Therapeutic options for the treatment of colorectal cancer(CRC) are diverse but still not always satisfying. Recent success of immune checkpoint inhibition treatment for the subgroup of CRC patients suffering from hyp...Therapeutic options for the treatment of colorectal cancer(CRC) are diverse but still not always satisfying. Recent success of immune checkpoint inhibition treatment for the subgroup of CRC patients suffering from hypermutated tumors suggests a permanent role of immune therapy in the clinical management of CRC. Substantial improvement in treatment outcome could be achieved by development of efficient patient-individual CRC vaccination strategies. This mini-review summarizes the current knowledge on the two general classes of targets: tumor-associated antigens(TAAs) and tumorspecific antigens. TAAs like carcinoembryonic antigen and melanoma associated antigen are present in and shared by a subgroup of patients and a variety of clinical studies examined the efficacy of different TAA-derived peptide vaccines. Combinations of several TAAs as the next step and the development of personalized TAA-based peptide vaccines are discussed. Improvements of peptidebased vaccines achievable by adjuvants and immunestimulatory chemotherapeutics are highlighted. Finally, we sum up clinical studies using tumor-specific antigens-in CRC almost exclusively neoantigens-which revealed promising results; particularly no severe adverse events were reported so far. Critical progress for clinical outcomes can be expected by individualizing neoantigen-based peptide vaccines and combining them with immunestimulatory chemotherapeutics and immune checkpoint inhibitors. In light of these data and latest developments, truly personalized neoantigen-based peptide vaccines can be expected to fulfill modern precision medicine's requirements and will manifest as treatment pillar for routine clinical management of CRC.展开更多
Objective To study the effects of liver specific antigen(LSA)on liver allotransplantation rejection. Methods Orthotopic liver transplantation was performed in this study. GroupⅠ: syngeneic control(Wistar-to-Wistar); ...Objective To study the effects of liver specific antigen(LSA)on liver allotransplantation rejection. Methods Orthotopic liver transplantation was performed in this study. GroupⅠ: syngeneic control(Wistar-to-Wistar); GroupⅡ: acute rejection(SD-to-Wistar). GroupIII: thymic inoculation of SD rat LSA day 7 before transplantation. The observation of general condition and survival time, rejection grades and the NF-кB activity of splenocytes were used to analyze severity of acute rejection and immune state of animals in different groups. Results The general condition of groupⅠwas fair post transplantation with no sign of rejection. All recipients of group Ⅱ died within days 9 to 13 post transplantation with median survival time of 10.7 ±1.37 days. As for group III, 5 out of 6 recipients survived for a long period with remarkably better ge-neral condition than that of group Ⅱ. Its rejection grades were significantly lower than groupⅡ(P < 0.05).NF-кB activity was only detected in groupⅠbetween days 5 and 7 after transplantation, whereas highactivity of NF-кB was detected at all points in group Ⅱ and low NF-кB activity was detected in group III which was significantly lower than that of group Ⅱ(P < 0.05). Conclusions LSA is an important transplantation antigen directly involved in the immunorejection of liver transplantation. Intrathymic inoculation of LSA can alleviate the rejection of liver allotransplantation,grafts survive for a period of time thereby, allowing a novel way to liver transplantation immunotolerance.展开更多
A cross-sectional study was conducted to estimate the age-stratified normal levels and age-related changes in the risk predictors of benign prostatic hyperplasia(BPH)progression.A total of 4706 male participants aged ...A cross-sectional study was conducted to estimate the age-stratified normal levels and age-related changes in the risk predictors of benign prostatic hyperplasia(BPH)progression.A total of 4706 male participants aged 40 years or older in Zhengzhou(China)were enrolled.The values of the International Prostate Symptom Score(IPSS),prostate-specific antigen(PSA),prostate volume(PV),and postvoid residual urine volume(PVR)significantly increased with age.Nonlinear relationships between age and IPSS scores≥8(P for nonlinearity=0.046),PSA level≥1.6 ng ml^(-1),PV≥31 ml,or PVR≥39 ml(all P for nonlinearity<0.001)were observed.After the age of 61 years,the risk indicators related to BPH progression were positively correlated with age(odds ratio[OR]>1),regardless of the predictors of the IPSS score,PSA level,PV,or PVR;and the OR values increased gradually.Therefore,after the age of 61 years,the risk predictors related to BPH progression were positively correlated with age.展开更多
