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Association between periodontal disease and prostatic disease:a systematic review and meta-analysis of observational studies
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作者 Qiang Li Lan Wu +5 位作者 Yi Zhang Di Huang Song Ou-Yang Jia-Yu Yang Bing-Hui Li Xian-Tao Zeng 《The Canadian Journal of Urology》 2026年第1期7-20,共14页
Objective:Current research highlights periodontal disease as a systemic inflammatory condition that may influence extra-oral diseases such as prostatic diseases,which prompted us to explore the potential association.T... Objective:Current research highlights periodontal disease as a systemic inflammatory condition that may influence extra-oral diseases such as prostatic diseases,which prompted us to explore the potential association.To evaluate whether periodontal disease is associated with an increased risk of prostatic disease,including prostate cancer,benign prostatic hyperplasia(BPH),and prostatitis.Methods:A systematic search of observational studies concerning the relationship between periodontal disease and prostatic disease was performed in online databases PubMed,Embase,Web of Science,Scopus,CENTRAL,CNKI,and WanFang.Searches were conducted from database inception to 31 July 2025.Pooled hazard ratio(HR)or odds ratio(OR)with 95%confidence intervals(CIs)were synthesized.Subgroup analysis was used to detect the origin of heterogeneity,sensitivity analysis was employed to evaluate the robustness of the results,and publication bias analyses were also performed.R software was used to perform statistical analyses.Results:Sixteen studies that met the preset criteria were included in this study.In the pooled analysis,periodontal disease was associated with increased risk of prostate cancer(HR=1.23,95%CI:1.16-1.29,p<0.001)or BPH(OR=1.55,95%CI:1.41-1.70,p<0.001).Sensitivity analysis confirmed the robustness of the results.No obvious publication biaswas found in the meta-analysis.Only one cohort study reported that chronic periodontitis increases the risk of prostatitis(HR=2.521,95%CI:1.685-4.005,p<0.001).The effect of periodontal treatment on prostatic disease is still unclear.Conclusions:The systematic review and meta-analysis identified an observational association between periodontal disease and increased risks of prostate cancer and BPH.Because all included studies were observational,these results indicate association rather than causation,and further prospective and mechanistic studies are required to clarify temporality and causality. 展开更多
关键词 Periodontal diseases prostatic diseases prostatic neoplasms prostatic hyperplasia systematic review META-ANALYSIS
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Feasibility of water vapor thermal therapy for treating lower urinary tract symptoms in men with localized prostate cancer on active surveillance:a case series
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作者 Mustufa Babar Farooz Babar +2 位作者 Noah Hawks-Ladds Justin Loloi Michael Ciatto 《The Canadian Journal of Urology》 2026年第1期193-199,共7页
Background:Prostate cancer is a common malignancy,with many men on active surveillance for localized,low-risk disease also experiencing lower urinary tract symptoms(LUTS)from benign prostatic hyperplasia(BPH).Water Va... Background:Prostate cancer is a common malignancy,with many men on active surveillance for localized,low-risk disease also experiencing lower urinary tract symptoms(LUTS)from benign prostatic hyperplasia(BPH).Water Vapor Thermal Therapy(WVTT)is a minimally invasive BPH treatment,but its safety and efficacy in this setting are unclear.Case Description:We report three men with localized PCa on active surveillance who underwent WVTT for LUTS.Conclusions:WVTT appears safe and potentially effective in treating LUTS,especially in those with lower-risk disease and smaller prostate volumes.Further research is needed to confirm safety,efficacy,and optimal patient selection. 展开更多
