BACKGROUND Benign prostatic hyperplasia (BPH) and prostate cancer (PCa) are the most prevalent diseases in male population, implicated with fundamental differences between benign and malignant growth of prostate cells. An imbalance through a network of nervous, endocrine, and immune systems initiate a signal of altered growth from the brain to the prostate gland, leading to adverse effects such as inflammation. OBJECTIVE The aim of this study was to evaluate the gene expression of dopamine receptor family, COMT, and IL6 to identify novel correlations in BPH and PCa in both blood and tumor of the patients. METHODS Peripheral blood mononuclear cells from BPH (n= 30) and PCa (n= 30) patients, and prostate tumor tissues (n= 14) along with pathologically normal adjacent tissues (n= 14) were isolated, mRNA was extracted, and cDNA was synthesized, respectively. Quantitative real- time PCR was applied for DRD1- DRD5, COMT, and IL6 genes in all samples. RESULTS We found, for the first time, that the expression of COMT and IL6 genes were inversely correlated with the expression of DRD1 and DRD2 genes through the extent of differentiation of PCa from BPH condition. In addition, the PSA levels were correlated with the expression of DRD1 in BPH cases and DRD1, DRD4, DRD5, and IL6 in PCa cases. CONCLUSION Results implicate a potential cross- talk between the signaling pathways derived by IL6 cytokine and dopamine receptors in PCa. Thus, it seems promising to reassemble the consequent signaling pathways by adequate agonists and antagonists to help increase therapeutic efficacy.

Novel Insight into Differential Gene Expression and Clinical Significance of Dopamine Receptors, COMT, and IL6 in BPH and Prostate Cancer.

Cancer is a major public health problem worldwide and the second leading cause of death in the United States of America (USA), following heart disease. Male lung cancer death rates are decreasing in the western world and increasing in China and several other countries in Asia and Africa. Female lung cancer death rates are increasing worldwide, with the exception of the USA, Canada and Australia. Differences in lung cancer incidence patterns between men and women reflect historical differences in tobacco use. Staging of cancer at the time of diagnosis is the most important predictor of survival, and treatment options should be based on the stage. The aim of this overview is to discuss the changes in the 8th Edition of the TNM (Tumor, Nodes, Metastasis) Classification of lung cancer and its impact on predicting patient prognosis. Potential limitations of the classification system and future directions are discussed. A systematic literature search was performed to identify relevant reports. Studies and articles were identified using several online searches of the U.S. National Library of Medicine via www.pubmed.com. The article is based on the International Association for the Study of Lung Cancer (IASLC) Staging and Prognostic Factors Committee report. An international lung cancer database was developed from 35 sources in 16 countries around the globe, with staging and outcome data on 94,708 cases of lung cancer. This new edition of lung cancer TNM staging placed additional emphasis on tumor size, and size cut-off points have been added, which will now be a descriptor in all TNM categories. For the first time a new term was introduced, defined as minimally invasive adenocarcinoma. The additional cut-off point changes will definitely alter treatment recommendations in the future. The node classification remained unchanged in the new edition. Regarding metastasis, M1a refers to cases with intrathoracic metastases, M1b cases with a single metastasis outside the thoracic cavity. The situation involving multiple metastatic deposits, usually in more than one organ, is now classified as M1c. The new staging of lung cancer is based on analysis of survival in large databases, based on tumor size and disease proliferation, and is therefore expected to assess the prognosis of the individual patient more accurately. Based on the current edition of the TNM staging system many patients will be given a different staging category,. It is evident that improved survival may reflect the expected improvements in diagnosis and treatment, the net effect being a stage-for-stage survival increase at all stages. This 8th edition of the TNM classification for lung cancer has placed additional emphasis on tumor size.

Comments on the eighth edition of the TNM classification for lung cancer. Radical changes and limitations: Does size matter?

Lung Cancer Staging With Minimally Invasive Endoscopic Techniques. Authors' reply

Aim-Background
During the staging process of lung cancer, accurate mediastinal lymph node staging is one of the more important factors to affect patient outcome. Accurate staging of the disease is important not only in determining prognosis but also in deciding the optimal treatment plan. The most significant treatment decision is establishing which patients can benefit from surgical resection and which should receive chemotherapy, radiation, or both. This paper reviews indications and current data regarding minimally invasive approaches for diagnosis and staging of lung cancer. In addition, current advances in diagnostic endoscopy for lung cancer will be reviewed.

Invasive techniques in diagnosis and staging of lung cancer

Aim-Background
The aim of this study was to evaluate the application of evidence-based medicine (EBM) to the diagnosis, staging and treatment of lung cancer. These guidelines were drawn up by special committees of the American College of Chest Physicians (ACCP). The guidelines are useful but should not be taken as dogma. Differences exist among guidelines concerning the same subject as written by experts of different disciplines and guidelines drawn up by the same committee that may be reviewed whenever new data emerge. The main objective of these guidelines is to enable informed clinical decisions to be made jointly by physicians and patients when developing diagnostic, treatment and management plans so that they can enhance the benefits and reduce the harm associated with various options. These guidelines are intended for multidisciplinary readership, including primary care, medical, and surgical specialists, plus nursing and allied health professionals.

A. Mouzakiti

Papers

Invasive techniques in diagnosis and staging of lung cancer

Applied evidence-based medicine. Guidelines for the diagnosis and management of lung cancer