We performed this study to investigate the diagnostic performance of prostate-specific antigen density(PSAD)in a multicenter cohort of the Chinese Prostate Cancer Consortium.Outpatients with prostate-specific antigen(...We performed this study to investigate the diagnostic performance of prostate-specific antigen density(PSAD)in a multicenter cohort of the Chinese Prostate Cancer Consortium.Outpatients with prostate-specific antigen(PSA)levels≥4.0 ng ml^(-1) regardless of digital rectal examination(DRE)results or PSA levels<4.0 ng ml^(-1)and abnormal DRE results were included from 18 large referral hospitals in China.The diagnostic performance of PSAD and the sensitivity and specificity for the diagnosis of prostate cancer(PCa)and high-grade prostate cancer(HGPCa)at different cutoff values were evaluated.A total of 5220 patients were included in the study,and 2014(38.6%)of them were diagnosed with PCa.In patients with PSA levels ranging from 4.0 to 10.0 ng ml^(-1),PSAD was associated with PCa and HGPCa in both univariate(odds ratio[OR]=45.15,P<0.0001 and OR=25.38,P<0.0001,respectively)and multivariate analyses(OR=52.55,P<0.0001 and OR=26.05,P<0.0001,respectively).The areas under the receiver operating characteristic curves(AUCs)of PSAD in predicting PCa and HGPCa were 0.627 and 0.630,respectively.With the PSAD cutoff of 0.10 ng ml^(-2),we obtained a sensitivity of 88.7%for PCa,and nearly all(89.9%)HGPCa cases could be detected and biopsies could be avoided in 20.2%of the patients(359/1776 cases).Among these patients who avoided biopsies,only 30 cases had HGPCa.We recommend 0.10 ng ml^(-2) as the proper cutoff value of PSAD,which will obtain a sensitivity of nearly 90%for both PCa and HGPCa.The results of this study should be validated in prospective,population-based multicenter studies.展开更多
Objective:To test the diagnostic performance of percent free prostate-specific antigen(%fPSA)in predicting any prostate cancer(PCa)and high-grade prostate cancer(HGPCa)in a retrospective multi-center biopsy cohort wit...Objective:To test the diagnostic performance of percent free prostate-specific antigen(%fPSA)in predicting any prostate cancer(PCa)and high-grade prostate cancer(HGPCa)in a retrospective multi-center biopsy cohort with a PSA level of 4.0e10.0 ng/mL in China.Methods:Consecutive patients with a PSA of 4.0-10.0 ng/mL who underwent transrectal ultrasound-guided biopsy were enrolled at 16 Chinese medical centers from January 1st,2010 to December 31st,2013.Total and free serum PSA determinations were performed using three types of electro-chemiluminescence immunoassays recalibrated to the World Health Organization(WHO)standard.The diagnostic accuracy of PSA,%fPSA,and %fPSA in combination with PSA(%fPSA t PSA)was determined using the area under the receiver operating characteristic(ROC)curve(AUC).Results:A total of 2310 consecutive men with PSA levels between 4.0 and 10.0 ng/mL were included,and the detection rate of PCa was 25.1%.The AUC of%fPSA and %fPSA t PSA in predicting any PCa was superior to PSA alone in men aged≥60 years(0.623 vs.0.534,p<0.0001)but not in men aged 40e59 years(0.517 vs.0.518,p=0.939).Similar result was yield in predicting HGPCa.Conclusion:In a clinical setting of Chinese men with 4.0e10.0 ng/mL PSA undergoing initial prostate biopsy,adding %fPSA to PSA can moderately improve the diagnostic accuracy for any PCa and HGPCa compared with PSA alone in patients≥60 but not in patients aged 40-59 years.展开更多
Objective To establish and optimize the proteomic analysis of protoscoleces-specific antigens from Echinococcus granulosus. To provide a foundation for identifying specific antigens in the soluble proteins of E. granu...Objective To establish and optimize the proteomic analysis of protoscoleces-specific antigens from Echinococcus granulosus. To provide a foundation for identifying specific antigens in the soluble proteins of E. granulosus protoscoleces for further research. Methods Brood capsules were collected aseptically from fertile E. granulosus cysts from the livers of an infected patient. The fertile E. granulosus cysts were fractured, and protoscoleces were collected by centrifugation. The soluble proteins of protoscoleces were acquired using the 2D Quant kit according to the manufacturer＇s instructions. We employed two-dimensional electrophoresis （2-DE） combined with immunoblot assay （Western blot） to analyze the soluble components of E. granulosus protoscoleces antigens. The 2-DE and immunoblot maps obtained were analyzed with PDQuest 8.0 image analysis software. Results About 233 soluble protein spots were identified with Coomassie-stained gels. Most of the proteins had a molecular weight of 16 000 Da to 117 000 Da, and an isoelectric point value of 3.0 to 10.0. 2-DE immunoblot was conducted and 57 specific antigen spots were observed, among which 23 spots were identified. Conclusion 2-DE combined with Western blot is the key to successful proteomic analysis and presents a new possibility for searching the specific E. granulosus protoscoleces antigens.展开更多
BACKGROUND Prostate cancer(PC)is one of the most common malignant tumors in men,and bone metastasis is one of its common complications,which seriously affects the quality of life and prognosis of patients.AIM To inves...BACKGROUND Prostate cancer(PC)is one of the most common malignant tumors in men,and bone metastasis is one of its common complications,which seriously affects the quality of life and prognosis of patients.AIM To investigate the diagnostic value of technetium-99m-methylene diphosphonate(99mTc-MDP)single photon emission computed tomography(SPECT)/CT imaging combined with the serum prostate-specific antigen(PSA)/free PSA ratio for PC bone metastasis(PCBM).METHODS One hundred patients with PC who visited the Hospital of Chengdu University of Traditional Chinese Medicine from January 2020 to January 2022 were recruited as the experimental(Exp)group,while 30 patients with benign prostatic lesions(BPLs)were recruited as the control(Ctrl)group.All patients underwent 99mTc-MDP SPECT/CT imaging and serum PSA/fPSA testing.The SPECT/CT imaging results and serum PSA/fPSA ratios of patients were analyzed to evaluate their diagnostic values for PCBM.RESULTS The difference in general information of the patients was not obvious,showing comparability.The two methods showed no visible differences in negative predictive value and sensitivity for patients with PCBM,but had great differences in positive predictive value and specificity(P<0.05).The PSA/fPSA ratio of patients with PC in the Exp group was lower than those with BPLs,and patients with PCBM had a much lower PSA/fPSA ratio than those without PC(P<0.05).The results confirmed that the combined use of 99mTc-MDP SPECT/CT imaging and serum PSA/fPSA ratio achieved a detection rate of 95%for PCBM.CONCLUSION The combination of 99mTc-MDP SPECT/CT and PSA/fPSA ratio is accurate and reliable for the diagnosis of PCBM,which provides an important reference for clinical practice.展开更多
