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Xu S, Liu X, Zhang X, Ji H, Wang R, Cui H, Ma J, Nian Y, Wu Y, Cao X. Prostate zones and tumor morphological parameters on magnetic resonance imaging for predicting the tumor-stage diagnosis of prostate cancer. Diagn Interv Radiol 2023; 29:753-760. [PMID: 37787046 PMCID: PMC10679559 DOI: 10.4274/dir.2023.232284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/23/2023] [Indexed: 10/04/2023]
Abstract
PURPOSE To determine whether the morphological parameters of prostate zones and tumors on magnetic resonance imaging (MRI) can predict the tumor-stage (T-stage) of prostate cancer (PCa) and establish an optimal T-stage diagnosis protocol based on three-dimensional reconstruction and quantization after image segmentation. METHODS A dataset of the prostate MRI scans and clinical data of 175 patients who underwent biopsy and had pathologically proven PCa from January 2018 to November 2020 was retrospectively analyzed. The authors manually segmented and measured the volume, major axis, and cross-sectional area of the peripheral zone (PZ), transition zone, central zone (CZ), anterior fibromuscular stroma, and tumor. The differences were evaluated by the One-Way analysis of variance, Pearson's chi-squared test, or independent samples t-test. Spearman's correlation coefficient and receiver operating characteristic curve analyses were also performed. The cut-off values of the T-stage diagnosis were generated using Youden's J index. RESULTS The prostate volume (PV), PZ volume (PZV), CZ volume, tumor's major axis (TA), tumor volume (TV), and volume ratio of the TV and PV were significantly different among stages T1 to T4. The cut-off values of the PV, PZV, CZV, TA, TV, and the ratio of TV/PV for the discrimination of the T1 and T2 stages were 53.63 cm3, 11.60 cm3, 1.97 cm3, 2.30 mm, 0.90 cm3, and 0.03 [area under the curves (AUCs): 0.628, 0.658, 0.610, 0.689, 0.724, and 0.764], respectively. The cut-off values of the TA, TV, and the ratio of TV/PV for the discrimination of the T2 and T3 stages were 2.80 mm, 8.29 cm3, and 0.12 (AUCs: 0.769, 0.702, and 0.688), respectively. The cut-off values of the TA, TV, and the ratio of TV/PV for the discrimination of the T3 and T4 stages were 4.17 mm, 18.71 cm3, and 0.22 (AUCs: 0.674, 0.709, and 0.729), respectively. CONCLUSION The morphological parameters of the prostate zones and tumors on the MRIs are simple and valuable diagnostic factors for predicting the T-stage of patients with PCa, which can help make accurate diagnoses and lateral treatment decisions.
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Affiliation(s)
- Shanshan Xu
- Department of Digital Medicine, College of Biomedical Engineering and Medical Imaging, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Histology and Embryology, Shanxi Medical University, Taiyuan, China
- Yu-Yue Pathology Research Center, Jinfeng Laboratory, Chongqing 401329, People’s Republic China
| | - Xiaobing Liu
- Department of Digital Medicine, College of Biomedical Engineering and Medical Imaging, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Urology, Xinqiao Hospital of Army Medical University, Chongqing, China
| | - Xiaoqin Zhang
- Department of Digital Medicine, College of Biomedical Engineering and Medical Imaging, Army Medical University (Third Military Medical University), Chongqing, China
| | - Huihui Ji
- Department of Histology and Embryology, Shanxi Medical University, Taiyuan, China
| | - Runyuan Wang
- Department of Digital Medicine, College of Biomedical Engineering and Medical Imaging, Army Medical University (Third Military Medical University), Chongqing, China
- Department of Histology and Embryology, Shanxi Medical University, Taiyuan, China
| | - Huilin Cui
- Department of Histology and Embryology, Shanxi Medical University, Taiyuan, China
| | - Jinfeng Ma
- Department of General Surgery, Shanxi Province Cancer Hospital of Shanxi Medical University, Taiyuan, China
| | - Yongjian Nian
- Department of Digital Medicine, College of Biomedical Engineering and Medical Imaging, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yi Wu
- Department of Digital Medicine, College of Biomedical Engineering and Medical Imaging, Army Medical University (Third Military Medical University), Chongqing, China
- Yu-Yue Pathology Research Center, Jinfeng Laboratory, Chongqing 401329, People’s Republic China
| | - Ximei Cao
- Department of Histology and Embryology, Shanxi Medical University, Taiyuan, China
