Pub Date : 2024-09-25eCollection Date: 2024-01-01DOI: 10.1155/2024/3997576
Nahid Ahmadi, Seyyed Amir Yasin Ahmadi, Abdolreza Kheirollahi, Farhad Shahsavar
Introduction: Genetic and environmental factors are involved in prostate cancer. The current study was conducted to study the relationship between G-137C, C-607A, and A-1447G polymorphisms in the promoter of IL-18 and CXCL10 inflammatory genes with prostate cancer.
Methods: As a genetic association study with a case-control design, the genomes of people living in Khorasan, Iran, were compared in two groups of cases and controls. The genotype of the A-1447G polymorphism present in the CXCL10 gene promoter was investigated by the PCR-RFLP method. PCR-SSP was used to study the genotype of G-137C and C-607A polymorphisms present in the IL-18 gene promoter. Odds ratio (OR) and 95% confidence interval (CI) were reported.
Results: One mutant allele in CXCL10 A-1447G polymorphism (AG) increased the chance of cancer (OR = 4.902, 95% CI = 2.70-8.87) and two mutant alleles (GG) increased more (OR = 7.174, 95% CI = 2.48-20.68). One mutant allele in IL-18 G-137C polymorphism (CG) increased the chance of cancer (OR = 5.583, 95% CI = 3.04-10.22) and two mutant alleles (CC) increased more (OR = 9.571, 95% CI = 3.10-29.46). One mutant allele in IL-18 C607A polymorphism (CA) increased the chance of cancer (OR = 5.359, 95% CI = 2.95-9.70) and two mutant alleles (AA) increased more (OR = 7.083, 95% CI = 2.61-19.15) (P < 0.001).
Conclusion: According to the results, the mutant alleles in polymorphisms CXCL10 A-1447G, IL-18 G-137C, and IL-18 C-607A alleles were associated with an increased chance of prostate cancer in this population.
简介前列腺癌与遗传和环境因素有关。本研究旨在探讨 IL-18 和 CXCL10 炎症基因启动子中的 G-137C、C-607A 和 A-1447G 多态性与前列腺癌的关系:作为一项采用病例对照设计的遗传关联研究,我们将伊朗呼罗珊地区居民的基因组分为病例组和对照组两组进行比较。采用 PCR-RFLP 方法调查了 CXCL10 基因启动子中 A-1447G 多态性的基因型。PCR-SSP用于研究IL-18基因启动子中G-137C和C-607A多态性的基因型。结果显示,CXL-18基因中有一个突变等位基因:结果:CXCL10 A-1447G多态性中的一个突变等位基因(AG)会增加患癌症的几率(OR = 4.902,95% CI = 2.70-8.87),而两个突变等位基因(GG)会增加患癌症的几率(OR = 7.174,95% CI = 2.48-20.68)。IL-18 G-137C 多态性中的一个突变等位基因(CG)会增加患癌症的几率(OR = 5.583,95% CI = 3.04-10.22),而两个突变等位基因(CC)会增加患癌症的几率(OR = 9.571,95% CI = 3.10-29.46)。IL-18 C607A多态性中的一个突变等位基因(CA)会增加患癌几率(OR = 5.359,95% CI = 2.95-9.70),而两个突变等位基因(AA)会增加患癌几率(OR = 7.083,95% CI = 2.61-19.15)(P < 0.001):结果显示,在该人群中,CXCL10 A-1447G、IL-18 G-137C和IL-18 C-607A等位基因的突变等位基因与前列腺癌发病几率增加有关。
{"title":"Investigating the Relationship of <i>G-137C</i>, <i>C-607A</i>, and <i>A-1447G</i> Polymorphisms in the Promoter of <i>IL-18</i> and <i>CXCL10</i> Inflammatory Genes with Prostate Cancer in an Iranian Population.","authors":"Nahid Ahmadi, Seyyed Amir Yasin Ahmadi, Abdolreza Kheirollahi, Farhad Shahsavar","doi":"10.1155/2024/3997576","DOIUrl":"10.1155/2024/3997576","url":null,"abstract":"<p><strong>Introduction: </strong>Genetic and environmental factors are involved in prostate cancer. The current study was conducted to study the relationship between <i>G-137C</i>, <i>C-607A</i>, and <i>A-1447G</i> polymorphisms in the promoter of <i>IL-18</i> and <i>CXCL10</i> inflammatory genes with prostate cancer.</p><p><strong>Methods: </strong>As a genetic association study with a case-control design, the genomes of people living in Khorasan, Iran, were compared in two groups of cases and controls. The genotype of the <i>A-1447G</i> polymorphism present in the <i>CXCL10</i> gene promoter was investigated by the PCR-RFLP method. PCR-SSP was used to study the genotype of <i>G-137C</i> and <i>C-607A</i> polymorphisms present in the <i>IL-18</i> gene promoter. Odds ratio (OR) and 95% confidence interval (CI) were reported.</p><p><strong>Results: </strong>One mutant allele in <i>CXCL10 A-1447G</i> polymorphism (AG) increased the chance of cancer (OR = 4.902, 95% CI = 2.70-8.87) and two mutant alleles (GG) increased more (OR = 7.174, 95% CI = 2.48-20.68). One mutant allele in <i>IL-18 G-137C</i> polymorphism (CG) increased the chance of cancer (OR = 5.583, 95% CI = 3.04-10.22) and two mutant alleles (CC) increased more (OR = 9.571, 95% CI = 3.10-29.46). One mutant allele in <i>IL-18 C607A</i> polymorphism (CA) increased the chance of cancer (OR = 5.359, 95% CI = 2.95-9.70) and two mutant alleles (AA) increased more (OR = 7.083, 95% CI = 2.61-19.15) (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>According to the results, the mutant alleles in polymorphisms <i>CXCL10 A-1447G</i>, <i>IL-18 G-137C</i>, and <i>IL-18 C-607A</i> alleles were associated with an increased chance of prostate cancer in this population.</p>","PeriodicalId":20907,"journal":{"name":"Prostate Cancer","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11446609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study evaluated the effects of docetaxel and androgen receptor signaling inhibitors as second-line treatments in patients with castration-resistant prostate cancer after androgen receptor signaling inhibitors as first-line treatment. This study retrospectively evaluated the clinical outcomes of second-line treatment with docetaxel or androgen receptor signaling inhibitor in patients with castration-resistant prostate cancer who received first-line treatment with androgen receptor signaling inhibitors. Clinical backgrounds and outcomes were compared between docetaxel and androgen receptor signaling inhibitors as second-line treatment. Of 59 patients, 21 (35.6%) and 38 (64.4%) received docetaxel and androgen receptor signaling inhibitors as second-line treatment after first-line treatment with androgen receptor signaling inhibitors, respectively. In the second-line setting, the median progression-free survival was longer with androgen receptor signaling inhibitor than with docetaxel (17 versus 6 months, P=0.014). In the first-line setting, the median progression-free survival was longer with androgen receptor signaling inhibitors than with docetaxel (32 versus 25 months, P=0.014); however, no significant difference was found in the overall survival. Multivariate analysis revealed that there was no significant association between second-line treatment and survival, and first-line treatment with abiraterone was identified as a prognostic factor for progression-free survival. Subgroup analysis showed that the abiraterone-enzalutamide sequence was more effective than the other three sequences for progression-free survival and overall survival. This study suggests that second-line treatment with an androgen receptor signaling inhibitor for castration-resistant prostate cancer after androgen receptor signaling inhibitors as first-line treatment may be more beneficial, particularly with abiraterone as the upfront treatment.
