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Mala KS, Plage H, Mödl L, Hofbauer S, Friedersdorff F, Schostak M, Miller K, Schlomm T, Cash H. Follow-Up of Men Who Have Undergone Focal Therapy for Prostate Cancer with HIFU-A Real-World Experience. J Clin Med 2023; 12:7089. [PMID: 38002699 PMCID: PMC10672492 DOI: 10.3390/jcm12227089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/01/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
PURPOSE To determine oncological and functional outcomes and side effects after focal therapy of prostate cancer (PCa) with high-intensity focused ultrasound (HIFU). METHODS This retrospective single-center study included 57 consecutive patients with localised PCa. Aged 18-80 with ≤2 suspicious lesions on mpMRI (PIRADS ≥ 3), PSA of ≤15 ng/mL, and an ISUP GG of ≤2. HIFU was performed between November 2014 and September 2018. All men had an MRI/US fusion-guided targeted biopsy (TB) combined with a TRUS-guided 10-core systematic biopsy (SB) prior to focal therapy. HIFU treatment was performed as focal, partial, or hemiablative, depending on the prior histopathology. Follow-up included Questionnaires (IIEF-5, ICIQ, and IPSS), prostate-specific antigen (PSA) measurement, follow-up mpMRI, and follow-up biopsies. RESULTS The median age of the cohort was 72 years (IQR 64-76), and the median PSA value before HIFU was 7.3 ng/mL (IQR 5.75-10.39 ng/mL). The median follow-up was 27.5 (IQR 23-41) months. At the time of the follow-up, the median PSA value was 2.5 ng/mL (IQR 0.94-4.96 ng/mL), which shows a significant decrease (p < 0.001). In 17 (29.8%) men, mpMRI revealed a suspicious lesion, and 19 (33.3%) men had a positive biopsy result. Only IIEF values significantly decreased from 16 (IQR 10.75-20.25) to 11.5 (IQR 4.5-17) (p < 0.001). The rate of post-HIFU complications was low, at 19.3% (11 patients). The limitation of this study is the lack of long-term follow-up. CONCLUSIONS HIFU as a therapy option for nonmetastatic, significant prostate cancer is effective in the short term for carefully selected patients and shows a low risk of adverse events and side effects.
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Affiliation(s)
- Katharina Sophie Mala
- Department of Urology, Charité University Medicine Berlin, 10117 Berlin, Germany; (H.P.); (H.C.)
| | - Henning Plage
- Department of Urology, Charité University Medicine Berlin, 10117 Berlin, Germany; (H.P.); (H.C.)
| | - Lukas Mödl
- Institute of Biometry and Clinical Epidemiology, Charité University Medicine Berlin, 10117 Berlin, Germany
| | - Sebastian Hofbauer
- Department of Urology, Charité University Medicine Berlin, 10117 Berlin, Germany; (H.P.); (H.C.)
| | - Frank Friedersdorff
- Department of Urology, Charité University Medicine Berlin, 10117 Berlin, Germany; (H.P.); (H.C.)
- Department of Urology, Koenigin Elisabeth Herzberge, 10365 Berlin, Germany
| | - Martin Schostak
- Department of Urology, Otto-von-Guericke-University Magdeburg, 39106 Magdeburg, Germany
| | - Kurt Miller
- Department of Urology, Charité University Medicine Berlin, 10117 Berlin, Germany; (H.P.); (H.C.)
| | - Thorsten Schlomm
- Department of Urology, Charité University Medicine Berlin, 10117 Berlin, Germany; (H.P.); (H.C.)
| | - Hannes Cash
- Department of Urology, Charité University Medicine Berlin, 10117 Berlin, Germany; (H.P.); (H.C.)
- Department of Urology, Otto-von-Guericke-University Magdeburg, 39106 Magdeburg, Germany
- PROURO, 10117 Berlin, Germany
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2
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Zhang Z, Cai Q, Wang J, Yao Z, Ji F, Hang Y, Ma J, Jiang H, Yan B, Zhanghuang C. Development and validation of a nomogram to predict cancer-specific survival in nonsurgically treated elderly patients with prostate cancer. Sci Rep 2023; 13:17719. [PMID: 37853026 PMCID: PMC10584808 DOI: 10.1038/s41598-023-44911-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 10/13/2023] [Indexed: 10/20/2023] Open
Abstract
Prostate Cancer (PC) is the most common male nonskin tumour in the world, and most diagnosed patients are over 65 years old. The main treatment for PC includes surgical treatment and nonsurgical treatment. Currently, for nonsurgically treated elderly patients, few studies have evaluated their prognostic factors. Our aim was to construct a nomogram that could predict cancer-specific survival (CSS) in nonsurgically treated elderly PC patients to assess their prognosis-related independent risk factors. Patient information was obtained from the Surveillance, Epidemiology and End Results (SEER) database, and our target population was nonsurgically treated PC patients who were over 65 years old. Independent risk factors were determined using both univariate and multivariate Cox regression models. A nomogram was built using a multivariate Cox regression model. The accuracy and discrimination of the prediction model were tested using the consistency index (C-index), the area under the subject operating characteristic curve (AUC), and the calibration curve. Decision curve analysis (DCA) was used to examine the potential clinical value of this model. A total of 87,831 elderly PC patients with nonsurgical treatment in 2010-2018 were included in the study and were randomly assigned to the training set (N = 61,595) and the validation set (N = 26,236). Univariate and multivariate Cox regression model analyses showed that age, race, marital status, TNM stage, chemotherapy, radiotherapy modality, PSA and GS were independent risk factors for predicting CSS in nonsurgically treated elderly PC patients. The C-index of the training set and the validation set was 0.894 (95% CI 0.888-0.900) and 0.897 (95% CI 0.887-0.907), respectively, indicating the good discrimination ability of the nomogram. The AUC and the calibration curves also show good accuracy and discriminability. We developed a new nomogram to predict CSS in elderly PC patients with nonsurgical treatment. The model is internally validated with good accuracy and reliability, as well as potential clinical value, and can be used for clinical aid in decision-making.
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Affiliation(s)
- Zhaoxia Zhang
- Department of Urology, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing Higher Institution Engineering Research Center of Children's Medical Big Data Intelligent Application, Chongqing, People's Republic of China
| | - Qian Cai
- Department of Urology, Affiliated Hospital of Yunnan University (The Second People's Hospital of Yunnan Province, Ophthalmic Hospital of Yunnan Province), Kunming, Yunnan, People's Republic of China
| | - Jinkui Wang
- Department of Urology, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing Higher Institution Engineering Research Center of Children's Medical Big Data Intelligent Application, Chongqing, People's Republic of China
| | - Zhigang Yao
- Department of Urology, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), 288 Qianxing Road, Kunming, 650228, Yunnan, China
| | - Fengming Ji
- Department of Urology, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), 288 Qianxing Road, Kunming, 650228, Yunnan, China
| | - Yu Hang
- Department of Urology, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), 288 Qianxing Road, Kunming, 650228, Yunnan, China
| | - Jing Ma
- Yunnan Key Laboratory of Children's Major Disease Research, Kunming Children's Hospital (Children's Hospital Affiliated to Kunming Medical University), Yunnan Province Clinical Research Center for Children's Health and Disease, Kunming, People's Republic of China
| | - Hongchao Jiang
- Science and Education Department, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), Kunming, People's Republic of China
| | - Bing Yan
- Department of Urology, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), 288 Qianxing Road, Kunming, 650228, Yunnan, China.
- Yunnan Key Laboratory of Children's Major Disease Research, Kunming Children's Hospital (Children's Hospital Affiliated to Kunming Medical University), Yunnan Province Clinical Research Center for Children's Health and Disease, Kunming, People's Republic of China.
| | - Chenghao Zhanghuang
- Department of Urology, Kunming Children's Hospital (Children's Hospital affiliated to Kunming Medical University), 288 Qianxing Road, Kunming, 650228, Yunnan, China.
- Department of Urology, Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing Higher Institution Engineering Research Center of Children's Medical Big Data Intelligent Application, Chongqing, People's Republic of China.
- Yunnan Key Laboratory of Children's Major Disease Research, Kunming Children's Hospital (Children's Hospital Affiliated to Kunming Medical University), Yunnan Province Clinical Research Center for Children's Health and Disease, Kunming, People's Republic of China.
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Kohar A, Cramb SM, Pickles K, Smith DP, Baade PD. Changes in prostate specific antigen (PSA) "screening" patterns by geographic region and socio-economic status in Australia: Analysis of medicare data in 50-69 year old men. Cancer Epidemiol 2023; 83:102338. [PMID: 36841020 DOI: 10.1016/j.canep.2023.102338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 01/30/2023] [Accepted: 02/10/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND While it is known that national PSA testing rates have decreased in Australia since 2007, it is not known whether these trends are consistent by broad geographical areas, nor whether previously reported area-specific differences have remained in more recent time periods. METHODS Population-based cohort study of Australian men (n = 2793,882) aged 50-69 who received at least one PSA test (Medicare Benefit Schedule item number 66655) during 2002-2018. Outcome measures included age-standardised participation rate, annual percentage change using JoinPoint regression and indirectly standardised participation rate ratio using multivariable Poisson regression. RESULTS During 2005-09, two thirds (68%) of Australian men aged 50-69 had at least one PSA test, reducing to about half (48%) during 2014-18. In both periods, testing rates were highest among men living in major cities, men aged 50-59 years, and among men living in the most advantaged areas. Nationally, the Australian PSA testing rate increased by 9.2% per year between 2002 and 2007, but then decreased by 5.0% per year to 2018. This pattern was generally consistent across States and Territories, and socio-economic areas, however the magnitude of the trends was less pronounced in remote and very remote areas. CONCLUSIONS The decreasing trends are consistent with a greater awareness of the current guidelines for clinical practice in Australia, which recommend a PSA test be done only with the informed consent of individual men who understand the potential benefits and risks. However, given there remain substantial geographical disparities in prostate cancer incidence and survival in Australia, along with the equivocal evidence for any benefit from PSA screening, there remains a need for more effective diagnostic strategies for prostate cancer to be implemented consistently regardless of where men live.
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Affiliation(s)
- Ankur Kohar
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia; Sydney School of Public Health, The University of Sydney, Australia
| | - Susanna M Cramb
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; Australian Centre for Health Services Innovation & Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia; Centre for Data Science, Queensland University of Technology, Brisbane, Australia
| | - Kristen Pickles
- Faculty of Medicine and Health, Sydney Health Literacy Lab, School of Public Health, The University of Sydney, Sydney, Australia
| | - David P Smith
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, New South Wales, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Peter D Baade
- Cancer Council Queensland, Brisbane, Australia; Centre for Data Science, Queensland University of Technology, Brisbane, Australia; Menzies Health Institute, Griffith University, Gold Coast, Australia.
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Li X, Xi H, Cheng X, Yu Y, Zhang C, Wang G, Zhou X. Assessment of oligometastasis status of prostate cancer following combined robot-assisted radical prostatectomy and androgen deprivation versus androgen deprivation therapy alone using PSA percentage decline rate. Front Endocrinol (Lausanne) 2023; 14:1123934. [PMID: 36843605 PMCID: PMC9951113 DOI: 10.3389/fendo.2023.1123934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 01/31/2023] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVE To compare the tumor control in prostate cancer patients with oligo-metastasis following combined robot-assisted radical prostatectomy and androgen deprivation versus androgen deprivation therapy alone based on total prostate-specific antigen (tPSA) assessment. METHODS Medical data of a total of 18 prostate cancer patients with oligometastasis administered in The First Affiliated Hospital of Nanchang University from March 2017 to March 2018 were prospectively collected. 10 patients received a combined therapy of robot-assisted radical prostatectomy and pharmaceutical androgen deprivation (RARP+ADT group), while 8 patients received pharmaceutical androgen deprivation therapy alone (ADT group). Then demographic characteristics, prostate volume, tumor characteristics and tPSA data were analysised and compared. Statistical analysis was performed using t-test for continuous variables and Pearson chi-square test or Fisher's exact test for categorical variables. RESULTS No significant difference was found in patients' age (p = 0.075), prostate volume (p = 0.134) and number of bone metastasis (p = 0.342). Pre-treatment Gleason score was significantly lower in RA group (p = 0.003). Patients in RARP+ADT group had significantly lower pre-treatment tPSA (p = 0.014), while no statistical difference was noted in reexamined tPSA (p = 0.140) on follow-up. No statistical difference was noted in tPSA decline rates (declined tPSA value per day) in RARP+ADT and ADT group (8.1 ± 4.7 verse 7.5 ± 8.0 ng/ml/d, p = 0.853). However, tPSA percentage decline rate (declined tPSA percentage per day) was significantly higher in RARP+ADT group (11.6 ± 1.5%/d verses 2.9 ± 2.2%/d, p< 0.001). Immediate urinary continence was achieved in 9 patients (90%) upon removal of urethral catheter on post-operative day 7 in RARP+ADT group. CONCLUSION ADT alone and in combination with RARP both provide effective tumor control in patients suffering from prostate cancer with oligometastasis. ADT combined with RARP exhibited significant advantage in PSA percentage decline rate without compromising patients' urinary continence. Long-term tumor control requires further follow-up.
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Affiliation(s)
- Xuwen Li
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Haibo Xi
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiaofeng Cheng
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yue Yu
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Cheng Zhang
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Gongxian Wang
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiaochen Zhou
- Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, China
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Pantelidou M, Caglic I, George A, Blyuss O, Gnanapragasam VJ, Barrett T. Evaluation of transabdominal and transperineal ultrasound-derived prostate specific antigen (PSA) density and clinical utility compared to MRI prostate volumes: A feasibility study. PLoS One 2022; 17:e0274014. [PMID: 36084119 PMCID: PMC9462719 DOI: 10.1371/journal.pone.0274014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/19/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the accuracy of surface-based ultrasound-derived PSA-density (US-PSAD) versus gold-standard MRI-PSAD as a risk-stratification tool. Methods Single-centre prospective study of patients undergoing MRI for suspected prostate cancer (PCa). Four combinations of US-volumes were calculated using transperineal (TP) and transabdominal (TA) views, with triplanar measurements to calculate volume and US-PSAD. Intra-class correlation coefficient (ICC) was used to compare US and MRI volumes. Categorical comparison of MRI-PSAD and US-PSAD was performed at PSAD cut-offs <0.15, 0.15–0.20, and >0.20 ng/mL2 to assess agreement with MRI-PSAD risk-stratification decisions. Results 64 men were investigated, mean age 69 years and PSA 7.0 ng/mL. 36/64 had biopsy-confirmed prostate cancer (18 Gleason 3+3, 18 Gleason ≥3+4). Mean MRI-derived gland volume was 60 mL, compared to 56 mL for TA-US, and 65 mL TP-US. ICC demonstrated good agreement for all US volumes with MRI, with highest agreement for transabdominal US, followed by combined TA/TP volumes. Risk-stratification decisions to biopsy showed concordant agreement between triplanar MRI-PSAD and ultrasound-PSAD in 86–91% and 92–95% at PSAD thresholds of >0.15 ng/mL2 and >0.12 ng/mL2, respectively. Decision to biopsy at threshold >0.12 ng/mL2, demonstrated sensitivity ranges of 81–100%, specificity 85–100%, PPV 86–100% and NPV 83–100%. Transabdominal US provided optimal sensitivity of 100% for this clinical decision, with specificity 85%, and transperineal US provided optimal specificity of 100%, with sensitivity 87%. Conclusion Transperineal-US and combined TA-TP US-derived PSA density values compare well with standard MRI-derived values and could be used to provide accurate PSAD at presentation and inform the need for further investigations.
