This study investigated the impact of metabolic syndrome (MetS) and its components on prostate volume (PV) in the general Chinese population. In total, 43 455 participants in The First Medical Center of the Chinese PL...This study investigated the impact of metabolic syndrome (MetS) and its components on prostate volume (PV) in the general Chinese population. In total, 43 455 participants in The First Medical Center of the Chinese PLA General Hospital (Beijing, China) from January 1, 2012, to December 31, 2022, undergoing health examinations were included in the study. Participants were categorized into four groups according to PV quartiles: Q1 (PV ≤24.94 ml), Q2 (PV >24.94 ml and ≤28.78 ml), Q3 (PV >28.78 ml and ≤34.07 ml), and Q4 (PV >34.07 ml), with Q1 serving as the reference group. Logistic regression analyses were used to examine the association between MetS and PV, with subgroup analyses conducted by age. Among the participants, 18 787 (43.2%) were diagnosed with MetS. In the multivariate analysis model, a significant correlation between MetS and PV was observed, with odds ratios (ORs) increasing as PV increased (Q2, OR = 1.203, 95% confidence interval [CI]: 1.139–1.271;Q3, OR = 1.300, 95% CI: 1.230–1.373;and Q4, OR = 1.556, 95% CI: 1.469–1.648). Analysis of MetS components revealed that all components were positively associated with PV, with abdominal obesity showing the most significant effect. The number of MetS components was identified as a dose-dependent risk factor for elevated PV. The impact of MetS, its components, and component count on PV exhibited a decreasing trend with advancing age. Overall, the influence of MetS, its components, and component count on PV was predominantly observed in the age groups of 40–49 years and 50–59 years. Early intervention targeting MetS can significantly alleviate the increase in PV, particularly benefiting individuals aged 40–59 years who have abdominal obesity.展开更多
Previous investigations have shown that changes in total prostate volume（TPV） are highly variable among aging men,and a considerable proportion of aging men have a stable or decreasing prostate size.Although there i...Previous investigations have shown that changes in total prostate volume（TPV） are highly variable among aging men,and a considerable proportion of aging men have a stable or decreasing prostate size.Although there is an abundance of literature describing prostatic enlargement in association with benign prostatic hyperplasia,less is known about the appropriate age cut-off points for TPV growth rate.In this community-based cohort study,TPV was examined once a year in men who had consecutive health checkup,during a follow-up of 4 years.A total of 5058 men（age 18–92 years old） were included.We applied multiple regression analyses to estimate the correlation between TPV growth rate and age.Overall,3232（63.9%） men had prostate growth,and 1826（36.1%） had a stable or decreased TPV during the study period.The TPV growth rate was correlated negatively with baseline TPV（r= –0.32,P〈0.001）.Among 2620 men with baseline TPV 〈15 cm^3,the TPV growth rate increased with age（β=0.98,95% CI：0.77%–1.18%） only up to 53 years old.Among 2188 men with baseline TPV of 15–33.6 cm3,the TPV growth rate increased with age（β=0.84,95% CI,0.66%–1.01%） only up to 61 years old after adjusting for factors of hypertension,obesity,baseline TPV,diabetes mellitus and dyslipidemia.In this longitudinal study,the TPV growth rate increased negatively with baseline TPV,only extending to a certain age and not beyond.Further research is needed to identify the mechanism underlying such differences in prostate growth.展开更多
Nomograms for predicting the risk of prostate cancer developed using other populations may introduce sizable bias when applied to a Chinese cohort. In the present study, we sought to develop a nomogram for predicting ...Nomograms for predicting the risk of prostate cancer developed using other populations may introduce sizable bias when applied to a Chinese cohort. In the present study, we sought to develop a nomogram for predicting the probability of a positive initial prostate biopsy in a Chinese population. A total of 535 Chinese men who underwent a prostatic biopsy for the detection of prostate cancer in the past decade with complete biopsy data were included. Stepwise logistic regression was used to determine the independent predictors of a positive initial biopsy. Age, prostate-specific antigen （PSA）, prostate volume （PV）, digital rectal examination （DRE） status, % free PSA and transrectal ultrasound （TRUS） findings were included in the analysis. A nomogram model was developed that was based on these independent predictors to calculate the probability of a positive initial prostate biopsy. A receiver-operating characteristic curve was used to assess the accuracy of using the nomogram and PSA levels alone for predicting positive prostate biopsy. The rate for positive initial prostate biopsy was 41.7% （223/535）. The independent variables used to predict a positive initial prostate biopsy were age, PSA, PV and DRE status. The areas under the receiver-operating characteristic curve for a positive initial prostate biopsy for PSA alone and the nomogram were 79.7% and 84.8%, respectively. Our results indicate that the risk of a positive initial prostate biopsy can be predicted to a satisfactory level in a Chinese population using our nomogram. The nomogram can be used to identify and counsel patients who should consider a prostate biopsy, ultimately enhancing accuracy in diagnosing prostate cancer.展开更多
Prostate volume （PV） has been shown to be associated with prostate cancer （PCa） detection rates in men with a prostate-specific antigen （PSA） in the ＇grey zone＇ （2.0-10.0 ng ml-1）. However, the PSA ＇grey z...Prostate volume （PV） has been shown to be associated with prostate cancer （PCa） detection rates in men with a prostate-specific antigen （PSA） in the ＇grey zone＇ （2.0-10.0 ng ml-1）. However, the PSA ＇grey zone＇ in Asian men should be higher because the incidence of PCa in Asian men is relatively low. Therefore, we evaluated the association between PV and PCa detection rates in men with PSAs measuring 10-50 ng ml-1, Men who underwent a 13-core prostatic biopsy with PV documentation participated in the study. A multivariate stepwise regression was used to evaluate whether the PV at time of prostate biopsy could predict the risk of PCa. The rates of PCa among men in different PSA ranges, stratified by PV medians （〈60 and ≥60 ml）, were calculated. There were 261 men included in the final analysis. PV was the strongest predictor of PCa risk （odds ratio, 0.02; P〈0.001） compared to other variables. The PCa rates in men with PVs measuring 〈60 and ≥ 60 ml in the 10-19.9 ng ml-1 PSA group were 40.6% and 15.1%, respectively, while the rates for men with PSAs measuring 20-50 ng ml- 1 were 65.1% and 26.8%. PV is an independent predictor of PCa in men with PSA measuring 10-50 ng ml-1. In clinical practice, particularly for those countries with lower incidences of PCa, PV should be considered when counselling patients with PSAs measuring 10-50 ng ml-1 regarding their PCa risks.展开更多
In western populations, prostate volume （PV） has been proven to be one of the strongest predictors of detecting prostate cancer （PCa） in biopsies. We performed this study in a biopsy cohort, to evaluate associatio...In western populations, prostate volume （PV） has been proven to be one of the strongest predictors of detecting prostate cancer （PCa） in biopsies. We performed this study in a biopsy cohort, to evaluate associations among the prostate volume, prostate-specific antigen （PSA） and PCa detection in the Chinese population. Between the years, 2007-13, 1486 men underwent prostate biopsy at Huashan Hospital, Fudan University, Shanghai, China. The study population was divided into two groups for analysis according to total PSA （tPSA） range （4 ng m1-1 〈tPSA 〈20 ng m1-1 and tPSA 〉20 ng ml-1）. PV, age, tPSA, digital rectal examination （DRE） and transrectal ultrasound （TRUS） results were also included in the analysis. Although the positive biopsy rates decreased in both tPSA range groups, the downtrend was more pronounced in the 4 ng ml-2 〈tPSA 〈20 ng m1-1 group; therefore, we focused on 853 men in this group with increasing PV. In multivariate logistic regression analysis, only DRE was found to be associated with PCa in four PV groups （P 〈 0.05） and tPSA did not show a good predictive ability when PV exceeded 50 ml （P 〉 0.05）. Further, it may suggest that with increasing PV, the cancer detection rate decreased in men with different tPSA, DRE and TRUS nodule statuses （all P values for trends were 〈0.001）. Our study indicates that in tPSA ranging from 4 to 20 ng ml-1, the use of PV ranges of 0-35 ml, 35-50 ml and 〉50 ml might be taken into consideration for the biopsy decision-making in the Chinese population.展开更多