{"title":"Evaluation of Second-Line Treatment for Castration-Resistant Prostate Cancer following the Administration of Upfront Androgen Receptor Signaling Inhibitors.","authors":"Kazuro Kikkawa, Masahiro Tamaki, Kouhei Maruno, Tatsuya Hazama, Toshifumi Takahashi, Yuya Yamada, Masakazu Nakashima, Noriyuki Ito","doi":"10.1155/2024/9303603","DOIUrl":"10.1155/2024/9303603","url":null,"abstract":"<p><p>This study evaluated the effects of docetaxel and androgen receptor signaling inhibitors as second-line treatments in patients with castration-resistant prostate cancer after androgen receptor signaling inhibitors as first-line treatment. This study retrospectively evaluated the clinical outcomes of second-line treatment with docetaxel or androgen receptor signaling inhibitor in patients with castration-resistant prostate cancer who received first-line treatment with androgen receptor signaling inhibitors. Clinical backgrounds and outcomes were compared between docetaxel and androgen receptor signaling inhibitors as second-line treatment. Of 59 patients, 21 (35.6%) and 38 (64.4%) received docetaxel and androgen receptor signaling inhibitors as second-line treatment after first-line treatment with androgen receptor signaling inhibitors, respectively. In the second-line setting, the median progression-free survival was longer with androgen receptor signaling inhibitor than with docetaxel (17 versus 6 months, <i>P</i>=0.014). In the first-line setting, the median progression-free survival was longer with androgen receptor signaling inhibitors than with docetaxel (32 versus 25 months, <i>P</i>=0.014); however, no significant difference was found in the overall survival. Multivariate analysis revealed that there was no significant association between second-line treatment and survival, and first-line treatment with abiraterone was identified as a prognostic factor for progression-free survival. Subgroup analysis showed that the abiraterone-enzalutamide sequence was more effective than the other three sequences for progression-free survival and overall survival. This study suggests that second-line treatment with an androgen receptor signaling inhibitor for castration-resistant prostate cancer after androgen receptor signaling inhibitors as first-line treatment may be more beneficial, particularly with abiraterone as the upfront treatment.</p>","PeriodicalId":20907,"journal":{"name":"Prostate Cancer","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11319047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Prostate cancer is a common cancer with significant implications for global health. Prompt and precise identification is crucial for efficient treatment strategizing and enhanced patient results. This research study investigates the utilization of machine learning techniques to diagnose prostate cancer. It emphasizes utilizing deep learning models, namely VGG16, VGG19, ResNet50, and ResNet50V2, to extract relevant features. The random forest approach then uses these features for classification. The study begins by doing a thorough comparison examination of the deep learning architectures outlined above to evaluate their effectiveness in extracting significant characteristics from prostate cancer imaging data. Key metrics such as sensitivity, specificity, and accuracy are used to assess the models’ efficacy. With an accuracy of 99.64%, ResNet50 outperformed other tested models when it came to identifying important features in images of prostate cancer. Furthermore, the analysis of understanding factors aims to offer valuable insights into the decision-making process, thereby addressing a critical problem for clinical practice acceptance. The random forest classifier, a powerful ensemble learning method renowned for its adaptability and ability to handle intricate datasets, then uses the collected characteristics as input. The random forest model seeks to identify patterns in the feature space and produce precise predictions on the presence or absence of prostate cancer. In addition, the study tackles the restricted availability of datasets by utilizing transfer learning methods to refine the deep learning models using a small amount of annotated prostate cancer data. The objective of this method is to improve the ability of the models to generalize across different patient populations and clinical situations. This study’s results are useful because they show how well VGG16, VGG19, ResNet50, and ResNet50V2 work for extracting features in the field of diagnosing prostate cancer, when used with random forest’s classification abilities. The results of this work provide a basis for creating reliable and easily understandable machine learning-based diagnostic tools for detecting prostate cancer. This will enhance the possibility of an early and precise diagnosis in clinical settings such as index terms deep learning, machine learning, prostate cancer, cancer identification, and cancer classification.
