were 1 (1.9%), 37 (69.8%), 11 (20.7%), 1 (1.9%), and 3 (5.7%), respectively. Pathologic examination showed 23 (43.4%) cases of cancer, 27 (50.9%) cases of benign prostatic hyperplasia, and 3 (5.7%) cases of high-grade prostatic intraepithelial neoplasia. All three patients with class 5 results had prostate cancer (Gleason score, 7 to 10). All 9 patients with a PSA level greater than 16 ng/ml had biopsy-proven cancer, and 3 of these 9 patients (33.3%) were in cytology class 5. Therefore, PF cytologic examination showed a specificity of 100% and a sensitivity of 33.3% in patients with PSA levels higher than 16 ng/ml. The cytologic classes differed in PSA levels (F=8.271, P=0.000) but not in patient age, TPV, or PF volume. CONCLUSIONS: Exfoliative cytologic examination of PF is a valuable, noninvasive method for detecting prostate cancer, especially in patients with high PSA levels.

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PubMed2006

Study of prostatic fluid from patients with elevated levels of prostate-specific antigen.

INTRODUCTION: Characteristics of prostatic fluid (PF), which can be obtained in large amounts during screening transrectal ultrasound just before prostate biopsy to detect prostate cancer, were investigated. These characteristics include the amount of PF obtained and the number of leukocytes in PF, which would be useful for planning cell-biological or immunological studies of leukocytes in PF and for increasing the understanding of prostatitis in elderly men. PATIENTS AND METHODS: The volume of PF and the number of leukocytes in PF were measured in 50 patients suspected of having prostate cancer because of elevated levels of serum prostate-specific antigen (PSA). Correlations of the volume of PF, the number of leukocytes per milliliter, the total leukocyte number with age and prostate volume and correlation of PSA levels with the number of leukocytes per milliliter and total leukocyte number were also investigated. RESULTS: The average patient age was 67.2 years, and PF specimens were obtained from 43 of the 50 patients (86%). The mean +/- SD of PF volume, number of leukocytes in PF, and total leukocyte number were 347.65 +/- 305.76 microl, 4.84 +/- 6.07 x 10(6) /ml, and 1.47 +/- 2.10 x 10(6), respectively. A correlation was observed only between the total leukocyte number and the volume of the transitional zone (P=0.039). CONCLUSIONS: These data provide information for investigators to plan cell-biological or immunological studies of leukocytes in PF and for understanding prostatitis in elderly men.

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PubMed2006

[Production of granulocyte colony-stimulating factor and parathyroid hormone-related protein in squamous cell carcinoma of the renal pelvis accompanied with inferior vena cava thrombus].

A 54-year-old man with general fatigue and lumbago was admitted for further examination of hypercalcemia and leukocytosis. CT showed a huge renal tumor and extension of the tumor thrombus to the inferior vena cava (IVC). Moreover, the serum granulocyte colony-stimulating factor (G-CSF) and the C-terminal of parathyroid hormone-related protein (PTHrP) were elevated. Under the diagnosis of advanced renal tumor, we performed nephro-ureterectomy and throbectomy. Pathological examination revealed squamous cell carcinoma of the renal pelvis. To our knowledge, this is the first case in Japan that of the simultaneous production of G-CSF and PTHrP in squamous cell carcinoma of the renal pelvis accompanied with IVC thrombus.

Carcinoma, Squamous Cell↗
PubMed2005

Random systematic sextant biopsy versus power doppler ultrasound-guided target biopsy in the diagnosis of prostate cancer: positive rate and clinicopathological features.

