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Investigating the Relationship of G-137C, C-607A, and A-1447G Polymorphisms in the Promoter of IL-18 and CXCL10 Inflammatory Genes with Prostate Cancer in an Iranian Population. 研究伊朗人群中 IL-18 和 CXCL10 炎症基因启动子中 G-137C、C-607A 和 A-1447G 多态性与前列腺癌的关系。
IF 2.3 Q3 ONCOLOGY Pub Date : 2024-09-25 eCollection Date: 2024-01-01 DOI: 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。
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引用次数: 0
Evaluation of Second-Line Treatment for Castration-Resistant Prostate Cancer following the Administration of Upfront Androgen Receptor Signaling Inhibitors. 评估前期使用雄激素受体信号抑制剂后对阉割耐药前列腺癌的二线治疗。
IF 2.3 Q3 ONCOLOGY Pub Date : 2024-08-05 eCollection Date: 2024-01-01 DOI: 10.1155/2024/9303603
Kazuro Kikkawa, Masahiro Tamaki, Kouhei Maruno, Tatsuya Hazama, Toshifumi Takahashi, Yuya Yamada, Masakazu Nakashima, Noriyuki Ito

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.

本研究评估了多西他赛和雄激素受体信号转导抑制剂作为二线治疗药物对接受雄激素受体信号转导抑制剂一线治疗后的阉割耐药前列腺癌患者的治疗效果。本研究回顾性评估了接受雄激素受体信号抑制剂一线治疗的阉割耐药前列腺癌患者接受多西他赛或雄激素受体信号抑制剂二线治疗的临床结果。比较了多西他赛和雄激素受体信号抑制剂作为二线治疗的临床背景和疗效。在59名患者中,分别有21人(35.6%)和38人(64.4%)在接受雄激素受体信号抑制剂一线治疗后接受了多西他赛和雄激素受体信号抑制剂的二线治疗。在二线治疗中,雄激素受体信号抑制剂的中位无进展生存期长于多西他赛(17个月对6个月,P=0.014)。在一线治疗中,雄激素受体信号抑制剂的中位无进展生存期长于多西他赛(32个月对25个月,P=0.014);但在总生存期方面没有发现显著差异。多变量分析显示,二线治疗与生存期之间没有显著关联,而阿比特龙一线治疗被认为是无进展生存期的预后因素。亚组分析显示,在无进展生存期和总生存期方面,阿比特龙-苯扎鲁胺序列比其他三种序列更有效。这项研究表明,在使用雄激素受体信号转导抑制剂作为一线治疗后,使用雄激素受体信号转导抑制剂对阉割耐药前列腺癌进行二线治疗可能更有益,尤其是使用阿比特龙作为前期治疗。
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引用次数: 0
Prostate Cancer Detection from MRI Using Efficient Feature Extraction with Transfer Learning 利用迁移学习高效提取特征,从核磁共振成像中检测前列腺癌
IF 4.2 Q2 Medicine Pub Date : 2024-05-16 DOI: 10.1155/2024/1588891
Rafiqul Islam, Al Imran, Md. Fazle Rabbi
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.
