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MP-03.18 Plasma Amino Acid Profile as a Novel Diagnostic Marker for Prostate Cancer: Multicenter Study
MODERATED POSTER SESSIONS
patients were also affected but do not have a specific clinical presentation. Most of them consult for complications. We recommend to all physicians the systematic digital rectal examination for all patients from 39 years and above; to the histopathologists to be conscious and aware of the importance of results given to physicians; to the public authority to organize voluntary campaigns for cancer detection.
MP-03.18 Plasma Amino Acid Profile as a Novel Diagnostic Marker for Prostate Cancer: Multicenter Study Miura T1, Moriyama M2, Ikeda I3, Saruki N4, Yamamoto H5, Imaizumi A5, Mitsushima T6, Yamakado M7, Miyagi Y1 1 Kanagawa Cancer Center, Yokohama, Japan; 2Yokohama Municipal Citizen’s Hospital, Yokohama, Japan; 3Yokohama Minami Kyosai Hospital, Yokohama, Japan; 4Gunma Prefectural Cancer Center, Ota, Japan; 5Ajinomoto Co. Inc, Kawasaki, Japan; 6Kameda Med. Ctr., Makuhari, Japan; 7Center For Multiphasic Health Testing and Services, Mitsui Memorial Hospital, Tokyo, Japan Introduction and Objective: Plasma amino acid concentration could change depending on metabolic states of the human body. It has been previously reported that plasma amino acid concentrations can change in patients with early stage lung, colorectal, breast and prostate cancer, suggesting that plasma amino acid profile can be a novel biomarker for early detection of cancer. We investigated a multicenter study to validate the performance of plasma amino acid profile for detection of prostate cancer. Materials and Methods: Between May 2007 and April 2010, the multicenter study assessed 280 male patients with prostate cancer who showed increased serum prostate-specific antigen (PSA) concentration (⬎4ng/ml) and who diagnosed by histopathological examination of biopsy specimens and 2788 control subjects. Each of the patients and control subjects was assigned to a training, or a validation dataset. Plasma amino acid levels were measured by liquid chromatography and mass spectrometry. For multivariate analysis, plasma amino acid profile model, “AminoIndex” to distinguish 134 patients with prostate cancer from 666 age-matched control subjects in the training dataset was performed by using multiple logistic regression analysis. The model was validated in 146 patients with pros-
tate cancer and 2122 control subjects in the validation dataset. Results: The levels of several plasma amino acids were significantly different in patients with prostate cancer when compared with control subjects. The model achieved an area under the receiver operating characteristic curve (AUC) of 0.78 in the validation dataset. For the patients with early (stage B) endometrial cancer, AUC for the model was 0.79. Conclusions: In this multicenter study, we tested the diagnostic accuracy of the model based on plasma amino acid profile for the early detection of prostate cancer. The results show that “AminoIndex” could be a novel promising tool for early detection of prostate cancer, and “AminoIndex” in conjunction with PSA for prostate cancer screening could be a promising way to decrease both false positive and false negative cases.
MP-03.19 Efficacy of Transperineal Versus Transrectal 12-Core Initial Prostate Biopsy with PSA Levels Between 4.0 and 20.0 ng/ml Ohira S, Hara R, Obatake A, Fujita M, Shouhei T, Hukumotou K, Jo M, Fijii T, Yokoyama M, Miyaji S, Nagai A Dept. of Urology, Kawasaki Medical School, Kurashiki, Japan Objectives: Transperineal and transrectal prostate biopsy are used for prostate cancer detection. However, to determine which approach is superior remains unknown. In this study, we compared the efficacy of transperineal versus transrectal 12-core initial prostate biopsy. Methods: From September 2002 to March 2010, a retrospective study of transperineal versus transrectal 12-core biopsy was conducted in 814 patients with PSA levels between 4.0 and 20.0 ng/ml (327 and 487 patients, respectively). All procedures were performed in the lithotomy position, with transperineal and transrectal approach being carried out under spinal anesthesia (0.5% bupivacaine) and caudal block (1% lidocaine), respectively. With both approaches, 8 biopsy specimens were obtained systematically from the peripheral zone (PZ) including the apex and 4 were obtained from the transition zone (TZ). Results: The cancer detection rate was 37.6% (123/327 patients) with the transperineal approach and 44.1% (215/487 patients) with the transrectal approach (p⫽0.064). Among patients with PSA levels between 4.0-10.0 ng/ml, the detection
UROLOGY 78 (Supplement 3A), September 2011
rate was 34.8% (81/233 patients) via the transperineal approach and 40.7% (135/ 332 patients) via the transrectal approach (p⫽0.156). Although the detection rates stratified by PSA levels were slightly lower with the transperineal approach, there were no statistically significant differences between the two groups. There were also no significant differences of the cancer detection rate in relation to prostate volume, DRE and TRUS in either group.(⬎38.5oC) was seen in five patients from the transperineal approach and in seven patients from the transrectal approach. Sepsis was seen in one patient from the transperineal approach and in two patients from the transrectal approach. There were no cases of mortality in either group. Ten patients with headache, presumably related to spinal anesthesia, were seen in only transperineal approach. There were no significant differences of any complications between the two groups without the headache. Conclusions: The preferred approach as an initial prostate biopsy would be transrectal approach which dose not require spinal anesthesia, no catheterization and is no difference in efficacy. Therefore, we recommended the transrectal approach which is more clinically applicable than transperineal approach as an initial prostate biopsy.