{"title":"Prostate Cancer Detection from MRI Using Efficient Feature Extraction with Transfer Learning","authors":"Rafiqul Islam, Al Imran, Md. Fazle Rabbi","doi":"10.1155/2024/1588891","DOIUrl":"https://doi.org/10.1155/2024/1588891","url":null,"abstract":"Prostate cancer is a common cancer with significant implications for global health. Prompt and precise identification is crucial for efficient treatment strategizing and enhanced patient results. This research study investigates the utilization of machine learning techniques to diagnose prostate cancer. It emphasizes utilizing deep learning models, namely VGG16, VGG19, ResNet50, and ResNet50V2, to extract relevant features. The random forest approach then uses these features for classification. The study begins by doing a thorough comparison examination of the deep learning architectures outlined above to evaluate their effectiveness in extracting significant characteristics from prostate cancer imaging data. Key metrics such as sensitivity, specificity, and accuracy are used to assess the models’ efficacy. With an accuracy of 99.64%, ResNet50 outperformed other tested models when it came to identifying important features in images of prostate cancer. Furthermore, the analysis of understanding factors aims to offer valuable insights into the decision-making process, thereby addressing a critical problem for clinical practice acceptance. The random forest classifier, a powerful ensemble learning method renowned for its adaptability and ability to handle intricate datasets, then uses the collected characteristics as input. The random forest model seeks to identify patterns in the feature space and produce precise predictions on the presence or absence of prostate cancer. In addition, the study tackles the restricted availability of datasets by utilizing transfer learning methods to refine the deep learning models using a small amount of annotated prostate cancer data. The objective of this method is to improve the ability of the models to generalize across different patient populations and clinical situations. This study’s results are useful because they show how well VGG16, VGG19, ResNet50, and ResNet50V2 work for extracting features in the field of diagnosing prostate cancer, when used with random forest’s classification abilities. The results of this work provide a basis for creating reliable and easily understandable machine learning-based diagnostic tools for detecting prostate cancer. This will enhance the possibility of an early and precise diagnosis in clinical settings such as index terms deep learning, machine learning, prostate cancer, cancer identification, and cancer classification.","PeriodicalId":20907,"journal":{"name":"Prostate Cancer","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140966789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Gesztesi, Z. Kocsis, K. Jorgo, G. Fröhlich, C. Polgár, P. Ágoston
The aim of the study was to compare the side effects of high-dose-rate brachytherapy (HDRBT) and low-dose-rate brachytherapy (LDRBT), with a particular focus on the effects on sexual functions and sexual well-being (PROMOBRA study, NCT02258087). Localized low-risk and low-intermediate-risk prostate cancer patients were treated with mono LDR (N = 123, 145 Gy dose) or mono HDR brachytherapy (N = 117, 19/21 Gy). Prior to the treatment and during follow-up (at 3, 6, 9, 12, 18, and 24 months after treatment, and then annually after two years), patients completed patient-reported outcome measurement (PROM) questionnaires EORTC QLQ-PR-25, International Index of Erectile Function (IIEF), and IIEF-5 (SHIM). We compared the patients in different group breakdowns (HDR vs. LDR, hormone naïve and hormone-receiving HDR vs. LDR, hormone naïve and hormone-receiving patients in general, and 19 Gy HDR vs. 21 Gy HDR). In the hormone-naive LDR group, erectile function, orgasm function, sexual desire, satisfaction with intercourse, and overall satisfaction functions significantly decreased compared to baseline throughout the whole follow-up period. However, there were significant decreases in function at a maximum of three time points after HDR therapy without hormone therapy. In hormone-receiving patients, the orgasm function was significantly better in the HDR group at multiple time points compared to the baseline, and sexual desire improved at four time points. According to our results, both LDRBT and HDRBT can be safely administered to patients with localized prostate cancer. In hormone-naive patients, the HDR group showed only recovering decreases in sexual functions, while the LDR group showed a lasting decline in multiple areas. Thus, HDR appears to be more advantageous to hormone-naive patients.
