ObjectiveTo investigate the expression of tumor necrosis factor-α (TNF-α) in prostate cancer tissue and explore its relations with tumor angiogenesis. MethodsThe expression of TNF-α and CD105 were detected with two-step immunohistochemical staining technique in 20 cases of benign prostatic hyperplasia and 50 cases of prostate cancer between January 2010 and January 2012, and microvessel density (MVD) marked with CD105 was also measured. ResultsThe expressions of TNF-α and CD105 were higher in prostate cancer (41.72±8.67, 20.15±2.67) than those in benign prostatic hyperplasia (21.01±3.85, 4.34±1.67) (t'=13.990, P<0.001; t'=29.771, P<0.001). TNF-α and MVD were not correlated with age and size of tumor, but were positively correlated with tumor differentiation degree (rs=0.847, P<0.001; rs=0.776, P<0.001) and negatively correlated with clinical grades (rs=-0.769, P<0.001; rs=-0.842, P<0.001). ConclusionThe result indicates that over expression of TNF-α exists in prostate cancer. It may play an important role in the anginogenesis and carcinogenesis of prostate cancer.
目的 应用基于链式方程的填补方法处理医学研究中的数据缺失，并以填补后完全数据构建联合指标的logistic判别函数，判断其在前列腺癌的预测诊断中的应用价值。 方法 采用模拟研究，针对现实数据缺失情况模拟不同填补集结果，并以此对现实数据进行填补，以完整数据构建logistic判别，进行分析预测。 结果 填补结果随着填补次数的增加而逐渐接近真实值并趋于稳定。联合年龄、血清前列腺特异性抗原值、血流阻力指数及经直肠前列腺超声检查指标的logistic判别分析结果的灵敏度为82.39%，特异度为74.86%。 结论 联合指标分析可提高前列腺癌的诊断预测水平，以减轻患者穿刺痛苦。
Objective To investigate the application of the dynamic contrast enhanced MRI (DCE-MRI ) combined with magnetic resonance spectroscopy (MRS) in the diagnosis of prostate cancer. Method A total of 60 patients with prostate cancer and 60 patients with benign prostatic hyperplasia diagnoses in Sichuan Cancer Hospital from January 2011 to January 2014 were included as prostate cancer group and proliferative group respectively. Sixty healthy individuals during the same period were included as the control group. We used Siemens Avanto 1.5 T high field superconducting MRI for DCE-MRI scan and MRS scan. After the MRS scan was finished, we used the workstation spectroscopy tab spectral analysis. Eventually we got the crest lines of prostate metabolites choline (Cho), creatine (Cr) and citrate (Cit). Then we calculated Cho/Cit, (Cho+Cr)/Cit and their average. Results Comparing the signal value in 21 seconds, 1 minute, 2 minutes of DCE-MRI, the differences among the three groups were statistically significant (P<0.05). Comparing the results of spectral analysis, the differences among the three groups were statistically significant (P<0.05). The sensitivity was 89.67%, the specificity was 95.45% and the accuracy was 94.34% when using DCE-MRI combined with MRS. Conclusion DCE-MRI combined with MRS greatly improves the sensitivity, specificity and accuracy of the diagnosis of prostate cancer; it has a great application value in the diagnosis of prostate cancer.
Prostate cancer is the most common malignant tumor in male urinary system, and the morbidity and mortality rate are increasing year by year. Traditional imaging examinations have some limitations in the diagnosis of prostate cancer, and the advent of molecular imaging probes and imaging technology have provided new ideas for the integration of diagnosis and treatment of prostate cancer. In recent years, prostate-specific membrane antigen (PSMA) has attracted much attention as a target for imaging and treatment of prostate cancer. PSMA ligand positron emission tomography (PET) has important reference value in the diagnosis, initial staging, detection of biochemical recurrence and metastasis, clinical decision-making guidance and efficacy evaluation of prostate cancer. This article briefly reviews the clinical research and application progress on PSMA ligand PET imaging in prostate cancer in recent years, so as to raise the efficiency of clinical applications.