关键词 lower urinary tract symptoms benign prostatic hyperplasia prostatic neoplasms active surveillance case report
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KAI1/CD82 gene expression in benign prostatic hyperplasia and late-stage prostate cancer in Chinese 被引量:6
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作者 Wei-LieHU Ying-QiuLI +4 位作者 Hui-XuHE Qing-RongLI YeTIAN Ri-QuanLAI HuaMEI 《Asian Journal of Andrology》 SCIE CAS CSCD 2000年第3期221-224,共4页
Aim: To evaluate KAII/CD82 expression in Chinese patients with benign prostatic hyperplasia (BPH) and late-stage carcinoma of prostate (CaP). Methods: Thirty Chinese patients with benign prostatic hyperplasia and 34 w... Aim: To evaluate KAII/CD82 expression in Chinese patients with benign prostatic hyperplasia (BPH) and late-stage carcinoma of prostate (CaP). Methods: Thirty Chinese patients with benign prostatic hyperplasia and 34 withCaP (adenocarcinoma clinical stage C and D) were analyzed by means of immunohistochemical methods. Results:The KAII/CD82 expression in BPH tissue was all positive, which was uniformly located on the glandular cell mem-brane at the cell-to-cell borders, but KAII/CD82 expression in metastasis CaP tissues was either significantly lower thanthat of BPH or negative, and the immunostaining pattern was not continuous. In late-stage CAP KAII/CD82 expressionwas correlated inversely to the pathological grade ( P < 0.05), but not to clinical stage ( P > 0.05). Conclusion:The authors believe that decreased and negative KAII/CD82 expression in late-stage CaP may be related to tumor pro-gression and metastasis, and appears to be a prognostic marker. 展开更多
关键词 KAII/CD82 metastasis suppressor gene expression benign prostatic hyperplasia prostatic neoplasms IMMUNOHISTOCHEMISTRY
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Effect of serum testosterone and percent tumor volume on extra-prostatic extension and biochemical recurrence after laparoscopic radical prostatectomy 被引量:3
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作者 Eu Chang Hwang Seong Hyeon Yu +8 位作者 Yang Hyun Jo Seung I1 Jung Taek Won Kang Dong Deuk Kwon Chan Choi Suk Hee Heo Jun Eul Hwang Sung-Hoon Jung Tae-Young Jung 《Asian Journal of Andrology》 SCIE CAS CSCD 2016年第1期54-59,共6页
Several studies have revealed that the preoperative serum testosterone and percent tumor volume (PTV) predict extra-prostatic extension (EPE) and biochemical recurrence (BCR) after radical prostatectomy. This st... Several studies have revealed that the preoperative serum testosterone and percent tumor volume (PTV) predict extra-prostatic extension (EPE) and biochemical recurrence (BCR) after radical prostatectomy. This study investigated the prognostic significance of serum testosterone and PTV in relation to EPE and BCR after laparoscopic radical prostatectomy (LRP). We reviewed 520 patients who underwent LRP between 2004 and 2012. PTV was determined as the sum of all visually estimated tumor foci in every section. BCR was defined as two consecutive increases in the postoperative prostate-specific antigen (PSA) 〉0.2 ng ml^-1. The threshold for serum total testosterone was 3.0 ng ml^-1, Multivariate logistic regression was used to define the effect of variables on the risk of EPE and BCR. A low serum testosterone (〈3.0 ng ml^-1) was associated with a high serum PSA, Gleason score, positive core percentage of the prostate biopsy, PTV, and all pathological variables. On multivariate analysis, similar to previous studies, the serum PSA, biopsy positive core percentage, Gleason score, and pathological variables predicted EPE and BCR. In addition, low serum testosterone (〈3.0 ng ml^-1, adjusted OR, 8.52; 95% CI, 5.04-14.4, P = 0.001) predicted EPE and PTV (adjusted OR, 1.02; 95% CI, 1.01-1.05, P = 0.046) predicted BCR. In addition to previous predictors of EPE and BCR, low serum testosterone and PTV are valuable predictors of EPE and BCR after LRP. 展开更多
关键词 biochemical recurrence extra-prostatic extension prostate neoplasms prostatectomy TESTOSTERONE tumor burden
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Using CT imaging to delineate the prostatic apex for radiation treatment planning 被引量:3
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作者 Xiao-Mei Li Xian-Shu Gao +2 位作者 Xue-Mei Guo Ya-Gang Li Xiao-Ying Wang 《Chinese Journal of Cancer》 SCIE CAS CSCD 北大核心 2010年第11期914-922,共9页
Background and Objective: In computed tomography (CT)-based radiotherapy planning for prostate cancer, it is difficult to precisely delineate the prostatic apex because of its relationship with the urogenital diaphrag... Background and Objective: In computed tomography (CT)-based radiotherapy planning for prostate cancer, it is difficult to precisely delineate the prostatic apex because of its relationship with the urogenital diaphragm and bulbospongiosus musculature. In this retrospective study, we analyzed the magnetic resonance imaging (MRI) and CT scans of the patients with prostate cancer to investigate the relationship between the prostatic apex and the anatomic structure visible on CT, and to provide evidence for localizing the prostatic apex in radiotherapy planning. Methods: MRI and CT scans of 108 patients with prostate cancer were analyzed to measure the distances between the prostatic apex and the bottom of ischial tuberosities, the bottom of obturator foramen, the bottom of pubic symphysis, and the bulb of the penis. The volume of the prostate was measured to analyze its relationship with the localization of the prostatic apex. Results: The prostatic apex was located (13.1 ± 3.3) mm above the bulb of the penis, (11.0 ± 5.4) mm above the bottom of the obturator foramen, (31.3 ± 5.5) mm above the ischial tuberosities, and (7.1 ± 4.7) mm above the bottom of the symphysis pubis. There was no correlation between the size of the prostate and the localization of the prostatic apex. Conclusions: The variance of the distance between the prostatic apex and the bulb of the penis is smaller than that of the distance between the apex and bony anatomy. Delineating the target to 6 mm above the bulb of the penis can cover the prostatic apex in 95% of the patients with prostate cancer, delineating to the bottom of obturator foramen can cover the prostatic apex in 100% of the patients. 展开更多
关键词 前列腺癌 CT检查 放射治疗 断层扫描 肌肉组织 解剖结构 磁共振成像 扫描测量
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Prostatic sarcoma of the Ewing family in a 33-year-old male e A case report and review of the literature 被引量:1
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作者 Lukas Esch Dimitri Barski +1 位作者 Reinhold Bug Thomas Otto 《Asian Journal of Urology》 2016年第2期103-106,共4页