{"title":"Alterations of Sexual and Erectile Functions after Brachytherapy for Prostate Cancer Based on Patient-Reported Questionnaires","authors":"L. Gesztesi, Z. Kocsis, K. Jorgo, G. Fröhlich, C. Polgár, P. Ágoston","doi":"10.1155/2024/5729185","DOIUrl":"https://doi.org/10.1155/2024/5729185","url":null,"abstract":"The aim of the study was to compare the side effects of high-dose-rate brachytherapy (HDRBT) and low-dose-rate brachytherapy (LDRBT), with a particular focus on the effects on sexual functions and sexual well-being (PROMOBRA study, NCT02258087). Localized low-risk and low-intermediate-risk prostate cancer patients were treated with mono LDR (N = 123, 145 Gy dose) or mono HDR brachytherapy (N = 117, 19/21 Gy). Prior to the treatment and during follow-up (at 3, 6, 9, 12, 18, and 24 months after treatment, and then annually after two years), patients completed patient-reported outcome measurement (PROM) questionnaires EORTC QLQ-PR-25, International Index of Erectile Function (IIEF), and IIEF-5 (SHIM). We compared the patients in different group breakdowns (HDR vs. LDR, hormone naïve and hormone-receiving HDR vs. LDR, hormone naïve and hormone-receiving patients in general, and 19 Gy HDR vs. 21 Gy HDR). In the hormone-naive LDR group, erectile function, orgasm function, sexual desire, satisfaction with intercourse, and overall satisfaction functions significantly decreased compared to baseline throughout the whole follow-up period. However, there were significant decreases in function at a maximum of three time points after HDR therapy without hormone therapy. In hormone-receiving patients, the orgasm function was significantly better in the HDR group at multiple time points compared to the baseline, and sexual desire improved at four time points. According to our results, both LDRBT and HDRBT can be safely administered to patients with localized prostate cancer. In hormone-naive patients, the HDR group showed only recovering decreases in sexual functions, while the LDR group showed a lasting decline in multiple areas. Thus, HDR appears to be more advantageous to hormone-naive patients.","PeriodicalId":20907,"journal":{"name":"Prostate Cancer","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139598463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michelle L. Aktary, Brittany Shewchuk, Qinggang Wang, Eric Hyndman, Lorraine Shack, Paula J. Robson, Karen A. Kopciuk
Prostate cancer (PCa) stage at diagnosis is an important predictor of cancer prognosis. In Canada, over one-quarter of males are diagnosed with advanced-stage PCa. Studies have identified several factors associated with PCa stage at diagnosis; however, evidence from Canada is limited. This study aimed to examine associations between sociodemographic characteristics, health history, health practices, and psychosocial factors and PCa stage at diagnosis among males participating in Alberta’s Tomorrow Project (ATP), a prospective cohort in Alberta, Canada. The study included males aged 35–69 years who developed PCa until January 2018. Factors associated with PCa stage at diagnosis were examined using partial proportional odds (PPO) ordinal regression models. A total of 410 males were diagnosed with PCa over the study period. A higher number of lifetime prostate-specific antigen tests were associated with earlier-stage PCa (OR 0.91, = 0.02, 95% CI 0.83–0.99), while higher abdominal circumference (OR 1.02, = 0.05, 95% CI 1.00–1.03), lower social support (OR 2.34, < 0.01, 95% CI 1.31–4.17), and having children (OR 2.67, < 0.01, 95% CI 1.38–5.16) were associated with later-stage disease. This study identified factors previously found in the literature as well as novel factors associated with PCa stage at diagnosis, which can help inform targets for cancer prevention programs to improve PCa prognosis.
前列腺癌(PCa)的诊断分期是预测预后的重要指标。在加拿大,超过四分之一的男性被诊断为晚期前列腺癌。研究已经确定了与前列腺癌诊断阶段相关的几个因素;然而,来自加拿大的证据有限。本研究旨在探讨社会人口统计学特征、健康史、健康习惯和心理社会因素与加拿大阿尔伯塔省明日计划(ATP)男性前列腺癌诊断阶段之间的关系。该研究包括年龄在35-69岁之间的男性,他们在2018年1月之前患有前列腺癌。诊断时与前列腺癌分期相关的因素采用部分比例odds (PPO)有序回归模型进行检验。在研究期间,共有410名男性被诊断为前列腺癌。终生前列腺特异性抗原检测次数较高与早期PCa相关(OR 0.91, p = 0.02, 95% CI 0.83-0.99),而较高的腹围(OR 1.02, p = 0.05, 95% CI 1.00-1.03),较低的社会支持(OR 2.34, p <0.01, 95% CI 1.31-4.17),有孩子(OR 2.67, p <0.01, 95% CI 1.38-5.16)与晚期疾病相关。本研究确定了先前文献中发现的因素以及与前列腺癌诊断阶段相关的新因素,这可以帮助告知癌症预防计划的目标,以改善前列腺癌预后。
{"title":"Health-Related and Psychosocial Factors Associated with Prostate Cancer Stage at Diagnosis among Males Participating in Alberta’s Tomorrow Project","authors":"Michelle L. Aktary, Brittany Shewchuk, Qinggang Wang, Eric Hyndman, Lorraine Shack, Paula J. Robson, Karen A. Kopciuk","doi":"10.1155/2023/4426167","DOIUrl":"https://doi.org/10.1155/2023/4426167","url":null,"abstract":"Prostate cancer (PCa) stage at diagnosis is an important predictor of cancer prognosis. In Canada, over one-quarter of males are diagnosed with advanced-stage PCa. Studies have identified several factors associated with PCa stage at diagnosis; however, evidence from Canada is limited. This study aimed to examine associations between sociodemographic characteristics, health history, health practices, and psychosocial factors and PCa stage at diagnosis among males participating in Alberta’s Tomorrow Project (ATP), a prospective cohort in Alberta, Canada. The study included males aged 35–69 years who developed PCa until January 2018. Factors associated with PCa stage at diagnosis were examined using partial proportional odds (PPO) ordinal regression models. A total of 410 males were diagnosed with PCa over the study period. A higher number of lifetime prostate-specific antigen tests were associated with earlier-stage PCa (OR 0.91, <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M1\"> <mi>p</mi> </math> = 0.02, 95% CI 0.83–0.99), while higher abdominal circumference (OR 1.02, <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M2\"> <mi>p</mi> </math> = 0.05, 95% CI 1.00–1.03), lower social support (OR 2.34, <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M3\"> <mi>p</mi> </math> < 0.01, 95% CI 1.31–4.17), and having children (OR 2.67, <math xmlns=\"http://www.w3.org/1998/Math/MathML\" id=\"M4\"> <mi>p</mi> </math> < 0.01, 95% CI 1.38–5.16) were associated with later-stage disease. This study identified factors previously found in the literature as well as novel factors associated with PCa stage at diagnosis, which can help inform targets for cancer prevention programs to improve PCa prognosis.","PeriodicalId":20907,"journal":{"name":"Prostate Cancer","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135093089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-18eCollection Date: 2023-01-01DOI: 10.1155/2023/6641707
Azeem Saleem, Syed Imran Ali Shah, Stephen A Mangar, Christopher Coello, Matthew B Wall, Gaia Rizzo, Terry Jones, Patricia M Price
Background: Androgen deprivation therapy (ADT) for prostate cancer is implicated as a possible cause of cognitive impairment (CI). CI in dementia and Alzheimer's disease is associated with neuroinflammation. In this study, we investigated a potential role of neuroinflammation in ADT-related CI.