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Affiliation(s)
- Maria Pantelidou
- Department of Radiology, Addenbrooke’s Hospital, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Iztok Caglic
- Department of Radiology, Addenbrooke’s Hospital, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Anne George
- Cambridge Urology Translational Research and Clinical Trials Office, University of Cambridge, Cambridge, United Kingdom
| | - Oleg Blyuss
- School of Physics, Engineering & Computer Science, University of Hertfordshire, Hatfield, United Kingdom
- Department of Paediatrics and Paediatric Infectious Diseases, Sechenov First Moscow State Medical University, Moscow, Russia
- Department of Applied Mathematics, Lobachevsky State University of Nizhny Novgorod, Nizhny Novgorod, Russia
| | - Vincent J. Gnanapragasam
- Cambridge Urology Translational Research and Clinical Trials Office, University of Cambridge, Cambridge, United Kingdom
- Division of Urology, Department of Surgery, University of Cambridge, Cambridge, United Kingdom
- Department of Urology, Addenbrooke’s Hospital, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Tristan Barrett
- Department of Radiology, Addenbrooke’s Hospital, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge, United Kingdom
- * E-mail:
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Prostate cancer risk in men of differing genetic ancestry and approaches to disease screening and management in these groups. Br J Cancer 2022; 126:1366-1373. [PMID: 34923574 PMCID: PMC9090767 DOI: 10.1038/s41416-021-01669-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 11/02/2021] [Accepted: 12/03/2021] [Indexed: 01/12/2023] Open
Abstract
Prostate cancer is the second most common solid tumour in men worldwide and it is also the most common cancer affecting men of African descent. Prostate cancer incidence and mortality vary across regions and populations. Some of this is explained by a large heritable component of this disease. It has been established that men of African and African Caribbean ethnicity are predisposed to prostate cancer (PrCa) that can have an earlier onset and a more aggressive course, thereby leading to poorer outcomes for patients in this group. Literature searches were carried out using the PubMed, EMBASE and Cochrane Library databases to identify studies associated with PrCa risk and its association with ancestry, screening and management of PrCa. In order to be included, studies were required to be published in English in full-text form. An attractive approach is to identify high-risk groups and develop a targeted screening programme for them as the benefits of population-wide screening in PrCa using prostate-specific antigen (PSA) testing in general population screening have shown evidence of benefit; however, the harms are considered to weigh heavier because screening using PSA testing can lead to over-diagnosis and over-treatment. The aim of targeted screening of higher-risk groups identified by genetic risk stratification is to reduce over-diagnosis and treat those who are most likely to benefit.
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Mandel P, Hoeh B, Preisser F, Wenzel M, Humke C, Welte MN, Jerrentrup I, Köllermann J, Wild P, Tilki D, Haese A, Becker A, Roos FC, Chun FKH, Kluth LA. Influence of Tumor Burden on Serum Prostate-Specific Antigen in Prostate Cancer Patients Undergoing Radical Prostatectomy. Front Oncol 2021; 11:656444. [PMID: 34395240 PMCID: PMC8358926 DOI: 10.3389/fonc.2021.656444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 07/12/2021] [Indexed: 11/30/2022] Open
Abstract
Objective We aimed to assess the correlation between serum prostate-specific antigen (PSA) and tumor burden in prostate cancer (PCa) patients undergoing radical prostatectomy (RP), because estimation of tumor burden is of high value, e.g., in men undergoing RP or with biochemical recurrence after RP. Patients and Methods From January 2019 to June 2020, 179 consecutive PCa patients after RP with information on tumor and prostate weight were retrospectively identified from our prospective institutional RP database. Patients with preoperative systemic therapy (n=19), metastases (cM1, n=5), and locally progressed PCa (pT4 or pN1, n=50) were excluded from analyses. Histopathological features, including total weight of the prostate and specific tumor weight, were recorded by specialized uro-pathologists. Linear regression models were performed to evaluate the effect of PSA on tumor burden, measured by tumor weight after adjustment for patient and tumor characteristics. Results Overall, median preoperative PSA was 7.0 ng/ml (interquartile range [IQR]: 5.41–10) and median age at surgery was 66 years (IQR: 61-71). Median prostate weight was 34 g (IQR: 26–46) and median tumor weight was 3.7 g (IQR: 1.8–7.1), respectively. In multivariable linear regression analysis after adjustment for patients and tumor characteristics, a significant, positive correlation could be detected between preoperative PSA and tumor weight (coefficient [coef.]: 0.37, CI: 0.15–0.6, p=0.001), indicating a robust increase in PSA of almost 0.4 ng/ml per 1g tumor weight. Conclusion Preoperative PSA was significantly correlated with tumor weight in PCa patients undergoing RP, with an increase in PSA of almost 0.4 ng/ml per 1 g tumor weight. This might help to estimate both tumor burden before undergoing RP and in case of biochemical recurrence.
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Affiliation(s)
- Philipp Mandel
- Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Benedikt Hoeh
- Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Felix Preisser
- Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Mike Wenzel
- Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany.,Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada
| | - Clara Humke
- Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Maria-Noemi Welte
- Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Inga Jerrentrup
- Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Jens Köllermann
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Peter Wild
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Derya Tilki
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Haese
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas Becker
- Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Frederik C Roos
- Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Felix K H Chun
- Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Luis A Kluth
- Department of Urology, University Hospital Frankfurt, Frankfurt am Main, Germany
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Ding Z, Song D, Wu H, Tian H, Ye X, Liang W, Xu J, Dong F. Development and validation of a nomogram based on multiparametric magnetic resonance imaging and elastography-derived data for the stratification of patients with prostate cancer. Quant Imaging Med Surg 2021; 11:3252-3262. [PMID: 34249651 DOI: 10.21037/qims-20-978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 04/01/2021] [Indexed: 01/08/2023]
Abstract
Background This study sought to develop and validate a nomogram combining the elastographic Q-analysis score (EQS), the Prostate Imaging Reporting and Data System (PI-RADS) score, and clinical parameters for the stratification of patients with prostate cancer (PCa). Methods A retrospective study was conducted of 375 patients with 375 lesions who underwent volume-navigation transrectal ultrasound (TRUS) and multiparametric magnetic resonance imaging (MP-MRI)-fusion targeted biopsies between April 2017 and January 2020. Based on a multivariate logistic regression model, a nomogram was created to assess any PCa and high-risk PCa [Gleason score (GS) ≥4+3] using data from patients diagnosed between April 2017 and June 2019 (n=271), and was validated in patients diagnosed after July 2019 (n=104). The nomogram's performance was evaluated based on its discrimination, calibration, and clinical usefulness. Results The areas under the curve (AUCs) of the nomogram for predicting any PCa and high-risk PCa were 0.949 [95% confidence interval (CI), 0.921 to 0.978] and 0.936 (95% CI, 0.906 to 0.965), respectively, in the training cohort, and 0.946 (95% CI, 0.894 to 0.997) and 0.971 (95% CI, 0.9331 to 1), respectively, in the validation cohort. The nomogram was well calibrated, and no significant difference was found between the predicted and observed probabilities. A decision curve analysis (DCA) for the nomogram with and without the EQS showed that the threshold probability of for any PCa was <67%. Conclusions The nomogram that combined elastography-derived and MP-MRI data was more clinically useful than the model based on PI-RADS and clinical parameters alone. Our nomogram could aid urologists to make decisions and avoid unnecessary biopsies.
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Affiliation(s)
- Zhimin Ding
- Department of Ultrasound, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Di Song
- Department of Ultrasound, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Huaiyu Wu
- Department of Ultrasound, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Hongtian Tian
- Department of Ultrasound, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Xiuqin Ye
- Department of Ultrasound, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Weiyu Liang
- Department of Ultrasound, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Jinfeng Xu
- Department of Ultrasound, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Fajin Dong
- Department of Ultrasound, Shenzhen Medical Ultrasound Engineering Center, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
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9
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Shin S, Park YH, Jung SH, Jang SH, Kim MY, Lee JY, Chung YJ. Urinary exosome microRNA signatures as a noninvasive prognostic biomarker for prostate cancer. NPJ Genom Med 2021; 6:45. [PMID: 34117264 PMCID: PMC8196022 DOI: 10.1038/s41525-021-00212-w] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 05/20/2021] [Indexed: 01/06/2023] Open
Abstract
Predicting the risk of metastasis before starting prostate cancer (PCa) treatment can minimize the overtreatment of indolent cases and help choosing appropriate treatment. The levels of circulating microRNAs (miRNAs) from body fluids can be used as noninvasive prognostic biomarkers. In this study, urinary exosomal miRNA expression profiles of 149 PCas were determined and the miRNAs associated with metastasis were identified: miR-21, miR-16, miR-142-3p, miR-451, and miR-636. When evaluating clinical factors together, miR-21, miR-451, miR-636, and preoperative prostate-specific antigen (PSA) level remained significant in the multivariate analysis. Based on them, we developed a “Prostate Cancer Metastasis Risk Scoring (PCa-MRS)” model. The PCa-MRS showed superior stratification power (AUC = 0.925) to preoperative PSA or clinical Gleason score. Patients with high scores showed significantly poorer biochemical recurrence-free survival than those with low scores (P = 6.53 × 10−10). Our results showed the potential of urinary exosomal miRNAs as noninvasive markers for predicting metastasis and prognosis in PCa patients.
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Affiliation(s)
- Sun Shin
- Departments of Microbiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Precision Medicine Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Integrated Research Center for Genome Polymorphism, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong Hyun Park
- Departments of Urology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Catholic Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seung-Hyun Jung
- Departments of Biochemistry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sun-Hee Jang
- Departments of Microbiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Precision Medicine Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Integrated Research Center for Genome Polymorphism, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Mee Young Kim
- Departments of Urology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Catholic Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ji Youl Lee
- Departments of Urology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Catholic Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yeun-Jun Chung
- Departments of Microbiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. .,Precision Medicine Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. .,Integrated Research Center for Genome Polymorphism, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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10
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Zhang D, Fang C, Li H, Lu C, Huang J, Pan J, Yang Z, Liang E, Liu Z, Zhou X, Xin Z, Chen Y, Cai Q. Long ncRNA MALAT1 promotes cell proliferation, migration, and invasion in prostate cancer via sponging miR-145. Transl Androl Urol 2021; 10:2307-2319. [PMID: 34295718 PMCID: PMC8261405 DOI: 10.21037/tau-20-1526] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 04/12/2021] [Indexed: 12/17/2022] Open
Abstract
Background The long non-coding (lncRNA) RNA MALAT1 (metastasis-associated lung adenocarcinoma transcript 1) is known to promote tumorigenesis, whereas microRNA-145 (miR-145) plays an antitumor role in several cancers. In this study, we aimed to elucidate the role of MALAT1 and miR-145 in prostate cancer cells and investigate the effect of MALAT1 downregulation on prostate cancer (PCa) cells in vitro in vivo. Methods The Cancer Genome Atlas (TCGA) datasets were used to carry out the initial bioinformatics analysis; the findings were then tested in LNCaP and CWR22Rv1 cell lines. Western blot and quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was used to evaluate the levels of MALAT1 and miR-145 along with related biomarkers. Furthermore, wound-healing and Transwell assays were performed to test the migratory and invasive abilities of PCa cells. Luciferase reporter assays were used to validate the relationship between MALAT1 and miR-145; their down-stream target genes were also studied. To further substantiate these findings in an animal model, tumor studies including immunofluorescence staining of tissues were carried in nude mice. Results The expression of MALAT1 was upregulated in both LNCaP cell lines and CWR22Rv1 cell lines (F=2.882, t=13.370, P<0.001; F=2.268, t=15.859, P<0.001). Knockdown of MALAT1 reduced the migratory and invasive capabilities of PCa cells (F=0.017, t=12.212, P<0.001; F=10.723, t=6.016, P=0.002). Using direct binding, MALAT1 suppressed the antitumor function of miR-145, which in turn upregulated transforming growth factor-β1 (TGF-β1)-induced epithelial-mesenchymal transition (EMT) via SMAD3 and TGFBR2 (F=2.097, t=5.389, P=0.006; F=1.306, t=4.155, P=0.014). Conclusions We confirmed that MALAT1 acts as a competing endogenous RNA (ceRNA) of miR-145. The MALAT1 based regulation of MiR-145-5p-SMAD3/TGFBR2 interactions could be an intriguing molecular pathway for the progression of PCa.
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Affiliation(s)
- Dingrong Zhang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Cheng Fang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Haibo Li
- Department of Urology, Tianjin Baodi Hospital, Baodi Clinical College of Tianjin Medical University, Tianjin, China
| | - Chunyuan Lu
- Department of Anesthesia, the Second hospital of Tianjin Medical University, Tianjin, China
| | - Jiaohong Huang
- Department of Geriatric, the Second Hospital of Tianjin Medical University, Tianjin, China
| | - Jiancheng Pan
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zhizhao Yang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Enli Liang
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zhifei Liu
- Department of Urology, Tangshan People's Hospital, Tangshan, China
| | - Xiaodong Zhou
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Zhongcheng Xin
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China.,Andrology Center, Peking University First Hospital, Peking University, Beijing, China
| | - Yegang Chen
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
| | - Qiliang Cai
- Department of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, Tianjin, China
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11
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Ferro M, Lucarelli G, de Cobelli O, Del Giudice F, Musi G, Mistretta FA, Luzzago S, Busetto GM, Buonerba C, Sciarra A, Conti S, Porreca A, Battaglia M, Ditonno P, Manfredi M, Fiori C, Porpiglia F, Terracciano D. The emerging landscape of tumor marker panels for the identification of aggressive prostate cancer: the perspective through bibliometric analysis of an Italian translational working group in uro-oncology. Minerva Urol Nephrol 2021; 73:442-451. [PMID: 33769016 DOI: 10.23736/s2724-6051.21.04098-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Molecular heterogeneity and availability of different therapeutic strategies are relevant clinical features of prostate cancer. On this basis, there is an urgent need to identify prognostic and predictive biomarkers for an individualized therapeutic approach. In this context, researchers focused their attention on biomarkers able to discriminate potential life-threatening from organ-confined disease. Such biomarker could provide aid in clinical decision making, helping to choose the treatment which ensures the best results in terms of patient survival and quality of life. To address this need, many new laboratory tests have been proposed, with a clear tendency to use panels of combined biomarkers. In this review we evaluate current data on the application in clinical practice of the most promising laboratory tests: Phi, 4K score and Stockholm 3 as circulating biomarkers, Mi-prostate score, Exo DX Prostate and Select MD-X as urinary biomarkers, Confirm MDx, Oncotype Dx, Prolaris and Decipher as tissue biomarkers. In particular, the ability of these tests in the identification of clinically significant PCa and their potential use for precision medicine have been explored in this review.