Ewing sarcoma is the second most common primary bone tumor seen in children and adolescents,typically presenting between 10 and 20 years of age.Extraosseous sarcomas of the Ewing family in adults are rare.We report a ... Ewing sarcoma is the second most common primary bone tumor seen in children and adolescents,typically presenting between 10 and 20 years of age.Extraosseous sarcomas of the Ewing family in adults are rare.We report a manifestation of this tumor entity in the periprostatic tissue of a 33-year-old male and discuss our treatment approach.Transrectal biopsy is a feasible and simple diagnostic tool for unclear pelvic masses.Multi-modal therapy and central registries are needed to gain knowledge of rare pelvic tumors like Ewing sarcoma. 展开更多
关键词 Ewing sarcoma Pelvic neoplasms ADULT Surgery CHEMOTHERAPY prostatE
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Undescended epididymo-testicular metastasis from prostatic carcinoma
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作者 Li-Ping Xie Jie Qin Xiang-Yi Zheng Zhao-Dian Chen 《Asian Journal of Andrology》 SCIE CAS CSCD 2006年第2期251-252,共2页
Dear Sir, Metastasis of prostatic carcinoma to testis is un- common in the clinical situation, and the involvement of the epididymis is even rarer. Heidrich et al. [1] found only 80 cases of testicular involvement in... Dear Sir, Metastasis of prostatic carcinoma to testis is un- common in the clinical situation, and the involvement of the epididymis is even rarer. Heidrich et al. [1] found only 80 cases of testicular involvement in prostate cancer in published reports. In 1993, Wiebe et al. [2] found only 14 previous cases of epididymal metastasis from prostatic carcinoma in published work. The simulta- neous involvement of testis and epididymis was reported by Suhler and Blanchard in 1980 [3]. To our knowledge, this was the first documented case of a prostatic carcinoma metastasizing to undescended testis and epididymis. 展开更多
关键词 ADENOCARCINOMA Aged 80 and over CRYPTORCHIDISM Humans MALE prostatic neoplasms Testicular neoplasms
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Analysis on chromosome 8 heterozygosity loss in humanprostate carcinoma and high grade prostaticintraepithelial neoplasia
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作者 Zhao-MingWang FemandMacMouneLai 《Asian Journal of Andrology》 SCIE CAS CSCD 2004年第1期52-52,共1页
Objective: To analysis the chromosome 8 heterozygosity loss in human prostate carcinoma and high grade prostatic intraepithelial neoplasia. Methods: Pure DNA was obtained from prostate neoplasms and normal tissues by ... Objective: To analysis the chromosome 8 heterozygosity loss in human prostate carcinoma and high grade prostatic intraepithelial neoplasia. Methods: Pure DNA was obtained from prostate neoplasms and normal tissues by tissue microdissection. The chromosome 8 heterozygosity loss was detected by PCR based micro-satellite polymorphism analysis technique using 14 pairs of microsatellite primers in 10 samples of prostate carcinoma and 10 samples of high grade prostatic intraepithelial neoplasia. Results: There were different frequencies of chromosome 8 heterozygosity loss in 10 samples of prostate carcinoma. 8p23.1-p23.2 and p21-p22 were two high frequency heterozygosity loss regions. Chromosome 8 heterozygosity loss was detected in 3 samples of high grade prostatic intraepithelial neoplasia. Conclusion: There were high frequency heterozygosity loss regions on chromosome 8 of prostate carcinoma, located at 8p23.1-p23.2 and p21-p22. The high grade prostatic intraepithelial neoplasia and prostate carcinoma share the same allelic loss on 8p. Tumor suppressor genes located at these two regions may be potentially involved in the initiation and progression of prostate carcinoma. 展开更多