The aim of this study is to assess the ability of serum prostate-specific antigen （PSA） to predict prostate volume （PV） and lower urinary tract symptoms （LUTS） represented by the international prostate symptom s...The aim of this study is to assess the ability of serum prostate-specific antigen （PSA） to predict prostate volume （PV） and lower urinary tract symptoms （LUTS） represented by the international prostate symptom score （IPSS）. From January 2001 to December 2011, data were collected from men who first enrolled in the Korean Prostate Health Council Screening Program. Patients with a serum PSA level of 10 ng ml^-1 or age 〈40 years were excluded. Accordingly, a total of 34 857 men were included in our study, and serum PSA, PV and the IPSS were estimated in all patients. Linear and age-adjusted multivariate logistic analyses were used to assess the potential association between PSA and PV or IPSS. The predictive value of PSA for estimating PV and IPSS was assessed based on the receiver operating characteristics-derived area under the curve （AUC）. The mean PV was 29.9 ml, mean PSA level was 1.49 ng ml^-1 and mean IPSS was 15.4. A significant relationship was shown between PSA and PV, and the IPSS and PSA were also significantly correlated after adjusting by age. The AUCs of PSA for predicting PV ~20 ml, 〉25 ml and 〉35 ml were 0.722, 0.728 and 0.779, respectively. The AUCs of PSA for predicting IPSS 〉 7, 〉 13 and 〉 19 were 0. 548, 0.536 and 0. 537, respectively. Serum PSA was a strong predictor of PV in a community-based cohort in a large-scale screening study. Although PSA was also significantly correlated with IPSS, predictive values of PSA for IPSS above the cutoff levels were not excellent. Further investigations are required to elucidate the exact interactions between PSA and LUTS and between PSA and PV in prospective controlled studies. Such studies may suggest how PSA can be used to clinically predict PV and the IPSS.展开更多
To evaluate whether prostate volume(PV)would provide additional predictive utility to the prostate health index(phi)for predicting prostate cancer(PCa)or clinically significant prostate cancer,we designed a prospectiv...To evaluate whether prostate volume(PV)would provide additional predictive utility to the prostate health index(phi)for predicting prostate cancer(PCa)or clinically significant prostate cancer,we designed a prospective,observational multicenter study in two prostate biopsy cohorts.Cohort 1 included 595 patients from three medical centers from 2012 to 2013,and Cohort 2 included 1025 patients from four medical centers from 2013 to 2014.Area under the receiver operating characteristic curves(AUC)and logistic regression models were used to evaluate the predictive performance of PV-based derivatives and models.Linear regression analysis showed that both total prostate-specific antigen(tPSA)and free PSA(fPSA)were significantly correlated with PV(all P<0.05).[-2]proPSA(p2PSA)was significantly correlated with PV in Cohort 2(P<0.001)but not in Cohort 1(P=0.309),while no significant association was observed between phi and PV.When combining phi with PV,phi density(PHID)and another phi derivative(PHIV,calculated as phi/PV°5)did not outperform phi for predicting PCa or clinically significant PCa in either Cohort 1 or Cohort 2.Logistic regression analysis also showed that phi and PV were independent predictors for both PCa and clinically significant PCa(all P<0.05);however,PV did not provide additional predictive value to phi when combining these derivatives in a regression model(all models vs phi were not statistically significant,all P>0.05).In conclusion,PV-based derivatives(both PHIV and PHID)and models incorporating PV did not improve the predictive abilities of phi for either PCa or clinically significant PCa.展开更多
Anthropometric measurements, e.g., body weight （BW）, body mass index （BMI）, as well as serum prostate-specific antigen （PSA） and percent-free PSA （%fPSA） have been shown to have positive correlations with tota...Anthropometric measurements, e.g., body weight （BW）, body mass index （BMI）, as well as serum prostate-specific antigen （PSA） and percent-free PSA （%fPSA） have been shown to have positive correlations with total prostate volume （TPV）. We developed an equation and nomogram for estimating TPV, incorporating these predictors in men with benign prostatic hyperplasia （BPH）. A total of 1852 men, including 1113 at Tokyo Medical and Dental University （TMDU） Hospital as a training set and 739 at Cancer Institute Hospital （CIH） as a validation set, with PSA levels of up to 20 ng m1-1, who underwent extended prostate biopsy and were proved to have BPH, were enrolled in this study. We developed an equation for continuously coded TPV and a logistic regression-based nomogram for estimating a TPV grater than 40 mh Predictive accuracy and performance characteristics were assessed using an area under the receiver operating characteristics curve （AUC） and calibration plots. The final linear regression model indicated age, PSA, %fPSA and BW as independent predictors of continuously coded TPV. For predictions in the training set, the multiple correlation coefficient was increased from 0.38 for PSA alone to 0.60 in the final model. We developed a novel nomogram incorporating age, PSA, %fPSA and BW for estimating TPV greater than 40 mh External validation confirmed its predictive accuracy, with AUC value of 0.764. Calibration plots showed good agreement between predicted probability and observed proportion. In conclusion, TPV can be easily estimated using these four independent predictors.展开更多
This study investigated whether free prostate-specific antigen(fPSA)performs better than total PSA(tPSA)in predicting prostate volume(PV)in Chinese men with different PSA levels.A total of 5463 men with PSA levels of&...This study investigated whether free prostate-specific antigen(fPSA)performs better than total PSA(tPSA)in predicting prostate volume(PV)in Chinese men with different PSA levels.A total of 5463 men with PSA levels of<10 ng ml^(−1) and without prostate cancer diagnosis were included in this study.Patients were classified into four groups:PSA<2.5 ng ml^(−1),2.5–3.9 ng ml^(−1),4.0–9.9 ng ml^(−1),and 2.5–9.9 ng ml^(−1).Pearson/Spearman's correlation coefficient(r)and receiver operating characteristic(ROC)curves were used to evaluate the ability of tPSA and fPSA to predict PV.The correlation coefficient between tPSA and PV in the PSA<2.5 ng ml^(−1) cohort(r=0.422;P<0.001)was markedly higher than those of the cohorts with PSA levels of 2.5–3.9 ng ml^(−1),4.0–9.9 ng ml^(−1),and 2.5–9.9 ng ml^(−1)(r=0.114,0.167,and 0.264,respectively;all P≤0.001),while fPSA levels did not differ significantly among different PSA groups.Area under ROC curve(AUC)analyses revealed that the performance of fPSA in predicting PV≥40 ml(AUC:0.694,0.714,and 0.727)was better than that of tPSA(AUC=0.545,0.561,and 0.611)in men with PSA levels of 2.5–3.9 ng ml^(−1),4.0–9.9 ng ml^(−1),and 2.5–9.9 ng ml^(−1),respectively,but not at PSA levels of<2.5 ng ml^(−1)(AUC:0.713 vs 0.720).These findings suggest that the relationship between tPSA and PV may vary with PSA level and that fPSA is more powerful at predicting PV only in the"gray zone"(PSA levels of 2.5–9.9 ng ml^(−1)),but its performance was similar to that of tPSA at PSA levels of<2.5 ng ml^(−1).展开更多