PURPOSE: To determine the efficacy of power Doppler ultrasound (PDU)in the diagnosis of prostate cancer, the rate of detection of cancer with PDU-guided target biopsy and sextant biopsy, the clinicopathological features of cancer positive specimens, and the relation between these two findings were studied. METHODS: From January 1998 through March 2000, 302 men suspected to have prostate cancer underwent sextant biopsy in association with additional PDU-guided target biopsy. Cases with positive biopsy results were divided into 9 groups as follows: T0: sextant biopsy was positive, but target biopsy was negative; S0: all sextant biopsies were negative, but target biopsy was positive; S1 approximately S6: both sextant biopsy and target biopsy were positive (number indicates number of positive sextant biopsy); Tx: sextant biopsy was positive, but no target biopsy was performed owing to a lack of echogenic abnormalities. The Gleason score (GS) and percent organ confined disease (%OCD) were compared between these 9 groups. RESULTS: Cancer was pathologically detected in 143 of 302 patients (47.4%). PDU detected 39 of 49 digital rectal examination-negative cancers (79.6%) and 5 of 13 transrectal ultrasound-negative isoechoic cancers (38.5%). Of 143 biopsy-positive cases, 6 were in the T0 group (4.2%), 10 in S0 (7.0%), 119 in S1 approximately S6 (83.2%), and 8 in Tx (5.6%). Target biopsy missed 14 (sum of T0 and Tx) cancers, and sextant biopsy missed 10 (S0). The average GS in the Tx group was significantly lower than that in the other groups; consequently, the %OCD was significantly higher. Retrospective analysis revealed that the failure to obtain cancer tissue in 4 of the 6 cases in the T0 group is most likely due to technical failure in obtaining specimens. The overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of PDU were 90.2%, 77.4%, 78.2%, 89.8% and 83.4%, respectively. CONCLUSION: PDU in association with sextant biopsy is a useful tool for increasing the rate of detection of prostate cancer. Further advances in ultrasound technology may enable the detection of prostate cancer by target biopsy alone and consequently may reduce the number of unnecessary biopsies. However, PDU-guided target biopsy alone is insufficient for cancer detection at the present time because of possible technical failure in obtaining specimens and the existence of PDU-negative cancer. Although more evidence is required, PDU-negative cancer is suggested to be less aggressive clinically, possibly justifying a watch and wait policy.

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PubMed2005

Luteinizing hormone-releasing hormone agonist monotherapy for prostate cancer: outcome and prognostic factors.

BACKGROUND: We assessed the outcome and prognostic factors in men with prostate cancer after luteinizing hormone-releasing hormone agonist monotherapy. METHODS: Between April 1998 and August 2002, 62 men with prostate cancer who were treated with monotherapy at our institution were included in this analysis. Prostate-specific antigen (PSA) failure-free (bNED) survival was calculated using Kaplan-Meier methods. Prognostic factors were evaluated using Cox proportional hazards regression model. RESULTS: We reviewed the data of patients, with a median follow-up from the commencement of monotherapy of 26 months. The overall survival rate at 3 years was 89.9%. The bNED survival rate was 63.7% at 3 years. Of the 20 patients with clinical stage B, 2 progressed to PSA failure, whereas PSA failure was seen in 8 of 30 patients with stage C and 8 of 12 patients with stage D. The significant factors for bNED status were an initial PSA level of <30 ng/ml (p=0.0044), achievement of PSA nadir level of <2.0 ng/ml (p<0.001), and Gleason score of or=30 ng/ml, and high Gleason score of >or=7 are at increased risk for PSA failure. Failure to achieve PSA nadir level of <2.0 ng/ml is an important predictor of the progression. The use of PSA nadir can provide useful guidelines for the reconsideration of treatment in patients who have received monotherapy.

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PubMed2004

Effect of adjuvant transarterial infusion of anticancer agents after transurethral resection in patients with pT2a muscle invasive transitional cell carcinoma of the bladder: five and ten-year outcome.

Five- and ten-year survival rates in patients who had transurethral resection for pT2aN0M0 muscle invasive transitional cell carcinoma of the bladder was studied with emphasis on the effect of adjuvant transarterial infusions of anticancer agents (TAI). A total of 17 patients out of 290 patients with bladder cancer who had initial treatment in our department between January 1991 and May 2001 were found to be pT2aN0M0 and were included in the present study. Fifteen patients received intravesical instillations of BCG after transurethral resection of the bladder tumor and 8 patients received TAI which was given two weeks after bacillus Calmette-Guerin therapy, with the exception of 1 patient. Five- and ten-year overall survival rates were 76.0% and 52.1%, respectively, and both five- and ten-year cancer-specific survival rates were 76.0% with an average follow up of 71 months. Significant prognostic factor associated with survival rates was only the infiltration pattern of the tumor cells between the alpha and beta group and gamma group (P = 0.0420) in cancer-specific survival rates. The data support conservative management of transurethral resection followed by intravesical instillation of BCG and TAI in patients with pT2a bladder cancer.