关键词 prostate neoplasm heterozygosity loss chromosome 8 tumor suppressor gene
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Expression and Implication of Hypoxia Inducible Factor-1α in Prostate Neoplasm
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作者 平浩 陈晓春 +3 位作者 耿怀振 谷龙杰 陈江 鲁功成 《Journal of Huazhong University of Science and Technology(Medical Sciences)》 SCIE CAS 2004年第6期593-595,共3页
Summary: To study the expression of hypoxia inducible factor-1α (HIF-1α) protein in prostate cancer (Pca) and its biological significance, the expression of HIF-1α was assayed by means of immunohistochemical techni... Summary: To study the expression of hypoxia inducible factor-1α (HIF-1α) protein in prostate cancer (Pca) and its biological significance, the expression of HIF-1α was assayed by means of immunohistochemical technique in 42 prostate cancer, 12 prostatic intraepithelial neoplasm (PIN) and 9 normal prostate tissue (NP) specimens. Western blot was used to examine the expression of HIF-1α in prostate cancer cell line (PC-3M) induced by different oxygen tension. HIF-1α expression was positive in 33 Pca and 9 PIN specimens, and the positive rate of HIF-1α was higher in distant metastasis patients than in patients without metastasis of prostate cancer (P<0.05), while there was no expression of HIF-1α in NP. The level of HIF-1α in PC-3M significantly increased with the decrease of oxygen tension (P<0.01). Overexpression of HIF-1α is the preliminary event of the formation of Pca, which may induce carcinoma into malignant phenotype. Thus it may serve as an early diagnosis marker and the novel target for Pca treatment. 展开更多
关键词 prostatic neoplasms CARCINOMA hypoxia inducible factor-1α
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Erectile function after laparoscopic versus robotic-assisted radical prostatectomy:A systematic review and meta-analysis
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作者 Ana J.Pina Vitor C.Melo +4 位作者 Vinícius W.Carlos Luca S.Tristão Clara L.Santos Wanderley M.Bernardo Aguinaldo C.Nardi 《Asian Journal of Urology》 2025年第3期281-289,共9页
Objective:Prostate cancer is a common malignancy in men over 50 years old,and radical prostatectomy,particularly via laparoscopic and robotic-assisted techniques,significantly impacts quality of life,especially in ter... Objective:Prostate cancer is a common malignancy in men over 50 years old,and radical prostatectomy,particularly via laparoscopic and robotic-assisted techniques,significantly impacts quality of life,especially in terms of erectile dysfunction.This systematic review and meta-analysis aimed to evaluate the preservation of erectile function following robotic-assisted and laparoscopic radical prostatectomy,with a separate analysis of randomized clinical trials and non-randomized studies.Methods:This review was carried out using randomized and non-randomized studies involving adult patients diagnosed with localized prostate cancer undergoing radical prostatectomy,according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines and registered in PROSPERO.Applicable literature from PubMed,Cochrane,Embase,and the Latin American and Caribbean Health Sciences Literature