We evaluated whether the prostate-specific antigen (PSA)mass or free PSA (fPSA)mass (i.e.,absolute amount of total circulating PSA or fPSA protein,respectively),versus serum PSA or fPSA concentration,improves the accu...We evaluated whether the prostate-specific antigen (PSA)mass or free PSA (fPSA)mass (i.e.,absolute amount of total circulating PSA or fPSA protein,respectively),versus serum PSA or fPSA concentration,improves the accuracy of predicting the total prostate volume (TPV)in relation to obesity.Among men whose multicore (≥12)transrectal prostate biopsy was negative,586 who had a PSA of <10 ng ml^-1 and underwent the fPSA test prior to biopsy were enrolled.The PSA mass or fPSA mass (pg)was calculated by multiplying the serum level by plasma volume.At each TPV cut-off point (30 ml,40 ml,and 50 ml),the areas under the receiver operating characteristics curve (AUCs)of each variable were compared in obesity-based subgroups.AUCs of fPSA and fPSA mass for predicting TPV were significantly larger than those for PSA and PSA mass by 8.7%-12.1%at all cut-off points. Subgroup analyses based on obesity showed that,although PSA mass and fPSA mass enhanced accuracy by 4%(P =0.031)and 1.8%(P =0.003),respectively,for determining TPVs of ≥30 ml and ≥50 ml in obese and overweight men,they did not improve the accuracy in most other combinations of the degrees of obesity with TPV cut-off points.Thus,compared with serum PSA or fPSA,the absolute amount of PSA or fPSA protein mass improved the accuracy of predicting TPV in obese men very minimally and only for certain TPV cut-off points.Hence,these indicators may not provide clinically meaningful improvement in predicting TPV in obese men.展开更多
Purpose: Prostate specific antigen levels can be normalized by the prostate volume to give a prostate specific antigen density (PSAd). Magnetic resonance imaging (MRI) can more accurately determine prostate zonal anat...Purpose: Prostate specific antigen levels can be normalized by the prostate volume to give a prostate specific antigen density (PSAd). Magnetic resonance imaging (MRI) can more accurately determine prostate zonal anatomy and prostate volumes compared to transrectal ultrasound, and hence may lead to more accurate PSAd measurements. Methods: Imaging and pathology of men undergoing prostate MRI from April 2007 to May 2009 were reviewed in this retrospective study. 73 patients were included for analysis, of which 45 had prostate cancer and 28 did not have cancer. Total, transitional zone, and peripheral zone values were determined by ultrasound prolate ellipse, MRI prolate ellipse, and MRI segmentation methods. Results: The study population showed an average PSA of 6.3 ng/mL, with the control mean PSA (8.8 ng/mL) being greater than the cancer group (5.3 ng/mL). Transrectal ultrasound underestimated the prostate volume (mean 27.7 mL versus MRI volume of 38.3 mL, p ≤ 0.001). No difference was seen between cancer and control populations using PSAd. PSAd correctly categorized low (Gleason < 7) and high-grade cancers (Gleason ≥ 7) in patients with malignancy. Conclusion: Transrectal ultrasound underestimates prostate volumes and hence is inaccurate in calculating PSAd. MRI more accurately depicts PSAd, however PSAd is unable to differentiate between patients with cancer and benign disease such as BPH or prostatitis.展开更多
Objective:To investigate the effect of prostate volume on robot-assisted radical prostatectomy.Methods:Clinical data of 75 patients underwent RARP in the Affiliated Hospital of Qingdao University were retrospectively ...Objective:To investigate the effect of prostate volume on robot-assisted radical prostatectomy.Methods:Clinical data of 75 patients underwent RARP in the Affiliated Hospital of Qingdao University were retrospectively analyzed.The patients were divided into 3 groups according to size of prostate.A total of 35 cases with prostate volume less than 30ml were recorded as group 1,27 cases with volume of 30 to 50 ml were recorded as group 2,and 13 cases with volume greater than 50ml were recorded as group 3.Age,BMI,preoperative PSA,operation time,intraoperative bleeding volume,postoperative drainage volume,indwelling time of catheter,indwelling time of drainage tube,total hospitalization time,pathological stage,surgical margin,urine control and biochemical recurrence were observed.Results:All operations were performed under Da Vinci robot assistance,and no patient was transferred to open surgery.There was no significant difference in age,preoperative PSA,BMI,operation time,intraoperative bleeding volume,postoperative drainage volume,indwelling time of catheter,total hospitalization time,pathological stage,rate of positive surgical margin and recovery of urinary continence between the groups.Indwelling time of drainage tube was longer in group with larger prostate,6.4(±4.5)days in group 1,6.3(±2.9)days in group 2 and 7.1(±2.5)days in group 3.Gleason score was lower in group with larger prostate,with statistical difference.Conclusion:Prostate volume had no significant effect on urinary control,rate of positive surgical margin and recurrence after RARP.Gleason score of pathological tissue was lower and indwelling time of drainage tube was longer in patients with larger prostate after RARP.Operation time and intraoperative bleeding volume of large prostate patients underwent RARP need to be further studied.RARP has certain advantages for patients with large prostate.展开更多
BACKGROUND Carbon ion radiotherapy(CIRT)is currently used to treat prostate cancer.Rectal bleeding is a major cause of toxicity even with CIRT.However,to date,a correlation between the dose and volume parameters of th...BACKGROUND Carbon ion radiotherapy(CIRT)is currently used to treat prostate cancer.Rectal bleeding is a major cause of toxicity even with CIRT.However,to date,a correlation between the dose and volume parameters of the 12 fractions of CIRT for prostate cancer and rectal bleeding has not been shown.Similarly,the clinical risk factors for rectal bleeding were absent after 12 fractions of CIRT.AIM To identify the risk factors for rectal bleeding in 12 fractions of CIRT for prostate cancer.METHODS Among 259 patients who received 51.6 Gy[relative biological effectiveness(RBE)],in 12 fractions of CIRT,15 had grade 1(5.8%)and nine had grade 2 rectal bleeding(3.5%).The dose-volume parameters included the volume(cc)of the rectum irradiated with at least x Gy(RBE)(Vx)and the minimum dose in the most irradiated x cc normal rectal volume(Dx).RESULTS The mean values of D6cc,D2cc,V10 Gy(RBE),V20 Gy(RBE),V30 Gy(RBE),and V40 Gy(RBE)were significantly higher in the patients with rectal bleeding than in those without.The cutoff values were D6cc=34.34 Gy(RBE),D2cc=46.46 Gy(RBE),V10 Gy(RBE)=9.85 cc,V20 Gy(RBE)=7.00 cc,V30 Gy(RBE)=6.91 cc,and V40 Gy(RBE)=4.26 cc.The D2cc,V10 Gy(RBE),and V20 Gy(RBE)cutoff values were significant predictors of grade 2 rectal bleeding.CONCLUSION The above dose-volume parameters may serve as guidelines for preventing rectal bleeding after 12 fractions of CIRT for prostate cancer.展开更多
In recent years,advancements in single-cell and spatial transcriptomics,which are highly regarded developments in the current era,particularly the emerging integration of single-cell and spatiotemporal transcriptomics...In recent years,advancements in single-cell and spatial transcriptomics,which are highly regarded developments in the current era,particularly the emerging integration of single-cell and spatiotemporal transcriptomics,have enabled a detailed molecular comprehension of the complex regulation of cell fate.The insights obtained from these methodologies are anticipated to significantly contribute to the development of personalized medicine.Currently,single-cell technology is less frequently utilized for prostate cancer compared with other types of tumors.Start-ing from the perspective of RNA sequencing technology,this review outlined the signifcance of single-cell RNA sequencing(scRNA-seq)in prostate cancer research,encompassing preclinical medicine and clinical applications.We summarize the differences between mouse and human prostate cancer as revealed by scRNA-seq studies,as well as a combination of multi-omics methods involving scRNA-seq to highlight the key molecular targets for the diagnosis,treatment,and drug resistance characteristics of prostate cancer.These studies are expected to provide novel insights for the development of immunotherapy and other innovative treatment strategies for castration-resistant prostate cancer.Furthermore,we explore the potential clinical applications stemming from other single-cell technologies in this review,paving the way for future research in precision medicine.展开更多