BACKGROUND Prostate cancer is the second most common cancer among men worldwide,and prostate-specific antigen(PSA)is often used in clinical practice to screen for prostate cancer.Normal total PSA(tPSA)level initially ...BACKGROUND Prostate cancer is the second most common cancer among men worldwide,and prostate-specific antigen(PSA)is often used in clinical practice to screen for prostate cancer.Normal total PSA(tPSA)level initially excludes prostate cancer.Here,we report a case of prostate cancer with elevated free PSA density(fPSAD).CASE SUMMARY A patient diagnosed with benign prostatic hyperplasia underwent prostatectomy,and the postoperative pathological results showed acinar adenocarcinoma of the prostate.The patient is currently undergoing endocrine chemotherapy.CONCLUSION We provide a clinical reference for diagnosis and treatment of patients with normal tPSA but elevated fPSAD.展开更多
Our goal was to establish two new predictive models of prostate cancer to determine whether to require a prostate biopsy when the prostate-specific antigen level is in the diagnostic gray zone.A retrospective analysis...Our goal was to establish two new predictive models of prostate cancer to determine whether to require a prostate biopsy when the prostate-specific antigen level is in the diagnostic gray zone.A retrospective analysis of 197 patients undergoing prostate biopsy with prostate-specific antigens between 4 and 10 ng ml^?1 was conducted.Of these,47 patients were confirmed to have cancer,while the remaining 150 patients were diagnosed with benign prostate disease after examining biopsy pathology.Two multivariate logistic regression models were established including age,prostate volumes,free/total prostate-specific antigen ratio,and prostate-specific antigen density using SPSS 19.0 to obtain the predicted probability and Logit P,and then,two receiver operating characteristic(ROC)curves were drawn to obtain the best cutoff value for prostate biopsy:one for the group of all the prostate cancers and one for the group of clinically significant prostate cancers.The best cutoff value for prostate biopsy was 0.25 from the multivariate logistic regression ROC curve model of all the prostate cancers,which gave a sensitivity of 75.4%and a specificity of 75.8%.The best cutoff value for prostate biopsy was 0.20 from the multivariate logistic regression model of clinically significant prostate cancers,which gave a sensitivity of 76.7%and a specificity of 80.1%.We identified the best cutoff values for prostate biopsy(0.25 for all prostate cancers and 0.20 for clinically significant prostate cancers)to determine whether to require prostate biopsy when the PSA level is in the diagnostic gray zone.展开更多
BACKGROUND Aggressive variant prostate cancer(AVPC)is a rare disease that progresses rapidly.The first-line treatment for AVPC is currently unknown.We examined a rare case of AVPC with rare brain and bladder metastase...BACKGROUND Aggressive variant prostate cancer(AVPC)is a rare disease that progresses rapidly.The first-line treatment for AVPC is currently unknown.We examined a rare case of AVPC with rare brain and bladder metastases.A summary review of the mechanism of development,clinicopathological manifestations,associated treatments and prognosis of this disease is presented.CASE SUMMARY The patient was diagnosed with prostate cancer(PCA),and was actively treated with endocrine therapy,radiotherapy,chemotherapy,and traditional Chinese medicine.Unfortunately,he was insensitive to treatment,and the disease progressed rapidly.He died five years after being diagnosed with PCA.CONCLUSION We should reach consensus definitions of the AVPC and other androgen receptorindependent subtypes of PCA and develop new biomarkers to identify groups of high-risk variants.It is crucial to complete a puncture biopsy of the tumor or metastatic lesion as soon as possible in patients with advanced PCA who exhibit clinical features such as low Prostate-specific antigen levels,high carcinoembryonic antigen levels,and insensitivity to hormones to determine the pathological histological type and to create a more aggressive monitoring and treatment regimens.展开更多