Objective To systemically review the efficacy and safety of strontium chloride for bone metastases from prostate cancer. Methods PubMed, The Cochrane Library, EMbase, VIP, CBM, CNKI and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) about strontium chloride for bone metastases from prostate cancer from inception to November 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software. Results A total of 7 RCTs involving 1 532 patients were included. The results of meta-analysis showed that strontium chloride was superior to placebo in the rate of pain relief (RR=1.79, 95%CI 1.35 to 2.37, P<0.000 1), but more likely to cause slight leucopenia (Peto OR=5.02, 95%CI 1.49 to 16.95,P=0.009). However, no significant difference was found in overall survival time between two groups (RR=0.87, 95%CI 0.58 to 1.30, P=0.49). In addition, strontium chloride was superior to radiotherapy in rate of bone pain relief (RR=1.28, 95%CI 1.12 to 1.47, P=0.0004), but it would cause thrombocy (Peto OR=2.61, 95%CI 1.04 to 6.57, P=0.04). Conclusion Current evidence shows that the strontium chloride is superior to placebo in the rate of pain relief, but it will cause slight leucopenia. The strontium chloride is superior to radiotherapy in rate of bone pain relief. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To systematically review the efficacy and safety of abiraterone acetate in the treatment of castration-resistant prostate cancer. Methods CNKI, WanFang Data, VIP, Web of Science, PubMed, EMbase and The Cochrane Library databases were electronically searched to collect randomized controlled trials on abiraterone in the treatment of castration-resistant prostate cancer from inception to December 31st, 2020. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.3 software. Results A total of 25 randomized controlled trials involving 8 654 patients were included. Meta-analysis results showed that the median radiographic progression-free survival (MD=5.81, 95%CI 3.58 to 8.03, P<0.01), PSA response rate (RR=2.77, 95%CI 1.65 to 4.65, P<0.01), median overall survival (MD=6.44, 95%CI 4.54 to 8.33, P<0.01), median time to PSA progression (MD=2.57, 95%CI 1.30 to 3.84, P<0.01), median PSA progressionfree survival (MD=6.74, 95%CI 5.08 to 8.39, P<0.01), testosterone level control (MD=−0.41, 95%CI −0.68 to −0.14, P<0.01), PSA level control (MD=−8.06, 95%CI −13.82 to −2.31, P<0.01), effective rate (RR=2.94, 95%CI 1.89 to 4.58, P<0.01), complete remission (RR=1.66, 95%CI 1.02 to 2.72, P<0.05), granulocytopenia (RR=0.18, 95%CI 0.07 to 0.45, P<0.01) and KPS score (MD=4.29, 95%CI 4.06 to 4.52, P<0.01) were significantly superior to non-abiraterone treatment group. The incidence of hypertension (RR=2.04, 95%CI 1.62 to 2.57, P<0.01), heart disease (RR=2.27, 95%CI 1.80 to 2.86, P<0.01) and hypokalemia (RR=2.89, 95%CI 1.59 to 5.26, P<0.01) adverse reactions were significantly higher than those in non-abiraterone group. The number of drug withdrawals caused by adverse reactions (RR=1.26, 95%CI 0.98 to 1.61, P>0.05), fluid retention or edema (RR=1.23, 95%CI 0.73 to 2.09, P>0.05), liver function damage (RR=1.66, 95%CI 0.93 to 2.97, P>0.05), fatigue and weakness (RR=0.97, 95%CI 0.73 to 1.29, P>0.05), anemia (RR=0.86, 95%CI 0.64 to 1.16, P>0.05) and elevated blood glucose (RR=1.51, 95%CI 0.96 to 2.36, P>0.05), were not significantly different between the two groups. Conclusion Abiraterone acetate can effectively delay the progression of castration-resistant prostate cancer, prolong the survival period, and improve the quality of life. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo explore the feasibility of targeted cryoablation for localized prostate cancer in day surgery.MethodThe clinical data of patients with localized prostate cancer who underwent cryoablation from April 2017 to May 2019 were retrospective analyzed. The patients’ satisfaction, postoperative complications, chronic pain and indwelling catheter term were recorded on the 1st (the next day after operation) and 7th day after the operation of follow-up.ResultsA total of 98 patients were included. All patients underwent the surgeries successfully. The average age of the patients was (73.43±7.86) years old. The average length of postoperative hospital stay was (1.55±0.43) days, including 34 cases (34.69%) discharged within 24 hours after the surgery. The satisfaction rate of patients was 100% on the 1st and 7th day after the operation. Twelve cases (12.24%) removed the catheter at the discharge, 83 cases (84.69%) removed the catheter on the 7th day after the operation. Because of the urinary retention, 3 cases (3.06%) removed the catheter 2 weeks after the operation. All patients were satisfied with urine control after the removal of the catheter. Ten cases (10.20%) had postoperative complications, including 3 of urinary tract infection, 3 of urinary retention, and 4 of perineal edema; the patients recovered after symptomatic treatment. On the day of surgery, 8 cases (8.16%) had slight postoperative pain in perineal (the Visual Analogue Scale scores were all 2). After oral analgesic treatment, the patients’ symptoms were alleviated.ConclusionTargeted cryoablation is a safe and effective method for the treatment of localized prostate cancer with a low incidence of postoperative complications, and it has certain feasibility in day surgery mode.
Through searching and evaluating the evidence on advanced prostate cancer, we found that different types of androgen deprivation had similar effect, and immediate androgen deprivation had survival benefit. For the patient with hormone-refractory prostate cancer, therapies including mitoxantrone, prednisone, docetaxel and surmine were more effective. Strontium-89 provided more effective pain relief than external beam radiation. And bisphophonate had no effect. Antiandrogen withdrawal suggested prostate specific antigen would decline, but the clinical outcome wasn’t reported.
Prostate cancer ranks second among the causes of death of malignant tumors in middle-aged and elderly men. A considerable number of patients are not easily detected in early-stage prostate cancer. Although traditional imaging examinations are of high value in the diagnosis and staging of prostate cancer, they also have certain limitations. With the development of nuclear medicine instruments and molecular probes, molecular imaging is playing an increasingly important role in the diagnosis and treatment of prostate cancer. Positron emission tomography and computed tomography (PET/CT) using prostate-specific membrane antigen (PSMA) as a probe has gained increasing recognition. This article will review the latest progress in the application of PET/CT using probes for targeting PSMA to imaging and treatment of prostate cancer, in order to provide a theoretical basis for the application of probes for targeting PSMA in the diagnosis and treatment of prostate cancer.
ObjectivesTo systematically review the association between the variants of HNF1B gene and the risk of prostate cancer.MethodsPubMed, EMbase, The Cochrane Library, CNKI, CBM and WanFang Data databases were electronically searched to collect case-control studies on the association between the variants of HNF1B gene and risk of prostate cancer from inception to December, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using Stata 14.0 software.ResultsA total of 15 case-control studies involving 30 532 patients and 38 832 controls were included. The results of meta-analysis showed that: there was a strong significant association between rs4430796 variants (Gvs.A: OR=0.802, 95%CI 0.784 to 0.821, P<0.001; GGvs.AA: OR=0.659, 95%CI 0.606 to 0.717, P<0.001; AGvs.AA: OR=0.762, 95%CI 0.714 to 0.814, P<0.001), rs11649743 variants (Avs.G: OR=0.875, 95%CI 0.820 to 0.941, P<0.001; AAvs.GG: OR=0.669, 95%CI 0.564 to 0.792, P<0.001; AGvs.GG: OR=0.855, 95%CI 0.798 to 0.916, P<0.001), rs7501939 variants (Avs.G: OR=0.833, 95%CI 0.807 to 0.859, P<0.001), rs3760511 variants (Avs.C: OR=0.834, 95%CI 0.803 to 0.868, P<0.001) and risk of prostate cancer.ConclusionsCurrent evidence shows that HNF1B gene variants are associated with risk of prostate cancer. Due to limited quantity and quality of the included studies, more high quality studies are required to verify the above conclusion.