前列腺癌是一种对全球健康有重大影响的常见癌症。及时准确的识别对于制定高效的治疗策略和提高患者疗效至关重要。本研究调查了利用机器学习技术诊断前列腺癌的情况。它强调利用深度学习模型(即 VGG16、VGG19、ResNet50 和 ResNet50V2)来提取相关特征。然后,随机森林方法利用这些特征进行分类。研究首先对上述深度学习架构进行了全面的比较检查,以评估它们在从前列腺癌成像数据中提取重要特征方面的有效性。灵敏度、特异性和准确性等关键指标用于评估模型的功效。在识别前列腺癌图像中的重要特征方面,ResNet50 的准确率高达 99.64%,优于其他测试模型。此外,对理解因素的分析旨在为决策过程提供有价值的见解,从而解决临床实践验收中的一个关键问题。随机森林分类器是一种功能强大的集合学习方法,以其适应性和处理复杂数据集的能力而闻名,它将收集到的特征作为输入。随机森林模型旨在识别特征空间中的模式,并对前列腺癌的存在与否做出精确预测。此外,该研究还利用迁移学习方法,使用少量带注释的前列腺癌数据完善深度学习模型,从而解决了数据集可用性受限的问题。这种方法的目的是提高模型在不同患者群体和临床情况下的泛化能力。这项研究的结果非常有用,因为它们显示了 VGG16、VGG19、ResNet50 和 ResNet50V2 与随机森林的分类能力结合使用时,在前列腺癌诊断领域提取特征的效果如何。这项工作的成果为创建可靠、易懂的基于机器学习的前列腺癌诊断工具奠定了基础。这将提高在临床环境中进行早期精确诊断的可能性,如索引术语 "深度学习"、"机器学习"、"前列腺癌"、"癌症识别 "和 "癌症分类"。
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引用次数: 0
Alterations of Sexual and Erectile Functions after Brachytherapy for Prostate Cancer Based on Patient-Reported Questionnaires 基于患者报告问卷的前列腺癌近距离治疗后性功能和勃起功能的改变
IF 4.2 Q2 Medicine Pub Date : 2024-01-25 DOI: 10.1155/2024/5729185
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.
该研究旨在比较高剂量率近距离放射治疗(HDRBT)和低剂量率近距离放射治疗(LDRBT)的副作用,尤其关注对性功能和性幸福的影响(PROMOBRA 研究,NCT02258087)。局部低危和低中危前列腺癌患者接受了单次 LDR(123 人,145 Gy 剂量)或单次 HDR 近距离放射治疗(117 人,19/21 Gy)。在治疗前和随访期间(治疗后 3、6、9、12、18 和 24 个月,两年后每年随访一次),患者填写了患者报告结果测量 (PROM) 问卷 EORTC QLQ-PR-25、国际勃起功能指数 (IIEF) 和 IIEF-5 (SHIM)。我们对不同组别的患者进行了比较(HDR 与 LDR,未接受激素治疗和接受激素治疗的 HDR 与 LDR,未接受激素治疗和接受激素治疗的一般患者,19 Gy HDR 与 21 Gy HDR)。在未接受激素治疗的 LDR 组中,与基线相比,勃起功能、性高潮功能、性欲、性交满意度和总体满意度功能在整个随访期间均显著下降。然而,在不使用激素的情况下进行 HDR 治疗后,最多有三个时间点的功能出现明显下降。在接受激素治疗的患者中,HDR 组的性高潮功能在多个时间点都明显优于基线,性欲在四个时间点都有所改善。根据我们的研究结果,LDRBT 和 HDRBT 都可以安全地用于局部前列腺癌患者。在激素未激活的患者中,HDR 组的性功能仅出现恢复性下降,而 LDR 组则在多个方面出现持久性下降。因此,HDR 似乎对无激素患者更有利。
{"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}
引用次数: 0
Health-Related and Psychosocial Factors Associated with Prostate Cancer Stage at Diagnosis among Males Participating in Alberta’s Tomorrow Project 参与艾伯塔省明天项目的男性在诊断时与前列腺癌阶段有关的健康和社会心理因素
Q2 Medicine Pub Date : 2023-11-10 DOI: 10.1155/2023/4426167
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, p = 0.02, 95% CI 0.83–0.99), while higher abdominal circumference (OR 1.02, p = 0.05, 95% CI 1.00–1.03), lower social support (OR 2.34, p < 0.01, 95% CI 1.31–4.17), and having children (OR 2.67, p < 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。
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引用次数: 0
Cognitive Dysfunction in Patients Treated with Androgen Deprivation Therapy: A Multimodality Functional Imaging Study to Evaluate Neuroinflammation. 雄激素剥夺治疗患者的认知功能障碍:评估神经炎症的多模态功能成像研究。
IF 4.2 Q2 Medicine Pub Date : 2023-10-18 eCollection Date: 2023-01-01 DOI: 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.