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Affiliation(s)
- Matteo Ferro
- Department of Urology, IEO European Institute of Oncology, Milan, Italy
| | - Giuseppe Lucarelli
- Unit of Urology, Andrology and Kidney Transplantation, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Ottavio de Cobelli
- Department of Urology, IEO European Institute of Oncology, Milan, Italy.,Department of Oncology and Hematology-Oncology, University of Milan, Milan, Italy
| | | | - Gennaro Musi
- Department of Urology, IEO European Institute of Oncology, Milan, Italy
| | | | - Stefano Luzzago
- Department of Urology, IEO European Institute of Oncology, Milan, Italy
| | | | - Carlo Buonerba
- Service of Medical Oncology, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | | | - Simon Conti
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
| | - Angelo Porreca
- Department of Urology, Abano Terme Hospital, Padua, Italy
| | - Michele Battaglia
- Unit of Urology, Andrology and Kidney Transplantation, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Pasquale Ditonno
- Unit of Urology, Andrology and Kidney Transplantation, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Matteo Manfredi
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Cristian Fiori
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Francesco Porpiglia
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Daniela Terracciano
- Department of Translational Medical Sciences, Federico II University, Naples, Italy -
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12
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Focal low-dose-rate prostate brachytherapy for low- and intermediate-risk prostate cancer. J Contemp Brachytherapy 2021; 12:554-561. [PMID: 33437303 PMCID: PMC7787206 DOI: 10.5114/jcb.2020.101688] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/09/2020] [Indexed: 01/10/2023] Open
Abstract
Purpose To prospectively investigate the efficacy and feasibility of focal low-dose-rate (LDR) prostate brachytherapy for low- and intermediate-risk prostate cancer. Material and methods Between October 2014 and May 2019, nineteen low- and intermediate-risk prostate cancer patients who presented with abnormality on both diffusion-weighted and T2-weighted magnetic resonance imaging (MRI) underwent focal LDR brachytherapy at our institution. Focal gross tumor volume (F-GTV) was delineated on transrectal ultrasound, based on abnormality seen on fused T2-weighted MRI. F-GTV was expanded by 5 mm, as a safety margin, to create focal clinical target volume (F-CTV). Prescribed dose to F-CTV was 145 Gy. Biochemical recurrence (BCR) was determined using Phoenix criterion (prostate specific antigen nadir + 2 ng/ml). Pre- and post-implant dosimetry data were compared using non-parametric Wilcoxon’s rank sum test. Treatment-related toxicities were evaluated using common terminology criteria for adverse events. Results Mean F-CTV D90% was significantly lower in the post-implant evaluation than in intraoperative planning (p = 0.004). On post-implant dosimetry, the mean D90% for F-GTV and mean V100% for the entire prostate were 222 Gy and 35%, respectively. Median follow-up time for all patients was 31 months. BCR occurred in one patient after 23 months. Kaplan-Meier 2-year BCR-free rate was 92.9% (95% confidence interval [CI]: 79.4-100%). No patients had grade 1 or greater gastrointestinal toxicity. Three patients who were taking α-blockers to treat benign prostatic hyperplasia (present before brachytherapy), experienced no treatment-related genitourinary toxicities. Two patients suffered from temporary grade 2 urinary frequency. None of the remaining patients experienced grade 2 or higher genitourinary toxicity. Conclusions Focal LDR prostate brachytherapy appears acceptable for MRI-based index tumors, with a low cumulative incidence of BCR. Such brachytherapy might offer a feasible minimally invasive therapeutic option for localized prostate cancer.
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13
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Bura V, Caglic I, Snoj Z, Sushentsev N, Berghe AS, Priest AN, Barrett T. MRI features of the normal prostatic peripheral zone: the relationship between age and signal heterogeneity on T2WI, DWI, and DCE sequences. Eur Radiol 2021; 31:4908-4917. [PMID: 33398421 PMCID: PMC8213603 DOI: 10.1007/s00330-020-07545-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/30/2020] [Accepted: 11/18/2020] [Indexed: 12/24/2022]
Abstract
Objectives To assess the multiparametric MRI (mpMRI) appearances of normal peripheral zone (PZ) across age groups in a biopsy-naïve population, where prostate cancer (PCa) was subsequently excluded, and propose a scoring system for background PZ changes. Methods This retrospective study included 175 consecutive biopsy-naïve patients (40–74 years) referred with a suspicion of PCa, but with subsequent negative investigations. Patients were grouped by age into categories ≤ 54, 55–59, 60–64, and ≥ 65 years. MpMRI sequences (T2-weighted imaging [T2WI], diffusion-weighted imaging [DWI]/apparent diffusion coefficient [ADC], and dynamic contrast-enhanced imaging [DCE]) were independently evaluated by two uro-radiologists on a proposed 4-point grading scale for background change on each sequence, wherein score 1 mirrored PIRADS-1 change and score 4 represented diffuse background change. Peripheral zone T2WI signal intensity and ADC values were also analyzed for trends relating to age. Results There was a negative correlation between age and assigned background PZ scores for each mpMRI sequence: T2WI: r = − 0.52, DWI: r = − 0.49, DCE: r = − 0.45, p < 0.001. Patients aged ≤ 54 years had mean scores of 3.0 (T2WI), 2.7 (DWI), and 3.1 (DCE), whilst patients ≥ 65 years had significantly lower mean scores of 1.7, 1.4, and 1.9, respectively. There was moderate inter-reader agreement for all scores (range κ = 0.43–0.58). Statistically significant positive correlations were found for age versus normalized T2WI signal intensity (r = 0.2, p = 0.009) and age versus ADC values (r = 0.33, p = 0.001). Conclusion The normal PZ in younger patients (≤ 54 years) demonstrates significantly lower T2WI signal intensity, lower ADC values, and diffuse enhancement on DCE, which may hinder diagnostic interpretation in these patients. The proposed standardized PZ background scoring system may help convey the potential for diagnostic uncertainty to clinicians. Key Points • Significant, positive correlations were found between increasing age and higher normalized T2-weighted signal intensity and mean ADC values of the prostatic peripheral zone. • Younger men exhibit lower T2-weighted imaging signal intensity, lower ADC values, and diffuse enhancement on dynamic contrast-enhanced imaging, which may hinder MRI interpretation. • A scoring system is proposed which aims towards a standardized assessment of the normal background PZ. This may help convey the potential for diagnostic uncertainty to clinicians. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-020-07545-7.
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Affiliation(s)
- Vlad Bura
- Department of Radiology, County Clinical Emergency Hospital, Cluj-Napoca, Cluj, Romania
| | - Iztok Caglic
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Box 218, Hills Road, Cambridge, CB2 0QQ, UK
| | - Ziga Snoj
- Radiology Institute, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Nikita Sushentsev
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Box 218, Hills Road, Cambridge, CB2 0QQ, UK
| | - Alexandra S Berghe
- Department of Radiology, County Clinical Emergency Hospital, Cluj-Napoca, Cluj, Romania.,Department of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andrew N Priest
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Box 218, Hills Road, Cambridge, CB2 0QQ, UK
| | - Tristan Barrett
- Department of Radiology, Addenbrooke's Hospital and University of Cambridge, Box 218, Hills Road, Cambridge, CB2 0QQ, UK.
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14
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Cózar JM, Hernández C, Miñana B, Morote J, Alvarez-Cubero MJ. The role of prostate-specific antigen in light of new scientific evidence: An update in 2020. Actas Urol Esp 2021; 45:21-29. [PMID: 33408046 DOI: 10.1016/j.acuro.2020.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To review and update the latest scientific evidence gathered in recent years regarding prostate-specific antigen (PSA) for better implementation into routine clinical practice. EVIDENCE ACQUISITION Analysis of the available evidence on the current role of PSA, based on the experience of an expert panel in the subject under analysis. EVIDENCE SYNTHESIS Currently, PSA cannot be considered only as a guide for the presence or absence of prostate cancer. This determination can also help the urologist to decide on the most convenient treatment for a patient with benign prostatic hypertrophy (BPH) as a criterion for disease progression, and it can also suggest the suspicious existence of a prostatic tumor when there is PSA rise of>0.3 ng/ml over the level reached 6 months after having initiated treatment with 5-alpha-reductase inhibitor. However, the limits of this PSA rise with derivatives of alternative 5-alpha-reductase (5-ARI) inhibitors to dutasteride are controversial. Moreover, PSA is a key factor for the follow-up of patients with prostate adenocarcinoma at any stage who have received treatment (surgery, radiotherapy or focal therapies, hormone therapy), it acts as a guide to identify biochemical recurrence, to suspect the existence of local or distant recurrence, as well as to propose or discard adjuvant treatments. Finally, the role of PSA as a screening tool has been recently reinforced, demonstrating increased mortality rates or the existence of more aggressive cases of prostate cancer in those countries where the use of this tool has declined. CONCLUSIONS We present new data about the current role of PSA in the management of patients treated for BPH and/or prostate cancer that should be implemented into routine clinical practice, with special emphasis on the relevant role of this biomarker in the screening and follow-up of prostate cancer, as well as in the progression of BPH in dutasteride treatment.
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Affiliation(s)
- J M Cózar
- Servicio de Urología, Hospital Universitario Virgen de la Nieves, Granada, España; Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, España.
| | - C Hernández
- Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, España
| | - B Miñana
- Servicio de Urología, Hospital CUN de Madrid, Madrid, España
| | - J Morote
- Servicio de Urología, Hospital Universitario Vall de Hebrón, Barcelona, España
| | - M J Alvarez-Cubero
- Departamento de Bioquímica y Biología Molecular e Inmunología, Facultad de Medicina, Universidad de Granada, Granada, España
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15
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T2*-weighted MRI as a non-contrast-enhanced method for assessment of focal laser ablation zone extent in prostate cancer thermotherapy. Eur Radiol 2021; 31:325-332. [PMID: 32785769 PMCID: PMC7755698 DOI: 10.1007/s00330-020-07127-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 05/08/2020] [Accepted: 07/31/2020] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To evaluate utility of T2*-weighted (T2*W) MRI as a tool for intra-operative identification of ablation zone extent during focal laser ablation (FLA) of prostate cancer (PCa), as compared to the current standard of contrast-enhanced T1-weighted (T1W) MRI. METHODS Fourteen patients with biopsy-confirmed low- to intermediate-risk localized PCa received MRI-guided (1.5 T) FLA thermotherapy. Following FLA, axial multiple-TE T2*W images, diffusion-weighted images (DWI), and T2-weighted (T2W) images were acquired. Pre- and post-contrast T1W images were also acquired to assess ablation zone (n = 14) extent, as reference standard. Apparent diffusion coefficient (ADC) maps and subtracted contrast-enhanced T1W (sceT1W) images were calculated. Ablation zone regions of interest (ROIs) were outlined manually on all ablated slices. The contrast-to-noise ratio (CBR) of the ablation site ROI relative to the untreated contralateral prostate tissue was calculated on T2*W images and ADC maps and compared to that in sceT1W images. RESULTS CBRs in ablation ROIs on T2*W images (TE = 32, 63 ms) did not differ (p = 0.33, 0.25) from those in sceT1W images. Bland-Altman plots of ROI size and CBR in ablation sites showed good agreement between T2*W (TE = 32, 63 ms) and sceT1W images, with ROI sizes on T2*W (TE = 63 ms) strongly correlated (r = 0.64, p = 0.013) and within 15% of those in sceT1W images. CONCLUSIONS In detected ablation zone ROI size and CBR, non-contrast-enhanced T2*W MRI is comparable to contrast-enhanced T1W MRI, presenting as a potential method for intra-procedural monitoring of FLA for PCa. KEY POINTS • T2*-weighted MR images with long TE visualize post-procedure focal laser ablation zone comparably to the contrast-enhanced T1-weighted MRI. • T2*-weighted MRI could be used as a plausible method for repeated intra-operative monitoring of thermal ablation zone in prostate cancer, avoiding potential toxicity due to heating of contrast agent.
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16
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Aladwani M, Lophatananon A, Ollier W, Muir K. Prediction models for prostate cancer to be used in the primary care setting: a systematic review. BMJ Open 2020; 10:e034661. [PMID: 32690501 PMCID: PMC7371149 DOI: 10.1136/bmjopen-2019-034661] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To identify risk prediction models for prostate cancer (PCa) that can be used in the primary care and community health settings. DESIGN Systematic review. DATA SOURCES MEDLINE and Embase databases combined from inception and up to the end of January 2019. ELIGIBILITY Studies were included based on satisfying all the following criteria: (i) presenting an evaluation of PCa risk at initial biopsy in patients with no history of PCa, (ii) studies not incorporating an invasive clinical assessment or expensive biomarker/genetic tests, (iii) inclusion of at least two variables with prostate-specific antigen (PSA) being one of them, and (iv) studies reporting a measure of predictive performance. The quality of the studies and risk of bias was assessed by using the Prediction model Risk Of Bias ASsessment Tool (PROBAST). DATA EXTRACTION AND SYNTHESIS Relevant information extracted for each model included: the year of publication, source of data, type of model, number of patients, country, age, PSA range, mean/median PSA, other variables included in the model, number of biopsy cores to assess outcomes, study endpoint(s), cancer detection, model validation and model performance. RESULTS An initial search yielded 109 potential studies, of which five met the set criteria. Four studies were cohort-based and one was a case-control study. PCa detection rate was between 20.6% and 55.8%. Area under the curve (AUC) was reported in four studies and ranged from 0.65 to 0.75. All models showed significant improvement in predicting PCa compared with being based on PSA alone. The difference in AUC between extended models and PSA alone was between 0.06 and 0.21. CONCLUSION Only a few PCa risk prediction models have the potential to be readily used in the primary healthcare or community health setting. Further studies are needed to investigate other potential variables that could be integrated into models to improve their clinical utility for PCa testing in a community setting.
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Affiliation(s)
- Mohammad Aladwani
- Division of Population Health, Health Services Research and Primary Care School of Health Sciences Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Artitaya Lophatananon
- Division of Population Health, Health Services Research and Primary Care School of Health Sciences Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - William Ollier
- Division of Population Health, Health Services Research and Primary Care School of Health Sciences Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- School of Healthcare Science, Manchester Metropolitan University Faculty of Science and Engineering, Manchester, UK
| | - Kenneth Muir
- Division of Population Health, Health Services Research and Primary Care School of Health Sciences Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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17
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Perera M, Roberts MJ, Klotz L, Higano CS, Papa N, Sengupta S, Bolton D, Lawrentschuk N. Intermittent versus continuous androgen deprivation therapy for advanced prostate cancer. Nat Rev Urol 2020; 17:469-481. [PMID: 32606361 DOI: 10.1038/s41585-020-0335-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2020] [Indexed: 11/09/2022]
Abstract
Androgen deprivation therapy (ADT) is still a mainstay of treatment for advanced prostate cancer. Continuous ADT causes considerable patient morbidity including sexual dysfunction, poor mood and physical capacity, changes in body composition and health-care-related costs. Intermittent ADT has been used as an approach to ADT monotherapy to limit morbidity by enabling cyclical recovery of serum testosterone levels. To date, a number of well-performed randomized controlled trials and meta-analyses have demonstrated statistically insignificant differences in oncological outcomes between intermittent and continuous ADT monotherapy. Sexual outcomes, morbidity profiles and cost-savings favour intermittent therapy in most randomized trials, but the benefit for clinical practice is unclear. Despite the growing body of evidence, the optimal administration regime for ADT has not been clearly established and incorporation of adjunctive upfront treatments such as chemotherapy and novel anti-androgen agents has further hampered progress. Recommendations by authoritative urological and oncological societies regarding the use of intermittent ADT are limited. The potential benefits of reduced morbidity for a particular patient must be considered in light of the possible oncological outcomes. Although the oncological changes associated with intermittent ADT are controversial, intermittent ADT does seem to provide symptomatic benefit in patients compared with continuous ADT. However, careful selection of suitable patients is crucial.