Background:Transmembrane emp24 trafficking protein 3(TMED3)is associated with the development of several tumors;however,whether TMED3 regulates the progression of prostate cancer remains unclear.Materials and Methods:...Background:Transmembrane emp24 trafficking protein 3(TMED3)is associated with the development of several tumors;however,whether TMED3 regulates the progression of prostate cancer remains unclear.Materials and Methods:Short hairpin RNA was performed to repress TMED3 in prostate cancer cells(DU145 cells)and in a prostate cancer mice model to determine its function in prostate cancer in vitro and in vivo.Results:In the present study,we found that TMED3 was highly expressed in prostate cancer cells.In vitro,shTMED3 treatment suppressed the proliferation,invasion,and migration and promoted the apoptosis of DU145 cells.Additionally,the Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis showed a strong correlation between TMED3 and forkhead box O transcription factor(FOXO)pathway.Furthermore,TMED3 inhibition efficiently decreased FOXO1a and FOXO3a phosphorylation.In vivo,TMED3 downregulation suppressed the apoptosis,growth,and metastasis of prostate cancer cells via FOXO1a and FOXO3a.Conclusion:The present findings show that TMED3 participates in the regulation of prostate cancer progression via FOXO1a and FOXO3a phosphorylation,thereby revealing a novel mechanism underlying prostate cancer development and suggesting that TMED3 inhibition may serve as a novel strategy for prostate cancer treatment.展开更多
Prostate cancer(PCa)is one of the most common malignant tumors in the male genitourinary system,ranking second in incidence worldwide.Traditional Chinese medicine(TCM),as an important component of complementary and al...Prostate cancer(PCa)is one of the most common malignant tumors in the male genitourinary system,ranking second in incidence worldwide.Traditional Chinese medicine(TCM),as an important component of complementary and alternative medicine,shows unique advantages in cancer treatment.Chinese herbal medicine is usually composed of multiple ingredients and involves multiple signaling pathways,which showed function of inducing apoptosis of cancer cells,arresting the cell cycle,inhibiting invasion and metastasis,reducing drug resistance,and regulating immune function.Physical therapy is also an important treatment of TCM.Currently,Physical therapy such as acupuncture or Tai Chi and Qigong are gaining increased recognition in the management of PCa,particularly in addressing issues like urinary incontinence and bone metastasis-related pain.This article reviews the TCM treatment and therapy of PCa,in order to provide new research avenues and treatment options for the treatment of PCa with TCM and improve the quality of life of patients.展开更多
Prostate cancer (PC) is among the most common cancer diagnoses in men worldwide and the fifth leading cause of cancer-related deaths. Approximately 1.5 million new cases of PC were reported worldwide in 2022 with near...Prostate cancer (PC) is among the most common cancer diagnoses in men worldwide and the fifth leading cause of cancer-related deaths. Approximately 1.5 million new cases of PC were reported worldwide in 2022 with nearly 400,000 associated deaths1. Notably, the incidence of PC in China has increased substantially compared to the global average2.展开更多
BACKGROUND Vitamin D deficiency has been associated with prostate cancer,particularly in ethnic minorities.Patients with prostate cancer may still be deficient even in areas of high sun exposure.Although androgen depr...BACKGROUND Vitamin D deficiency has been associated with prostate cancer,particularly in ethnic minorities.Patients with prostate cancer may still be deficient even in areas of high sun exposure.Although androgen deprivation therapy(ADT)is well documented to affect bone health,its impact on vitamin D levels is still uncertain.This study investigates the subgroups of prostate cancer patients most associated with vitamin D deficiency and ADT’s relation to this.AIM To examine how prevalent vitamin D deficiency is among prostate cancer patients in a sun-rich environment,with focus on differences by race and disease stage.It also assessed whether ADT is associated with changes in vitamin D levels.METHODS Prostate cancer patients treated at Chao Family Comprehensive Cancer Center between 2014-2024 were retrospectively studied with regards to vitamin D levels across racial groups,disease stages,and ADT exposure.Changes in vitamin D levels pre-and post-ADT over 24 months were assessed by statistical methods including paired t-tests.RESULTS Among 120 patients(mean age:74 years,mean body mass index:27.6 kg/m^(2)),African American(33.3%)and Hispanic(31.8%)patients had the greatest prevalence of vitamin D deficiency(<20 ng/mL).With a 28.6%deficit rate,metastatic castration-resistant prostate cancer had the highest prevalence rates of deficiency.There was no significant difference between pre-and post-ADT vitamin D levels(P=0.45).CONCLUSION Vitamin D deficiency is common in prostate cancer patients,especially racial minorities and those with advanced disease,despite residing in an area with high sun exposure.ADT does not significantly impact vitamin D levels in the short term.Routine screening and supplementation should be considered in these high-risk groups.展开更多
This article discusses the coexistence of prostate adenocarcinoma and prostate urothelial carcinoma.Combining existing literature and research results,the potential mechanisms of the co-occurrence of these two cancers...This article discusses the coexistence of prostate adenocarcinoma and prostate urothelial carcinoma.Combining existing literature and research results,the potential mechanisms of the co-occurrence of these two cancers are explored,including the role of androgen receptor,gene mutations,and their complex interactions in cell signaling pathways,etc.Also,the hypothesis of prostate cancer transformation into urothelial carcinoma is explained from some perspectives,including tumor multipotent stem cell differentiation,epithelial-mesenchymal transition,mesenchymal-epithelial transition,and other mechanisms.Ultimately,the goal is to provide more accurate diagnoses and more personalized treatments in clinical practice,as well as to lay the foundation for improving patient prognoses in the future.展开更多
Objective:To explore clinicopathological predictors of adverse pathological changes(APCs)(upgrading,upstaging,and positive surgical margin[PSM])after robot-assisted radical prostatectomy(RARP)in clinical tumor stage 2...Objective:To explore clinicopathological predictors of adverse pathological changes(APCs)(upgrading,upstaging,and positive surgical margin[PSM])after robot-assisted radical prostatectomy(RARP)in clinical tumor stage 2c(cT2c)prostate cancer(PCa)patients.Methods:From January 2018 to December 2022,cT2cN0M0 PCa patients who underwent prostate biopsies and subsequent RARP at the Peking University First Hospital with an interval between biopsy and RARP of ≤90 days were included.Univariable and stepwise multivariable logistic regression analyses were performed to identify independent risk factors associated with APCs.Nomograms were constructed based on these predictive models.The performance of the nomograms was evaluated by receiver operating characteristic curves,decision curve analyses,and calibration plots.Results:A total of 423 eligible cT2cN0M0 PCa patients were included.The rates of upgrading,upstaging,and PSM in our cohortwere 33%,51%,and 35%,respectively.The stepwise multivariate logistic analysis suggested that PSA density and the percentage of positive cores in systematic biopsy were significantly associated with the occurrence of APCs.The score of the Prostate Imaging Reporting and Data System,PSA density,and the International Society of Urological Pathology grade group(IGG)of needle-biopsy specimens(or clinical IGG[cIGG])were significantly associated with upgrading.The PSA density,percentage of positive cores in systematic biopsy,and largest tumor percentage in all cores of each patient(LTP)were significantly associated with upstaging.The PSA density and LTP were significantly associatedwith the PSM.Based on these results,four nomogramswere developed.Receiver operating characteristic curves,decision curve analyses,and calibration plots implied that the nomograms exhibited excellent accuracy.Conclusion:The predictive models we developed could help to identify high-risk PCa early,and optimize clinical decisions of cT2cN0M0 PCa patients.展开更多
基金supported by the Beijing NOVA Program(grant No.20220484230)National Key Research and Development Program of China(grant No.2023YFC3605305).