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PubMed2004

Detection of urine survivin in 40 patients with bladder cancer.

PURPOSE: We investigated whether urine survivin, an inhibitor of the apoptosis protein, is useful for diagnosing bladder tumor. METHOD: We measured urine survivin levels in 40 patients with bladder tumors and 9 healthy volunteers. RESULTS: The average urine survivin levels in the 40 patients and 9 healthy controls were not significantly different (3.802+/-8.669 and 1.127+/-1.529, respectively (p=0.3646) ). However, significantly high urine survivin levels were observed in 3 of the 40 patients, but not in healthy volunteers. Urine Cyfra 21-1 was not elevated (1.3 ng/ml) in one patient with a significantly elevated urine survivin level (33.54 ng/ml), while in two patients with elevated Cyfra (320 ng/ml and 240 ng/ml), the urine survivin level was not detectable. CONCLUSION: With improvements in the sensitivity of our Elisa system for urine survivin and combined use of urine Cyfra 21-1, it is possible that urine survivin will be a useful tumor marker in detecting both new-onset and recurrent bladder tumors.

Adult↗
PubMed2004

Transitional cell carcinoma of the bladder in four patients on maintenance hemodialysis.

We report four patients on maintenance hemodialysis (HD) with transitional cell carcinoma (TCC) of the bladder. Three patients underwent transurethral resection (TUR) of their tumors, which were grade 2 or 3, stage pT1 TCC. Among them, one patient underwent repeat TUR for recurrent superficial TCC. The remaining one patient underwent total cystectomy for grade 3, stage pT4 TCC and squamous cell carcinoma of the bladder. Subsequently, he died suddenly without evidence of local recurrence or systemic metastasis. We discuss the relationship between the duration of HD and the tumor grade and stage of primary bladder TCC in maintenance HD patients.

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PubMed2003

Laparoscopic radical prostatectomy: initial 30-case experience.

BACKGROUND: We carried out this study to clarify whether the operative methods of laparoscopic prostatectomy established in France could become standard therapy. The purpose was to evaluate the technical feasibility, oncological efficacy, and intraoperative and postoperative morbidity of laparoscopic prostatectomy performed by a general urologist. METHODS: Between June 2000 and August 2002, 30 patients with clinically localized prostate cancer underwent laparoscopic radical prostatectomy performed as previously reported by Guillonneau and colleagues. Oncological data were assessed by pathological examination and by postoperative prostate-specific antigen (PSA) levels. All prostatectomy specimens were processed according to the Stanford protocol. Prostate features, including tumor weight; Gleason score; and the tumor status of the capsule, seminal vesicles, and surgical margins were studied. RESULTS: Complete laparoscopic removal of the prostate and seminal vesicles was achieved in all 30 patients. Operating time averaged 325.5 min (range, 165 to 880 min). The transfusion rate for the patients in the series was 50%, using own-blood transfusion (800-1200 ml). No patient required an allogenic blood transfusion. Only 2 of the 30 patients had a positive surgical margin that involved the urethra. There were three complications: bladder injury, rectal injury, and ileus associated with a drainage tube. No vascular, nervous system, or urethral complications were found. CONCLUSION: These preliminary results demonstrated that radical prostatectomy can be performed laparoscopically by general urologists. Laparoscopy offered better luminosity and magnification than conventional procedures, permitting precise dissection. Thus, laparoscopic prostatectomy could be a standard operation for patients with clinically organ-confirmed prostate cancer.

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PubMed2002

Expression of cycloxygenase-2 in human bladder and renal cell carcinoma.

In summary, we have showed that levels of COX-2 are increased in both TCC and RCC derived from urinary tract epithelium as well as gastrointestinal cancer. These results raised the possibility that selective inhibitors of COX-2 may be useful in the prevention or treatment of these diseases.

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