Methods: Patients with prostate cancer on ADT for ≥3 months were categorized as having ADT-emergent CI or normal cognition (NC) based on self-report at interview. Neuroinflammation was evaluated using positron emission tomography (PET) with the translocator protein (TSPO) radioligand [11C]-PBR28. [11C]-PBR28 uptake in various brain regions was quantified as standardized uptake value (SUVR, normalized to cerebellum) and related to blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI) choice-reaction time task (CRT) activation maps.
Results: Eleven patients underwent PET: four with reported CI (rCI), six with reported NC (rNC), and one status unrecorded. PET did not reveal any between-group differences in SUVR regionally or globally. There was no difference between groups on brain activation to the CRT. Regardless of the reported cognitive status, there was strong correlation between PET-TSPO signal and CRT activation in the hippocampus, amygdala, and medial cortex.
Conclusions: We found no difference in neuroinflammation measured by PET-TSPO between patients with rCI and rNC. However, we speculate that the strong correlation between TSPO uptake and BOLD-fMRI activation in brain regions involved in memory and known to have high androgen-receptor expression mediating plasticity (hippocampus and amygdala) might reflect inflammatory effects of ADT with compensatory upregulated/increased synaptic functions. Further studies of this imaging readout are warranted to investigate ADT-related CI.
{"title":"Cognitive Dysfunction in Patients Treated with Androgen Deprivation Therapy: A Multimodality Functional Imaging Study to Evaluate Neuroinflammation.","authors":"Azeem Saleem, Syed Imran Ali Shah, Stephen A Mangar, Christopher Coello, Matthew B Wall, Gaia Rizzo, Terry Jones, Patricia M Price","doi":"10.1155/2023/6641707","DOIUrl":"10.1155/2023/6641707","url":null,"abstract":"<p><strong>Background: </strong>Androgen deprivation therapy (ADT) for prostate cancer is implicated as a possible cause of cognitive impairment (CI). CI in dementia and Alzheimer's disease is associated with neuroinflammation. In this study, we investigated a potential role of neuroinflammation in ADT-related CI.</p><p><strong>Methods: </strong>Patients with prostate cancer on ADT for ≥3 months were categorized as having ADT-emergent CI or normal cognition (NC) based on self-report at interview. Neuroinflammation was evaluated using positron emission tomography (PET) with the translocator protein (TSPO) radioligand [<sup>11</sup>C]-PBR28. [<sup>11</sup>C]-PBR28 uptake in various brain regions was quantified as standardized uptake value (SUVR, normalized to cerebellum) and related to blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI) choice-reaction time task (CRT) activation maps.</p><p><strong>Results: </strong>Eleven patients underwent PET: four with reported CI (rCI), six with reported NC (rNC), and one status unrecorded. PET did not reveal any between-group differences in SUVR regionally or globally. There was no difference between groups on brain activation to the CRT. Regardless of the reported cognitive status, there was strong correlation between PET-TSPO signal and CRT activation in the hippocampus, amygdala, and medial cortex.</p><p><strong>Conclusions: </strong>We found no difference in neuroinflammation measured by PET-TSPO between patients with rCI and rNC. However, we speculate that the strong correlation between TSPO uptake and BOLD-fMRI activation in brain regions involved in memory and known to have high androgen-receptor expression mediating plasticity (hippocampus and amygdala) might reflect inflammatory effects of ADT with compensatory upregulated/increased synaptic functions. Further studies of this imaging readout are warranted to investigate ADT-related CI.</p>","PeriodicalId":20907,"journal":{"name":"Prostate Cancer","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10599921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54230785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-22eCollection Date: 2022-01-01DOI: 10.1155/2022/7631903
Pedro Castro, Paulo B O Arantes, Yves M R Martins, Matheus N M Reis, Ana Paula Drummond-Lage, Alberto J A Wainstein
Background: The knowledge of risk factors and complications related to extended pelvic lymph node dissection (ePLND) during radical prostatectomy can help selecting patients who will benefit the most with lymph node dissection concomitant to radical prostatectomy.
Materials and methods: Retrospective cohort evaluating 135 patients with PC, with a high risk for lymph node metastasis, submitted to ePLND by a single surgeon between 2013 and 2019, performed either by the laparoscopic or laparoscopic robot-assisted approach. Data related to complications were properly recorded using the Martin's criteria and were classified by the Satava and Clavien-Dindo-Strasberg methods. Logistic regression was used to determine predictors of complications related to ePLND.