背景:前列腺癌症的雄激素剥夺治疗(ADT)可能是认知障碍(CI)的一个原因。痴呆和阿尔茨海默病的CI与神经炎症有关。在本研究中,我们研究了神经炎症在ADT相关CI中的潜在作用。方法:癌症前列腺患者ADT≥3 根据访谈时的自我报告,月被归类为ADT突发CI或正常认知(NC)。使用正电子发射断层扫描(PET)和转运蛋白(TSPO)放射性配体[11C]-PBR28评估神经炎症。[11C]-PBR28在不同大脑区域的摄取被量化为标准摄取值(SUVR,标准化为小脑),并与血氧水平依赖性功能磁共振成像(BOLD-fMRI)选择反应时间任务(CRT)激活图相关。结果:11例患者接受了PET检查:4例报告CI(rCI),6例报告NC(rNC),1例未记录状态。PET未显示SUVR在区域或全球范围内的任何组间差异。两组对CRT的大脑激活没有差异。无论报告的认知状态如何,PET-TSPO信号与海马、杏仁核和内侧皮层的CRT激活之间都存在很强的相关性。结论:PET-TSPO检测rCI和rNC患者的神经炎症没有差异。然而,我们推测,TSPO摄取与大脑中参与记忆且已知具有高雄激素受体表达介导可塑性的区域(海马体和杏仁核)的BOLD fMRI激活之间的强相关性可能反映了ADT的炎症效应,其具有代偿性上调/增加的突触功能。有必要对这种成像读数进行进一步研究,以研究ADT相关的CI。
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引用次数: 0
Complications of Extended Pelvic Lymph Node Dissection in Patients Undergoing Minimally Invasive Radical Prostatectomy: Analysis and Risk Factors. 微创根治性前列腺切除术后扩大盆腔淋巴结清扫的并发症分析及危险因素分析。
IF 4.2 Q2 Medicine Pub Date : 2022-10-22 eCollection Date: 2022-01-01 DOI: 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.

背景:了解前列腺根治术中扩大盆腔淋巴结清扫(ePLND)相关的危险因素和并发症,有助于选择在前列腺根治术中淋巴结清扫获益最大的患者。材料和方法:回顾性队列评估2013年至2019年期间由一名外科医生提交至ePLND的135例淋巴结转移高风险PC患者,采用腹腔镜或腹腔镜机器人辅助入路。与并发症相关的数据使用Martin’s标准正确记录,并使用Satava和Clavien-Dindo-Strasberg方法进行分类。采用Logistic回归确定ePLND相关并发症的预测因素。结果:平均切除淋巴结数为10.2±4.9个,转移阳性占28.2%。术中并发症5例(4%),均为腹腔镜手术。术后严重并发症9例(7.3%),其中4例发生在术后第30天。3例患者(2.4%)有血栓栓塞并发症,5例患者(4.0%)有淋巴囊肿需要治疗。美国麻醉医师协会(ASA)身体状态分类与术后并发症之间存在相关性(p=0.06),但无法确定具有统计学意义的预测因素。结论:根治性前列腺切除术中ePLND的术中并发症发生率低,可改变前列腺癌的分期。术后并发症,特别是静脉血栓栓塞和淋巴囊肿,即使在术后后期也需要监测。
{"title":"Complications of Extended Pelvic Lymph Node Dissection in Patients Undergoing Minimally Invasive Radical Prostatectomy: Analysis and Risk Factors.","authors":"Pedro Castro,&nbsp;Paulo B O Arantes,&nbsp;Yves M R Martins,&nbsp;Matheus N M Reis,&nbsp;Ana Paula Drummond-Lage,&nbsp;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}
引用次数: 0
Expansion of Lymphocytes from Prostatic Adenocarcinoma and Adjacent Nonmalignant Tissue. 前列腺腺癌及邻近非恶性组织淋巴细胞的扩增。
IF 4.2 Q2 Medicine Pub Date : 2022-06-16 eCollection Date: 2022-01-01 DOI: 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.