MP-03.20 Prostate Cancer Angiogenesis: A Preliminary Experience with 64-Row Multidetector CT Perfusion. Do Quantitative Measurements Distinguish Tumor? Pastore A1, Palleschi G1, Silvestri L1, Ripoli A1, Autieri D1, Osimani M2, Laghi A2, Petrozza V3, Carbone A1 1 Dept. of Urology, Sapienza Rome University, Faculty of Pharmacy and Medicine, Latina, Italy; 2Dept. of Radiology, Sapienza Rome University, Faculty of Pharmacy and Medicine, Latina, Italy; 3Dept. of Histopathology, Sapienza Rome University, Faculty of Pharmacy and Medicine, Latina, Italy Objective: To prospectively test the relationships between quantitative CT perfusion parameters and immunohistochemical microvascular density (MVD), considered as a gold standard marker of angiogenesis, in prostate cancer. Materials and Methods: The study protocol used conformed to the guidelines of the Declaration of Helsinki and each patient provided written consent in accordance with the requirements of our insti-
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patients were also affected but do not have a specific clinical presentation. Most of them consult for complications. We recommend to all physicians the systematic digital rectal examination for all patients from 39 years and above; to the histopathologists to be conscious and aware of the importance of results given to physicians; to the public authority to organize voluntary campaigns for cancer detection.
MP-03.18 Plasma Amino Acid Profile as a Novel Diagnostic Marker for Prostate Cancer: Multicenter Study Miura T1, Moriyama M2, Ikeda I3, Saruki N4, Yamamoto H5, Imaizumi A5, Mitsushima T6, Yamakado M7, Miyagi Y1 1 Kanagawa Cancer Center, Yokohama, Japan; 2Yokohama Municipal Citizen’s Hospital, Yokohama, Japan; 3Yokohama Minami Kyosai Hospital, Yokohama, Japan; 4Gunma Prefectural Cancer Center, Ota, Japan; 5Ajinomoto Co. Inc, Kawasaki, Japan; 6Kameda Med. Ctr., Makuhari, Japan; 7Center For Multiphasic Health Testing and Services, Mitsui Memorial Hospital, Tokyo, Japan Introduction and Objective: Plasma amino acid concentration could change depending on metabolic states of the human body. It has been previously reported that plasma amino acid concentrations can change in patients with early stage lung, colorectal, breast and prostate cancer, suggesting that plasma amino acid profile can be a novel biomarker for early detection of cancer. We investigated a multicenter study to validate the performance of plasma amino acid profile for detection of prostate cancer. Materials and Methods: Between May 2007 and April 2010, the multicenter study assessed 280 male patients with prostate cancer who showed increased serum prostate-specific antigen (PSA) concentration (⬎4ng/ml) and who diagnosed by histopathological examination of biopsy specimens and 2788 control subjects. Each of the patients and control subjects was assigned to a training, or a validation dataset. Plasma amino acid levels were measured by liquid chromatography and mass spectrometry. For multivariate analysis, plasma amino acid profile model, “AminoIndex” to distinguish 134 patients with prostate cancer from 666 age-matched control subjects in the training dataset was performed by using multiple logistic regression analysis. The model was validated in 146 patients with pros-
tate cancer and 2122 control subjects in the validation dataset. Results: The levels of several plasma amino acids were significantly different in patients with prostate cancer when compared with control subjects. The model achieved an area under the receiver operating characteristic curve (AUC) of 0.78 in the validation dataset. For the patients with early (stage B) endometrial cancer, AUC for the model was 0.79. Conclusions: In this multicenter study, we tested the diagnostic accuracy of the model based on plasma amino acid profile for the early detection of prostate cancer. The results show that “AminoIndex” could be a novel promising tool for early detection of prostate cancer, and “AminoIndex” in conjunction with PSA for prostate cancer screening could be a promising way to decrease both false positive and false negative cases.