The goal of this study was to investigate the clinical application of free/total prostate-specific antigen(F/T PSA)ratio,considering the new broad serum total PSA(T-PSA)“gray zone”of 2.0–25.0 ng ml^(−1)in different...The goal of this study was to investigate the clinical application of free/total prostate-specific antigen(F/T PSA)ratio,considering the new broad serum total PSA(T-PSA)“gray zone”of 2.0–25.0 ng ml^(−1)in differential diagnosis of prostate cancer(PCa)and benign prostate diseases(BPD)in men over 50 years in Western China.A total of 1655 patients were included,528 with PCa and 1127 with BPD.Serum T-PSA,free PSA(F-PSA),and F/T PSA ratio were analyzed.Receiver operating characteristic curves were used to assess the efficiency of PSA and F/T PSA ratio.There were 47.4%of cancer patients with T-PSA of 2.0–25.0 ng ml^(−1).When T-PSA was 2.0–4.0 ng ml^(−1),4.0–10.0 ng ml^(−1),and 10.0–25.0 ng ml^(−1),the area under the curve(AUC)of F/T PSA ratio was 0.749,0.769,and 0.761,respectively.The best AUC of F/T PSA ratio was 0.811 when T-PSA was 2.0–25.0 ng ml^(−1),with a specificity of 0.732,a sensitivity of 0.788,and an optimal cutoff value of 15.5%.The AUC of F/T PSA ratio in different age groups(50–59 years,60–69 years,70–79 years,and≥80 years)was 0.767,0.806,0.815,and 0.833,respectively,and the best sensitivity(0.857)and specificity(0.802)were observed in patients over 80 years.The T-PSA trend was in accordance with the Gleason score,tumor node metastasis(TNM)stage,and American Joint Committee on Cancer prognosis group.Therefore,the F/T PSA ratio can facilitate the differential diagnosis of PCa and BPD in the broad T-PSA“gray zone”.Serum T-PSA can be a Gleason score and prognostic indicator.展开更多
Knowledge about the effect of different prostate biopsy approaches on the prostate cancer detection rate(CDR)in patients with gray-zone prostate-specific antigen(PSA)is limited.We performed this study to compare the C...Knowledge about the effect of different prostate biopsy approaches on the prostate cancer detection rate(CDR)in patients with gray-zone prostate-specific antigen(PSA)is limited.We performed this study to compare the CDR among patients who underwent different biopsy approaches and had rising PSA levels in the gray zone.Two hundred and twenty-two patients who underwent transrectal prostate biopsy(TRB)and 216 patients who underwent transperineal prostate biopsy(TPB)between June 2016 and September 2022 were reviewed in this study.In addition,110 patients who received additional targeted biopsies following the systematic TPB were identified.Clinical parameters,including age,PSA derivative,prostate volume(PV),and needle core count,were recorded.The data were fitted via propensity score matching(PSM),adjusting for potential confounders.TPB outperformed TRB in terms of the CDR(49.6%vs 28.3%,P=0.001).The clinically significant prostate cancer(csPCa)detection rate was not significantly different between TPB and TRB(78.6%vs 68.8%,P=0.306).In stratified analysis,TPB outperformed TRB in CDR when the age of patients was 65–75 years(59.0%vs 22.0%,P<0.001),when PV was 25.00–50.00 ml(63.2%vs 28.3%,P<0.001),and when needle core count was no more than 12(58.5%vs 31.5%,P=0.005).The CDR(P=0.712)and detection rate of csPCa(P=0.993)did not significantly differ among the systematic,targeted,and combined biopsies.TPB outperformed TRB in CDR for patients with gray-zone PSA.Moreover,performing target biopsy after systematic TPB provided no additional benefits in CDR.展开更多
This study explored a new model of Prostate Imaging Reporting and Data System(PIRADS)and adjusted prostate-specific antigen density of peripheral zone(aPSADPZ)for predicting the occurrence of prostate cancer(PCa)and c...This study explored a new model of Prostate Imaging Reporting and Data System(PIRADS)and adjusted prostate-specific antigen density of peripheral zone(aPSADPZ)for predicting the occurrence of prostate cancer(PCa)and clinically significant prostate cancer(csPCa).The demographic and clinical characteristics of 853 patients were recorded.Prostate-specific antigen(PSA),PSA density(PSAD),PSAD of peripheral zone(PSADPZ),aPSADPZ,and peripheral zone volume ratio(PZ-ratio)were calculated and subjected to receiver operating characteristic(ROC)curve analysis.The calibration and discrimination abilities of new nomograms were verified with the calibration curve and area under the ROC curve(AUC).The clinical benefits of these models were evaluated by decision curve analysis and clinical impact curves.The AUCs of PSA,PSAD,PSADPZ,aPSADPZ,and PZ-ratio were 0.669,0.762,0.659,0.812,and 0.748 for PCa diagnosis,while 0.713,0.788,0.694,0.828,and 0.735 for csPCa diagnosis,respectively.All nomograms displayed higher net benefit and better overall calibration than the scenarios for predicting the occurrence of PCa or csPCa.The new model significantly improved the diagnostic accuracy of PCa(0.945 vs 0.830,P<0.01)and csPCa(0.937 vs 0.845,P<0.01)compared with the base model.In addition,the number of patients with PCa and csPCa predicted by the new model was in good agreement with the actual number of patients with PCa and csPCa in high-risk threshold.This study demonstrates that aPSADPZ has a higher predictive accuracy for PCa diagnosis than the conventional indicators.Combining aPSADPZ with PIRADS can improve PCa diagnosis and avoid unnecessary biopsies.展开更多