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Alves EF, de Freitas Ribeiro BLM, Costa WS, Gallo CBM, Sampaio FJB. Histological and quantitative analyzes of the stromal and acinar components of normal human prostate zones. Prostate 2018; 78:289-293. [PMID: 29315701 DOI: 10.1002/pros.23472] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 12/04/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND McNeal divided the human prostate into three major anatomical areas: the peripheral zone (PZ), the central zone (CZ), and the transition zone (TZ). Each of these areas is biologically and histologically distinct. The PZ and TZ have clinical significance and are associated with prostate cancer (PC) and benign prostatic hyperplasia (BPH), respectively. Therefore, the objective of the present study was to quantitatively and qualitatively analyze the parenchymal and stromal components that constitute the different prostate zones. METHODS We assessed 19 samples from each prostate zone. The samples were obtained from necropsies of young people between 18 and 32 years of age with intact urogenital tracts. The samples were fixed in 4% buffered formalin and processed for paraffin embedding. Sections with a thickness of five micrometres were obtained from each sample. The sections were stained using histochemical and immunohistochemical techniques to identify the acinar and stromal components of each zone. Photomicrographs were obtained for morphometric analysis using an algorithm based on color segmentation. Data were analyzed using one-way analysis of variance (ANOVA) with the Bonferroni post-test. Differences with P < 0.05 were regarded as statistically significant. RESULTS Collagen fibres were more numerous in the TZ (+40.26%; P = 0.0230) than in the PZ. Muscle fibres were also more numerous in the TZ (+47.05%; P = 0.0120) than in the PZ. Elastic system fibres in the TZ significantly differed from those in the PZ (+84.61%; P = 0.0012) and the CZ (+61.66%; P = 0.0074). Similarly, nerves in the PZ (-42.86%; P = 0.0107) significantly differed from nerves in the CZ. Epithelial height was lower in the TZ than in the PZ (-30.17%; P = 0.0034) and the CZ (-25.01%; P = 0.0330). CONCLUSION Our objective, quantitative data regarding the various elements that constitute the normal prostate stroma allowed us to reveal differences among prostate zones. This study established patterns for normal parameters and may be used for posterior comparisons in histopathological analysis.
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Affiliation(s)
- Edilaine F Alves
- Urogenital Research Unit, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Waldemar S Costa
- Urogenital Research Unit, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carla B M Gallo
- Urogenital Research Unit, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Francisco J B Sampaio
- Urogenital Research Unit, State University of Rio de Janeiro, Rio de Janeiro, Brazil
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Al Kadhi O, Traka MH, Melchini A, Troncoso-Rey P, Jurkowski W, Defernez M, Pachori P, Mills RD, Ball RY, Mithen RF. Increased transcriptional and metabolic capacity for lipid metabolism in the peripheral zone of the prostate may underpin its increased susceptibility to cancer. Oncotarget 2017; 8:84902-84916. [PMID: 29156692 PMCID: PMC5689582 DOI: 10.18632/oncotarget.17926] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 05/02/2017] [Indexed: 12/31/2022] Open
Abstract
The human prostate gland comprises three distinct anatomical glandular zones, namely the peripheral, central and transitional zones. Although prostate cancer can arise throughout the prostate, it is more frequent in the peripheral zone. In contrast, hyperplasia occurs most frequently in the transitional zone. In this paper, we test the hypothesis that peripheral and transitional zones have distinct metabolic adaptations that may underlie their different inherent predispositions to cancer and hyperplasia. In order to do this, we undertook RNA sequencing and high-throughput metabolic analyses of non-cancerous tissue from the peripheral and transitional zones of patients undergoing prostatectomy. Integrated analysis of RNAseq and metabolomic data revealed that transcription of genes involved in lipid biosynthesis is higher in the peripheral zone, which was mirrored by an increase in fatty acid metabolites, such as lysolipids. The peripheral zone also exhibited increased fatty acid catabolic activity and contained higher level of neurotransmitters. Such increased capacity for de novo lipogenesis and fatty acid oxidation, which is characteristic of prostate cancer, can potentially provide a permissive growth environment within the peripheral zone for cancer growth and also transmit a metabolic growth advantage to newly emerging clones themselves. This lipo-rich priming may explain the observed susceptibility of the peripheral zone to oncogenesis.
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Affiliation(s)
- Omar Al Kadhi
- Food and Health Programme, Quadram Institute Bioscience, Norwich, UK.,Department of Urology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Maria H Traka
- Food and Health Programme, Quadram Institute Bioscience, Norwich, UK
| | | | | | | | | | - Purnima Pachori
- Platforms and Pipelines Bioinformatics, Earlham Institute, Norwich, UK
| | - Robert D Mills
- Department of Urology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | - Richard Y Ball
- Norfolk and Waveney Cellular Pathology Service, Norfolk and Norwich University Hospital, Norwich, UK
| | - Richard F Mithen
- Food and Health Programme, Quadram Institute Bioscience, Norwich, UK
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