database was analysed.The bias in randomized clinical trials was assessed using the Cochrane Risk of Bias 2.0 tool,and observational studies were evaluated via the Newcastle-Ottawa Scale.The statistical analysis was performed using Review Manager version 5.4.Results:Our analysis included 13 studies involving 6281 patients.Comparative meta-analysis of non-randomized studies demonstrated that robotic techniques were significantly more effective in preserving erectile function at 3 months(risk difference[RD]0.05,95%confidence interval[CI]0.00-0.11;p=0.040),6 months(RD 0.10,95%CI 0.03-0.17;p=0.006),and 12 months postoperatively(RD 0.06,95%CI 0.02-0.10;p=0.002).Conclusion:Robotic-assisted surgery showed greater preservation of erectile function 3 months,6 months,and 12 months after radical prostatectomy.However,additional studies with meticulous methodological criteria are necessary for future analysis. 展开更多
关键词 prostatic neoplasm Robotic-assisted surgical procedure Minimally invasive surgical procedure Laparoscopic surgical procedure Erectile dysfunction
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基于随机森林模型的前列腺特异性抗原灰区前列腺癌诊断研究
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作者 丁佳锋 王晨 +6 位作者 顾腾飞 潘永涛 谢丽丹 李颖 毛卫波 陈挺 李杰 《肿瘤学杂志》 2026年第2期150-155,共6页
[目的]应用随机森林(Random Forest,RF)算法,为前列腺特异性抗原(prostate-specific antigen,PSA)水平处于4~10 ng/mL(PSA灰区)的人群构建前列腺癌诊断模型,以提升前列腺癌诊断准确性并减少不必要的穿刺活检。[方法]回顾性收集520例患... [目的]应用随机森林(Random Forest,RF)算法,为前列腺特异性抗原(prostate-specific antigen,PSA)水平处于4~10 ng/mL(PSA灰区)的人群构建前列腺癌诊断模型,以提升前列腺癌诊断准确性并减少不必要的穿刺活检。[方法]回顾性收集520例患者的临床数据,按3∶1划分为训练集和测试集。通过网格搜索结合5折交叉验证优化超参数,并利用受试者工作特征(receiver operating characteristic,ROC)曲线、精确率-召回率(precision-recall,PR)曲线及准确率评价模型性能,同时进行变量重要性分析。[结果]PSA灰区患者中前列腺癌检出率为36.3%(189/520)。最优超参数组合为:每次分裂随机选择2个变量、50棵决策树及节点最小样本数20。在此条件下,模型平均表现为ROC曲线下面积为0.819,PR曲线下面积为0.860,准确率为0.769。RF模型在训练集和测试集上的ROC曲线下面积分别为0.93和0.80,袋外误差率为24.94%。变量重要性分析显示,前列腺体积和PSA密度(PSA density,PSAD)是最主要的影响因素。[结论]RF模型在PSA灰区患者中具备较高的分类性能和临床应用价值,其中前列腺体积和PSAD是关键诊断指标,可为前列腺癌的临床决策提供有力参考。 展开更多
关键词 前列腺肿瘤 前列腺特异性抗原 灰区 随机森林算法 前列腺穿刺
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超声联合MRI成像技术对高危前列腺癌的预测价值
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作者 严佳 季玲 +3 位作者 王小乐 崔永芬 顾峰 葛建钢 《中国临床医学影像杂志》 北大核心 2026年第1期34-38,共5页
目的:探讨超声联合多模态MRI成像技术对高危前列腺癌(PCa)中的预测价值。方法:回顾分析2019年12月—2024年6月我院收治的193例PCa患者临床资料。依据Gleason评分进行分级,将Gleason评分≤3+4分者纳入低危组(n=121),将病理学Gleason评分&... 目的:探讨超声联合多模态MRI成像技术对高危前列腺癌(PCa)中的预测价值。方法:回顾分析2019年12月—2024年6月我院收治的193例PCa患者临床资料。依据Gleason评分进行分级,将Gleason评分≤3+4分者纳入低危组(n=121),将病理学Gleason评分>4+3分者纳入高危组(n=72)。所有患者均接受经直肠超声、多模态MRI成像检查,采用单因素分析与Gleason评分有关的有效指标,然后应用Logistic回归进行多因素分析,获得高危PCa的独立危险因素及预测模型,并应用ROC曲线对比各独立危险因素与预测模型对高危PCa的诊断效能,同时分析各独立危险因素与Gleason评分的相关性。结果:经Spearman相关性分析,血清前列腺特异性抗原(t PSA)、前列腺体积(PV)、前列腺内腺特异抗原密度(IGPSAD)、前列腺特异抗原密度(PSAD)、前列腺外腺特异抗原密度(EGPSAD)、二维超声(2D-US)评分、最大强化程度(SI_(max))及最快强化率(R_(max))均与Gleason评分呈正相关,ADC值、达峰时间(T_(max))均与Gleason评分呈负相关(P<0.05)。单因素及Logistic回归分析结果 显示高PV、高2D-US评分、低ADC值、高SI_(max)、低T_(max)及高R_(max)是高危PCa的独立危险因素(P<0.05)。经ROC曲线分析,PV、2D-US评分、ADC值、SI_(max)、T_(max)及R_(max)对高危PCa的AUC分别为0.630、0.752、0.775、0.667、0.792、0.667,均低于预测模型的AUC为0.921(P<0.05)。结论:超声、多模态MRI参数是高危PCa的独立危险因素,其构建的预测模型对高危PCa有较好的诊断效能,在PCa病情评估中有一定的临床应用价值。 展开更多
关键词 前列腺肿瘤 超声检查 多普勒 彩色 磁共振成像
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免疫细胞与泌尿系统恶性肿瘤之间的因果关系:双向孟德尔随机化研究
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作者 张吉鲤 陈泽伟 +2 位作者 苏星星 郝智彬 年新文 《海军军医大学学报》 北大核心 2026年第2期194-202,共9页