Objectives This study aimed to evaluate the performance of prostate-specific membrane antigen positron emission tomography/computed tomography(PSMA PET/CT)in comparison to multiparametric magnetic resonance imaging(mp...Objectives This study aimed to evaluate the performance of prostate-specific membrane antigen positron emission tomography/computed tomography(PSMA PET/CT)in comparison to multiparametric magnetic resonance imaging(mpMRI)for detecting biochemical recurrence of prostate cancer(PCa).Materials and methods We conducted a comprehensive search for articles published in PubMed,Web of Science,Embase,and the Cochrane Library,spanning the inception of the database until October 26,2022,which included head-to-head comparisons of PSMA PET/CT and mpMRI for assessing the biochemical recurrence of PCa.Results A total of 5 studies including 228 patients were analyzed.The overall positivity rates of PSMA PET/CT and mpMRI for detecting biochemical recurrence of PCa after final treatment were 0.68(95%confidence interval[CI],0.52–0.89)and 0.56(95%CI,0.36–0.88),respectively.The positivity rates of PSMA PET/CT and mpMRI for detecting local recurrence,lymph node metastasis,and bone metastases were 0.37(95%CI,0.30–0.47)and 0.38(95%CI,0.22–0.67),0.44(95%CI,0.35–0.56)and 0.25(95%CI,0.17–0.35),and 0.19(95%CI,0.11–0.31)and 0.12(95%CI,0.05–0.25),respectively.Compared with mpMRI,PSMA PET/CT exhibited a higher positivity rate for detecting biochemical recurrence and lymph node metastases,and no significant difference in the positivity rate of local recurrence was observed between these 2 imaging modalities.Conclusions Compared with mpMRI,PSMA PET/CT appears to have a higher positivity rate for detecting biochemical recurrence of PCa.Although both imaging methods showed similar positivity rates of detecting local recurrence,PSMA PET/CT outperformed PSMA PET/CT in detecting lymph node involvement and overall recurrence.展开更多
基金Supported by Ministerium für Wirtschaft,Arbeit und Gesundheit Mecklenburg-Vorpommern,No.TBI-V-1-241-VBW-084
文摘Therapeutic options for the treatment of colorectal cancer(CRC) are diverse but still not always satisfying. Recent success of immune checkpoint inhibition treatment for the subgroup of CRC patients suffering from hypermutated tumors suggests a permanent role of immune therapy in the clinical management of CRC. Substantial improvement in treatment outcome could be achieved by development of efficient patient-individual CRC vaccination strategies. This mini-review summarizes the current knowledge on the two general classes of targets: tumor-associated antigens(TAAs) and tumorspecific antigens. TAAs like carcinoembryonic antigen and melanoma associated antigen are present in and shared by a subgroup of patients and a variety of clinical studies examined the efficacy of different TAA-derived peptide vaccines. Combinations of several TAAs as the next step and the development of personalized TAA-based peptide vaccines are discussed. Improvements of peptidebased vaccines achievable by adjuvants and immunestimulatory chemotherapeutics are highlighted. Finally, we sum up clinical studies using tumor-specific antigens-in CRC almost exclusively neoantigens-which revealed promising results; particularly no severe adverse events were reported so far. Critical progress for clinical outcomes can be expected by individualizing neoantigen-based peptide vaccines and combining them with immunestimulatory chemotherapeutics and immune checkpoint inhibitors. In light of these data and latest developments, truly personalized neoantigen-based peptide vaccines can be expected to fulfill modern precision medicine's requirements and will manifest as treatment pillar for routine clinical management of CRC.
文摘Objective To study the effects of liver specific antigen(LSA)on liver allotransplantation rejection. Methods Orthotopic liver transplantation was performed in this study. GroupⅠ: syngeneic control(Wistar-to-Wistar); GroupⅡ: acute rejection(SD-to-Wistar). GroupIII: thymic inoculation of SD rat LSA day 7 before transplantation. The observation of general condition and survival time, rejection grades and the NF-кB activity of splenocytes were used to analyze severity of acute rejection and immune state of animals in different groups. Results The general condition of groupⅠwas fair post transplantation with no sign of rejection. All recipients of group Ⅱ died within days 9 to 13 post transplantation with median survival time of 10.7 ±1.37 days. As for group III, 5 out of 6 recipients survived for a long period with remarkably better ge-neral condition than that of group Ⅱ. Its rejection grades were significantly lower than groupⅡ(P < 0.05).NF-кB activity was only detected in groupⅠbetween days 5 and 7 after transplantation, whereas highactivity of NF-кB was detected at all points in group Ⅱ and low NF-кB activity was detected in group III which was significantly lower than that of group Ⅱ(P < 0.05). Conclusions LSA is an important transplantation antigen directly involved in the immunorejection of liver transplantation. Intrathymic inoculation of LSA can alleviate the rejection of liver allotransplantation,grafts survive for a period of time thereby, allowing a novel way to liver transplantation immunotolerance.
基金founded by Zhengzhou Finance Bureau (No.201974).
文摘A cross-sectional study was conducted to estimate the age-stratified normal levels and age-related changes in the risk predictors of benign prostatic hyperplasia(BPH)progression.A total of 4706 male participants aged 40 years or older in Zhengzhou(China)were enrolled.The values of the International Prostate Symptom Score(IPSS),prostate-specific antigen(PSA),prostate volume(PV),and postvoid residual urine volume(PVR)significantly increased with age.Nonlinear relationships between age and IPSS scores≥8(P for nonlinearity=0.046),PSA level≥1.6 ng ml^(-1),PV≥31 ml,or PVR≥39 ml(all P for nonlinearity<0.001)were observed.After the age of 61 years,the risk indicators related to BPH progression were positively correlated with age(odds ratio[OR]>1),regardless of the predictors of the IPSS score,PSA level,PV,or PVR;and the OR values increased gradually.Therefore,after the age of 61 years,the risk predictors related to BPH progression were positively correlated with age.
基金for National Natural Science Foundation Youth Project(No.81702514 to RC).