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Affiliation(s)
- Marlon Perera
- University of Melbourne, Department of Surgery, Austin Health, Melbourne, Victoria, Australia. .,The University of Queensland Centre for Clinical Research, Faculty of Medicine, Brisbane, Queensland, Australia.
| | - Matthew J Roberts
- The University of Queensland Centre for Clinical Research, Faculty of Medicine, Brisbane, Queensland, Australia.,Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Laurence Klotz
- Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | | | - Nathan Papa
- University of Melbourne, Department of Surgery, Austin Health, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shomik Sengupta
- University of Melbourne, Department of Surgery, Austin Health, Melbourne, Victoria, Australia.,EHCS, Monash University, Box Hill, Melbourne, Victoria, Australia.,Urology Department, Eastern Health, Box Hill, Melbourne, Victoria, Australia
| | - Damien Bolton
- University of Melbourne, Department of Surgery, Austin Health, Melbourne, Victoria, Australia.,Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia
| | - Nathan Lawrentschuk
- Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Urology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
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18
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Valta M, Ylä-Pelto J, Lan Y, Kähkönen T, Taimen P, Boström PJ, Ettala O, Khan S, Paulin N, Elo LL, Koskinen PJ, Härkönen P, Tuomela J. Critical evaluation of the subcutaneous engraftments of hormone naïve primary prostate cancer. Transl Androl Urol 2020; 9:1120-1134. [PMID: 32676396 PMCID: PMC7354344 DOI: 10.21037/tau.2020.03.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Patient-derived xenografts (PDXs) are considered to better recapitulate the histopathological and molecular heterogeneity of human cancer than other preclinical models. Despite technological advances, PDX models from hormone naïve primary prostate cancer are scarce. We performed a detailed analysis of PDX methodology using a robust subcutaneous model and fresh tissues from patients with primary hormone naïve prostate cancer. Methods Clinical prostate tumor specimens (n=26, Gleason score 6-10) were collected from robotic-assisted laparoscopic radical prostatectomies at Turku University Hospital (Turku, Finland), cut into pieces, and implanted subcutaneously into 84 immunodeficient mice. Engraftments and the adjacent material from prostatic surgical specimens were compared using histology, immunohistochemistry and DNA sequencing. Results The probability of a successful engraftment correlated with the presence of carcinoma in the implanted tissue. Tumor take rate was 41%. Surprisingly, mouse hormone supplementation inhibited tumor take rate, whereas the degree of mouse immunodeficiency did not have an effect. Histologically, the engrafted tumors closely mimicked their parental tumors, and the Gleason grades and copy number variants of the engraftments were similar to those of their primary tumors. Expression levels of androgen receptor, prostate-specific antigen, and keratins were retained in engraftments, and a detailed genomic analysis revealed high fidelity of the engraftments with their corresponding primary tumors. However, in the second or third passage of tumors, the carcinoma areas were almost completely replaced by benign tissue with frequent degenerative or metaplastic changes. Conclusions Subcutaneous primary prostate engraftments preserve the phenotypic and genotypic landscape. Thus, they serve a potential model for personalized medicine and preclinical research but their use may be limited to the first passage.
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Affiliation(s)
- Maija Valta
- Institute of Biomedicine, University of Turku, Turku, Finland.,Division of Medicine, Turku City Hospital, Turku, Finland
| | - Jani Ylä-Pelto
- Institute of Biomedicine, University of Turku, Turku, Finland.,Department of Biology, University of Turku, Turku, Finland
| | - Yu Lan
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Tiina Kähkönen
- Institute of Biomedicine, University of Turku, Turku, Finland
| | - Pekka Taimen
- Institute of Biomedicine, University of Turku, Turku, Finland.,Department of Pathology, Turku University Hospital, Turku, Finland
| | - Peter J Boström
- Department of Urology, Turku University Hospital and University of Turku, Turku, Finland
| | - Otto Ettala
- Department of Urology, Turku University Hospital and University of Turku, Turku, Finland
| | - Sofia Khan
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland
| | - Niklas Paulin
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland
| | - Laura L Elo
- Institute of Biomedicine, University of Turku, Turku, Finland.,Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland
| | | | - Pirkko Härkönen
- Institute of Biomedicine, University of Turku, Turku, Finland.,FICAN WEST Cancer Research Laboratory, University of Turku and Turku University Hospital, Turku, Finland
| | - Johanna Tuomela
- Institute of Biomedicine, University of Turku, Turku, Finland.,FICAN WEST Cancer Research Laboratory, University of Turku and Turku University Hospital, Turku, Finland
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19
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Anderson DJ, Anderson RG, Moug SJ, Baker MJ. Liquid biopsy for cancer diagnosis using vibrational spectroscopy: systematic review. BJS Open 2020; 4:554-562. [PMID: 32424976 PMCID: PMC7397350 DOI: 10.1002/bjs5.50289] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 03/23/2020] [Indexed: 02/06/2023] Open
Abstract
Background Vibrational spectroscopy (VS) is a minimally invasive tool for analysing biological material to detect disease. This study aimed to review its application to human blood for cancer diagnosis. Methods A systematic review was undertaken using a keyword electronic database search (MEDLINE, Embase, PubMed, TRIP and Cochrane Library), with all original English‐language manuscripts examining the use of vibrational spectral analysis of human blood for cancer detection. Studies involving fewer than 75 patients in the cancer or control group, animal studies, or where the primary analyte was not blood were excluded. Results From 1446 results, six studies (published in 2010–2018) examining brain, bladder, oral, breast, oesophageal and hepatic cancer met the criteria for inclusion, with a total population of 2392 (1316 cancer, 1076 control; 1476 men, 916 women). For cancer detection, reported mean sensitivities in each included study ranged from 79·3 to 98 per cent, with specificities of 82·8–95 per cent and accuracies between 81·1 and 97·1 per cent. Heterogeneity in reporting strategies, methods and outcome measures made meta‐analysis inappropriate. Conclusion VS shows high potential for cancer diagnosis, but until there is agreement on uniform standard reporting methods and studies with adequate sample size for valid classification models have been performed, its value in clinical practice will remain uncertain.
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Affiliation(s)
- D J Anderson
- WestCHEM, Department of Pure and Applied Chemistry, Glasgow, UK.,Clinical Research Unit, Royal Alexandra Hospital, NHS Greater Glasgow and Clyde, Paisley, UK
| | - R G Anderson
- Clinical Research Unit, Royal Alexandra Hospital, NHS Greater Glasgow and Clyde, Paisley, UK
| | - S J Moug
- Clinical Research Unit, Royal Alexandra Hospital, NHS Greater Glasgow and Clyde, Paisley, UK
| | - M J Baker
- WestCHEM, Department of Pure and Applied Chemistry, Glasgow, UK.,ClinSpec Diagnostics, Technology and Innovation Centre, University of Strathclyde, Glasgow, UK
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20
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Seikkula H, Boström PJ, Seppä K, Pitkäniemi J, Malila N, Kaipia A. Survival and mortality of elderly men with localized prostate cancer managed with primary androgen deprivation therapy or by primary observation. BMC Urol 2020; 20:25. [PMID: 32164671 PMCID: PMC7069023 DOI: 10.1186/s12894-020-00593-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 02/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Androgen deprivation therapy (ADT) remains a primary treatment for localized prostate cancer (PCa) even though there is no evidence that its use is beneficial in the absence of curative treatment. METHODS Men aged ≥70 years (n = 16,534) diagnosed with localized PCa from 1985 to 2014 and managed either with primary observation or ADT in the absence of curative treatment were included. The cases were identified from the population-based Finnish Cancer Registry. We estimated the standardized mortality ratios (SMR) for overall mortality by treatment group. We determined the relative risk (RR) of PCa-specific mortality (PCSM) and other-cause mortality between the two treatment groups. Survival was determined using the life table method. Two age groups (70-79 years and ≥ 80 years) and three calendar time cohorts (1985-1994, 1995-2004, and 2005-2014) were compared following adjustment of propensity score matching between the treatment groups with four covariates (age, year of diagnosis, educational level, and hospital district). Follow-up continued until death or until December 31, 2015. RESULTS Patients in the observation group had lower overall SMRs than those in the ADT group in both age cohorts over the entire study period. PCSM was higher in men aged 70-79 years undergoing primary ADT compared to those managed by observation only (RR: 1.70, 95% confidence interval [CI]: 1.29-2.23 [1985-1994]; RR 1.55, 95% CI: 1.35-1.84 [1995-2004]; and RR 2.71, 95% CI: 2.08-3.53 [2005-2014]); p = 0.005 for periodic trend. A similar trend over time was also observed in men aged > 80 years; (p for age-period interaction = 0.237). Overall survival was also higher among men in their 70's managed by observation compared to those undergoing ADT. CONCLUSIONS Primary ADT within four months period from diagnosis is not associated with improved long-term overall survival or decreased PCSM compared to primary conservative management for men with localized PCa. However, this observational study's conclusions should be weighted with confounding factors related to cancer aggressiveness and comorbidities.
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Affiliation(s)
- Heikki Seikkula
- Department of Surgery, Central Hospital of Central Finland, Jyväskylä, Finland.
| | - Peter J Boström
- Department of Urology, Turku University Hospital, Turku, Finland.,Department of Urology, University of Turku, Turku, Finland
| | | | - Janne Pitkäniemi
- Finnish Cancer Registry, Helsinki, Finland.,Faculty of Social Sciences (Health Sciences), Tampere, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Nea Malila
- Finnish Cancer Registry, Helsinki, Finland.,School of Health Sciences, University of Tampere, Tampere, Finland
| | - Antti Kaipia
- Department of Urology, Tampere University Hospital, Tampere, Finland
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21
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Choi SY, Lim B, Kyung YS, Kim Y, Kim BM, Jeon BH, Park JC, Sohn YW, Lee JH, Uh JH, Jang S, Kim CS. Circulating Tumor Cell Counts in Patients With Localized Prostate Cancer Including Those Under Active Surveillance. In Vivo 2020; 33:1615-1620. [PMID: 31471413 DOI: 10.21873/invivo.11645] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/08/2019] [Accepted: 07/15/2019] [Indexed: 02/07/2023]
Abstract
AIM To evaluate the clinical efficacy of a circulating tumor cell (CTC) test by comparison between healthy volunteers and patients with localized prostate cancer including those under active surveillance. MATERIALS AND METHODS CTC counts in peripheral blood were compared between patients with prostate cancer (n=45) and healthy volunteers (n=17). CTCs were identified based on the expression of epithelial cell adhesion molecule (EpCAM) and counted using a SMART BIOPSY™ SYSTEM. RESULTS The number of EpCAM+ cells was significantly higher in patients with cancer than in healthy volunteers. Among the low-risk patients (n=9), two had up-staging and six had up-grading. Among those up-staged, there was one case which was EpCAM+ Among those cases up-graded, three were EpCAM+ In those with stage T2 tumors, the presence of Gleason pattern 5 was positively correlated with EpCAM positivity (rho=0.59, p<0.001). CONCLUSION CTC counts in localized prostate cancer were associated with Gleason pattern 5. Active treatment should be considered for patients with low-risk disease during active surveillance who are found to have EpCAM+ CTCs because of a risk of up-staging and up-grading.
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Affiliation(s)
- Se Young Choi
- Department of Urology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Bumjin Lim
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yoon Soo Kyung
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yunlim Kim
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Bong Min Kim
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | | | | | | | | | | | - Seongsoo Jang
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Choung-Soo Kim
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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22
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Gregorio EP, Alexandrino AP, Schuquel ITA, da Costa WF, Rodrigues MADF. Seminal citrate is superior to PSA for detecting clinically significant prostate cancer. Int Braz J Urol 2020; 45:1113-1121. [PMID: 31808398 PMCID: PMC6909860 DOI: 10.1590/s1677-5538.ibju.2018.0730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 07/08/2019] [Indexed: 01/13/2023] Open
Abstract
Purpose: To establish whether the citrate concentration in the seminal fluid ([CITRATE]) measured by means of high-resolution nuclear magnetic resonance spectroscopy (1HNMRS) is superior to the serum prostate-specific antigen (PSA) concentration in detecting of clinically significant prostate cancer (csPCa) in men with persistently elevated PSA. Materials and Methods: The group of patients consisted of 31 consecutively seen men with histological diagnosis of clinically localized csPCa. The control group consisted of 28 men under long-term follow-up (mean of 8.7 ± 3.0 years) for benign prostate hyperplasia (BPH), with persistently elevated PSA (above 4 ng/mL) and several prostate biopsies negative for cancer (mean of 2.7 ± 1.3 biopsies per control). Samples of blood and seminal fluid (by masturbation) for measurement of PSA and citrate concentration, respectively, were collected from patients and controls. Citrate concentration in the seminal fluid ([CITRATE]) was determined by means of 1HNMRS. The capacities of PSA and [CITRATE] to predict csPCa were compared by means of univariate analysis and receiver operating characteristic (ROC) curves. Results: Median [CITRATE] was significantly lower among patients with csPCa compared to controls (3.93 mM/l vs. 15.53 mM/l). There was no significant difference in mean PSA between patients and controls (9.42 ng/mL vs. 8.57 ng/mL). The accuracy of [CITRATE] for detecting csPCa was significantly superior compared to PSA (74.8% vs. 54.8%). Conclusion: Measurement of [CITRATE] by means of 1HNMRS is superior to PSA for early detection of csPCa in men with elevated PSA.
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Affiliation(s)
| | - Antonio Paulo Alexandrino
- Disciplina de Urologia, Departamento de Cirurgia Clínica, Universidade Estadual de Londrina (UEL), Londrina, PR, Brasil
| | | | - Willian Ferreira da Costa
- Departamento de Química, Universidade Estadual de Maringá (Universidade Estadual de Maringá-UEM), Maringá, PR, Brasil
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23
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DE Luca S, Amante E, Fiori C, Alleva G, Alladio E, Marini F, Garrou D, Manfredi M, Amparore D, Checcucci E, Pruner S, Salomone A, Scarpa RM, Vincenti M, Porpiglia F. Prospective evaluation of urinary steroids and prostate carcinoma-induced deviation: preliminary results. Minerva Urol Nephrol 2019; 73:98-106. [PMID: 31833333 DOI: 10.23736/s2724-6051.19.03529-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The serum prostate-specific antigen is the most widespread biomarker for prostate disease. Its low specificity for prostatic malignancies is a matter of concern and the reason why new biomarkers for screening purposes are needed. The correlation between altered production of the main steroids and prostate carcinoma (PCa) occurrence is historically known. The purpose of this study is to evaluate the modifications of a comprehensive urinary endogenous steroidal profile (USP) induced by PCa, by multivariate statistical methods. METHODS A total of 283 Italian subjects were included in the study, 139 controls and 144 PCa-affected patients. The USP, including 17 steroids and five urinary steroidal ratios, was quantitatively evaluated using gas chromatography coupled with single quadrupole mass spectrometry (GC-MS). The data were interpreted using a chemometric, multivariate approach (intrinsically more sensible to alterations with respect to traditional statistics) and a model for the discrimination of cancer-affected profiles was built. RESULTS Two multivariate classification models were calculated, the former including three steroids with the highest statistical significance (e.g. testosterone, etiocholanolone and 7β-OH-DHEA) and PSA values, the latter considering the three steroids' levels only. Both models yielded high sensitivity and specificity scores near to 70%, resulting significantly higher than PSA alone. CONCLUSIONS Three USP steroids resulted significantly altered in our PCa population. These preliminary results, combined with the simplicity and low-cost of the analysis, open to further investigation of the potential role of this restricted USP in PCa diagnosis.
