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Variation in HNF1B and Obesity May Influence Prostate Cancer Risk in African American Men: A Pilot Study. HNF1B变异和肥胖可能影响非裔美国男性前列腺癌风险:一项初步研究
IF 4.2 Q3 ONCOLOGY Pub Date : 2013-01-01 Epub Date: 2013-12-09 DOI: 10.1155/2013/384594
Ganna Chornokur, Ernest K Amankwah, Stacy N Davis, Catherine M Phelan, Jong Y Park, Julio Pow-Sang, Nagi B Kumar

Background. Prostate cancer (PCa) racial disparity is multifactorial, involving biological, sociocultural, and lifestyle determinants. We investigated the association between selected potentially functional polymorphisms (SNPs) and prostate cancer (PCa) risk in Black (AAM) and White (EAM) men. We further explored if these associations varied by the body mass index (BMI) and height. Methods. Age-matched DNA samples from 259 AAM and 269 EAM were genotyped for 10 candidate SNPs in 7 genes using the TaqMan allelic differentiation analysis. The dominant, recessive, and additive age-adjusted unconditional logistic regression models were fitted. Results. Three SNPs showed statistically significant associations with PCa risk: in AAM, HNF1B rs7501939 (OR = 2.42, P = 0.0046) and rs4430796 (OR = 0.57, P = 0.0383); in EAM, CTBP2 rs4962416 (OR = 1.52, P = 0.0384). In addition, high BMI in AAM (OR = 1.06, P = 0.022) and height in EAM (OR = 0.92, P = 0.0434) showed significant associations. Interestingly, HNF1B rs7501939 was associated with PCa exclusively in obese AAM (OR = 2.14, P = 0.0103). Conclusion. Our results suggest that variation in the HNF1B may influence PCa risk in obese AAM.

背景。前列腺癌(PCa)的种族差异是多因素的,涉及生物学、社会文化和生活方式的决定因素。我们研究了黑人(AAM)和白人(EAM)男性中选定的潜在功能多态性(snp)与前列腺癌(PCa)风险之间的关系。我们进一步探讨了这些关联是否因体重指数(BMI)和身高而异。方法。利用TaqMan等位基因分化分析,对259份AAM和269份EAM的年龄匹配DNA样本进行了7个基因的10个候选snp的基因分型。拟合了显性、隐性和加性年龄调整无条件logistic回归模型。结果。AAM、HNF1B、rs7501939 (OR = 2.42, P = 0.0046)、rs4430796 (OR = 0.57, P = 0.0383) 3个snp与PCa风险有统计学意义;在EAM中,CTBP2 rs4962416 (OR = 1.52, P = 0.0384)。此外,AAM的高BMI (OR = 1.06, P = 0.022)与EAM的高身高(OR = 0.92, P = 0.0434)呈显著相关。有趣的是,HNF1B rs7501939仅在肥胖AAM中与PCa相关(OR = 2.14, P = 0.0103)。结论。我们的研究结果表明,HNF1B的变异可能影响肥胖AAM中PCa的风险。
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引用次数: 18
The role of vascular endothelial growth factor in metastatic prostate cancer to the skeleton. 血管内皮生长因子在前列腺癌向骨骼转移中的作用。
IF 4.2 Q3 ONCOLOGY Pub Date : 2013-01-01 Epub Date: 2013-12-12 DOI: 10.1155/2013/418340
Emma Roberts, Davina A F Cossigny, Gerald M Y Quan

Despite the clinical implication and high incidence of bone and spinal metastases, the molecular mechanisms behind prostate cancer metastasis to bone and spine are not well understood. In this review the molecular mechanisms that may contribute to the highly metastatic phenotype of prostate cancer are discussed. Proangiogenic factors such as vascular endothelial growth factor (VEGF) have been shown to not only aid in the metastatic capabilities of prostate cancer but also encourage the colonization and growth of prostate tumour cells in the skeleton. The importance of VEGF in the complex process of prostate cancer dissemination to the skeleton is discussed, including its role in the development of the bone premetastatic niche, metastatic tumour cell recognition of bone, and bone remodeling. The expression of VEGF has also been shown to be upregulated in prostate cancer and is associated with clinical stage, Gleason score, tumour stage, progression, metastasis, and survival. Due to the multifaceted effect VEGF has on tumour angiogenesis, tumour cell proliferation, and bone destruction, therapies targeting the VEGF pathways have shown promising clinical application and are being investigated in clinical trials.

