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Free prostate specific antigen, complexed PSA and human glandular kallikrein 2 have independently been tested against the gold standard of total PSA for prostate cancer screening in largely white populations. With the incidence of prostate cancer much higher in black men, we sought to evaluate these markers simultaneously in a predominantly black population.A total of 138 men, of whom 108 were black, underwent ultrasound guided biopsy of the prostate for tPSA levels greater than 2.5 ng/ml or an abnormal digital rectal examination. Sera were drawn before biopsy and analyzed for tPSA, fPSA, cPSA and hK2 concentrations using standard methods (hK2 assay is for research use only, not for use in diagnostic procedures). The areas under the receiver operator characteristic curves were determined for each marker as well as biomarker combinations. Additionally, each parameter's specificity, positive and negative predictive values, and theoretical screening efficiency were assessed at or above the 95% sensitivity level.A total of 43 (31.1%) men had prostate cancer by biopsy. While the AUC for %fPSA was statistically the highest (0.822, p0.001), cPSA offered the highest specificity (31.6%) and positive predictive power (31.7%) of any of the tested biomarkers at comparable sensitivity (greater than 95%). The calculated efficiency of cPSA (51.4%) was also higher than the other markers. Nearly 20% of biopsies would be avoided using cPSA vs standard tPSA screening methods.Comparing the major PSA isoforms and hK2, cPSA alone appears to offer superior diagnostic discrimination for cancer detection in a predominantly black population.

Purpose: We evaluated the effects of the over expression of p27Kip1, a cyclin dependent kinase inhibitor and tumor suppressor protein, on the 786–0 human renal carcinoma cell line.Materials and Methods: The recombinant adenovirus Adp27Kip1 was evaluated for the induction of p27 protein expression in 786–0 renal carcinoma cells. Expression time and optimal vector concentration were determined. Growth curve studies, cell cycle analysis and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end-labeling were done to determine the effects of p27Kip1 on the cell cycle. Cyclin dependent protein kinase (Cdk) inhibitor (CDKI) activity assays were done to determine the expression/activities of Cdks and Western blot analysis was performed to determine the presence of CDKIs and other cell cycle regulator proteins. Nude mouse xenografts were established to demonstrate the in vivo efficacy of Adp27Kip1.Results: p27Kip1 protein expression was detected within 12 hours after Adp27Kip1 infection...

A 31-year-old black man presented to the emergency room with multiple skin lesions, shortness of breath and bilateral testicular masses. Genitourinary examination revealed a 7 3 7 3 4 cm. solid, nontender mass involving the right testicle and a similar but smaller mass on the left side. Although chest x-ray demonstrated a pattern most consistent with pulmonary sarcoidosis, metastatic germ cell tumor could not be excluded. Tumor markers were normal. Computerized tomography of the abdomen showed limited, shotty retroperitoneal adenopathy. The patient underwent inguinal exploration 2 days later. Because of the possibility for malignancy, radical orchiectomy was performed for the larger, right mass. Frozen sections revealed noncaseating granulomas and no evidence of tumor. Therefore, biopsy only of the contralateral testicle was done, which revealed a similar pathological condition. Permanent specimens confirmed bilateral testicular sarcoidosis with involvement of the epididymis and spermatic cord in the orchiectomy specimen. The patient began a course of corticosteroid therapy and had partial resolution of the symptoms and lesions.