Results: The mean number of lymph nodes removed was 10.2 ± 4.9, and in 28.2%, they were positive for metastasis. There were five intraoperative complications (4%), all in patients operated by laparoscopic approach. There were nine severe postoperative complications (7.3%), four of which occurred after postoperative day 30. Three patients (2.4%) had thromboembolic complications and five patients (4.0%) had lymphocele that required treatment. There was a correlation between the American Society of Anesthesiologists (ASA) physical status classification and postoperative complications (p=0.06), but it was not possible to identify statistically significant predictors.
Conclusion: ePLND during radical prostatectomy has a low rate of intraoperative complications and may change prostate cancer staging. Postoperative complications, especially venous thromboembolism and lymphocele, need to be monitored even in the late postoperative period.
{"title":"Complications of Extended Pelvic Lymph Node Dissection in Patients Undergoing Minimally Invasive Radical Prostatectomy: Analysis and Risk Factors.","authors":"Pedro Castro, Paulo B O Arantes, Yves M R Martins, Matheus N M Reis, Ana Paula Drummond-Lage, Alberto J A Wainstein","doi":"10.1155/2022/7631903","DOIUrl":"https://doi.org/10.1155/2022/7631903","url":null,"abstract":"<p><strong>Background: </strong>The knowledge of risk factors and complications related to extended pelvic lymph node dissection (ePLND) during radical prostatectomy can help selecting patients who will benefit the most with lymph node dissection concomitant to radical prostatectomy.</p><p><strong>Materials and methods: </strong>Retrospective cohort evaluating 135 patients with PC, with a high risk for lymph node metastasis, submitted to ePLND by a single surgeon between 2013 and 2019, performed either by the laparoscopic or laparoscopic robot-assisted approach. Data related to complications were properly recorded using the Martin's criteria and were classified by the Satava and Clavien-Dindo-Strasberg methods. Logistic regression was used to determine predictors of complications related to ePLND.</p><p><strong>Results: </strong>The mean number of lymph nodes removed was 10.2 ± 4.9, and in 28.2%, they were positive for metastasis. There were five intraoperative complications (4%), all in patients operated by laparoscopic approach. There were nine severe postoperative complications (7.3%), four of which occurred after postoperative day 30. Three patients (2.4%) had thromboembolic complications and five patients (4.0%) had lymphocele that required treatment. There was a correlation between the American Society of Anesthesiologists (ASA) physical status classification and postoperative complications (<i>p</i>=0.06), but it was not possible to identify statistically significant predictors.</p><p><strong>Conclusion: </strong>ePLND during radical prostatectomy has a low rate of intraoperative complications and may change prostate cancer staging. Postoperative complications, especially venous thromboembolism and lymphocele, need to be monitored even in the late postoperative period.</p>","PeriodicalId":20907,"journal":{"name":"Prostate Cancer","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2022-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9617711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40674364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-16eCollection Date: 2022-01-01DOI: 10.1155/2022/6499344
Linh T Nguyen, Charlotte S Lo, Michael Fyrsta, Jessica Nie, Jennifer Y Yam, Pei-Hua Yen, Michael X Le, Karen Hersey, Miran Kenk, Megan Crumbaker, Neil Fleshner, Girish Kulkarni, Robert Hamilton, Michael Jewett, Antonio Finelli, Andrew Evans, Joan Sweet, Pamela S Ohashi, Anthony M Joshua
Background: The evaluation of tumour-infiltrating lymphocytes (TILs) in solid malignancies has yielded insights into immune regulation within the tumour microenvironment and has also led to the development and optimisation of adoptive T cell therapies.
Objectives: This study examined the in vitro expansion of TILs from prostate adenocarcinoma, as a preliminary step to evaluate the potential of TILs for adoptive T cell therapy. Design, Setting, and Participants. Malignant and adjacent nonmalignant tissues were obtained from fifteen men undergoing radical prostatectomy. Interventions. There were no study interventions. Outcome Measurements and Statistical Analysis. Expanded cells were analysed by flow cytometry, and the data was assessed for associations between cell subpopulations and expansion rate.
Results: Tumour-infiltrating lymphocytes could be expanded to numbers that would be needed to generate a therapeutic infusion product from nine of 15 malignant specimens (60%). The CD4+ T cells predominated over CD8+ T cells (median 56.8% CD4+, 30.0% CD8+), and furthermore, faster TIL expansion was associated with a higher proportion of CD4+ T cells (median 69.8% in faster-growing cultures; 36.8% in slower-growing cultures). A higher proportion of CD3-CD56+ cells versus CD3+ cells was associated with slower TIL expansion in cultures from malignant specimens (median 13.3% in slower-growing cultures versus 2.05% in faster-growing cultures), but not from nonmalignant specimens.
Conclusions: The expansion of TILs for potential therapeutic use is feasible. Our findings also indicate that further examination of TILs from prostate adenocarcinomas may yield insights into mechanisms of regulation of T cells within the tumour microenvironment. Further research is required to evaluate their therapeutic potential.