尽管前列腺癌具有临床意义且骨和脊柱转移发生率高,但其骨和脊柱转移的分子机制尚不清楚。本文就前列腺癌高转移表型的分子机制作一综述。血管内皮生长因子(VEGF)等促血管生成因子已被证明不仅有助于前列腺癌的转移能力,而且还促进前列腺肿瘤细胞在骨骼中的定植和生长。本文讨论了VEGF在前列腺癌向骨骼扩散的复杂过程中的重要性,包括其在骨转移前生态位的发展、骨转移肿瘤细胞识别和骨重塑中的作用。VEGF的表达在前列腺癌中也被证明是上调的,并且与临床分期、Gleason评分、肿瘤分期、进展、转移和生存有关。由于VEGF对肿瘤血管生成、肿瘤细胞增殖和骨破坏的多方面影响,针对VEGF途径的治疗已显示出良好的临床应用前景,并正在临床试验中进行研究。
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引用次数: 99
Androgen deprivation therapy toxicity and management for men receiving radiation therapy. 接受放射治疗的男性雄激素剥夺疗法的毒性和管理。
IF 4.2 Q3 ONCOLOGY Pub Date : 2012-01-01 Epub Date: 2012-12-30 DOI: 10.1155/2012/580306
Matthew E Johnson, Mark K Buyyounouski

Androgen deprivation therapy is commonly used in combination with radiotherapy as part of the definitive treatment for men with clinically localized and locally advanced prostate cancer. Androgen deprivation has been associated with a wide range of iatrogenic effects impacting a variety of body systems including metabolic, musculoskeletal, cardiovascular, neurocognitive, and sexual. This review aims to provide the radiation oncology community with the knowledge to monitor and manage androgen deprivation therapy toxicity in an effort to provide the highest level of care for patients and to minimize the iatrogenic effects of androgen deprivation as much as possible.

雄激素剥夺疗法通常与放疗联合使用,作为临床上局限性和局部晚期前列腺癌患者的最终治疗的一部分。雄激素剥夺与影响多种身体系统的广泛医源性效应有关,包括代谢、肌肉骨骼、心血管、神经认知和性。本综述旨在为放射肿瘤学界提供监测和管理雄激素剥夺治疗毒性的知识,以便为患者提供最高水平的护理,并尽可能减少雄激素剥夺的医源性影响。
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引用次数: 7
Risk Stratification after Biochemical Failure following Curative Treatment of Locally Advanced Prostate Cancer: Data from the TROG 96.01 Trial. 局部晚期前列腺癌根治后生化失败的风险分层:来自TROG 96.01试验的数据。
IF 4.2 Q3 ONCOLOGY Pub Date : 2012-01-01 Epub Date: 2012-12-24 DOI: 10.1155/2012/814724
Allison Steigler, James W Denham, David S Lamb, Nigel A Spry, David Joseph, John Matthews, Chris Atkinson, Sandra Turner, John North, David Christie, Keen-Hun Tai, Chris Wynne