文摘This study investigated the impact of metabolic syndrome (MetS) and its components on prostate volume (PV) in the general Chinese population. In total, 43 455 participants in The First Medical Center of the Chinese PLA General Hospital (Beijing, China) from January 1, 2012, to December 31, 2022, undergoing health examinations were included in the study. Participants were categorized into four groups according to PV quartiles: Q1 (PV ≤24.94 ml), Q2 (PV >24.94 ml and ≤28.78 ml), Q3 (PV >28.78 ml and ≤34.07 ml), and Q4 (PV >34.07 ml), with Q1 serving as the reference group. Logistic regression analyses were used to examine the association between MetS and PV, with subgroup analyses conducted by age. Among the participants, 18 787 (43.2%) were diagnosed with MetS. In the multivariate analysis model, a significant correlation between MetS and PV was observed, with odds ratios (ORs) increasing as PV increased (Q2, OR = 1.203, 95% confidence interval [CI]: 1.139–1.271;Q3, OR = 1.300, 95% CI: 1.230–1.373;and Q4, OR = 1.556, 95% CI: 1.469–1.648). Analysis of MetS components revealed that all components were positively associated with PV, with abdominal obesity showing the most significant effect. The number of MetS components was identified as a dose-dependent risk factor for elevated PV. The impact of MetS, its components, and component count on PV exhibited a decreasing trend with advancing age. Overall, the influence of MetS, its components, and component count on PV was predominantly observed in the age groups of 40–49 years and 50–59 years. Early intervention targeting MetS can significantly alleviate the increase in PV, particularly benefiting individuals aged 40–59 years who have abdominal obesity.
基金supported by National Natural Science Foundation of China(No.81370468)
文摘Previous investigations have shown that changes in total prostate volume（TPV） are highly variable among aging men,and a considerable proportion of aging men have a stable or decreasing prostate size.Although there is an abundance of literature describing prostatic enlargement in association with benign prostatic hyperplasia,less is known about the appropriate age cut-off points for TPV growth rate.In this community-based cohort study,TPV was examined once a year in men who had consecutive health checkup,during a follow-up of 4 years.A total of 5058 men（age 18–92 years old） were included.We applied multiple regression analyses to estimate the correlation between TPV growth rate and age.Overall,3232（63.9%） men had prostate growth,and 1826（36.1%） had a stable or decreased TPV during the study period.The TPV growth rate was correlated negatively with baseline TPV（r= –0.32,P〈0.001）.Among 2620 men with baseline TPV 〈15 cm^3,the TPV growth rate increased with age（β=0.98,95% CI：0.77%–1.18%） only up to 53 years old.Among 2188 men with baseline TPV of 15–33.6 cm3,the TPV growth rate increased with age（β=0.84,95% CI,0.66%–1.01%） only up to 61 years old after adjusting for factors of hypertension,obesity,baseline TPV,diabetes mellitus and dyslipidemia.In this longitudinal study,the TPV growth rate increased negatively with baseline TPV,only extending to a certain age and not beyond.Further research is needed to identify the mechanism underlying such differences in prostate growth.
文摘Nomograms for predicting the risk of prostate cancer developed using other populations may introduce sizable bias when applied to a Chinese cohort. In the present study, we sought to develop a nomogram for predicting the probability of a positive initial prostate biopsy in a Chinese population. A total of 535 Chinese men who underwent a prostatic biopsy for the detection of prostate cancer in the past decade with complete biopsy data were included. Stepwise logistic regression was used to determine the independent predictors of a positive initial biopsy. Age, prostate-specific antigen （PSA）, prostate volume （PV）, digital rectal examination （DRE） status, % free PSA and transrectal ultrasound （TRUS） findings were included in the analysis. A nomogram model was developed that was based on these independent predictors to calculate the probability of a positive initial prostate biopsy. A receiver-operating characteristic curve was used to assess the accuracy of using the nomogram and PSA levels alone for predicting positive prostate biopsy. The rate for positive initial prostate biopsy was 41.7% （223/535）. The independent variables used to predict a positive initial prostate biopsy were age, PSA, PV and DRE status. The areas under the receiver-operating characteristic curve for a positive initial prostate biopsy for PSA alone and the nomogram were 79.7% and 84.8%, respectively. Our results indicate that the risk of a positive initial prostate biopsy can be predicted to a satisfactory level in a Chinese population using our nomogram. The nomogram can be used to identify and counsel patients who should consider a prostate biopsy, ultimately enhancing accuracy in diagnosing prostate cancer.
基金This work was supported by National Natural Science Foundation of China （No. 81072091/H 1619 ）, Guangdong Natural Science Foundation Grant, China （No. 10151006001000003） and the Key Project of Guangzhou Municipal Health Bureau Grant, China （No. 20121A021006） to Ping Tang.
文摘Prostate volume （PV） has been shown to be associated with prostate cancer （PCa） detection rates in men with a prostate-specific antigen （PSA） in the ＇grey zone＇ （2.0-10.0 ng ml-1）. However, the PSA ＇grey zone＇ in Asian men should be higher because the incidence of PCa in Asian men is relatively low. Therefore, we evaluated the association between PV and PCa detection rates in men with PSAs measuring 10-50 ng ml-1, Men who underwent a 13-core prostatic biopsy with PV documentation participated in the study. A multivariate stepwise regression was used to evaluate whether the PV at time of prostate biopsy could predict the risk of PCa. The rates of PCa among men in different PSA ranges, stratified by PV medians （〈60 and ≥60 ml）, were calculated. There were 261 men included in the final analysis. PV was the strongest predictor of PCa risk （odds ratio, 0.02; P〈0.001） compared to other variables. The PCa rates in men with PVs measuring 〈60 and ≥ 60 ml in the 10-19.9 ng ml-1 PSA group were 40.6% and 15.1%, respectively, while the rates for men with PSAs measuring 20-50 ng ml- 1 were 65.1% and 26.8%. PV is an independent predictor of PCa in men with PSA measuring 10-50 ng ml-1. In clinical practice, particularly for those countries with lower incidences of PCa, PV should be considered when counselling patients with PSAs measuring 10-50 ng ml-1 regarding their PCa risks.