目的采用孟德尔随机化(MR)和反向MR探讨731种免疫细胞表型与前列腺癌、膀胱癌和肾癌之间的潜在因果关系。方法从全基因组关联研究数据库提取免疫细胞、前列腺癌、膀胱癌和肾癌的汇总统计数据,采用两样本MR分析评估731种免疫细胞表型与... 目的采用孟德尔随机化(MR)和反向MR探讨731种免疫细胞表型与前列腺癌、膀胱癌和肾癌之间的潜在因果关系。方法从全基因组关联研究数据库提取免疫细胞、前列腺癌、膀胱癌和肾癌的汇总统计数据,采用两样本MR分析评估731种免疫细胞表型与前列腺癌、膀胱癌和肾癌之间的因果关系。主要分析采用逆方差加权(IVW)法,并采用错误发现率(FDR)法对IVW法的P值进行多重校正;利用敏感性分析评估主要结果的稳健性。最后,通过反向MR分析以探索反向因果关系。结果IVW法表明46种免疫细胞表型与前列腺癌相关(23个保护性特征和23个危险性特征),34种免疫细胞表型与肾癌相关(17个保护性特征和17个危险性特征),38种免疫细胞表型与膀胱癌相关(18个保护性特征和20个危险性特征)。通过FDR法多重校正后,4种免疫细胞表型[IgD^(+)CD24^(+)B细胞水平、CD24^(+)CD27^(+)淋巴细胞水平、人类白细胞抗原(HLA)DR^(+)T细胞绝对细胞计数水平和CD16^(-)CD56^(+)自然杀伤细胞水平]与前列腺癌风险有关,4种免疫细胞表型(IgD^(+)CD38^(-)淋巴细胞水平、CD127^(-)CD8^(bright) T细胞绝对细胞计数水平、CD11c^(+)髓样树突状细胞水平和HLA DR^(+)B细胞水平)与肾癌风险有关(均FDR<0.3)。反向MR分析在前列腺癌和肾癌与上述免疫细胞之间未发现阳性结果。结论免疫细胞与前列腺癌和肾癌之间有潜在因果关系。这可能为探索泌尿系统恶性肿瘤的早期筛查策略和生物学机制提供新的方向,对开发更有效的免疫疗法至关重要。 展开更多
关键词 孟德尔随机化 免疫细胞 泌尿系肿瘤 前列腺肿瘤 膀胱肿瘤 肾肿瘤
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局限期前列腺癌盆腔淋巴结预防性照射的价值探讨
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作者 谭黎 徐勇刚 《中华放射肿瘤学杂志》 北大核心 2026年第2期178-183,共6页
前列腺癌是老年男性常见的恶性肿瘤,放射治疗是其重要的根治手段。对于已出现盆腔淋巴结转移的前列腺癌患者,推荐进行盆腔淋巴结区域照射;而对于盆腔淋巴结阴性的患者,是否应进行盆腔淋巴结预防性照射尚无定论。现有的几项随机研究(如GE... 前列腺癌是老年男性常见的恶性肿瘤,放射治疗是其重要的根治手段。对于已出现盆腔淋巴结转移的前列腺癌患者,推荐进行盆腔淋巴结区域照射;而对于盆腔淋巴结阴性的患者,是否应进行盆腔淋巴结预防性照射尚无定论。现有的几项随机研究(如GETUG-01、RTOG-9413、POP-RT和EORTC 22863)在纳入人群、治疗方法和随访时间等方面存在明显差异,结论方面也各有侧重,未能形成具有强参考价值的一致性结论。因此,本文综述了根治性放疗和术后放疗中盆腔淋巴结预防性照射的相关研究,并对其进行了比较,希望进一步讨论盆腔预防性照射在盆腔淋巴结阴性患者中的作用和适用的人群,帮助临床做出决策。同时,随着磁共振淋巴造影、前列腺特异性膜抗原(PSMA)正电子发射计算机断层扫描(PET-CT)等新型检查技术在临床中应用,这些兼具高特异性和高灵敏度的影像学方法更准确地筛选出了盆腔淋巴结阴性患者,进而显著改变临床研究的结果,如POP-RT研究的阳性结论就可能与PSMA PET-CT的应用密切相关。鉴于此,本文对常用影像技术在该领域的应用情况进行了汇总,旨在为放疗医生提供有益参考。 展开更多
关键词 前列腺肿瘤 盆腔淋巴结 预防性照射
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大语言模型在诊断临床显著性前列腺癌中的应用
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作者 邱磊 倪乾洋 +6 位作者 李子昂 林秀石 赵震坤 伍佳龙 李思捷 王宏胤 卢剑 《中华外科杂志》 北大核心 2026年第2期182-190,共9页
目的探讨大语言模型(LLM)诊断临床显著性前列腺癌(csPCa)的效能,以及开源LLM通过低秩适应(LoRA)微调后在诊断csPCa效能上的改进。方法本研究为回顾性病例系列研究。收集2018年1月至2024年12月于北京大学第三医院泌尿外科行超声引导下系... 目的探讨大语言模型(LLM)诊断临床显著性前列腺癌(csPCa)的效能,以及开源LLM通过低秩适应(LoRA)微调后在诊断csPCa效能上的改进。方法本研究为回顾性病例系列研究。收集2018年1月至2024年12月于北京大学第三医院泌尿外科行超声引导下系统性前列腺穿刺的1077例患者资料,年龄[M(IQR)]69(13)岁(范围:38~90)。其中灰区患者(前列腺特异性抗原为4~10μg/L)391例。收集资料包括患者的临床特征、前列腺MRI报告与穿刺组织病理学检查结果。使用4种LLM(GPT 4.1、DeepSeek R1、Qwen3-235B-A22B、Qwen3-32B)利用患者信息进行csPCa的诊断,以穿刺组织病理学检查结果为金标准评估LLM的表现。之后将1077例患者数据以8︰2的比例划分为训练集与测试集,对Qwen3-32B进行LoRA微调,微调后的模型命名为PCD-Qwen3,评估其在测试集中的诊断效能。绘制受试者工作特征(ROC)曲线并计算曲线下面积(AUC)及95%CI,以评估LLM的诊断效能,采用Delong检验比较组间AUC的差异。结果在全体患者中,DeepSeek R1诊断csPCa的AUC最高,为0.848(95%CI:0.826~0.871),与Qwen3-235B-A22B[0.827(95%CI:0.803~0.851)]、Qwen3-32B[0.753(95%CI:0.724~0.781)]的差异均有统计学意义(Z=2.34,P=0.020;Z=7.35,P<0.01),但与GPT 4.1[0.842(95%CI:0.819~0.865)]无差异(P>0.05)。DeepSeek R1诊断csPCa的准确率、灵敏度、特异度分别为77.3%、70.2%、84.1%。在总前列腺特异性抗原为4~10μg/L的灰区患者中,DeepSeek R1诊断csPCa的AUC为0.765(95%CI:0.715~0.816),利用DeepSeek R1对灰区患者进行诊断可避免46.3%(181/391)的患者接受不必要穿刺,但有5.9%(23/391)的csPCa患者被漏诊。除Qwen3-32B外,3种LLM评估的PI-RADS评分与影像科医师达到中等一致性。经LoRA微调后,PCD-Qwen3的诊断性能较Qwen3-32B显著提高,在216例患者的测试集中准确率、灵敏度、特异度、AUC分别为77.3%、75.5%、79.1%、0.831(95%CI:0.776~0.885),与DeepSeek R1表现相当(P值均>0.05)。结论4种LLM中,DeepSeek R1诊断csPCa的效能最高。在进行LoRA微调后,PCD-Qwen3可达到与DeepSeek R1相当的表现。LLM在诊断csPCa方面展现出良好的应用价值。 展开更多
关键词 前列腺肿瘤 诊断 临床显著性前列腺癌 大语言模型
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血清基线碱性磷酸酶水平对阿比特龙治疗转移性去势抵抗性前列腺癌患者预后的影响
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作者 刘田 姚榆 +1 位作者 孙立江 张桂铭 《精准医学杂志》 2026年第1期62-67,共6页