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Affiliation(s)
- Stefano DE Luca
- Division of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Eleonora Amante
- Department of Chemistry, University of Turin, Turin, Italy - .,A. Bertinaria Anti-Doping Center, Orbassano, Turin, Italy
| | - Cristian Fiori
- Division of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Giorgio Alleva
- Division of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | | | | | - Diletta Garrou
- Division of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Matteo Manfredi
- Division of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Daniele Amparore
- Division of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Enrico Checcucci
- Division of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Serena Pruner
- Department of Chemistry, University of Turin, Turin, Italy
| | - Alberto Salomone
- Department of Chemistry, University of Turin, Turin, Italy.,A. Bertinaria Anti-Doping Center, Orbassano, Turin, Italy
| | - Roberto M Scarpa
- Division of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Marco Vincenti
- Department of Chemistry, University of Turin, Turin, Italy.,A. Bertinaria Anti-Doping Center, Orbassano, Turin, Italy
| | - Francesco Porpiglia
- Division of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
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24
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Xu L, Wen Y, Pandit S, Mokkapati VRSS, Mijakovic I, Li Y, Ding M, Ren S, Li W, Liu G. Graphene-based biosensors for the detection of prostate cancer protein biomarkers: a review. BMC Chem 2019; 13:112. [PMID: 31508598 PMCID: PMC6720397 DOI: 10.1186/s13065-019-0611-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 07/15/2019] [Indexed: 02/07/2023] Open
Abstract
Prostate cancer (PC) is the sixth most common cancer type in the world, which causes approximately 10% of total cancer fatalities. The detection of protein biomarkers in body fluids is the key topic for the diagnosis and prognosis of PC. Highly sensitive screening of PC is the most effective approach for reducing mortality. Thus, there are a growing number of literature that recognizes the importance of new technologies for early diagnosis of PC. Graphene is playing an important role in the biosensor field with remarkable physical, optical, electrochemical and magnetic properties. Many recent studies demonstrated the potential of graphene materials for sensitive detection of protein biomarkers. In this review, the graphene-based biosensors toward PC analysis are mainly discussed in two groups: Firstly, novel biosensor interfaces were constructed through the modification of graphene materials onto sensor surfaces. Secondly, ingenious signal amplification strategies were developed using graphene materials as catalysts or carriers. Graphene-based biosensors have exhibited remarkable performance with high sensitivities, wide detection ranges, and long-term stabilities.
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Affiliation(s)
- Li Xu
- 1Laboratory of Biometrory, Division of Chemistry and Ionizing Radiation Measurement Technology, Shanghai Institute of Measurement and Testing Technology, Shanghai, 201203 People's Republic of China.,2Division of Systems and Synthetic Biology, Department of Biology and Biological Engineering, Chalmers University of Technology, 41126 Gothenburg, Sweden
| | - Yanli Wen
- 1Laboratory of Biometrory, Division of Chemistry and Ionizing Radiation Measurement Technology, Shanghai Institute of Measurement and Testing Technology, Shanghai, 201203 People's Republic of China
| | - Santosh Pandit
- 2Division of Systems and Synthetic Biology, Department of Biology and Biological Engineering, Chalmers University of Technology, 41126 Gothenburg, Sweden
| | - Venkata R S S Mokkapati
- 2Division of Systems and Synthetic Biology, Department of Biology and Biological Engineering, Chalmers University of Technology, 41126 Gothenburg, Sweden
| | - Ivan Mijakovic
- 2Division of Systems and Synthetic Biology, Department of Biology and Biological Engineering, Chalmers University of Technology, 41126 Gothenburg, Sweden.,3The Novo Nordisk Foundation Center for Biosustainability, Technical University of Denmark, 2800 Lyngby, Denmark
| | - Yan Li
- 1Laboratory of Biometrory, Division of Chemistry and Ionizing Radiation Measurement Technology, Shanghai Institute of Measurement and Testing Technology, Shanghai, 201203 People's Republic of China
| | - Min Ding
- 1Laboratory of Biometrory, Division of Chemistry and Ionizing Radiation Measurement Technology, Shanghai Institute of Measurement and Testing Technology, Shanghai, 201203 People's Republic of China
| | - Shuzhen Ren
- 1Laboratory of Biometrory, Division of Chemistry and Ionizing Radiation Measurement Technology, Shanghai Institute of Measurement and Testing Technology, Shanghai, 201203 People's Republic of China
| | - Wen Li
- 1Laboratory of Biometrory, Division of Chemistry and Ionizing Radiation Measurement Technology, Shanghai Institute of Measurement and Testing Technology, Shanghai, 201203 People's Republic of China
| | - Gang Liu
- 1Laboratory of Biometrory, Division of Chemistry and Ionizing Radiation Measurement Technology, Shanghai Institute of Measurement and Testing Technology, Shanghai, 201203 People's Republic of China
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25
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McCaffery K, Nickel B, Pickles K, Moynihan R, Kramer B, Barratt A, Hersch J. Resisting recommended treatment for prostate cancer: a qualitative analysis of the lived experience of possible overdiagnosis. BMJ Open 2019; 9:e026960. [PMID: 31122983 PMCID: PMC6537980 DOI: 10.1136/bmjopen-2018-026960] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To describe the lived experience of a possible prostate cancer overdiagnosis in men who resisted recommended treatment. DESIGN Qualitative interview study SETTING: Australia PARTICIPANTS: 11 men (aged 59-78 years) who resisted recommended prostate cancer treatment because of concerns about overdiagnosis and overtreatment. OUTCOMES Reported experience of screening, diagnosis and treatment decision making, and its impact on psychosocial well-being, life and personal circumstances. RESULTS Men's accounts revealed profound consequences of both prostate cancer diagnosis and resisting medical advice for treatment, with effects on their psychological well-being, family, employment circumstances, identity and life choices. Some of these men were tested for prostate-specific antigen without their knowledge or informed consent. The men felt uninformed about their management options and unsupported through treatment decision making. This often led them to develop a sense of disillusionment and distrust towards the medical profession and conventional medicine. The findings show how some men who were told they would soon die without treatment (a prognosis which ultimately did not eventuate) reconciled issues of overdiagnosis and potential overtreatment with their own diagnosis and situation over the ensuing 1 to 20+ years. CONCLUSIONS Men who choose not to have recommended treatment for prostate cancer may avoid treatment-associated harms like incontinence and impotence, however our findings showed that the impact of the diagnosis itself is immense and far-reaching. A high priority for improving clinical practice is to ensure men are adequately informed of these potential consequences before screening is considered.
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Affiliation(s)
- Kirsten McCaffery
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Brooke Nickel
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kristen Pickles
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Ray Moynihan
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | - Barnett Kramer
- National Cancer Institute Division of Cancer Prevention, Bethesda, Maryland, USA
| | - Alexandra Barratt
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Jolyn Hersch
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
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26
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Senapati U, Sengupta M, Datta C, Chatterjee U, Pal DK, Das D, Poddar P. Correlation of Gleason Grading and Prognostic Immunohistochemistry Markers (Human Epidermal Growth Factor Receptor 2/neu and Androgen Receptor) in Prostatic Core Needle Biopsy: A Study in a Tertiary Care Center. Indian J Med Paediatr Oncol 2019. [DOI: 10.4103/ijmpo.ijmpo_139_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abstract
Background: Worldwide prostate cancer is the most common cause of cancer and the second leading cause of cancer death among men. Transrectal ultrasound-guided core needle biopsies are the diagnostic modalities which help in proper categorization and grading of prostatic carcinoma, thus facilitating individualized treatment. These biopsies are the primary source for performance of additional diagnostic immunohistochemical testing for basal cell-associated markers to rule out the morphological mimicker and prognostic markers such as androgen receptor (AR) and human epidermal growth factor receptor 2 (HER2)/neu. Materials and Methods: A prospective, observational study was conducted in the department of pathology in collaboration with department of urosurgery of a tertiary care hospital. One hundred and nineteen patients diagnosed with prostatic nodules were included in this study. Values of serum prostate-specific antigen were recorded. Tissue for histopathological study was obtained in the form of core needle biopsy, and Gleason grade was calculated in all malignant cases. Immunohistochemistry for p63 and alpha-methylacyl-CoA racemase was performed as an additional test in premalignant cases. Prognostication of the prostate cancer cases was done using AR and HER2/neu. Results: A total of 119 cases aged between 20 and 90 years were included in this study. Malignant lesions reveal an increase in the percentage of AR staining in comparison to the benign glandular structure. The Gleason score with higher value (8–9) showed increased expression of HER2/neu receptor. Conclusion: Critical histopathological analysis of core needle biopsy along with immunohistochemical evaluation maximizes the diagnostic accuracy in prostate cancer cases and also helps in prognosis assessment.
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Affiliation(s)
- Utsha Senapati
- Departments of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Moumita Sengupta
- Departments of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Chhanda Datta
- Departments of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Uttara Chatterjee
- Departments of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Dilip Kumar Pal
- Urosurgery, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Diya Das
- Departments of Pathology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
| | - Piyali Poddar
- Urosurgery, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India
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27
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Jain AL, Sidana A, Maruf M, Sugano D, Calio B, Wood BJ, Pinto PA. Analyzing the current practice patterns and views among urologists regarding focal therapy for prostate cancer. Urol Oncol 2019; 37:182.e1-182.e8. [PMID: 30522903 PMCID: PMC8258689 DOI: 10.1016/j.urolonc.2018.11.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/11/2018] [Accepted: 11/19/2018] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND OBJECTIVE Focal therapy (FT) for localized prostate cancer (CaP) has been shown to have encouraging short-term oncological outcomes, excellent preservation of functional outcomes and is increasing in popularity in urologic community. We aim to evaluate the preferences and practice trends among urologists regarding this treatment strategy. METHODS A 20 item online questionnaire was designed to collect information on urologists' views and use of FT. The survey was sent to the members of the Endourological Society and the American Urological Association. Multivariate logistic regression analysis was done to determine predictors for utilization of FT. RESULTS A total of 425 responses were received [American Urological Association: 319, Endourological Society: 106]. Mean age of respondents was 53(SD: 11.3) years. Although half of the respondents (50.8%) believed FT to be moderate to extremely beneficial in the treatment of CaP, only 24.2% (103) of the respondents currently utilize FT in their practice. Respondents who were fellowship trained in urologic oncology were more likely to consider FT to be at least moderately beneficial (P < 0.001). Surgeon's experience (greater than 15 years in urology practice) (P = 0.025) and seeing more than 10 patients with new CaP diagnosis per month (P = 0.002) were independent predictors of FT utilization for localized CaP. While the most common setting for utilization of FT was in patients with unilateral intermediate-risk (72.8%) CaP, a small percentage of respondents also used FT for patients with unilateral high-risk CaP and bilateral intermediate risk (21.4% and 10.7%, respectively). Most common reasons for not using FT were the lack of belief in 'index lesion theory' (63.2%), lack of experience (41.3%), lack of belief in FT's efficacy (41.1%), lack of infrastructure (35.8%), difficult salvage treatment in cases of recurrence (22.7%) and high cost (21.8%). About 57.6% would use FT more often in an office or outpatient setting if they had access to reliable and cost-effective options. CONCLUSIONS Only a quarter of our respondents utilize FT in their practice with surgeon's experience being the important independent predictor for using FT. Majority of respondents though consider FT to be beneficial in CaP management, would use it more often if provided more reliable and cost-effective options. Over time, experience and accessibility to reliable methods to perform FT may lead to further utilization of this novel treatment strategy.
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Affiliation(s)
- Amit L Jain
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD.
| | - Abhinav Sidana
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Mahir Maruf
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Dordaneh Sugano
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Brian Calio
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Bradford J Wood
- Center for Interventional Oncology, National Cancer Institute & Clinical Center, National Institutes of Health, Bethesda, MD
| | - Peter A Pinto
- Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
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Giganti F, Moore CM, Punwani S, Allen C, Emberton M, Kirkham A. The natural history of prostate cancer on MRI: lessons from an active surveillance cohort. Prostate Cancer Prostatic Dis 2018; 21:556-563. [PMID: 30038388 DOI: 10.1038/s41391-018-0058-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 04/08/2018] [Accepted: 04/17/2018] [Indexed: 11/08/2022]
Abstract
BACKGROUND Multiparametric magnetic resonance imaging (mpMRI) is being used increasingly in the setting of active surveillance (AS) for prostate cancer. We investigated changes in the mpMRI appearance of lesions on AS, to show the variability of volume measurements in visible lesions and assess change in lesion size according to grade. METHODS We retrospectively retrieved 86 men on AS (NICE guidelines) with more than one mpMRI (the first before 2013). Two radiologists, in consensus, were blinded to patient demographics and date of scan. The scans were randomly reported to reduce any bias. For visible lesions, we measured volume by planimetry on the sequence best showing the most conspicuous (index) tumour and attributed a 5-point Likert score. RESULTS 43/86 men did not have a visible lesion on the initial mpMRI (≤2/5). Of these, 5/43 had developed a lesion scoring ≥3/5 at a median of 3.6 years of follow up. 40/86 had a lesion scoring ≥3/5 on two or more scans. There was a significant increase in volume over 3.6 years by a median of 10% (p < 0.01)-by a median of 6% for Gleason 3+3 and 18% for 3+4 (p = 0.058). Thirty-five men had a visible lesion on two scans separated by <2 years; of these, 21/35 showed a 78% median increase in tumour size between the two scans and 11/35 showed an apparent 25% median decrease in lesion size. CONCLUSIONS A total of 17% of men with no visible lesion developed a visible lesion at a median follow up of 3.6 years. It is possible to show significant growth in patients with a visible lesion, but variability in volume measurements between scans means that it is difficult to reliably detect increases of this order. This variability may inform the design of mpMRI protocols in AS and the time between follow up scans.
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Affiliation(s)
- Francesco Giganti
- Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK.
