Novel palliative strategies for patients with androgen-independent prostate cancer (AIPC) include targeting the epidermal growth factor receptor (EGFR) family. The aim of the present study was to investigate intrapatient changes of EGFRs during the development of AIPC. In total, 106 symptomatic AIPC patients were identified in whom prostatic biopsies (adenocarcinoma) were available both before the start of androgen deprivation (PRTR biopsy) and after the development of AIPC (AIPC biopsy). All four known subgroups of the EGFR family were determined by immunohistochemistry (IHC): c-erbB-1 (EGFR), c-erbB-2 (HER2/neu), c-erbB-3 (HER3) and c-erbB-4 (HER4). Moderate to strong membrane-specific staining was recorded semiquantitatively (o10% vs X10% ¼ IHC stained tumour cells: 'negative' vs 'positive' staining). The medical records were reviewed for clinical variables. During the development of AIPC, intrapatient changes occurred in two opposite directions for each of the four EGFRs: negativity changed to positivity, and vice versa, statistically significant only for the increase of c-erbB-1 expression (P ¼ 0.001). The c-erbB-2 expression in the AIPC biopsy was associated with a significantly shorter survival from the time of the AIPC biopsy (P ¼ 0.029). Our results support ongoing therapeutic attempts of EGFR inhibition in subgroups of patients with prostate cancer. Further research is needed to understand the function of EGFRs in this malignancy.

In vitro instability of free PSA in serum and large interindividual differences should be considered when using the ratio of free-to-total PSA in evaluation of patients with suspected prostate cancer. Serum samples should be stored frozen if not analyzed immediately or acidified to pH 5.5. Interpretation of data from determination of free-to-total PSA ratio should be done with caution if the sampling and storage conditions are not known.

Our findings demonstrate the considerable burden imposed both on patients and health-care resources by symptomatic prostate cancer, conservatively treated. There are few data available for comparison.

Stones from the upper urinary tract of 172 male and 73 female patients have been analyzed by X-ray diffraction. Pure calcium oxalate stones contribute 39.5% of all stones from men, but only 6.9% of stones from women. This difference is consistent both above and below 50 years of age and largely independent of whether patients with known causes of stone formation are excluded. Other sex differences, such as a greater tendency to pure calcium phosphate and triple phosphate stones in female patients, are to a large extent dependent on demonstrable causes. The possibility of analysis error is discussed, considering the possibility of minor amounts of calcium phosphate being overlooked in "pure" calcium oxalate stones. Although this possibility cannot be rejected, there will still be a definite male preponderance of calcium oxalate stones with no or minimal admixture of calcium phosphate.