文摘We performed this study to investigate the diagnostic performance of prostate-specific antigen density(PSAD)in a multicenter cohort of the Chinese Prostate Cancer Consortium.Outpatients with prostate-specific antigen(PSA)levels≥4.0 ng ml^(-1) regardless of digital rectal examination(DRE)results or PSA levels<4.0 ng ml^(-1)and abnormal DRE results were included from 18 large referral hospitals in China.The diagnostic performance of PSAD and the sensitivity and specificity for the diagnosis of prostate cancer(PCa)and high-grade prostate cancer(HGPCa)at different cutoff values were evaluated.A total of 5220 patients were included in the study,and 2014(38.6%)of them were diagnosed with PCa.In patients with PSA levels ranging from 4.0 to 10.0 ng ml^(-1),PSAD was associated with PCa and HGPCa in both univariate(odds ratio[OR]=45.15,P<0.0001 and OR=25.38,P<0.0001,respectively)and multivariate analyses(OR=52.55,P<0.0001 and OR=26.05,P<0.0001,respectively).The areas under the receiver operating characteristic curves(AUCs)of PSAD in predicting PCa and HGPCa were 0.627 and 0.630,respectively.With the PSAD cutoff of 0.10 ng ml^(-2),we obtained a sensitivity of 88.7%for PCa,and nearly all(89.9%)HGPCa cases could be detected and biopsies could be avoided in 20.2%of the patients(359/1776 cases).Among these patients who avoided biopsies,only 30 cases had HGPCa.We recommend 0.10 ng ml^(-2) as the proper cutoff value of PSAD,which will obtain a sensitivity of nearly 90%for both PCa and HGPCa.The results of this study should be validated in prospective,population-based multicenter studies.
文摘Objective:To test the diagnostic performance of percent free prostate-specific antigen(%fPSA)in predicting any prostate cancer(PCa)and high-grade prostate cancer(HGPCa)in a retrospective multi-center biopsy cohort with a PSA level of 4.0e10.0 ng/mL in China.Methods:Consecutive patients with a PSA of 4.0-10.0 ng/mL who underwent transrectal ultrasound-guided biopsy were enrolled at 16 Chinese medical centers from January 1st,2010 to December 31st,2013.Total and free serum PSA determinations were performed using three types of electro-chemiluminescence immunoassays recalibrated to the World Health Organization(WHO)standard.The diagnostic accuracy of PSA,%fPSA,and %fPSA in combination with PSA(%fPSA t PSA)was determined using the area under the receiver operating characteristic(ROC)curve(AUC).Results:A total of 2310 consecutive men with PSA levels between 4.0 and 10.0 ng/mL were included,and the detection rate of PCa was 25.1%.The AUC of%fPSA and %fPSA t PSA in predicting any PCa was superior to PSA alone in men aged≥60 years(0.623 vs.0.534,p<0.0001)but not in men aged 40e59 years(0.517 vs.0.518,p=0.939).Similar result was yield in predicting HGPCa.Conclusion:In a clinical setting of Chinese men with 4.0e10.0 ng/mL PSA undergoing initial prostate biopsy,adding %fPSA to PSA can moderately improve the diagnostic accuracy for any PCa and HGPCa compared with PSA alone in patients≥60 but not in patients aged 40-59 years.
基金supported by the National Natural Science Foundation of China (Nos. 30260105 and 30660176)the Natural Science Foundation of Ningxia Hui Autonomous Region (NZ10192)the Doctor’s Subject Science Foundation of Ningxia Medical University (KF2010-33)
文摘Objective To establish and optimize the proteomic analysis of protoscoleces-specific antigens from Echinococcus granulosus. To provide a foundation for identifying specific antigens in the soluble proteins of E. granulosus protoscoleces for further research. Methods Brood capsules were collected aseptically from fertile E. granulosus cysts from the livers of an infected patient. The fertile E. granulosus cysts were fractured, and protoscoleces were collected by centrifugation. The soluble proteins of protoscoleces were acquired using the 2D Quant kit according to the manufacturer＇s instructions. We employed two-dimensional electrophoresis （2-DE） combined with immunoblot assay （Western blot） to analyze the soluble components of E. granulosus protoscoleces antigens. The 2-DE and immunoblot maps obtained were analyzed with PDQuest 8.0 image analysis software. Results About 233 soluble protein spots were identified with Coomassie-stained gels. Most of the proteins had a molecular weight of 16 000 Da to 117 000 Da, and an isoelectric point value of 3.0 to 10.0. 2-DE immunoblot was conducted and 57 specific antigen spots were observed, among which 23 spots were identified. Conclusion 2-DE combined with Western blot is the key to successful proteomic analysis and presents a new possibility for searching the specific E. granulosus protoscoleces antigens.
文摘BACKGROUND Prostate cancer(PC)is one of the most common malignant tumors in men,and bone metastasis is one of its common complications,which seriously affects the quality of life and prognosis of patients.AIM To investigate the diagnostic value of technetium-99m-methylene diphosphonate(99mTc-MDP)single photon emission computed tomography(SPECT)/CT imaging combined with the serum prostate-specific antigen(PSA)/free PSA ratio for PC bone metastasis(PCBM).METHODS One hundred patients with PC who visited the Hospital of Chengdu University of Traditional Chinese Medicine from January 2020 to January 2022 were recruited as the experimental(Exp)group,while 30 patients with benign prostatic lesions(BPLs)were recruited as the control(Ctrl)group.All patients underwent 99mTc-MDP SPECT/CT imaging and serum PSA/fPSA testing.The SPECT/CT imaging results and serum PSA/fPSA ratios of patients were analyzed to evaluate their diagnostic values for PCBM.RESULTS The difference in general information of the patients was not obvious,showing comparability.The two methods showed no visible differences in negative predictive value and sensitivity for patients with PCBM,but had great differences in positive predictive value and specificity(P<0.05).The PSA/fPSA ratio of patients with PC in the Exp group was lower than those with BPLs,and patients with PCBM had a much lower PSA/fPSA ratio than those without PC(P<0.05).The results confirmed that the combined use of 99mTc-MDP SPECT/CT imaging and serum PSA/fPSA ratio achieved a detection rate of 95%for PCBM.CONCLUSION The combination of 99mTc-MDP SPECT/CT and PSA/fPSA ratio is accurate and reliable for the diagnosis of PCBM,which provides an important reference for clinical practice.