文摘In western populations, prostate volume （PV） has been proven to be one of the strongest predictors of detecting prostate cancer （PCa） in biopsies. We performed this study in a biopsy cohort, to evaluate associations among the prostate volume, prostate-specific antigen （PSA） and PCa detection in the Chinese population. Between the years, 2007-13, 1486 men underwent prostate biopsy at Huashan Hospital, Fudan University, Shanghai, China. The study population was divided into two groups for analysis according to total PSA （tPSA） range （4 ng m1-1 〈tPSA 〈20 ng m1-1 and tPSA 〉20 ng ml-1）. PV, age, tPSA, digital rectal examination （DRE） and transrectal ultrasound （TRUS） results were also included in the analysis. Although the positive biopsy rates decreased in both tPSA range groups, the downtrend was more pronounced in the 4 ng ml-2 〈tPSA 〈20 ng m1-1 group; therefore, we focused on 853 men in this group with increasing PV. In multivariate logistic regression analysis, only DRE was found to be associated with PCa in four PV groups （P 〈 0.05） and tPSA did not show a good predictive ability when PV exceeded 50 ml （P 〉 0.05）. Further, it may suggest that with increasing PV, the cancer detection rate decreased in men with different tPSA, DRE and TRUS nodule statuses （all P values for trends were 〈0.001）. Our study indicates that in tPSA ranging from 4 to 20 ng ml-1, the use of PV ranges of 0-35 ml, 35-50 ml and 〉50 ml might be taken into consideration for the biopsy decision-making in the Chinese population.
文摘The aim of this study is to assess the ability of serum prostate-specific antigen （PSA） to predict prostate volume （PV） and lower urinary tract symptoms （LUTS） represented by the international prostate symptom score （IPSS）. From January 2001 to December 2011, data were collected from men who first enrolled in the Korean Prostate Health Council Screening Program. Patients with a serum PSA level of 10 ng ml^-1 or age 〈40 years were excluded. Accordingly, a total of 34 857 men were included in our study, and serum PSA, PV and the IPSS were estimated in all patients. Linear and age-adjusted multivariate logistic analyses were used to assess the potential association between PSA and PV or IPSS. The predictive value of PSA for estimating PV and IPSS was assessed based on the receiver operating characteristics-derived area under the curve （AUC）. The mean PV was 29.9 ml, mean PSA level was 1.49 ng ml^-1 and mean IPSS was 15.4. A significant relationship was shown between PSA and PV, and the IPSS and PSA were also significantly correlated after adjusting by age. The AUCs of PSA for predicting PV ~20 ml, 〉25 ml and 〉35 ml were 0.722, 0.728 and 0.779, respectively. The AUCs of PSA for predicting IPSS 〉 7, 〉 13 and 〉 19 were 0. 548, 0.536 and 0. 537, respectively. Serum PSA was a strong predictor of PV in a community-based cohort in a large-scale screening study. Although PSA was also significantly correlated with IPSS, predictive values of PSA for IPSS above the cutoff levels were not excellent. Further investigations are required to elucidate the exact interactions between PSA and LUTS and between PSA and PV in prospective controlled studies. Such studies may suggest how PSA can be used to clinically predict PV and the IPSS.
基金by grants from the innovation grant by Shanghai Hospital Development Center(SHDC12015105)to Jianfeng Xuthe National Natural Science Foundation of China(Grant No.81772741)+3 种基金Shanghai Rising-Star Program(Grant No.18QA1402800)the“Chen Guang”project supported by Shanghai Municipal Education CommissionShanghai Education Development FoundationShanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support(Grant No.20181701)to Rong Na.
文摘To evaluate whether prostate volume(PV)would provide additional predictive utility to the prostate health index(phi)for predicting prostate cancer(PCa)or clinically significant prostate cancer,we designed a prospective,observational multicenter study in two prostate biopsy cohorts.Cohort 1 included 595 patients from three medical centers from 2012 to 2013,and Cohort 2 included 1025 patients from four medical centers from 2013 to 2014.Area under the receiver operating characteristic curves(AUC)and logistic regression models were used to evaluate the predictive performance of PV-based derivatives and models.Linear regression analysis showed that both total prostate-specific antigen(tPSA)and free PSA(fPSA)were significantly correlated with PV(all P<0.05).[-2]proPSA(p2PSA)was significantly correlated with PV in Cohort 2(P<0.001)but not in Cohort 1(P=0.309),while no significant association was observed between phi and PV.When combining phi with PV,phi density(PHID)and another phi derivative(PHIV,calculated as phi/PV°5)did not outperform phi for predicting PCa or clinically significant PCa in either Cohort 1 or Cohort 2.Logistic regression analysis also showed that phi and PV were independent predictors for both PCa and clinically significant PCa(all P<0.05);however,PV did not provide additional predictive value to phi when combining these derivatives in a regression model(all models vs phi were not statistically significant,all P>0.05).In conclusion,PV-based derivatives(both PHIV and PHID)and models incorporating PV did not improve the predictive abilities of phi for either PCa or clinically significant PCa.
文摘Anthropometric measurements, e.g., body weight （BW）, body mass index （BMI）, as well as serum prostate-specific antigen （PSA） and percent-free PSA （%fPSA） have been shown to have positive correlations with total prostate volume （TPV）. We developed an equation and nomogram for estimating TPV, incorporating these predictors in men with benign prostatic hyperplasia （BPH）. A total of 1852 men, including 1113 at Tokyo Medical and Dental University （TMDU） Hospital as a training set and 739 at Cancer Institute Hospital （CIH） as a validation set, with PSA levels of up to 20 ng m1-1, who underwent extended prostate biopsy and were proved to have BPH, were enrolled in this study. We developed an equation for continuously coded TPV and a logistic regression-based nomogram for estimating a TPV grater than 40 mh Predictive accuracy and performance characteristics were assessed using an area under the receiver operating characteristics curve （AUC） and calibration plots. The final linear regression model indicated age, PSA, %fPSA and BW as independent predictors of continuously coded TPV. For predictions in the training set, the multiple correlation coefficient was increased from 0.38 for PSA alone to 0.60 in the final model. We developed a novel nomogram incorporating age, PSA, %fPSA and BW for estimating TPV greater than 40 mh External validation confirmed its predictive accuracy, with AUC value of 0.764. Calibration plots showed good agreement between predicted probability and observed proportion. In conclusion, TPV can be easily estimated using these four independent predictors.
基金supported by grants from Guangzhou Municipal Science and Technology,China (grant No.201804010453 to PT,and grant No.201904010256 to CSK)Medical Scientific Research Foundation of Guangdong Province,China (grant No.A2018503 to MPH)Scientific and Technological Projects,Guangdong Province (grant No.2015A020210005 to SLM).
文摘This study investigated whether free prostate-specific antigen(fPSA)performs better than total PSA(tPSA)in predicting prostate volume(PV)in Chinese men with different PSA levels.A total of 5463 men with PSA levels of<10 ng ml^(−1) and without prostate cancer diagnosis were included in this study.Patients were classified into four groups:PSA<2.5 ng ml^(−1),2.5–3.9 ng ml^(−1),4.0–9.9 ng ml^(−1),and 2.5–9.9 ng ml^(−1).Pearson/Spearman's correlation coefficient(r)and receiver operating characteristic(ROC)curves were used to evaluate the ability of tPSA and fPSA to predict PV.The correlation coefficient between tPSA and PV in the PSA<2.5 ng ml^(−1) cohort(r=0.422;P<0.001)was markedly higher than those of the cohorts with PSA levels of 2.5–3.9 ng ml^(−1),4.0–9.9 ng ml^(−1),and 2.5–9.9 ng ml^(−1)(r=0.114,0.167,and 0.264,respectively;all P≤0.001),while fPSA levels did not differ significantly among different PSA groups.Area under ROC curve(AUC)analyses revealed that the performance of fPSA in predicting PV≥40 ml(AUC:0.694,0.714,and 0.727)was better than that of tPSA(AUC=0.545,0.561,and 0.611)in men with PSA levels of 2.5–3.9 ng ml^(−1),4.0–9.9 ng ml^(−1),and 2.5–9.9 ng ml^(−1),respectively,but not at PSA levels of<2.5 ng ml^(−1)(AUC:0.713 vs 0.720).These findings suggest that the relationship between tPSA and PV may vary with PSA level and that fPSA is more powerful at predicting PV only in the"gray zone"(PSA levels of 2.5–9.9 ng ml^(−1)),but its performance was similar to that of tPSA at PSA levels of<2.5 ng ml^(−1).