Purpose. Survival following biochemical failure is highly variable. Using a randomized trial dataset, we sought to define a risk stratification scheme in men with locally advanced prostate cancer (LAPC). Methods. The TROG 96.01 trial randomized 802 men with LAPC to radiation ± neoadjuvant androgen suppression therapy (AST) between 1996 and 2000. Ten-year follow-up data was used to develop three-tier post-biochemical failure risk stratification schemes based on cutpoints of time to biochemical failure (TTBF) and PSA doubling time (PSADT). Schemes were evaluated in univariable, competing risk models for prostate cancer-specific mortality. The performance was assessed by c-indices and internally validated by the simple bootstrap method. Performance rankings were compared in sensitivity analyses using multivariable models and variations in PSADT calculation. Results. 485 men developed biochemical failure. c-indices ranged between 0.630 and 0.730. The most discriminatory scheme had a high risk category defined by PSADT < 4 months or TTBF < 1 year and low risk category by PSADT > 9 months or TTBF > 3 years. Conclusion. TTBF and PSADT can be combined to define risk stratification schemes after biochemical failure in men with LAPC treated with short-term AST and radiotherapy. External validation, particularly in long-term AST and radiotherapy datasets, is necessary.

目的。生化失败后的生存是高度可变的。使用随机试验数据集,我们试图定义局部晚期前列腺癌(LAPC)男性的风险分层方案。方法。TROG 96.01试验在1996年至2000年期间将802名LAPC患者随机分为放疗±新辅助雄激素抑制治疗(AST)。利用10年随访数据,根据生化失效时间(TTBF)和PSA倍增时间(PSADT)制定了三层生化失效后风险分层方案。方案在前列腺癌特异性死亡率的单变量、竞争风险模型中进行评估。采用c- index对其性能进行了评价,并用简单的自举法对其进行了内部验证。在使用多变量模型和PSADT计算的变化的敏感性分析中,比较了性能排名。结果:485例患者出现生化功能衰竭。c指数在0.630 ~ 0.730之间。最具歧视性的方案是PSADT 9个月或TTBF > 3年定义的高风险类别。结论。TTBF和PSADT可以联合用于确定短期AST和放疗治疗的男性LAPC患者生化失败后的风险分层方案。外部验证,特别是长期AST和放疗数据集,是必要的。
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引用次数: 7
Prostate intrafraction translation margins for real-time monitoring and correction strategies. 前列腺浸润内平移边缘的实时监测和纠正策略。
IF 4.2 Q3 ONCOLOGY Pub Date : 2012-01-01 Epub Date: 2011-07-13 DOI: 10.1155/2012/130579
Dale W Litzenberg, James M Balter, Scott W Hadley, Daniel A Hamstra, Twyla R Willoughby, Patrick A Kupelian, Toufik Djemil, Arul Mahadevan, Shirish Jani, Geoffrey Weinstein, Timothy Solberg, Charles Enke, Lisa Levine, Howard M Sandler

The purpose of this work is to determine appropriate radiation therapy beam margins to account for intrafraction prostate translations for use with real-time electromagnetic position monitoring and correction strategies. Motion was measured continuously in 35 patients over 1157 fractions at 5 institutions. This data was studied using van Herk's formula of (αΣ + γσ') for situations ranging from no electromagnetic guidance to automated real-time corrections. Without electromagnetic guidance, margins of over 10 mm are necessary to ensure 95% dosimetric coverage while automated electromagnetic guidance allows the margins necessary for intrafraction translations to be reduced to submillimeter levels. Factors such as prostate deformation and rotation, which are not included in this analysis, will become the dominant concerns as margins are reduced. Continuous electromagnetic monitoring and automated correction have the potential to reduce prostate margins to 2-3 mm, while ensuring that a higher percentage of patients (99% versus 90%) receive a greater percentage (99% versus 95%) of the prescription dose.

这项工作的目的是确定适当的放射治疗束边缘,以考虑前列腺偏移,用于实时电磁位置监测和校正策略。在5个机构对35名患者的1157个分数进行连续运动测量。这些数据是用van Herk公式(αΣ + γσ’)对从无电磁制导到自动实时校正的情况进行研究的。在没有电磁制导的情况下,需要超过10毫米的余量来确保95%的剂量测量覆盖率,而自动电磁制导允许将抽吸内平移所需的余量降低到亚毫米水平。前列腺变形和旋转等因素不包括在本分析中,随着边缘减少,将成为主要关注的问题。持续的电磁监测和自动校正有可能将前列腺边缘减少到2-3毫米,同时确保更高比例的患者(99%对90%)接受更大比例(99%对95%)的处方剂量。
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引用次数: 22
Factors implicated in radiation therapy failure and radiosensitization of prostate cancer. 前列腺癌放射治疗失败和放射致敏的相关因素。
IF 4.2 Q3 ONCOLOGY Pub Date : 2012-01-01 Epub Date: 2011-09-08 DOI: 10.1155/2012/593241
Helmut Bonkhoff