文摘BACKGROUND Prostate cancer is the second most common cancer among men worldwide,and prostate-specific antigen(PSA)is often used in clinical practice to screen for prostate cancer.Normal total PSA(tPSA)level initially excludes prostate cancer.Here,we report a case of prostate cancer with elevated free PSA density(fPSAD).CASE SUMMARY A patient diagnosed with benign prostatic hyperplasia underwent prostatectomy,and the postoperative pathological results showed acinar adenocarcinoma of the prostate.The patient is currently undergoing endocrine chemotherapy.CONCLUSION We provide a clinical reference for diagnosis and treatment of patients with normal tPSA but elevated fPSAD.
文摘Our goal was to establish two new predictive models of prostate cancer to determine whether to require a prostate biopsy when the prostate-specific antigen level is in the diagnostic gray zone.A retrospective analysis of 197 patients undergoing prostate biopsy with prostate-specific antigens between 4 and 10 ng ml^?1 was conducted.Of these,47 patients were confirmed to have cancer,while the remaining 150 patients were diagnosed with benign prostate disease after examining biopsy pathology.Two multivariate logistic regression models were established including age,prostate volumes,free/total prostate-specific antigen ratio,and prostate-specific antigen density using SPSS 19.0 to obtain the predicted probability and Logit P,and then,two receiver operating characteristic(ROC)curves were drawn to obtain the best cutoff value for prostate biopsy:one for the group of all the prostate cancers and one for the group of clinically significant prostate cancers.The best cutoff value for prostate biopsy was 0.25 from the multivariate logistic regression ROC curve model of all the prostate cancers,which gave a sensitivity of 75.4%and a specificity of 75.8%.The best cutoff value for prostate biopsy was 0.20 from the multivariate logistic regression model of clinically significant prostate cancers,which gave a sensitivity of 76.7%and a specificity of 80.1%.We identified the best cutoff values for prostate biopsy(0.25 for all prostate cancers and 0.20 for clinically significant prostate cancers)to determine whether to require prostate biopsy when the PSA level is in the diagnostic gray zone.
基金Guangdong Provincial Hospital of Traditional Chinese Medicine,NO 2022KT1166 and NO 2018KT1635Guangdong Provincial Bureau of Traditional Chinese Medicine,NO 2021KT1500Guangzhou Science and Technology Bureau,NO 202201020350.
文摘BACKGROUND Aggressive variant prostate cancer(AVPC)is a rare disease that progresses rapidly.The first-line treatment for AVPC is currently unknown.We examined a rare case of AVPC with rare brain and bladder metastases.A summary review of the mechanism of development,clinicopathological manifestations,associated treatments and prognosis of this disease is presented.CASE SUMMARY The patient was diagnosed with prostate cancer(PCA),and was actively treated with endocrine therapy,radiotherapy,chemotherapy,and traditional Chinese medicine.Unfortunately,he was insensitive to treatment,and the disease progressed rapidly.He died five years after being diagnosed with PCA.CONCLUSION We should reach consensus definitions of the AVPC and other androgen receptorindependent subtypes of PCA and develop new biomarkers to identify groups of high-risk variants.It is crucial to complete a puncture biopsy of the tumor or metastatic lesion as soon as possible in patients with advanced PCA who exhibit clinical features such as low Prostate-specific antigen levels,high carcinoembryonic antigen levels,and insensitivity to hormones to determine the pathological histological type and to create a more aggressive monitoring and treatment regimens.
基金This study was supported by the Sichuan Science and Technology Program(No.2020YFS0137).
文摘The goal of this study was to investigate the clinical application of free/total prostate-specific antigen(F/T PSA)ratio,considering the new broad serum total PSA(T-PSA)“gray zone”of 2.0–25.0 ng ml^(−1)in differential diagnosis of prostate cancer(PCa)and benign prostate diseases(BPD)in men over 50 years in Western China.A total of 1655 patients were included,528 with PCa and 1127 with BPD.Serum T-PSA,free PSA(F-PSA),and F/T PSA ratio were analyzed.Receiver operating characteristic curves were used to assess the efficiency of PSA and F/T PSA ratio.There were 47.4%of cancer patients with T-PSA of 2.0–25.0 ng ml^(−1).When T-PSA was 2.0–4.0 ng ml^(−1),4.0–10.0 ng ml^(−1),and 10.0–25.0 ng ml^(−1),the area under the curve(AUC)of F/T PSA ratio was 0.749,0.769,and 0.761,respectively.The best AUC of F/T PSA ratio was 0.811 when T-PSA was 2.0–25.0 ng ml^(−1),with a specificity of 0.732,a sensitivity of 0.788,and an optimal cutoff value of 15.5%.The AUC of F/T PSA ratio in different age groups(50–59 years,60–69 years,70–79 years,and≥80 years)was 0.767,0.806,0.815,and 0.833,respectively,and the best sensitivity(0.857)and specificity(0.802)were observed in patients over 80 years.The T-PSA trend was in accordance with the Gleason score,tumor node metastasis(TNM)stage,and American Joint Committee on Cancer prognosis group.Therefore,the F/T PSA ratio can facilitate the differential diagnosis of PCa and BPD in the broad T-PSA“gray zone”.Serum T-PSA can be a Gleason score and prognostic indicator.