- Division of Surgery and Interventional Science, University College London, London, UK.
| | - Caroline M Moore
- Division of Surgery and Interventional Science, University College London, London, UK
- Department of Urology, University College London Hospital NHS Foundation Trust, London, UK
| | - Shonit Punwani
- Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK
- Centre for Medical Imaging, University College London, London, UK
| | - Clare Allen
- Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK
| | - Mark Emberton
- Division of Surgery and Interventional Science, University College London, London, UK
- Department of Urology, University College London Hospital NHS Foundation Trust, London, UK
| | - Alex Kirkham
- Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK
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A chemiluminescent dual-aptasensor capable of simultaneously quantifying prostate specific antigen and vascular endothelial growth factor. Anal Biochem 2018; 564-565:102-107. [PMID: 30367880 DOI: 10.1016/j.ab.2018.10.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 10/22/2018] [Accepted: 10/22/2018] [Indexed: 01/10/2023]
Abstract
An aptasensor with guanine chemiluminescence detection was developed for the early diagnosis of prostate cancer with the simultaneous quantifications of prostate specific antigen (PSA) and vascular endothelial growth factor (VEGF). A PSA DNA aptamer conjugated with Texas Red emits red light in guanine chemiluminescence reaction, whereas a VEGF DNA aptamer conjugated with 6-FAM emits green light. The PSA and VEGF aptamers immobilized on the surface of paramagnetic beads mixed with a sample were incubated for 30 min. After the incubation, PSA and VEGF bound with PSA and VEGF aptamers were simultaneously quantified for 20 s using guanine chemiluminescence detections operated with two photomultiplier tubes and two optical filters capable of selectively collecting green or red light. With the increase of PSA concentration, the strength of the red light emitted from Texas Red dropped exponentially, whereas with the increase of VEGF concentration, the green light emitted from 6-FAM was enhanced. The limits of detection were as low as 0.6 ng/ml for PSA and 0.4 ng/ml for VEGF. We confirmed that the dual-aptasensor can be applied as an advanced and new medical device capable of simultaneously quantifying PSA and VEGF to early diagnose prostate cancer with good accuracy, precision, and reproducibility.
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30
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Zou J, Huang RY, Jiang FN, Chen DX, Wang C, Han ZD, Liang YX, Zhong WD. Overexpression of TPX2 is associated with progression and prognosis of prostate cancer. Oncol Lett 2018; 16:2823-2832. [PMID: 30127868 PMCID: PMC6096215 DOI: 10.3892/ol.2018.9016] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 04/06/2018] [Indexed: 12/17/2022] Open
Abstract
Targeting protein for Xenopus kinesin-like protein 2 (TPX2) activates Aurora kinase A during mitosis and targets its activity to the mitotic spindle, serving an important role in mitosis. It has been associated with different types of cancer and is considered to promote tumor growth. The aim of the present study was to explore the role of TPX2 in diagnosing prostate cancer (PCa). It was identified that TPX2 expression in PCa tissues was increased compared with benign prostate tissues. Microarray analysis demonstrated that TPX2 was positively associated with the Gleason score, tumor-node-metastasis (TNM) stage, clinicopathological stage, metastasis, overall survival and biochemical relapse-free survival. In vitro studies revealed that the high expression of TPX2 in PCa cells improved proliferative, invasive and migratory abilities, and repressed apoptosis of the PCa cells, without affecting tolerance to docetaxel. The results suggested that TPX2 serves as a tumorigenesis-promoting gene in PCa, and a potential therapeutic target for patients with PCa.
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Affiliation(s)
- Jun Zou
- Department of Emergency Surgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong 510150, P.R. China
| | - Rui-Yan Huang
- Department of Ultrasonography and Electrocardiograms, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong 510060, P.R. China
| | - Fu-Neng Jiang
- Department of Urology, Guangdong Key Laboratory of Clinical Molecular Medicine and Diagnostics, The Second Affiliated Hospital of South China University of Technology, Guangzhou, Guangdong 510180, P.R. China
| | - De-Xiong Chen
- Department of Emergency Surgery, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, Guangdong 510150, P.R. China
| | - Cong Wang
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, Zhejiang 325035, P.R. China
| | - Zhao-Dong Han
- Department of Urology, Guangdong Key Laboratory of Clinical Molecular Medicine and Diagnostics, The Second Affiliated Hospital of South China University of Technology, Guangzhou, Guangdong 510180, P.R. China
| | - Yu-Xiang Liang
- Department of Urology, Guangdong Key Laboratory of Clinical Molecular Medicine and Diagnostics, The Second Affiliated Hospital of South China University of Technology, Guangzhou, Guangdong 510180, P.R. China
| | - Wei-De Zhong
- Department of Urology, Guangdong Key Laboratory of Clinical Molecular Medicine and Diagnostics, The Second Affiliated Hospital of South China University of Technology, Guangzhou, Guangdong 510180, P.R. China.,Department of Urology, Huadu District People's Hospital, Southern Medical University, Guangzhou, Guangdong 510800, P.R. China
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Chang J, Xu W, Du X, Hou J. MALAT1 silencing suppresses prostate cancer progression by upregulating miR-1 and downregulating KRAS. Onco Targets Ther 2018; 11:3461-3473. [PMID: 29942138 PMCID: PMC6007192 DOI: 10.2147/ott.s164131] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Prostate cancer (PC) is the second leading cause of cancer-related deaths among men. Long noncoding RNA metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) performed as an oncogene in multiple cancers including PC. However, the molecular mechanisms of MALAT1 implicated in PC progression have not been thoroughly elaborated. Materials and methods Reverse transcription-quantitative polymerase chain reaction assay was used to detect the expressions of MALAT1 and microRNA-1 (miR-1). Protein levels of cleaved poly (ADP-ribose) polymerase, cleaved caspase-3, BAX, bcl-2, and KRAS were determined using a western blot assay. Cell proliferation was assessed by colony formation and MTS assays. Cell migration capacity was examined by transwell migration assay (Corning Incorporated, Corning, NY, USA). Apoptosis rate was measured by flow cytometry via double staining of annexin V-FITC and propidium iodide. Luciferase and RNA immunoprecipitation assays were employed to explore the relationship among miR-1, MALAT1, and KRAS. Results MALAT1 expression was upregulated and miR-1 expression was downregulated in PC tissues and cell lines. MALAT1 knockdown inhibited cell proliferation and migration, and promoted cell apoptosis in androgen receptor-negative DU145 and PC3 cells. Molecular mechanism explorations disclosed that MALAT1 acted as a molecular sponge of miR-1 in DU145 cells. Moreover, miR-1 downregulation partly abrogated MALAT1 silencing-mediated anti-proliferative, antimigratory, and proapoptotic effects in DU145 and PC3 cells. Further investigation revealed that KRAS was a target of miR-1 in DU145 cells. MALAT1 acted as a competing endogenous RNA of miR-1, resulting in the increase of KRAS expression in DU145 and PC3 cells. Furthermore, miR-1 overexpression hampered proliferation and migration and promoted apoptosis in DU145 and PC3 cells, while these effects were markedly weakened following KRAS upregulation. Conclusion MALAT1 knockdown inhibited proliferation and migration and facilitated apoptosis by upregulating miR-1 and downregulating KRAS in androgen receptor-negative PCa cells, providing a new insight into the molecular basis of MALAT1 and a potential biomarker or therapeutic target for suppressing castration-resistant PC.
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Affiliation(s)
- Junkai Chang
- Department of Urology, Huaihe Hospital of Henan University, Kaifeng 475000, China
| | - Weibo Xu
- Department of Urology, Huaihe Hospital of Henan University, Kaifeng 475000, China
| | - Xinyi Du
- Department of Urology, Huaihe Hospital of Henan University, Kaifeng 475000, China
| | - Junqing Hou
- Department of Urology, Huaihe Hospital of Henan University, Kaifeng 475000, China
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Automatic Prostate Cancer Segmentation Using Kinetic Analysis in Dynamic Contrast-Enhanced MRI. J Biomed Phys Eng 2018; 8:107-116. [PMID: 29732345 PMCID: PMC5928300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 08/27/2016] [Indexed: 10/27/2022]
Abstract
BACKGROUND Dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) provides functional information on the microcirculation in tissues by analyzing the enhancement kinetics which can be used as biomarkers for prostate lesions detection and characterization. OBJECTIVE The purpose of this study is to investigate spatiotemporal patterns of tumors by extracting semi-quantitative as well as wavelet-based features, both extracted from pixel-based time-signal intensity curves to segment prostate lesions on prostate DCE-MRI. METHODS Quantitative dynamic contrast-enhanced MRI data were acquired on 22 patients. Optimal features selected by forward selection are used for the segmentation of prostate lesions by applying fuzzy c-means (FCM) clustering. The images were reviewed by an expert radiologist and manual segmentation performed as the ground truth. RESULTS Empirical results indicate that fuzzy c-mean classifier can achieve better results in terms of sensitivity, specificity when semi-quantitative features were considered versus wavelet kinetic features for lesion segmentation (Sensitivity of 87.58% and 75.62%, respectively) and (Specificity of 89.85% and 68.89 %, respectively). CONCLUSION The proposed segmentation algorithm in this work can potentially be implemented for automatic prostate lesion detection in a computer aided diagnosis scheme and combined with morphologic features to increase diagnostic credibility.
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Houston KA, King J, Li J, Jemal A. Trends in Prostate Cancer Incidence Rates and Prevalence of Prostate Specific Antigen Screening by Socioeconomic Status and Regions in the United States, 2004 to 2013. J Urol 2018; 199:676-682. [PMID: 28965781 PMCID: PMC11181155 DOI: 10.1016/j.juro.2017.09.103] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE To our knowledge it is unknown whether decreases in the prevalence of prostate specific antigen screening and prostate cancer incidence rates following the USPSTF (United States Preventive Services Task Force) recommendations against routine prostate specific antigen screening are similar across socioeconomic groups and United States census regions. MATERIALS AND METHODS We analyzed incidence rates and prostate specific antigen screening prevalence by age, race/ethnicity, disease stage, United States region and area level socioeconomic status. Annual percent changes were examined for changes in rates with time. The predicted marginal probability and 95% CIs were calculated to estimate changes in prostate specific antigen screening. RESULTS Incidence rates in men 50 years old or older decreased in all race/ethnic, regional and socioeconomic status groups. From 2007 to 2013 the overall incidence rates for localized cancer significantly decreased 7.5% per year (95% CI -10.5--4.4) at ages 50 to 74 years and 11.1% per year (95% CI -14.1--8.1) at ages 75 years or greater. In contrast, the incidence of distant stage cancer significantly increased 1.4% per year (95% CI 0.3-2.5) from 2008 to 2013 at ages 50 to 74 years but stabilized from 2011 to 2013 at ages 75 years or greater at 5.1% per year (95% CI -3.4-14.4). Distant stage disease rates increased with increasing poverty level at ages 50 to 74 years but not at 75 years or greater. CONCLUSIONS The prostate cancer incidence of early stage disease decreased in men 50 years old or older while the rate of distant stage disease slightly increased in men 50 to 74 years old following USPSTF recommendations against routine prostate specific antigen screening. Further studies with additional years of data are needed to substantiate our findings and monitor the effects of the late stage disease increase on prostate cancer mortality rates.
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Affiliation(s)
- Keisha A Houston
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, and Surveillance and Health Services Research, American Cancer Society (AJ), Atlanta, Georgia.
| | - Jessica King
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, and Surveillance and Health Services Research, American Cancer Society (AJ), Atlanta, Georgia
| | - Jun Li
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, and Surveillance and Health Services Research, American Cancer Society (AJ), Atlanta, Georgia
| | - Ahmedin Jemal
- Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, and Surveillance and Health Services Research, American Cancer Society (AJ), Atlanta, Georgia
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34
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Eeles R, Ni Raghallaigh H. Men with a susceptibility to prostate cancer and the role of genetic based screening. Transl Androl Urol 2018; 7:61-69. [PMID: 29594021 PMCID: PMC5861282 DOI: 10.21037/tau.2017.12.30] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 12/18/2017] [Indexed: 12/12/2022] Open
Abstract
Prostate cancer is the second most common malignancy affecting men worldwide, and the commonest affecting men of African descent. Significant diagnostic and therapeutic advances have been made in the past decade. Improvements in the accuracy of prostate cancer diagnosis include the uptake of multi-parametric MRI and a shift towards targeted biopsy. We also now have more life-prolonging systemic and hormonal therapies for men with advanced disease at our disposal than ever before. However, the development of robust screening tools and targeted screening programs has not followed at the same pace. Evidence to support population-based screening remains unclear, with the use of PSA as a screening test limiting our ability to discriminate between clinically significant and insignificant disease. Prostate cancer has a large heritable component. Given that most men without risk factors have a low lifetime risk of developing lethal prostate cancer, much work is being done to further our knowledge of how we can best screen men in higher risk categories, such as those with a family history (FH) of the disease or those of African ancestry. These men have been reported to carry upwards of a two-fold increased risk of developing the disease at an earlier age, with evidence suggesting poorer survival outcomes. In men with a FH of prostate cancer, this is felt to be due to rare, high-penetrance mutations and the presence of multiple, common low penetrance alleles, with men carrying specific germline mutations in the BRCA and other DNA repair genes at particularly high risk. To date, large scale genome-wide association studies (GWAS) have led to the discovery of approximately 170 single nucleotide polymorphisms (SNPs) associated with prostate cancer risk, allowing over 30% of prostate cancer risk to be explained. Genomic tests, utilising somatic (prostate biopsy) tissue can also predict the risk of unfavourable pathology, biochemical recurrence and the likelihood of metastatic disease using gene expression. Targeted screening studies are currently under way in men with DNA repair mutations, men with a FH and those of Afro-Caribbean ethnicity which will greater inform our understanding of disease incidence and behaviour in these men, treatment outcomes and developing the most appropriate screening regime for such men. Incorporating a patient's genetic mutation status into risk algorithms allows us an opportunity to develop targeted screening programs for men in whom early cancer detection and treatment will positively influence survival, and in the process offer male family members of affected men the chance to be counselled and screened accordingly.
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Affiliation(s)
- Rosalind Eeles
- Division of Genetics & Epidemiology, Institute of Cancer Research, Sutton, London, UK
| | - Holly Ni Raghallaigh
- Division of Genetics & Epidemiology, Institute of Cancer Research, Sutton, London, UK
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35
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Crulhas BP, Karpik AE, Delella FK, Castro GR, Pedrosa VA. Electrochemical aptamer-based biosensor developed to monitor PSA and VEGF released by prostate cancer cells. Anal Bioanal Chem 2017; 409:6771-6780. [PMID: 29032455 DOI: 10.1007/s00216-017-0630-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 08/30/2017] [Accepted: 09/07/2017] [Indexed: 11/21/2022]
Abstract
Early prostate cancer (PCa) diagnostic is crucial to enhance patient survival rates; besides, non-invasive platforms have been developed worldwide in order to precisely detect PCa biomarkers. Therefore, the aim of the present study is to develop a new aptamer-based biosensor through the self-assembling of thiolated aptamers for PSA and VEGF on the top of gold electrodes. This biosensor was tested in three prostate cell lines (RWPE-1, LNCaP and PC3). The results evidenced a stable and sensitive sensor presenting wide linear detection ranges (0.08-100 ng/mL for PSA and 0.15 ng-100 ng/mL for VEGF). Therefore, the aptasensor was able to detect the patterns of PSA and VEGF released in vitro by PCa cells, which gave new insights about the prostate cancer protein dynamics. Thus, it could be used as a non-invasive PCa clinical diagnosis instrument in the near future. Graphical Abstract Overview of the experimental design applied to the aptamer-based electrochemical sensor self-assembled on the thiolated hairpin structure. A filter membrane was added on top of working electrode to provide the cell-attachment surface after aptamer incubation, without compromising the aptamer layer. The pore membrane allowed target proteins to pass to the aptamer surface; the MCH backfilling avoided unspecific protein binding to the gold electrode surface.