MP-03.19 Efficacy of Transperineal Versus Transrectal 12-Core Initial Prostate Biopsy with PSA Levels Between 4.0 and 20.0 ng/ml Ohira S, Hara R, Obatake A, Fujita M, Shouhei T, Hukumotou K, Jo M, Fijii T, Yokoyama M, Miyaji S, Nagai A Dept. of Urology, Kawasaki Medical School, Kurashiki, Japan Objectives: Transperineal and transrectal prostate biopsy are used for prostate cancer detection. However, to determine which approach is superior remains unknown. In this study, we compared the efficacy of transperineal versus transrectal 12-core initial prostate biopsy. Methods: From September 2002 to March 2010, a retrospective study of transperineal versus transrectal 12-core biopsy was conducted in 814 patients with PSA levels between 4.0 and 20.0 ng/ml (327 and 487 patients, respectively). All procedures were performed in the lithotomy position, with transperineal and transrectal approach being carried out under spinal anesthesia (0.5% bupivacaine) and caudal block (1% lidocaine), respectively. With both approaches, 8 biopsy specimens were obtained systematically from the peripheral zone (PZ) including the apex and 4 were obtained from the transition zone (TZ). Results: The cancer detection rate was 37.6% (123/327 patients) with the transperineal approach and 44.1% (215/487 patients) with the transrectal approach (p⫽0.064). Among patients with PSA levels between 4.0-10.0 ng/ml, the detection
UROLOGY 78 (Supplement 3A), September 2011
rate was 34.8% (81/233 patients) via the transperineal approach and 40.7% (135/ 332 patients) via the transrectal approach (p⫽0.156). Although the detection rates stratified by PSA levels were slightly lower with the transperineal approach, there were no statistically significant differences between the two groups. There were also no significant differences of the cancer detection rate in relation to prostate volume, DRE and TRUS in either group.(⬎38.5oC) was seen in five patients from the transperineal approach and in seven patients from the transrectal approach. Sepsis was seen in one patient from the transperineal approach and in two patients from the transrectal approach. There were no cases of mortality in either group. Ten patients with headache, presumably related to spinal anesthesia, were seen in only transperineal approach. There were no significant differences of any complications between the two groups without the headache. Conclusions: The preferred approach as an initial prostate biopsy would be transrectal approach which dose not require spinal anesthesia, no catheterization and is no difference in efficacy. Therefore, we recommended the transrectal approach which is more clinically applicable than transperineal approach as an initial prostate biopsy.
MP-03.20 Prostate Cancer Angiogenesis: A Preliminary Experience with 64-Row Multidetector CT Perfusion. Do Quantitative Measurements Distinguish Tumor? Pastore A1, Palleschi G1, Silvestri L1, Ripoli A1, Autieri D1, Osimani M2, Laghi A2, Petrozza V3, Carbone A1 1 Dept. of Urology, Sapienza Rome University, Faculty of Pharmacy and Medicine, Latina, Italy; 2Dept. of Radiology, Sapienza Rome University, Faculty of Pharmacy and Medicine, Latina, Italy; 3Dept. of Histopathology, Sapienza Rome University, Faculty of Pharmacy and Medicine, Latina, Italy Objective: To prospectively test the relationships between quantitative CT perfusion parameters and immunohistochemical microvascular density (MVD), considered as a gold standard marker of angiogenesis, in prostate cancer. Materials and Methods: The study protocol used conformed to the guidelines of the Declaration of Helsinki and each patient provided written consent in accordance with the requirements of our insti-
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