{"title":"Expansion of Lymphocytes from Prostatic Adenocarcinoma and Adjacent Nonmalignant Tissue.","authors":"Linh T Nguyen, Charlotte S Lo, Michael Fyrsta, Jessica Nie, Jennifer Y Yam, Pei-Hua Yen, Michael X Le, Karen Hersey, Miran Kenk, Megan Crumbaker, Neil Fleshner, Girish Kulkarni, Robert Hamilton, Michael Jewett, Antonio Finelli, Andrew Evans, Joan Sweet, Pamela S Ohashi, Anthony M Joshua","doi":"10.1155/2022/6499344","DOIUrl":"https://doi.org/10.1155/2022/6499344","url":null,"abstract":"<p><strong>Background: </strong>The evaluation of tumour-infiltrating lymphocytes (TILs) in solid malignancies has yielded insights into immune regulation within the tumour microenvironment and has also led to the development and optimisation of adoptive T cell therapies.</p><p><strong>Objectives: </strong>This study examined the <i>in vitro</i> expansion of TILs from prostate adenocarcinoma, as a preliminary step to evaluate the potential of TILs for adoptive T cell therapy. <i>Design, Setting, and Participants</i>. Malignant and adjacent nonmalignant tissues were obtained from fifteen men undergoing radical prostatectomy. <i>Interventions</i>. There were no study interventions. <i>Outcome Measurements and Statistical Analysis</i>. Expanded cells were analysed by flow cytometry, and the data was assessed for associations between cell subpopulations and expansion rate.</p><p><strong>Results: </strong>Tumour-infiltrating lymphocytes could be expanded to numbers that would be needed to generate a therapeutic infusion product from nine of 15 malignant specimens (60%). The CD4<sup>+</sup> T cells predominated over CD8<sup>+</sup> T cells (median 56.8% CD4<sup>+</sup>, 30.0% CD8<sup>+</sup>), and furthermore, faster TIL expansion was associated with a higher proportion of CD4<sup>+</sup> T cells (median 69.8% in faster-growing cultures; 36.8% in slower-growing cultures). A higher proportion of CD3<sup>-</sup>CD56<sup>+</sup> cells versus CD3<sup>+</sup> cells was associated with slower TIL expansion in cultures from malignant specimens (median 13.3% in slower-growing cultures versus 2.05% in faster-growing cultures), but not from nonmalignant specimens.</p><p><strong>Conclusions: </strong>The expansion of TILs for potential therapeutic use is feasible. Our findings also indicate that further examination of TILs from prostate adenocarcinomas may yield insights into mechanisms of regulation of T cells within the tumour microenvironment. Further research is required to evaluate their therapeutic potential.</p>","PeriodicalId":20907,"journal":{"name":"Prostate Cancer","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2022-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40398433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-08eCollection Date: 2022-01-01DOI: 10.1155/2022/1742789
Mohammad Saatchi, Fatemeh Khatami, Rahil Mashhadi, Akram Mirzaei, Leila Zareian, Zeinab Ahadi, Seyed Mohammad Kazem Aghamir
Aim: Accurate diagnosis of prostate cancer (PCa) has a fundamental role in clinical and patient care. Recent advances in diagnostic testing and marker lead to standardized interpretation and increased prescription by clinicians to improve the detection of clinically significant PCa and select patients who strictly require targeted biopsies.
Methods: In this study, we present a systematic review of the overall diagnostic accuracy of each testing panel regarding the panel details. In this meta-analysis, using a structured search, Web of Science and PubMed databases were searched up to 23 September 2019 with no restrictions and filters. The study's outcome was the AUC and 95% confidence interval of prediction models. This index was reported as an overall and based on the WHO region and models with/without MRI.
Results: The thirteen final articles included 25,691 people. The overall AUC and 95% CI in thirteen studies were 0.78 and 95% CI: 0.73-0.82. The weighted average AUC in the countries of the Americas region was 0.73 (95% CI: 0.70-0.75), and in European countries, it was 0.80 (95% CI: 0.72-0.88). In four studies with MRI, the average weighted AUC was 0.88 (95% CI: 0.86-0.90), while in other articles where MRI was not a parameter in the diagnostic model, the mean AUC was 0.73 (95% CI: 0.70-0.76).
Conclusions: The present study's findings showed that MRI significantly improved the detection accuracy of prostate cancer and had the highest discrimination to distinguish candidates for biopsy.