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Affiliation(s)
- Bruno P Crulhas
- Department of Chemistry and Biochemistry, Institute of Bioscience, UNESP-Botucatu, Distrito de Rubiao Jr, 18618-000 Botucatu, São Paulo, 18618-000, Brazil
| | - Agnieszka E Karpik
- Department of Chemistry and Biochemistry, Institute of Bioscience, UNESP-Botucatu, Distrito de Rubiao Jr, 18618-000 Botucatu, São Paulo, 18618-000, Brazil
| | - Flávia K Delella
- Department of Chemistry and Biochemistry, Institute of Bioscience, UNESP-Botucatu, Distrito de Rubiao Jr, 18618-000 Botucatu, São Paulo, 18618-000, Brazil
| | - Gustavo R Castro
- Department of Chemistry and Biochemistry, Institute of Bioscience, UNESP-Botucatu, Distrito de Rubiao Jr, 18618-000 Botucatu, São Paulo, 18618-000, Brazil
| | - Valber A Pedrosa
- Department of Chemistry and Biochemistry, Institute of Bioscience, UNESP-Botucatu, Distrito de Rubiao Jr, 18618-000 Botucatu, São Paulo, 18618-000, Brazil.
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36
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Wang X, An P, Zeng J, Liu X, Wang B, Fang X, Wang F, Ren G, Min J. Serum ferritin in combination with prostate-specific antigen improves predictive accuracy for prostate cancer. Oncotarget 2017; 8:17862-17872. [PMID: 28160568 PMCID: PMC5392292 DOI: 10.18632/oncotarget.14977] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 01/24/2017] [Indexed: 01/10/2023] Open
Abstract
Ferritin is highly expressed in many cancer types. Although a few studies have reported an association between high serum ferritin levels and an increased risk of prostate cancer, the results are inconsistent. Therefore, we performed a large case-control study consisting of 2002 prostate cancer patients and 951 control patients with benign prostatic hyperplasia (BPH). We found that high ferritin levels were positively associated with increased serum prostate-specific antigen (PSA) levels and prostate cancer risk; each 100 ng/ml increase in serum ferritin increased the odds ratio (OR) by 1.20 (95% CI: 1.13−1.36). In the prostate cancer group, increased serum ferritin levels were significantly correlated with higher Gleason scores (p < 0.001). Notably, serum PSA values had even higher predictive accuracy among prostate cancer patients with serum ferritin levels > 400 ng/ml (Gleason score + total PSA correlation: r = 0.38; Gleason score + free PSA correlation: r = 0.49). Moreover, using immunohistochemistry, we found that prostate tissue ferritin levels were significantly higher (p < 0.001) in prostate cancer patients (n = 129) compared to BPH controls (n = 31). Prostate tissue ferritin levels were also highly correlated with serum ferritin when patients were classified by cancer severity (r = 0.81). Importantly, we found no correlation between serum ferritin levels and the inflammation marker C-reactive protein (CRP) in prostate cancer patients. In conclusion, serum ferritin is significantly associated with prostate cancer and may serve as a non-invasive biomarker to complement the PSA test in the diagnosis and prognostic evaluation of prostate cancer.
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Affiliation(s)
- Xijuan Wang
- The First Affiliated Hospital, Institute of Translational Medicine, School of Public Health, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Peng An
- The First Affiliated Hospital, Institute of Translational Medicine, School of Public Health, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Jiling Zeng
- The First Affiliated Hospital, Institute of Translational Medicine, School of Public Health, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Xiaoyan Liu
- The First Affiliated Hospital, Institute of Translational Medicine, School of Public Health, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Bo Wang
- The First Affiliated Hospital, Institute of Translational Medicine, School of Public Health, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Xuexian Fang
- The First Affiliated Hospital, Institute of Translational Medicine, School of Public Health, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Fudi Wang
- The First Affiliated Hospital, Institute of Translational Medicine, School of Public Health, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, School of Medicine, Zhejiang University, Hangzhou 310058, China.,Department of Nutrition, Precision Nutrition Innovation Center, School of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Guoping Ren
- The First Affiliated Hospital, Institute of Translational Medicine, School of Public Health, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, School of Medicine, Zhejiang University, Hangzhou 310058, China
| | - Junxia Min
- The First Affiliated Hospital, Institute of Translational Medicine, School of Public Health, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, School of Medicine, Zhejiang University, Hangzhou 310058, China
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37
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Role of MRI-US Fusion Biopsy in Diagnosing Prostatic Cancer. Indian J Surg Oncol 2017; 8:357-360. [DOI: 10.1007/s13193-016-0612-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 11/10/2016] [Indexed: 10/20/2022] Open
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38
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Fütterer JJ. Multiparametric MRI in the Detection of Clinically Significant Prostate Cancer. Korean J Radiol 2017; 18:597-606. [PMID: 28670154 PMCID: PMC5447635 DOI: 10.3348/kjr.2017.18.4.597] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 02/20/2017] [Indexed: 11/15/2022] Open
Abstract
Prostate cancer is the most common cancer among men aged 50 years and older in developed countries and the third leading cause of cancer-related death in men. Multiparametric prostate MR imaging is currently the most accurate imaging modality to detect, localize, and stage prostate cancer. The role of multi-parametric MR imaging in the detection of clinically significant prostate cancer are discussed. In addition, insights are provided in imaging techniques, protocol, and interpretation.
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Affiliation(s)
- Jurgen J Fütterer
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen 6500HB, the Netherlands
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Schmuck S, von Klot CA, Henkenberens C, Sohns JM, Christiansen H, Wester HJ, Ross TL, Bengel FM, Derlin T. Initial Experience with Volumetric 68Ga-PSMA I&T PET/CT for Assessment of Whole-Body Tumor Burden as a Quantitative Imaging Biomarker in Patients with Prostate Cancer. J Nucl Med 2017; 58:1962-1968. [DOI: 10.2967/jnumed.117.193581] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 05/10/2017] [Indexed: 12/25/2022] Open
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Jayadevappa R, Chhatre S, Wong YN, Wittink MN, Cook R, Morales KH, Vapiwala N, Newman DK, Guzzo T, Wein AJ, Malkowicz SB, Lee DI, Schwartz JS, Gallo JJ. Comparative effectiveness of prostate cancer treatments for patient-centered outcomes: A systematic review and meta-analysis (PRISMA Compliant). Medicine (Baltimore) 2017; 96:e6790. [PMID: 28471976 PMCID: PMC5419922 DOI: 10.1097/md.0000000000006790] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND In the context of prostate cancer (PCa) characterized by the multiple alternative treatment strategies, comparative effectiveness analysis is essential for informed decision-making. We analyzed the comparative effectiveness of PCa treatments through systematic review and meta-analysis with a focus on outcomes that matter most to newly diagnosed localized PCa patients. METHODS We performed a systematic review of literature published in English from 1995 to October 2016. A search strategy was employed using terms "prostate cancer," "localized," "outcomes," "mortality," "health related quality of life," and "complications" to identify relevant randomized controlled trials (RCTs), prospective, and retrospective studies. For observational studies, only those adjusting for selection bias using propensity-score or instrumental-variables approaches were included. Multivariable adjusted hazard ratio was used to assess all-cause and disease-specific mortality. Funnel plots were used to assess the level of bias. RESULTS Our search strategy yielded 58 articles, of which 29 were RCTs, 6 were prospective studies, and 23 were retrospective studies. The studies provided moderate data for the patient-centered outcome of mortality. Radical prostatectomy demonstrated mortality benefit compared to watchful waiting (all-cause HR = 0.63 CI = 0.45, 0.87; disease-specific HR = 0.48 CI = 0.40, 0.58), and radiation therapy (all-cause HR = 0.65 CI = 0.57, 0.74; disease-specific HR = 0.51 CI = 0.40, 0.65). However, we had minimal comparative information about tradeoffs between and within treatment for other patient-centered outcomes in the short and long-term. CONCLUSION Lack of patient-centered outcomes in comparative effectiveness research in localized PCa is a major hurdle to informed and shared decision-making. More rigorous studies that can integrate patient-centered and intermediate outcomes in addition to mortality are needed.
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Affiliation(s)
- Ravishankar Jayadevappa
- Department of Medicine
- Urology Division, Department of Surgery, Perelman School of Medicine, University of Pennsylvania
- Corporal Michael J. Crescenz VAMC
- Leonard Davis Institute of Health Economics
- Abramson Cancer Center
| | - Sumedha Chhatre
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania
| | - Yu-Ning Wong
- Fox Chase Cancer Center, Temple University, Philadelphia, PA
| | - Marsha N. Wittink
- Department of Psychiatry, University of Rochester Medical Center, NY
| | | | | | | | - Diane K. Newman
- Urology Division, Department of Surgery, Perelman School of Medicine, University of Pennsylvania
| | - Thomas Guzzo
- Urology Division, Department of Surgery, Perelman School of Medicine, University of Pennsylvania
| | - Alan J. Wein
- Urology Division, Department of Surgery, Perelman School of Medicine, University of Pennsylvania
- Abramson Cancer Center
| | - Stanley B. Malkowicz
- Urology Division, Department of Surgery, Perelman School of Medicine, University of Pennsylvania
- Corporal Michael J. Crescenz VAMC
- Abramson Cancer Center
| | - David I. Lee
- Urology Division, Department of Surgery, Perelman School of Medicine, University of Pennsylvania
| | - Jerome S. Schwartz
- Department of Medicine
- Leonard Davis Institute of Health Economics
- Abramson Cancer Center
- Health Care Management Department, Wharton School of Business, University of Pennsylvania, Philadelphia, PA
| | - Joseph J. Gallo
- General Internal Medicine, Johns Hopkins University School of Medicine, and Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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Reply by Authors. J Urol 2017; 197:96. [DOI: 10.1016/j.juro.2016.08.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Aydin O, Vlaisavljevich E, Yuksel Durmaz Y, Xu Z, ElSayed MEH. Noninvasive Ablation of Prostate Cancer Spheroids Using Acoustically-Activated Nanodroplets. Mol Pharm 2016; 13:4054-4065. [PMID: 27696857 DOI: 10.1021/acs.molpharmaceut.6b00617] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We have developed acoustically activated nanodroplets (NDs) using an amphiphilic triblock copolymer, which self-assembles and encapsulates different perfluorocarbons including perfluoropentane (PFP) and perfluorohexane (PFH). Applying histotripsy pulses (i.e., short, high pressure, ultrasound pulses) to solutions of PFP- and PFH-NDs generated bubble clouds at a significantly reduced acoustic pressure compared to the cavitation pressure observed for histotripsy treatment alone. In this report, we summarize the results of combining histotripsy at low frequency (345 and 500 kHz) with PFP-NDs and PFH-NDs on the ablation of PC-3 and C4-2B prostate cancer cells. Using custom built histotripsy transducers coupled to a microscope and a high speed recording camera, we imaged the generation of a cavitation bubble cloud in response to different ultrasound regimes in solution and in tissue-mimicking gel phantoms. We quantified the associated ablation of individual cancer cells and 3D spheroids suspended in solution and embedded in tissue phantoms to compare the ablative capacity of PFP-NDs and PFH-NDs. Results show that histotripsy pulses at high acoustic pressure (26.2 MPa) ablated 80% of prostate cancer spheroids embedded in tissue-mimicking gel phantoms. In comparison, combining histotripsy pulses at a dramatically lower acoustic pressure (12.8 MPa) with PFP-NDs and PFH-NDs caused an ablation of 40% and 80% of the tumor spheroid volumes, respectively. These results show the potential of acoustically activated NDs as an image-guided ablative therapy for solid tumors and highlight the higher ablative capacity of PFH-NDs, which correlates with the boiling point of the encapsulated PFH and the stability of the formed bubble cloud.
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Affiliation(s)
- Omer Aydin
- Department of Biomedical Engineering, University of Michigan , Ann Arbor, Michigan 48109, United States
| | - Eli Vlaisavljevich
- Department of Biomedical Engineering, University of Michigan , Ann Arbor, Michigan 48109, United States
| | - Yasemin Yuksel Durmaz
- Department of Biomedical Engineering, University of Michigan , Ann Arbor, Michigan 48109, United States.,Department of Biomedical Engineering, School of Engineering and Natural Sciences, Istanbul Medipol University , Beykoz, Istanbul, 34810, Turkey
| | - Zhen Xu
- Department of Biomedical Engineering, University of Michigan , Ann Arbor, Michigan 48109, United States.,Division of Pediatric Cardiology, Department of Pediatrics and Communicable Diseases, University of Michigan , Ann Arbor, Michigan 48109, United States
| | - Mohamed E H ElSayed
- Department of Biomedical Engineering, University of Michigan , Ann Arbor, Michigan 48109, United States.,Macromolecular Science and Engineering Program, University of Michigan , Ann Arbor, Michigan 48109, United States
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Perera M, Krishnananthan N, Lindner U, Lawrentschuk N. An update on focal therapy for prostate cancer. Nat Rev Urol 2016; 13:641-653. [DOI: 10.1038/nrurol.2016.177] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Park YH, Shin HW, Jung AR, Kwon OS, Choi YJ, Park J, Lee JY. Prostate-specific extracellular vesicles as a novel biomarker in human prostate cancer. Sci Rep 2016; 6:30386. [PMID: 27503267 PMCID: PMC4977541 DOI: 10.1038/srep30386] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 06/30/2016] [Indexed: 01/09/2023] Open
Abstract
Extracellular vesicles (EVs) may play an important role in cancer development and progression. We aimed to investigate the prognostic potential of prostate-specific EVs in prostate cancer (PCa) patients. Plasma and prostate tissue were collected from patients who underwent surgery for PCa (n = 82) or benign prostatic hyperplasia (BPH, n = 28). To analyze the quantity of EVs in prostate, we performed transmission electron microscopy (TEM), immuno-TEM with CD63 and prostate-specific membrane antigen (PSMA), and immunofluorescence staining. After EV isolation from plasma, CD63 and PSMA concentration was measured using ELISA kits. PSMA-positive areas in prostate differed in patients with BPH, and low-, intermediate-, and high-risk PCa (2.4, 8.2, 17.5, 26.5%, p < 0.001). Plasma PSMA-positive EV concentration differed in patients with BPH, and low-, intermediate-, and high-risk PCa (21.9, 43.4, 49.2, 59.9 ng/mL, p < 0.001), and ROC curve analysis indicated that plasma PSMA-positive EV concentration differentiated PCa from BPH (AUC 0.943). Patients with lower plasma PSMA-positive EV concentration had greater prostate volume (50.2 vs. 33.4 cc, p < 0.001) and lower pathologic Gleason score (p = 0.025). During the median follow-up of 18 months, patients with lower plasma PSMA-positive EV concentration tended to have a lower risk of biochemical failure than those with higher levels of prostate-specific EVs (p = 0.085).