文摘We evaluated whether the prostate-specific antigen (PSA)mass or free PSA (fPSA)mass (i.e.,absolute amount of total circulating PSA or fPSA protein,respectively),versus serum PSA or fPSA concentration,improves the accuracy of predicting the total prostate volume (TPV)in relation to obesity.Among men whose multicore (≥12)transrectal prostate biopsy was negative,586 who had a PSA of <10 ng ml^-1 and underwent the fPSA test prior to biopsy were enrolled.The PSA mass or fPSA mass (pg)was calculated by multiplying the serum level by plasma volume.At each TPV cut-off point (30 ml,40 ml,and 50 ml),the areas under the receiver operating characteristics curve (AUCs)of each variable were compared in obesity-based subgroups.AUCs of fPSA and fPSA mass for predicting TPV were significantly larger than those for PSA and PSA mass by 8.7%-12.1%at all cut-off points. Subgroup analyses based on obesity showed that,although PSA mass and fPSA mass enhanced accuracy by 4%(P =0.031)and 1.8%(P =0.003),respectively,for determining TPVs of ≥30 ml and ≥50 ml in obese and overweight men,they did not improve the accuracy in most other combinations of the degrees of obesity with TPV cut-off points.Thus,compared with serum PSA or fPSA,the absolute amount of PSA or fPSA protein mass improved the accuracy of predicting TPV in obese men very minimally and only for certain TPV cut-off points.Hence,these indicators may not provide clinically meaningful improvement in predicting TPV in obese men.
文摘Purpose: Prostate specific antigen levels can be normalized by the prostate volume to give a prostate specific antigen density (PSAd). Magnetic resonance imaging (MRI) can more accurately determine prostate zonal anatomy and prostate volumes compared to transrectal ultrasound, and hence may lead to more accurate PSAd measurements. Methods: Imaging and pathology of men undergoing prostate MRI from April 2007 to May 2009 were reviewed in this retrospective study. 73 patients were included for analysis, of which 45 had prostate cancer and 28 did not have cancer. Total, transitional zone, and peripheral zone values were determined by ultrasound prolate ellipse, MRI prolate ellipse, and MRI segmentation methods. Results: The study population showed an average PSA of 6.3 ng/mL, with the control mean PSA (8.8 ng/mL) being greater than the cancer group (5.3 ng/mL). Transrectal ultrasound underestimated the prostate volume (mean 27.7 mL versus MRI volume of 38.3 mL, p ≤ 0.001). No difference was seen between cancer and control populations using PSAd. PSAd correctly categorized low (Gleason < 7) and high-grade cancers (Gleason ≥ 7) in patients with malignancy. Conclusion: Transrectal ultrasound underestimates prostate volumes and hence is inaccurate in calculating PSAd. MRI more accurately depicts PSAd, however PSAd is unable to differentiate between patients with cancer and benign disease such as BPH or prostatitis.
文摘Objective:To investigate the effect of prostate volume on robot-assisted radical prostatectomy.Methods:Clinical data of 75 patients underwent RARP in the Affiliated Hospital of Qingdao University were retrospectively analyzed.The patients were divided into 3 groups according to size of prostate.A total of 35 cases with prostate volume less than 30ml were recorded as group 1,27 cases with volume of 30 to 50 ml were recorded as group 2,and 13 cases with volume greater than 50ml were recorded as group 3.Age,BMI,preoperative PSA,operation time,intraoperative bleeding volume,postoperative drainage volume,indwelling time of catheter,indwelling time of drainage tube,total hospitalization time,pathological stage,surgical margin,urine control and biochemical recurrence were observed.Results:All operations were performed under Da Vinci robot assistance,and no patient was transferred to open surgery.There was no significant difference in age,preoperative PSA,BMI,operation time,intraoperative bleeding volume,postoperative drainage volume,indwelling time of catheter,total hospitalization time,pathological stage,rate of positive surgical margin and recovery of urinary continence between the groups.Indwelling time of drainage tube was longer in group with larger prostate,6.4(±4.5)days in group 1,6.3(±2.9)days in group 2 and 7.1(±2.5)days in group 3.Gleason score was lower in group with larger prostate,with statistical difference.Conclusion:Prostate volume had no significant effect on urinary control,rate of positive surgical margin and recurrence after RARP.Gleason score of pathological tissue was lower and indwelling time of drainage tube was longer in patients with larger prostate after RARP.Operation time and intraoperative bleeding volume of large prostate patients underwent RARP need to be further studied.RARP has certain advantages for patients with large prostate.
文摘BACKGROUND Carbon ion radiotherapy(CIRT)is currently used to treat prostate cancer.Rectal bleeding is a major cause of toxicity even with CIRT.However,to date,a correlation between the dose and volume parameters of the 12 fractions of CIRT for prostate cancer and rectal bleeding has not been shown.Similarly,the clinical risk factors for rectal bleeding were absent after 12 fractions of CIRT.AIM To identify the risk factors for rectal bleeding in 12 fractions of CIRT for prostate cancer.METHODS Among 259 patients who received 51.6 Gy[relative biological effectiveness(RBE)],in 12 fractions of CIRT,15 had grade 1(5.8%)and nine had grade 2 rectal bleeding(3.5%).The dose-volume parameters included the volume(cc)of the rectum irradiated with at least x Gy(RBE)(Vx)and the minimum dose in the most irradiated x cc normal rectal volume(Dx).RESULTS The mean values of D6cc,D2cc,V10 Gy(RBE),V20 Gy(RBE),V30 Gy(RBE),and V40 Gy(RBE)were significantly higher in the patients with rectal bleeding than in those without.The cutoff values were D6cc=34.34 Gy(RBE),D2cc=46.46 Gy(RBE),V10 Gy(RBE)=9.85 cc,V20 Gy(RBE)=7.00 cc,V30 Gy(RBE)=6.91 cc,and V40 Gy(RBE)=4.26 cc.The D2cc,V10 Gy(RBE),and V20 Gy(RBE)cutoff values were significant predictors of grade 2 rectal bleeding.CONCLUSION The above dose-volume parameters may serve as guidelines for preventing rectal bleeding after 12 fractions of CIRT for prostate cancer.
基金Chinese Scholarship Council(202206240086)National Natural Science Foundation of China(81974099,82170785,81974098,82170784)+4 种基金National Key Research and Development Program of China(2021YFC2009303)programs from Science and Technology Department of Sichuan Province(2021YFH0172)Young Investigator Award of Sichuan University 2017(2017SCU04A17)Technology Innovation Research and Development Project of Chengdu Science and Technology Bureau(2019-YF05-00296-SN)Sichuan University-Panzhihua science and technology cooperation special fund(2020CDPZH-4).
文摘In recent years,advancements in single-cell and spatial transcriptomics,which are highly regarded developments in the current era,particularly the emerging integration of single-cell and spatiotemporal transcriptomics,have enabled a detailed molecular comprehension of the complex regulation of cell fate.The insights obtained from these methodologies are anticipated to significantly contribute to the development of personalized medicine.Currently,single-cell technology is less frequently utilized for prostate cancer compared with other types of tumors.Start-ing from the perspective of RNA sequencing technology,this review outlined the signifcance of single-cell RNA sequencing(scRNA-seq)in prostate cancer research,encompassing preclinical medicine and clinical applications.We summarize the differences between mouse and human prostate cancer as revealed by scRNA-seq studies,as well as a combination of multi-omics methods involving scRNA-seq to highlight the key molecular targets for the diagnosis,treatment,and drug resistance characteristics of prostate cancer.These studies are expected to provide novel insights for the development of immunotherapy and other innovative treatment strategies for castration-resistant prostate cancer.Furthermore,we explore the potential clinical applications stemming from other single-cell technologies in this review,paving the way for future research in precision medicine.