目的:前列腺癌(PCa)的准确诊断在临床和患者护理中起着基础性作用。诊断检测和标记物的最新进展促进了标准化解读,临床医生也可根据这些进展开出更多处方,以便更好地检测出具有临床意义的 PCa,并挑选出严格需要进行靶向活检的患者:在本研究中,我们对每个检测小组的整体诊断准确性进行了系统性回顾,并对小组细节进行了分析。在这项荟萃分析中,我们采用结构化检索,检索了截至2019年9月23日的Web of Science和PubMed数据库,没有任何限制和过滤。研究结果是预测模型的AUC和95%置信区间。该指数以总体指数和基于世界卫生组织地区的指数以及有/无磁共振成像的模型进行报告:13篇最终文章共纳入25,691人。13 项研究的总体 AUC 和 95% CI 分别为 0.78 和 95% CI:0.73-0.82。美洲地区国家的加权平均AUC为0.73(95% CI:0.70-0.75),欧洲国家为0.80(95% CI:0.72-0.88)。在四项有核磁共振成像的研究中,平均加权AUC为0.88(95% CI:0.86-0.90),而在核磁共振成像不是诊断模型参数的其他文章中,平均AUC为0.73(95% CI:0.70-0.76):本研究结果表明,磁共振成像能显著提高前列腺癌的检测准确率,在区分活检候选者方面具有最高的鉴别力。
{"title":"Diagnostic Accuracy of Predictive Models in Prostate Cancer: A Systematic Review and Meta-Analysis.","authors":"Mohammad Saatchi, Fatemeh Khatami, Rahil Mashhadi, Akram Mirzaei, Leila Zareian, Zeinab Ahadi, Seyed Mohammad Kazem Aghamir","doi":"10.1155/2022/1742789","DOIUrl":"10.1155/2022/1742789","url":null,"abstract":"<p><strong>Aim: </strong>Accurate diagnosis of prostate cancer (PCa) has a fundamental role in clinical and patient care. Recent advances in diagnostic testing and marker lead to standardized interpretation and increased prescription by clinicians to improve the detection of clinically significant PCa and select patients who strictly require targeted biopsies.</p><p><strong>Methods: </strong>In this study, we present a systematic review of the overall diagnostic accuracy of each testing panel regarding the panel details. In this meta-analysis, using a structured search, Web of Science and PubMed databases were searched up to 23 September 2019 with no restrictions and filters. The study's outcome was the AUC and 95% confidence interval of prediction models. This index was reported as an overall and based on the WHO region and models with/without MRI.</p><p><strong>Results: </strong>The thirteen final articles included 25,691 people. The overall AUC and 95% CI in thirteen studies were 0.78 and 95% CI: 0.73-0.82. The weighted average AUC in the countries of the Americas region was 0.73 (95% CI: 0.70-0.75), and in European countries, it was 0.80 (95% CI: 0.72-0.88). In four studies with MRI, the average weighted AUC was 0.88 (95% CI: 0.86-0.90), while in other articles where MRI was not a parameter in the diagnostic model, the mean AUC was 0.73 (95% CI: 0.70-0.76).</p><p><strong>Conclusions: </strong>The present study's findings showed that MRI significantly improved the detection accuracy of prostate cancer and had the highest discrimination to distinguish candidates for biopsy.</p>","PeriodicalId":20907,"journal":{"name":"Prostate Cancer","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2022-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9200600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40000305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-03eCollection Date: 2022-01-01DOI: 10.1155/2022/7930744
Daniel R Schmidt, Mandar Bhagwat, Daniel I Glazer, Ming-Hui Chen, Maryam Moteabbed, Elizabeth McMahon, Marian J Loffredo, Clare M Tempany, Anthony V D'Amico
Materials and methods: This prospective single-arm study enrolled 15 men treated with IG-IMRT for localized prostate cancer. All participants received a dedicated 3 Tesla MRI examination of the prostate in addition to a pelvic CT examination for treatment planning. Two volumetric modulated arc therapy (VMAT) plans with a prescription dose of 79.2 Gy were designed using identical constraints based on CT- and MRI-defined consensus volumes. The volume of rectum exposed to 70 Gy or more was compared using the Wilcoxon paired signed rank test.
Results: For CT-based treatment plans, the median volume of rectum receiving 70 Gy or more was 9.3 cubic centimeters (cc) (IQR 7.0 to 10.2) compared with 4.9 cc (IQR 4.1 to 7.8) for MRI-based plans. This resulted in a median volume reduction of 2.1 cc (IQR 0.5 to 5.3, P < .001).
Conclusions: Using MRI to plan prostate IG-IMRT to a dose of 79.2 Gy reduces the volume of rectum receiving radiation dose in excess of tolerance (70 Gy or more) and should be considered in men who are at high risk for late rectal toxicity and are not good candidates for other rectal sparing techniques such as hydrogel spacer. This trial is registered with NCT02470910.
{"title":"MRI-Based Radiotherapy Planning to Reduce Rectal Dose in Excess of Tolerance.","authors":"Daniel R Schmidt, Mandar Bhagwat, Daniel I Glazer, Ming-Hui Chen, Maryam Moteabbed, Elizabeth McMahon, Marian J Loffredo, Clare M Tempany, Anthony V D'Amico","doi":"10.1155/2022/7930744","DOIUrl":"https://doi.org/10.1155/2022/7930744","url":null,"abstract":"<p><strong>Materials and methods: </strong>This prospective single-arm study enrolled 15 men treated with IG-IMRT for localized prostate cancer. All participants received a dedicated 3 Tesla MRI examination of the prostate in addition to a pelvic CT examination for treatment planning. Two volumetric modulated arc therapy (VMAT) plans with a prescription dose of 79.2 Gy were designed using identical constraints based on CT- and MRI-defined consensus volumes. The volume of rectum exposed to 70 Gy or more was compared using the Wilcoxon paired signed rank test.</p><p><strong>Results: </strong>For CT-based treatment plans, the median volume of rectum receiving 70 Gy or more was 9.3 cubic centimeters (cc) (IQR 7.0 to 10.2) compared with 4.9 cc (IQR 4.1 to 7.8) for MRI-based plans. This resulted in a median volume reduction of 2.1 cc (IQR 0.5 to 5.3, <i>P</i> < .001).</p><p><strong>Conclusions: </strong>Using MRI to plan prostate IG-IMRT to a dose of 79.2 Gy reduces the volume of rectum receiving radiation dose in excess of tolerance (70 Gy or more) and should be considered in men who are at high risk for late rectal toxicity and are not good candidates for other rectal sparing techniques such as hydrogel spacer. This trial is registered with NCT02470910.</p>","PeriodicalId":20907,"journal":{"name":"Prostate Cancer","volume":null,"pages":null},"PeriodicalIF":4.2,"publicationDate":"2022-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8831048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39914899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}