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Affiliation(s)
- Yong Hyun Park
- Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Catholic Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun Woo Shin
- School of Interdisciplinary Bioscience and Bioengineering, Pohang University of Science and Technology, Pohang, Republic of Korea
| | - Ae Ryang Jung
- Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Catholic Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Oh Sung Kwon
- Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yeong-Jin Choi
- Department of Hospital Pathology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
| | - Jaesung Park
- School of Interdisciplinary Bioscience and Bioengineering, Pohang University of Science and Technology, Pohang, Republic of Korea
| | - Ji Youl Lee
- Department of Urology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Catholic Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Barati M, Amirzargar MA, Bashirian S, Kafami V, Mousali AA, Moeini B. Psychological Predictors of Prostate Cancer Screening Behaviors Among Men Over 50 Years of Age in Hamadan: Perceived Threat and Efficacy. IRANIAN JOURNAL OF CANCER PREVENTION 2016; 9:e4144. [PMID: 27761205 PMCID: PMC5055754 DOI: 10.17795/ijcp-4144] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 12/23/2015] [Accepted: 05/30/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Prostate cancer is the fourth most common cancer worldwide and is the second most lethal cancer. OBJECTIVES The aim of this study was to investigate psychological predictors of prostate cancer screening behaviors among men over 50 years of age in Hamadan. MATERIALS AND METHODS This cross-sectional study was carried out on 200 men over 50 years of age in Hamadan, west of Iran. Participants were recruited with a cluster sampling method. The subjects completed a self-administered questionnaire including demographic characteristics, prostate cancer screening behaviors and psychological factors related to prostate cancer. Data was analyzed by SPSS-18 using chi-square, fisher exact test, and logestic regression. RESULTS According to the results, 8.5 and 7.5 percent of participants reported history of digital rectal exam and prostate-specific antigen test, respectively. Also, the subjects reported 18.5%, 49.3% and 50.3% of receivable scores of knowledge, perceived threat, and perceived efficacy of prostate cancer screening behaviors, respectively. There was a significant association between prostate cancer screening behaviors and age groups (P < 0.05). CONCLUSIONS The results showed that providing analytical studies in this field helps to surface the hidden aspects of this context and the health care providers and administrators will hopefully consider them in planning for identification of psychological factors, such as barriers and facilitators factors.
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Affiliation(s)
- Majid Barati
- Social Determinants of Health Research Center, Department of Public Health, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Mohammad Ali Amirzargar
- Urology and Nephrology Research Center, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Saeed Bashirian
- Social Determinants of Health Research Center, Department of Public Health, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Vahid Kafami
- Department of Public Health, School of Health, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Amir Abbas Mousali
- Department of Public Health, School of Health, Hamadan University of Medical Sciences, Hamadan, IR Iran
| | - Babak Moeini
- Social Determinants of Health Research Center, Department of Public Health, Hamadan University of Medical Sciences, Hamadan, IR Iran
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Mengual L, Lozano JJ, Ingelmo-Torres M, Izquierdo L, Musquera M, Ribal MJ, Alcaraz A. Using gene expression from urine sediment to diagnose prostate cancer: development of a new multiplex mRNA urine test and validation of current biomarkers. BMC Cancer 2016; 16:76. [PMID: 26856686 PMCID: PMC4746764 DOI: 10.1186/s12885-016-2127-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 02/04/2016] [Indexed: 12/18/2022] Open
Abstract
Background Additional accurate non-invasive biomarkers are needed in the clinical setting to improve prostate cancer (PCa) diagnosis. Here we have developed a new and improved multiplex mRNA urine test to detect prostate cancer (PCa). Furthermore, we have validated the PCA3 urinary transcript and some panels of urinary transcripts previously reported as useful diagnostic biomarkers for PCa in our cohort. Methods Post-prostatic massage urine samples were prospectively collected from PCa patients and controls. Expression levels of 42 target genes selected from our previous studies and from the literature were studied in 224 post-prostatic massage urine sediments by quantitative PCR. Univariate logistic regression was used to identify individual PCa predictors. A variable selection method was used to develop a multiplex biomarker model. Discrimination was measured by ROC curve AUC for both, our model and the previously published biomarkers. Results Seven of the 42 genes evaluated (PCA3, ELF3, HIST1H2BG, MYO6, GALNT3, PHF12 and GDF15) were found to be independent predictors for discriminating patients with PCa from controls. We developed a four-gene expression signature (HIST1H2BG, SPP1, ELF3 and PCA3) with a sensitivity of 77 % and a specificity of 67 % (AUC = 0.763) for discriminating between tumor and control urines. The accuracy of PCA3 and previously reported panels of biomarkers is roughly maintained in our cohort. Conclusions Our four-gene expression signature outperforms PCA3 as well as previously reported panels of biomarkers to predict PCa risk. This study suggests that a urinary biomarker panel could improve PCa detection. However, the accuracy of the panels of urinary transcripts developed to date, including our signature, is not high enough to warrant using them routinely in a clinical setting. Electronic supplementary material The online version of this article (doi:10.1186/s12885-016-2127-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lourdes Mengual
- Laboratory and Department of Urology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain. .,Laboratory of Urology, Hospital Clínic, Centre de Recerca Biomèdica CELLEX, office B22, C/Casanova, 143, 08036, Barcelona, Spain.
| | - Juan José Lozano
- CIBERehd. Plataforma de Bioinformática, Centro de Investigación Biomédica en red de Enfermedades Hepáticas y Digestivas, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Mercedes Ingelmo-Torres
- Laboratory and Department of Urology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Laura Izquierdo
- Laboratory and Department of Urology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Mireia Musquera
- Laboratory and Department of Urology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - María José Ribal
- Laboratory and Department of Urology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
| | - Antonio Alcaraz
- Laboratory and Department of Urology, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Barcelona, Spain
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Wang X, Han J, Hardie DB, Yang J, Borchers CH. The use of matrix coating assisted by an electric field (MCAEF) to enhance mass spectrometric imaging of human prostate cancer biomarkers. JOURNAL OF MASS SPECTROMETRY : JMS 2016; 51:86-95. [PMID: 26757076 DOI: 10.1002/jms.3728] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2015] [Revised: 10/26/2015] [Accepted: 10/27/2015] [Indexed: 06/05/2023]
Abstract
In this work, we combined a newly developed matrix coating technique - matrix coating assisted by an electric field (MCAEF) and matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS) to enhance the imaging of peptides and proteins in tissue specimens of human prostate cancer. MCAEF increased the signal-to-noise ratios of the detected proteins by a factor of 2 to 5, and 232 signals were detected within the m/z 3500-37500 mass range on a time-of-flight mass spectrometer and with the sinapinic acid MALDI matrix. Among these species, three proteins (S100-A9, S100-A10, and S100-A12) were only observed in the cancerous cell region and 14 proteins, including a fragment of mitogen-activated protein kinase/extracellular signal-regulated kinase kinase kinase 2, a fragment of cAMP-regulated phosphoprotein 19, 3 apolipoproteins (C-I, A-I, and A-II), 2 S100 proteins (A6 and A8), β-microseminoprotein, tumor protein D52, α-1-acid glycoprotein 1, heat shock protein β-1, prostate-specific antigen, and 2 unidentified large peptides at m/z 5002.2 and 6704.2, showed significantly differential distributions at the p < 0.05 (t-test) level between the cancerous and the noncancerous regions of the tissue. Among these 17 species, the distributions of apolipoprotein C-I, S100-A6, and S100-A8 were verified by immunohistological staining. In summary, this study resulted in the imaging of the largest group of proteins in prostate cancer tissues by MALDI-MS reported thus far, and is the first to show a correlation between S100 proteins and prostate cancer in a MS imaging study. The successful imaging of the three proteins only found in the cancerous tissues, as well as those showing differential expressions demonstrated the potential of MCAEF-MALDI/MS for the in situ detection of potential cancer biomarkers. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
- Xiaodong Wang
- University of Victoria-Genome British Columbia Proteomics Centre, #3101-4464 Markham St., Vancouver Island Technology Park, Victoria, BC, V8Z 7X8, Canada
| | - Jun Han
- University of Victoria-Genome British Columbia Proteomics Centre, #3101-4464 Markham St., Vancouver Island Technology Park, Victoria, BC, V8Z 7X8, Canada
| | - Darryl B Hardie
- University of Victoria-Genome British Columbia Proteomics Centre, #3101-4464 Markham St., Vancouver Island Technology Park, Victoria, BC, V8Z 7X8, Canada
| | - Juncong Yang
- University of Victoria-Genome British Columbia Proteomics Centre, #3101-4464 Markham St., Vancouver Island Technology Park, Victoria, BC, V8Z 7X8, Canada
| | - Christoph H Borchers
- University of Victoria-Genome British Columbia Proteomics Centre, #3101-4464 Markham St., Vancouver Island Technology Park, Victoria, BC, V8Z 7X8, Canada
- Department of Biochemistry and Microbiology, University of Victoria, Petch Building Room 207, 3800 Finnerty Rd., Victoria, BC, V8P 5C2, Canada
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Yarnell E. Preliminary Case Series of Artemisinin for Prostate Cancer in a Naturopathic Practice. ACTA ACUST UNITED AC 2015; 4:24-32. [PMID: 31157126 DOI: 10.14200/jrm.2015.4.0103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Objective To determine if oral artemisinin is safe and has a short-term effect on prostate specific antigen (PSA) kinetics in patients with prostate cancer (CaP). Design Retrospective case series. Setting A private naturopathic urology clinic in Seattle, WA. Patients All artemisinin-treated CaP patients were identified retrospectively between 2005 and 2008. A total of 15 patients were identified who had taken artemisinin and included in the study, comprising 5 patients who had previously undergone radical prostatectomy (RP) and were having biochemical recurrences as well as 10 patients with no prior conventional therapy for CaP. Interventions High-dose, pulsed oral artemisinin 300-400 mg three times a day every other week for 3-24 months (median 9.5 months, IQR 5-12 months). All patients were treated with an array of other naturopathic therapies. Outcome measures The primary outcomes were the PSA doubling time and velocity; secondary outcome measures were signs and symptoms of metastasis and survival. Results Of those patients who have previously undergone RP, 2/5 (40%) had improved PSA kinetics after artemisinin therapy. Of those with no prior RP, 5/10 (50%) had improved PSA kinetics. No patient developed signs of metastasis and no patients died. There were no reported adverse effects. Conclusions This pilot study provides preliminary evidence to suggest that high-dose, pulsed oral artemisinin therapy may have activity in patients with CaP. A larger controlled trial is warranted to confirm these preliminary beneficial effects.
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Affiliation(s)
- Eric Yarnell
- Department of Botanical Medicine, Bastyr University, 14500 Juanita Dr NE, Kenmore, WA 98028, USA; Chief Medical Officer, Northwest Naturopathic Urology, 3670 Stone Wy N, Seattle, WA 98103, USA. Tel.: +1 206-834-4100
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Saar M, Körbel C, Linxweiler J, Jung V, Kamradt J, Hasenfus A, Stöckle M, Unteregger G, Menger MD. Orthotopic tumorgrafts in nude mice: A new method to study human prostate cancer. Prostate 2015; 75:1526-37. [PMID: 26074274 DOI: 10.1002/pros.23027] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 05/05/2015] [Indexed: 01/12/2023]
Abstract
BACKGROUND In vivo model systems in prostate cancer research that authentically reproduce tumor growth are still sparse. While orthotopic implantation is technically difficult, particularly in the mouse, most models favor subcutaneous tumor growth. This however provides little information about natural tumor growth behavior and tumor stroma interaction. Furthermore, established prostate cancer cell lines grown as in vivo xenografts are not able to reflect the variety of tumor specific growth patterns and growth behavior in men. Primary cell cultures are difficult to handle and an induction of orthotopic tumors has not been successful yet. Therefore, a tumorgraft model using tumor tissue from prostatectomy specimens was developed. METHODS Balb/c nude mice were used to graft fresh prostate tumor tissue by renal subcapsular and orthotopic implantation. Testosterone propionate was supplemented. Animals were tracked by means of 30 MHz ultrasound to monitor tumor engraftment and growth. Autopsy, histology, PSA measurements as well as immunostaining and PCR for human tissue were performed to confirm orthotopic tumor growth. RESULTS Renal subcapsular engraftment was seen in 2 of 3 mice. Orthotopic engraftment was observed in 7 of 11 animals (63.6%) with an overall engraftment of 5 out of 9 patient specimens (55.6%). Ultrasound confirmed the tumor growth over time. Of interest, the tumorgrafts not only retained essential features of the parental tumors, but also stained positive for tumor specific markers such as AR, PSA, and AMACR. Tumor positive animals showed highly elevated serum PSA levels with confirmation of a human specific PCR sequence and a human endothelial cell lining in the tumor vessels. CONCLUSIONS Standardized implantation of fresh tumor tissue in nude mice prostates generates tumorgrafts with histological properties of organ-confined prostate cancer. These tumorgrafts display a new approach for an optimized in vivo model of prostate cancer and will allow further investigations on specific pathways of tumor initiation and progression as well as therapeutic response.
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Affiliation(s)
- Matthias Saar
- Department of Urology and Pediatric Urology, Saarland University, Homburg/Saar, Germany
| | - Christina Körbel
- Institute for Clinical and Experimental Surgery, Saarland University, Homburg/Saar, Germany
| | - Johannes Linxweiler
- Department of Urology and Pediatric Urology, Saarland University, Homburg/Saar, Germany
| | - Volker Jung
- Department of Urology and Pediatric Urology, Saarland University, Homburg/Saar, Germany
| | - Jörn Kamradt
- Department of Urology and Pediatric Urology, Saarland University, Homburg/Saar, Germany
| | - Andrea Hasenfus
- Institute of Pathology, Saarland University, Homburg/Saar, Germany
| | - Michael Stöckle
- Department of Urology and Pediatric Urology, Saarland University, Homburg/Saar, Germany
| | - Gerhard Unteregger
- Department of Urology and Pediatric Urology, Saarland University, Homburg/Saar, Germany
| | - Michael D Menger
- Institute for Clinical and Experimental Surgery, Saarland University, Homburg/Saar, Germany
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Development and prospective multicenter evaluation of the long noncoding RNA MALAT-1 as a diagnostic urinary biomarker for prostate cancer. Oncotarget 2015; 5:11091-102. [PMID: 25526029 PMCID: PMC4294360 DOI: 10.18632/oncotarget.2691] [Citation(s) in RCA: 141] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Accepted: 11/04/2014] [Indexed: 02/05/2023] Open
Abstract
The current strategy for diagnosing prostate cancer (PCa) is mainly based on the serum prostate-specific antigen (PSA) test. However, PSA has low specificity and has led to numerous unnecessary biopsies. We evaluated the effectiveness of urinary metastasis-associated lung adenocarcinoma transcript 1 (MALAT-1), a long noncoding RNA, for predicting the risk of PCa before biopsy. The MALAT-1 score was tested in a discovery phase and a multi-center validation phase. The predictive power of the MALAT-1 score was evaluated by the area under receiver operating characteristic (ROC) curve (AUC) and by decision curve analysis. As an independent predictor of PCa, the MALAT-1 score was significantly higher in men with a positive biopsy than in those with a negative biopsy. The ROC analysis showed a higher AUC for the MALAT-1 score (0.670 and 0.742) vs. the total PSA (0.545 and 0.601) and percent free PSA (0.622 and 0.627) in patients with PSA values of 4.0-10 ng/ml. According to the decision curve analysis, using a probability threshold of 25%, the MALAT-1 model would prevent 30.2%-46.5% of unnecessary biopsies in PSA 4–10 ng/ml cohorts, without missing any high-grade cancers. Our results demonstrate that urine MALAT-1 is a promising biomarker for predicting prostate cancer risk.
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