Tissue markers may be helpful in enhancing prediction of radiation therapy (RT) failure of prostate cancer (PCa). Among the various biomarkers tested in Phase III randomized trials conducted by the Radiation Therapy Oncology Group, p16, Ki-67, MDM2, COX-2, and PKA yielded the most robust data in predicting RT failure. Other pathways involved in RT failure are also implicated in the development of castration-resistant PCa, including the hypersensitive androgen receptor, EGFR, VEGF-R, and PI3K/Akt. Most of them are detectable in PCa tissue even at the time of initial diagnosis. Emerging evidence suggests that RT failure of PCa results from a multifactorial and heterogeneous disease process. A number of tissue markers are available to identify patients at high risk to fail RT. Some of these markers have the promise to be targeted by drugs currently available to enhance the efficacy of RT and delay disease progression.

组织标志物可能有助于提高前列腺癌(PCa)放射治疗(RT)失败的预测。在放射治疗肿瘤组进行的III期随机试验中测试的各种生物标志物中,p16, Ki-67, MDM2, COX-2和PKA在预测RT失败方面提供了最可靠的数据。参与RT失败的其他途径也与去势抵抗性PCa的发展有关,包括超敏感雄激素受体、EGFR、VEGF-R和PI3K/Akt。它们中的大多数在PCa组织中甚至在最初诊断时就可以检测到。新出现的证据表明,前列腺癌的RT失败是多因素和异质性疾病过程的结果。许多组织标记物可用于识别RT失败的高风险患者。其中一些标记物有望成为现有药物的靶点,以提高RT的疗效并延缓疾病进展。
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引用次数: 42
The role of targeted focal therapy in the management of low-risk prostate cancer: update on current challenges. 靶向病灶疗法在低风险前列腺癌治疗中的作用:当前挑战的最新进展。
IF 4.2 Q3 ONCOLOGY Pub Date : 2012-01-01 Epub Date: 2012-12-31 DOI: 10.1155/2012/587139
Daniel W Smith, Diliana Stoimenova, Khadijah Eid, Al Barqawi

Prostate cancer is one of the most prevalent cancers among men in the United States, second only to nonmelanomatous skin cancer. Since prostate-specific antigen (PSA) testing came into widespread use in the late 1980s, there has been a sharp increase in annual prostate cancer incidence. Cancer-specific mortality, though, is relatively low. The majority of these cancers will not progress to mortal disease, yet most men who are diagnosed opt for treatment as opposed to observation or active surveillance (AS). These men are thus burdened with the morbidities associated with aggressive treatments, commonly incontinence and erectile dysfunction, without receiving a mortality benefit. It is therefore necessary to both continue investigating outcomes associated with AS and to develop less invasive techniques for those who desire treatment but without the significant potential for quality-of-life side effects seen with aggressive modalities. The goals of this paper are to discuss the problems of overdiagnosis and overtreatment since the advent of PSA screening as well as the potential for targeted focal therapy (TFT) to bridge the gap between AS and definitive therapies. Furthermore, patient selection criteria for TFT, costs, side effects, and brachytherapy template-guided three-dimensional mapping biopsies (3DMB) for tumor localization will also be explored.