目的探讨血清基线碱性磷酸酶(ALP)水平与接受阿比特龙治疗的转移性去势抵抗性前列腺癌(mCRPC)患者预后的相关性。方法回顾性分析55例接受阿比特龙治疗的mCRPC患者的临床病理资料,所有患者均检测血清基线ALP水平,按照其正常值(125 U/L)... 目的探讨血清基线碱性磷酸酶(ALP)水平与接受阿比特龙治疗的转移性去势抵抗性前列腺癌(mCRPC)患者预后的相关性。方法回顾性分析55例接受阿比特龙治疗的mCRPC患者的临床病理资料,所有患者均检测血清基线ALP水平,按照其正常值(125 U/L)分为高ALP组和正常ALP组。通过Log-rank检验分析两组间临床病理特征的差异并绘制Kaplan-Meier生存分析曲线。通过Cox回归分析研究基线ALP水平与患者总生存期(OS)、前列腺特异性抗原无进展生存期(PSA-PFS)的相关性。结果两组患者的一般资料(年龄、化疗人数、ECOG评分、ADT方式、Gleason评分、转移部位、血清初始PSA水平、血中性粒细胞计数、血清白蛋白水平和血清乳酸脱氢酶水平)无明显差异(P>0.05)。Kaplan-Meier生存分析结果显示,高ALP组患者OS和PSA-PFS均较正常ALP组更短(χ^(2)=8.91、7.44,P<0.05)。单因素和多因素Cox回归分析结果显示,较高的中性粒细胞计数和血清基线ALP水平与mCRPC患者较短的OS相关(HR=21.71、2.83,P<0.05);既往化疗史和较高的血清基线ALP水平与mCRPC患者较短的PSA-PFS相关(HR=3.11、0.38,P<0.05)。结论ALP可能是评估阿比特龙治疗的mCRPC患者预后的重要指标,血清基线ALP水平较低的患者预后更好。 展开更多
关键词 前列腺肿瘤 去势难治性 醋酸阿比特龙 碱性磷酸酶 预后
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术前系统免疫炎症指数及血浆纤维蛋白原与白蛋白比值对前列腺癌病人骨转移预测价值
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作者 何浩 周睿 +2 位作者 吴奔 汪群锋 鲍彤 《蚌埠医科大学学报》 2026年第1期54-57,共4页
目的:研究术前外周血中系统免疫炎症指数(SII)联合血浆纤维蛋白原/白蛋白比值(FAR)与前列腺癌病人骨转移的相关性。方法:回顾性分析118例初诊前列腺癌病人的临床资料,其中有骨转移组40例,无骨转移组78例。结果:有骨转移的病人SII与FAR... 目的:研究术前外周血中系统免疫炎症指数(SII)联合血浆纤维蛋白原/白蛋白比值(FAR)与前列腺癌病人骨转移的相关性。方法:回顾性分析118例初诊前列腺癌病人的临床资料,其中有骨转移组40例,无骨转移组78例。结果:有骨转移的病人SII与FAR值均高于无骨转移病人(P<0.01)。多因素logistic回归分析,SII与FAR(标准化)每增加一个单位时,转移的概率分别是无转移的1.003倍和6.604倍。SII诊断前列腺癌骨转移的ROC曲线下面积(AUC)为0.799(95%CI:0.713~0.885),最佳截断值为406.917,敏感性为87.5%,特异性为67.9%,约登指数为0.554。FAR诊断前列腺癌骨转移的AUC为0.853(95%CI:0.769~0.937),最佳截断值为0.101,敏感性为67.5%,特异性为98.7%,约登指数为0.662。SII联合FAR预测前列腺癌骨转移的AUC为0.873(95%CI:0.796~0.950),最佳截断值为0.558,敏感性为70.0%,特异性为98.7%,约登指数为0.687。结论:SII、FAR数值与初诊前列腺癌且已发生骨转移灶具有相关性,SII与FAR联合检测初诊前列腺癌病人骨转移相关性的效能高于两者指标的单独检测,更有利于初诊前列腺癌病人骨转移风险预测。 展开更多
关键词 前列腺肿瘤 系统免疫炎症指数 血浆纤维蛋白原与白蛋白比值 骨转移
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生物标志物对前列腺特异性抗原灰区前列腺癌早期诊断价值的研究进展
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作者 王庆 肖跃海 孙发 《安徽医药》 2026年第3期461-465,共5页
前列腺癌是老年男性常见的恶性肿瘤之一,发病率逐渐增加。早期诊断和治疗对延长生存期、降低病死率以及提高老年病人的生活质量意义重大。目前前列腺癌的诊断主要依靠血清前列腺特异性抗原(PSA)筛查及前列腺穿刺活检确诊。近年来,有许... 前列腺癌是老年男性常见的恶性肿瘤之一,发病率逐渐增加。早期诊断和治疗对延长生存期、降低病死率以及提高老年病人的生活质量意义重大。目前前列腺癌的诊断主要依靠血清前列腺特异性抗原(PSA)筛查及前列腺穿刺活检确诊。近年来,有许多新型诊断方法对早期前列腺癌的诊断有重要参考价值,尤其是对PSA灰区前列腺癌的诊断意义重大,可避免不必要的前列腺穿刺活检和过度治疗,但其有效性及实用性还需大量的研究进一步验证。该文就生物标志物对PSA灰区前列腺癌的早期诊断价值作一综述,以期为临床研究提供参考依据。 展开更多
关键词 前列腺肿瘤 诊断 前列腺特异性抗原 前列腺特异性抗原灰区 生物标志物
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重离子治疗临床难治性恶性肿瘤的现状与展望
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作者 俞丹清 NITTA YUKI 朱骥 《肿瘤学杂志》 2026年第2期87-92,共6页
全文系统评述重离子治疗在胰腺癌等多种实体瘤中的临床应用现状,深入剖析其克服肿瘤乏氧微环境、诱导免疫原性细胞死亡的分子机制,并展望联合免疫治疗、多离子精准治疗及人工智能自适应放疗等前沿技术。尽管面临设施稀缺、成本高昂等挑... 全文系统评述重离子治疗在胰腺癌等多种实体瘤中的临床应用现状,深入剖析其克服肿瘤乏氧微环境、诱导免疫原性细胞死亡的分子机制,并展望联合免疫治疗、多离子精准治疗及人工智能自适应放疗等前沿技术。尽管面临设施稀缺、成本高昂等挑战,重离子治疗正从突破性技术向多种难治性肿瘤的基石治疗方案演进,为全球癌症患者带来生存改善新希望。 展开更多
关键词 放射疗法 重离子治疗 碳离子 胰腺肿瘤 前列腺肿瘤
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分段读出扩散加权成像序列超高b值对鉴别前列腺癌与增生的价值
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作者 苏业明 景月月 +4 位作者 孟欣欣 贾永军 于楠 马光明 杨创勃 《分子影像学杂志》 2026年第2期238-243,共6页
目的评估分段读出扩散加权成像序列(RS-EPI)超高b值在鉴别前列腺癌(PCa)与前列腺增生(BPH)中的价值。方法回顾性收集2022年3月~2023年4月在陕西中医药大学附属医院确诊的37例前列腺疾病患者,其中PCa患者15例,BPH患者22例。术前使用Sieme... 目的评估分段读出扩散加权成像序列(RS-EPI)超高b值在鉴别前列腺癌(PCa)与前列腺增生(BPH)中的价值。方法回顾性收集2022年3月~2023年4月在陕西中医药大学附属医院确诊的37例前列腺疾病患者,其中PCa患者15例,BPH患者22例。术前使用Siemens Skyra 3.0 T MRI行RS-EPI DWI扫描(b=0、1000、2000、3000 s/mm^(2)),由2位影像科医生在双盲法下观察各b值图像,测量DWI高信号区和邻近肌肉组织的信号强度,计算出各b值DWI对PCa及BPH的定性诊断准确率。结果b=1000、2000、3000 s/mm^(2)时,DWI诊断前列腺癌和前列腺增生的敏感度及特异度分别为80.0%和63.6%、93.3%和68.2%、93.3%和72.7%,AUC(95%CI)依次为0.852(0.732~0.972)、0.882(0.782~0.982)、0.939(0.872~0.999)。b=1000 s/mm^(2)时,诊断前列腺癌和前列腺增生的敏感度及特异度低于b=2000、3000 s/mm^(2)(P<0.05)。结论选择超高b值(b=2000、3000 s/mm^(2))对PCa和BPH的鉴别有较高的敏感度和特异度,可作为其诊断及鉴别的重要辅助方法。 展开更多
关键词 前列腺肿瘤 前列腺增生 磁共振成像 弥散扩散加权成像 诊断 鉴别
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