背景:对实体恶性肿瘤中肿瘤浸润淋巴细胞(til)的评估已经深入了解了肿瘤微环境中的免疫调节,也导致了过继T细胞疗法的发展和优化。目的:本研究检测了前列腺腺癌中TILs的体外扩增,作为评估TILs用于过继T细胞治疗潜力的初步步骤。设计,设置和参与者。恶性和邻近的非恶性组织来自15名接受根治性前列腺切除术的男性。干预措施。没有研究干预。结果测量和统计分析。流式细胞术分析扩增细胞,并评估细胞亚群与扩增率之间的关系。结果:肿瘤浸润淋巴细胞可以扩增到所需的数量,从15个恶性标本中的9个(60%)中产生治疗性输注产品。CD4+ T细胞高于CD8+ T细胞(中位数为56.8% CD4+,中位数为30.0% CD8+),此外,TIL扩增速度越快,CD4+ T细胞比例越高(中位数为69.8%;在生长较慢的培养基中为36.8%)。与CD3+细胞相比,CD3- cd56 +细胞的比例更高,恶性标本培养物的TIL扩增速度较慢(生长较慢的培养物中位数为13.3%,而生长较快的培养物中位数为2.05%),但非恶性标本培养物的TIL扩增速度较慢。结论:扩大TILs的潜在治疗用途是可行的。我们的研究结果还表明,进一步检查前列腺腺癌的TILs可能有助于了解肿瘤微环境中T细胞的调节机制。需要进一步的研究来评估它们的治疗潜力。
{"title":"Expansion of Lymphocytes from Prostatic Adenocarcinoma and Adjacent Nonmalignant Tissue.","authors":"Linh T Nguyen,&nbsp;Charlotte S Lo,&nbsp;Michael Fyrsta,&nbsp;Jessica Nie,&nbsp;Jennifer Y Yam,&nbsp;Pei-Hua Yen,&nbsp;Michael X Le,&nbsp;Karen Hersey,&nbsp;Miran Kenk,&nbsp;Megan Crumbaker,&nbsp;Neil Fleshner,&nbsp;Girish Kulkarni,&nbsp;Robert Hamilton,&nbsp;Michael Jewett,&nbsp;Antonio Finelli,&nbsp;Andrew Evans,&nbsp;Joan Sweet,&nbsp;Pamela S Ohashi,&nbsp;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}
引用次数: 0
Diagnostic Accuracy of Predictive Models in Prostate Cancer: A Systematic Review and Meta-Analysis. 前列腺癌预测模型的诊断准确性:系统回顾与元分析》。
IF 2.3 Q3 ONCOLOGY Pub Date : 2022-06-08 eCollection Date: 2022-01-01 DOI: 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}
引用次数: 0
MRI-Based Radiotherapy Planning to Reduce Rectal Dose in Excess of Tolerance. 以核磁共振为基础的放疗计划减少直肠剂量超过耐受。
IF 4.2 Q2 Medicine Pub Date : 2022-02-03 eCollection Date: 2022-01-01 DOI: 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.

材料和方法:这项前瞻性单臂研究招募了15名接受IG-IMRT治疗局限性前列腺癌的男性。所有参与者都接受了专门的3特斯拉前列腺MRI检查,以及骨盆CT检查以制定治疗计划。两种处方剂量为79.2 Gy的体积调节电弧治疗(VMAT)方案采用基于CT和mri定义的共识体积的相同约束设计。使用Wilcoxon配对符号秩检验比较暴露于70 Gy或以上的直肠体积。结果:对于基于ct的治疗方案,直肠接受70 Gy或更高的中位体积为9.3立方厘米(cc) (IQR 7.0至10.2),而基于mri的方案为4.9立方厘米(IQR 4.1至7.8)。结论:使用MRI计划79.2 Gy剂量的前列腺IG-IMRT可减少接受超过耐受剂量(70 Gy或更高)的直肠体积,对于后期直肠毒性高风险且不适合其他直肠保留技术(如水凝胶间隔器)的男性应考虑使用。该试验注册号为NCT02470910。
{"title":"MRI-Based Radiotherapy Planning to Reduce Rectal Dose in Excess of Tolerance.","authors":"Daniel R Schmidt,&nbsp;Mandar Bhagwat,&nbsp;Daniel I Glazer,&nbsp;Ming-Hui Chen,&nbsp;Maryam Moteabbed,&nbsp;Elizabeth McMahon,&nbsp;Marian J Loffredo,&nbsp;Clare M Tempany,&nbsp;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}
引用次数: 3
期刊
Prostate Cancer
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