前列腺癌是美国男性发病率最高的癌症之一,仅次于非黑色素瘤皮肤癌。自 20 世纪 80 年代末前列腺特异性抗原(PSA)检测开始广泛使用以来,前列腺癌的年发病率急剧上升。不过,癌症特异性死亡率相对较低。大多数前列腺癌不会发展成致命疾病,但大多数男性在确诊后都会选择治疗,而不是观察或主动监测(AS)。因此,这些男性承受着积极治疗带来的发病负担,通常是尿失禁和勃起功能障碍,但却没有获得死亡率方面的益处。因此,有必要继续研究与主动监测相关的结果,并为那些希望接受治疗但又没有积极治疗方法所可能带来的严重生活质量副作用的患者开发侵入性较小的技术。本文旨在讨论自 PSA 筛查出现以来的过度诊断和过度治疗问题,以及靶向病灶疗法(TFT)弥合 AS 与明确疗法之间差距的潜力。此外,本文还将探讨 TFT 的患者选择标准、成本、副作用以及用于肿瘤定位的近距离放射治疗模板引导三维绘图活检 (3DMB)。
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引用次数: 0
Markers of field cancerization: proposed clinical applications in prostate biopsies. 野癌标志物:前列腺活检的临床应用建议。
IF 4.2 Q3 ONCOLOGY Pub Date : 2012-01-01 Epub Date: 2012-05-14 DOI: 10.1155/2012/302894
Kristina A Trujillo, Anna C Jones, Jeffrey K Griffith, Marco Bisoffi

Field cancerization denotes the occurrence of genetic, epigenetic, and biochemical aberrations in structurally intact cells in histologically normal tissues adjacent to cancerous lesions. This paper tabulates markers of prostate field cancerization known to date and discusses their potential clinical value in the analysis of prostate biopsies, including diagnosis, monitoring progression during active surveillance, and assessing efficacy of presurgical neoadjuvant and focal therapeutic interventions.

野灶癌变是指癌灶附近组织学正常组织中结构完整的细胞发生遗传、表观遗传和生化畸变。本文列出了迄今为止已知的前列腺野癌标志物,并讨论了它们在前列腺活检分析中的潜在临床价值,包括诊断、主动监测过程中的监测进展、评估术前新辅助和局灶性治疗干预的疗效。
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引用次数: 54
Incidentally found prostate cancer and influence on overall survival after radical cystoprostatectomy. 偶然发现前列腺癌及其对根治性膀胱前列腺切除术后总生存率的影响。
IF 4.2 Q3 ONCOLOGY Pub Date : 2012-01-01 Epub Date: 2012-06-03 DOI: 10.1155/2012/690210
Algimantas Sruogis, Albertas Ulys, Giedre Smailyte, Zygimantas Kardelis, Arunas Kulboka, Giedre Anglickienė, Nerimantas Samalavicius, Marius Anglickis
Objectives. To determine incidentally found prostate cancer frequency and impact on overall survival after RCP. Patients and Methods. The records of 81 men who underwent cystoprostatectomy from January 2000 to December 2009 were reviewed. The vital status of the study group was assessed as on September 1, 2009, by passive followup, using data from the population registry. Results. The 81 men underwent RCP. The incidental prostate cancer was found in the specimens of 27 (33.3%) patients. 13 (48.1%) of 27 prostate cancer cases were clinically significant. For 3 patients (11.1%) an extraprostatic extension was found. For 2 patients (7.4%)—positive margins, for 1 patient (3.7%)—Gleason sum 8, and for the rest 7 patients bigger than 0.5 cm3 volume tumor, and Gleason sum 7 was found. The mean follow-up time was 39.2 ± 33.8 months (varies from 0.8 to 131.2 months). The patients with bladder cancer and incidentally found prostate cancer lived shorter (28.1 ± 27.5 and 45.5 ± 35.40 months). Higher overall survival (P = 0.03) was found in the patient group with bladder cancer without incidentally diagnosed prostate cancer. Conclusion. There are indications that in this small study prostate cancer has influenced on patients' survival with bladder cancer after radical cystoprostatectomy.
目标。确定偶然发现前列腺癌的频率及其对RCP术后总生存率的影响。患者和方法。本文回顾了2000年1月至2009年12月行膀胱前列腺切除术的81例男性患者的记录。通过被动随访,使用人口登记处的数据,于2009年9月1日对研究组的生命状况进行评估。结果。81名男性接受了RCP。27例(33.3%)患者标本中发现偶发前列腺癌。27例前列腺癌中有13例(48.1%)具有临床意义。3例患者(11.1%)发现前列腺外展。2例(7.4%)边缘阳性,1例(3.7%)Gleason sum 8,其余7例肿瘤体积大于0.5 cm(3),并发现Gleason sum 7。平均随访时间39.2±33.8个月(0.8 ~ 131.2个月)。膀胱癌伴发前列腺癌患者生存时间较短,分别为28.1±27.5个月和45.5±35.40个月。膀胱癌患者的总生存率高于前列腺癌患者(P = 0.03)。结论。有迹象表明,在这项小型研究中,前列腺癌影响膀胱癌根治性膀胱前列腺切除术后患者的生存。
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引用次数: 14
Intake of grains and dietary fiber and prostate cancer aggressiveness by race. 不同种族的谷物和膳食纤维摄入量与前列腺癌侵袭性的关系。
IF 4.2 Q3 ONCOLOGY Pub Date : 2012-01-01 Epub Date: 2012-11-13 DOI: 10.1155/2012/323296
Fred Tabung, Susan E Steck, L Joseph Su, James L Mohler, Elizabeth T H Fontham, Jeannette T Bensen, James R Hebert, Hongmei Zhang, Lenore Arab