文摘Knowledge about the effect of different prostate biopsy approaches on the prostate cancer detection rate(CDR)in patients with gray-zone prostate-specific antigen(PSA)is limited.We performed this study to compare the CDR among patients who underwent different biopsy approaches and had rising PSA levels in the gray zone.Two hundred and twenty-two patients who underwent transrectal prostate biopsy(TRB)and 216 patients who underwent transperineal prostate biopsy(TPB)between June 2016 and September 2022 were reviewed in this study.In addition,110 patients who received additional targeted biopsies following the systematic TPB were identified.Clinical parameters,including age,PSA derivative,prostate volume(PV),and needle core count,were recorded.The data were fitted via propensity score matching(PSM),adjusting for potential confounders.TPB outperformed TRB in terms of the CDR(49.6%vs 28.3%,P=0.001).The clinically significant prostate cancer(csPCa)detection rate was not significantly different between TPB and TRB(78.6%vs 68.8%,P=0.306).In stratified analysis,TPB outperformed TRB in CDR when the age of patients was 65–75 years(59.0%vs 22.0%,P<0.001),when PV was 25.00–50.00 ml(63.2%vs 28.3%,P<0.001),and when needle core count was no more than 12(58.5%vs 31.5%,P=0.005).The CDR(P=0.712)and detection rate of csPCa(P=0.993)did not significantly differ among the systematic,targeted,and combined biopsies.TPB outperformed TRB in CDR for patients with gray-zone PSA.Moreover,performing target biopsy after systematic TPB provided no additional benefits in CDR.
基金supported by two grants from the Key Research and Development Program of jiangsu Province (No.BE2020654 and No.BE2020655)a grant from the General Program of Jiangsu Health Commission (No.H2019040)a grant from National Key R&D Program of China (No.2017YFC0114303).
文摘This study explored a new model of Prostate Imaging Reporting and Data System(PIRADS)and adjusted prostate-specific antigen density of peripheral zone(aPSADPZ)for predicting the occurrence of prostate cancer(PCa)and clinically significant prostate cancer(csPCa).The demographic and clinical characteristics of 853 patients were recorded.Prostate-specific antigen(PSA),PSA density(PSAD),PSAD of peripheral zone(PSADPZ),aPSADPZ,and peripheral zone volume ratio(PZ-ratio)were calculated and subjected to receiver operating characteristic(ROC)curve analysis.The calibration and discrimination abilities of new nomograms were verified with the calibration curve and area under the ROC curve(AUC).The clinical benefits of these models were evaluated by decision curve analysis and clinical impact curves.The AUCs of PSA,PSAD,PSADPZ,aPSADPZ,and PZ-ratio were 0.669,0.762,0.659,0.812,and 0.748 for PCa diagnosis,while 0.713,0.788,0.694,0.828,and 0.735 for csPCa diagnosis,respectively.All nomograms displayed higher net benefit and better overall calibration than the scenarios for predicting the occurrence of PCa or csPCa.The new model significantly improved the diagnostic accuracy of PCa(0.945 vs 0.830,P<0.01)and csPCa(0.937 vs 0.845,P<0.01)compared with the base model.In addition,the number of patients with PCa and csPCa predicted by the new model was in good agreement with the actual number of patients with PCa and csPCa in high-risk threshold.This study demonstrates that aPSADPZ has a higher predictive accuracy for PCa diagnosis than the conventional indicators.Combining aPSADPZ with PIRADS can improve PCa diagnosis and avoid unnecessary biopsies.
文摘Objectives This study aimed to evaluate the performance of prostate-specific membrane antigen positron emission tomography/computed tomography(PSMA PET/CT)in comparison to multiparametric magnetic resonance imaging(mpMRI)for detecting biochemical recurrence of prostate cancer(PCa).Materials and methods We conducted a comprehensive search for articles published in PubMed,Web of Science,Embase,and the Cochrane Library,spanning the inception of the database until October 26,2022,which included head-to-head comparisons of PSMA PET/CT and mpMRI for assessing the biochemical recurrence of PCa.Results A total of 5 studies including 228 patients were analyzed.The overall positivity rates of PSMA PET/CT and mpMRI for detecting biochemical recurrence of PCa after final treatment were 0.68(95%confidence interval[CI],0.52–0.89)and 0.56(95%CI,0.36–0.88),respectively.The positivity rates of PSMA PET/CT and mpMRI for detecting local recurrence,lymph node metastasis,and bone metastases were 0.37(95%CI,0.30–0.47)and 0.38(95%CI,0.22–0.67),0.44(95%CI,0.35–0.56)and 0.25(95%CI,0.17–0.35),and 0.19(95%CI,0.11–0.31)and 0.12(95%CI,0.05–0.25),respectively.Compared with mpMRI,PSMA PET/CT exhibited a higher positivity rate for detecting biochemical recurrence and lymph node metastases,and no significant difference in the positivity rate of local recurrence was observed between these 2 imaging modalities.Conclusions Compared with mpMRI,PSMA PET/CT appears to have a higher positivity rate for detecting biochemical recurrence of PCa.Although both imaging methods showed similar positivity rates of detecting local recurrence,PSMA PET/CT outperformed PSMA PET/CT in detecting lymph node involvement and overall recurrence.