基金supported by Guangxi Medical and Health Appropriate Technology Development and Promotion Application Project(S2022022).
文摘Background:Transmembrane emp24 trafficking protein 3(TMED3)is associated with the development of several tumors;however,whether TMED3 regulates the progression of prostate cancer remains unclear.Materials and Methods:Short hairpin RNA was performed to repress TMED3 in prostate cancer cells(DU145 cells)and in a prostate cancer mice model to determine its function in prostate cancer in vitro and in vivo.Results:In the present study,we found that TMED3 was highly expressed in prostate cancer cells.In vitro,shTMED3 treatment suppressed the proliferation,invasion,and migration and promoted the apoptosis of DU145 cells.Additionally,the Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis showed a strong correlation between TMED3 and forkhead box O transcription factor(FOXO)pathway.Furthermore,TMED3 inhibition efficiently decreased FOXO1a and FOXO3a phosphorylation.In vivo,TMED3 downregulation suppressed the apoptosis,growth,and metastasis of prostate cancer cells via FOXO1a and FOXO3a.Conclusion:The present findings show that TMED3 participates in the regulation of prostate cancer progression via FOXO1a and FOXO3a phosphorylation,thereby revealing a novel mechanism underlying prostate cancer development and suggesting that TMED3 inhibition may serve as a novel strategy for prostate cancer treatment.
基金supported by China Postdoctoral Science Foundation(2022M722674)Peixian Science and Technology Plan Project(P202410)Xuzhou Medical Reserve Talents Project(XWRCHT20220009).
文摘Prostate cancer(PCa)is one of the most common malignant tumors in the male genitourinary system,ranking second in incidence worldwide.Traditional Chinese medicine(TCM),as an important component of complementary and alternative medicine,shows unique advantages in cancer treatment.Chinese herbal medicine is usually composed of multiple ingredients and involves multiple signaling pathways,which showed function of inducing apoptosis of cancer cells,arresting the cell cycle,inhibiting invasion and metastasis,reducing drug resistance,and regulating immune function.Physical therapy is also an important treatment of TCM.Currently,Physical therapy such as acupuncture or Tai Chi and Qigong are gaining increased recognition in the management of PCa,particularly in addressing issues like urinary incontinence and bone metastasis-related pain.This article reviews the TCM treatment and therapy of PCa,in order to provide new research avenues and treatment options for the treatment of PCa with TCM and improve the quality of life of patients.
文摘Prostate cancer (PC) is among the most common cancer diagnoses in men worldwide and the fifth leading cause of cancer-related deaths. Approximately 1.5 million new cases of PC were reported worldwide in 2022 with nearly 400,000 associated deaths1. Notably, the incidence of PC in China has increased substantially compared to the global average2.
文摘BACKGROUND Vitamin D deficiency has been associated with prostate cancer,particularly in ethnic minorities.Patients with prostate cancer may still be deficient even in areas of high sun exposure.Although androgen deprivation therapy(ADT)is well documented to affect bone health,its impact on vitamin D levels is still uncertain.This study investigates the subgroups of prostate cancer patients most associated with vitamin D deficiency and ADT’s relation to this.AIM To examine how prevalent vitamin D deficiency is among prostate cancer patients in a sun-rich environment,with focus on differences by race and disease stage.It also assessed whether ADT is associated with changes in vitamin D levels.METHODS Prostate cancer patients treated at Chao Family Comprehensive Cancer Center between 2014-2024 were retrospectively studied with regards to vitamin D levels across racial groups,disease stages,and ADT exposure.Changes in vitamin D levels pre-and post-ADT over 24 months were assessed by statistical methods including paired t-tests.RESULTS Among 120 patients(mean age:74 years,mean body mass index:27.6 kg/m^(2)),African American(33.3%)and Hispanic(31.8%)patients had the greatest prevalence of vitamin D deficiency(<20 ng/mL).With a 28.6%deficit rate,metastatic castration-resistant prostate cancer had the highest prevalence rates of deficiency.There was no significant difference between pre-and post-ADT vitamin D levels(P=0.45).CONCLUSION Vitamin D deficiency is common in prostate cancer patients,especially racial minorities and those with advanced disease,despite residing in an area with high sun exposure.ADT does not significantly impact vitamin D levels in the short term.Routine screening and supplementation should be considered in these high-risk groups.
文摘This article discusses the coexistence of prostate adenocarcinoma and prostate urothelial carcinoma.Combining existing literature and research results,the potential mechanisms of the co-occurrence of these two cancers are explored,including the role of androgen receptor,gene mutations,and their complex interactions in cell signaling pathways,etc.Also,the hypothesis of prostate cancer transformation into urothelial carcinoma is explained from some perspectives,including tumor multipotent stem cell differentiation,epithelial-mesenchymal transition,mesenchymal-epithelial transition,and other mechanisms.Ultimately,the goal is to provide more accurate diagnoses and more personalized treatments in clinical practice,as well as to lay the foundation for improving patient prognoses in the future.
基金supported by the Interdepartmental Research Project of Peking University First Hospital(No.2023IR27 to Liu Y)the Scientific Research Seed Fund of Peking University First Hospital(No.2023SF40 to Qiu J)+3 种基金the High Quality Clinical Research Project of Peking University First Hospital(No.2022CR75 to Gong K)the Beijing Natural Science Foundation(No.QY23068 to Deng R)the National Natural Science Foundation of China(No.82141103,No.82172617,and No.81872081 to Gong K)the Capital’s Funds for Health Improvement and Research(No.2022-2-4074 to Gong K).
文摘Objective:To explore clinicopathological predictors of adverse pathological changes(APCs)(upgrading,upstaging,and positive surgical margin[PSM])after robot-assisted radical prostatectomy(RARP)in clinical tumor stage 2c(cT2c)prostate cancer(PCa)patients.Methods:From January 2018 to December 2022,cT2cN0M0 PCa patients who underwent prostate biopsies and subsequent RARP at the Peking University First Hospital with an interval between biopsy and RARP of ≤90 days were included.Univariable and stepwise multivariable logistic regression analyses were performed to identify independent risk factors associated with APCs.Nomograms were constructed based on these predictive models.The performance of the nomograms was evaluated by receiver operating characteristic curves,decision curve analyses,and calibration plots.Results:A total of 423 eligible cT2cN0M0 PCa patients were included.The rates of upgrading,upstaging,and PSM in our cohortwere 33%,51%,and 35%,respectively.The stepwise multivariate logistic analysis suggested that PSA density and the percentage of positive cores in systematic biopsy were significantly associated with the occurrence of APCs.The score of the Prostate Imaging Reporting and Data System,PSA density,and the International Society of Urological Pathology grade group(IGG)of needle-biopsy specimens(or clinical IGG[cIGG])were significantly associated with upgrading.The PSA density,percentage of positive cores in systematic biopsy,and largest tumor percentage in all cores of each patient(LTP)were significantly associated with upstaging.The PSA density and LTP were significantly associatedwith the PSM.Based on these results,four nomogramswere developed.Receiver operating characteristic curves,decision curve analyses,and calibration plots implied that the nomograms exhibited excellent accuracy.Conclusion:The predictive models we developed could help to identify high-risk PCa early,and optimize clinical decisions of cT2cN0M0 PCa patients.