Purpose. To examine the associations among intake of refined grains, whole grains and dietary fiber and aggressiveness of prostate cancer in African Americans (AA, n = 930) and European Americans (EA, n = 993) in a population-based, case-only study (The North Carolina-Louisiana Prostate Cancer Project, PCaP). Methods. Prostate cancer aggressiveness was categorized as high, intermediate or low based on Gleason grade, PSA level and clinical stage. Dietary intake was assessed utilizing the NCI Diet History Questionnaire. Logistic regression (comparing high to intermediate/low aggressive cancers) and polytomous regression with adjustment for potential confounders were used to determine odds of high prostate cancer aggressiveness with intake of refined grains, whole grains and dietary fiber from all sources. Results. An inverse association with aggressive prostate cancer was observed in the 2nd and 3rd tertiles of total fiber intake (OR = 0.70; 95% CI, 0.50-0.97 and OR = 0.61; 95% CI, 0.40-0.93, resp.) as compared to the lowest tertile of intake. In the race-stratified analyses, inverse associations were observed in the 3rd tertile of total fiber intake for EA (OR = 0.44; 95% CI, 0.23-0.87) and the 2nd tertile of intake for AA (OR = 0.57; 95% CI, 0.35-0.95). Conclusions. Dietary fiber intake was inversely associated with aggressive prostate cancer among both AA and EA men.

目的。在一项以人群为基础的病例研究(北卡罗莱纳州-路易斯安那州前列腺癌项目,PCaP)中,研究非裔美国人(AA, n = 930)和欧裔美国人(EA, n = 993)中精制谷物、全谷物和膳食纤维的摄入与前列腺癌侵袭性之间的关系。方法。根据Gleason分级、PSA水平和临床分期将前列腺癌侵袭性分为高、中、低三个级别。使用NCI饮食史问卷评估饮食摄入量。采用Logistic回归(比较高侵袭性与中/低侵袭性癌症)和校正潜在混杂因素的多元回归来确定摄入各种来源的精制谷物、全谷物和膳食纤维的前列腺癌高侵袭性的几率。结果。总纤维摄入量的第二和第三十分之一与侵袭性前列腺癌呈负相关(OR = 0.70;95% CI, 0.50-0.97, OR = 0.61;95% CI, 0.40-0.93,相对而言)。在种族分层分析中,在EA总纤维摄入量的第三分位数中观察到负相关(OR = 0.44;95% CI, 0.23-0.87)和AA摄取量的第二分位数(OR = 0.57;95% ci, 0.35-0.95)。结论。在AA和EA男性中,膳食纤维摄入量与侵袭性前列腺癌呈负相关。
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引用次数: 28
期刊
Prostate Cancer
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