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Analysis of preoperative detection for apex prostate cancer by transrectal biopsy. 经直肠前列腺癌的术前活检分析。
IF 4.2 Q2 Medicine Pub Date : 2013-01-01 Epub Date: 2013-02-21 DOI: 10.1155/2013/705865
Tomokazu Sazuka, Takashi Imamoto, Takeshi Namekawa, Takanobu Utsumi, Mitsuru Yanagisawa, Koji Kawamura, Naoto Kamiya, Hiroyoshi Suzuki, Takeshi Ueda, Satoshi Ota, Yukio Nakatani, Tomohiko Ichikawa

Background. The aim of this study was to determine concordance rates for prostatectomy specimens and transrectal needle biopsy samples in various areas of the prostate in order to assess diagnostic accuracy of the transrectal biopsy approach, especially for presurgical detection of cancer in the prostatic apex. Materials and Methods. From 2006 to 2011, 158 patients whose radical prostatectomy specimens had been evaluated were retrospectively enrolled in this study. Concordance rates for histopathology results of prostatectomy specimens and needle biopsy samples were evaluated in 8 prostatic sections (apex, middle, base, and transitional zones bilaterally) from 73 patients diagnosed at this institution, besides factors for detecting apex cancer in total 118 true positive and false negative apex cancers. Results. Prostate cancer was found most frequently (85%) in the apex of all patients. Of 584 histopathology sections, 153 (49%) from all areas were false negatives, as were 45% of apex biopsy samples. No readily available preoperative factors for detecting apex cancer were identified. Conclusions. In Japanese patients, the most frequent location of prostate cancer is in the apex. There is a high false negative rate for transrectal biopsy samples. To improve the detection rate, transperitoneal biopsy or more accurate imaging technology is needed.

背景。本研究的目的是确定前列腺切除术标本和经直肠穿刺活检标本在前列腺不同区域的一致性率,以评估经直肠穿刺活检方法的诊断准确性,特别是对前列腺尖端癌的术前检测。材料与方法。从2006年到2011年,158例根治性前列腺切除术标本评估的患者被回顾性纳入本研究。对本院诊断的73例患者的8个前列腺切片(前列腺尖区、中间区、基底区和双侧过渡区)的前列腺切除术标本和穿刺活检标本的组织病理学结果的一致性进行了评估,并对118例真阳性和假阴性的前列腺尖癌的检测因素进行了评估。结果。前列腺癌最常见于所有患者的前列腺尖部(85%)。在584份组织病理切片中,153份(49%)为假阴性,45%的顶点活检样本为假阴性。没有现成的术前检测癌的因素被确定。结论。在日本患者中,前列腺癌最常见的位置是前列腺顶端。经直肠活检标本有很高的假阴性率。为了提高检出率,需要经腹膜活检或更精确的成像技术。
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引用次数: 22
Galectins as new prognostic markers and potential therapeutic targets for advanced prostate cancers. 半凝集素作为晚期前列腺癌新的预后标志物和潜在的治疗靶点。
IF 4.2 Q2 Medicine Pub Date : 2013-01-01 Epub Date: 2013-09-24 DOI: 10.1155/2013/519436
Diego J Laderach, Lucas Gentilini, Felipe M Jaworski, Daniel Compagno

A better understanding of multimolecular interactions involved in tumor dissemination is required to identify new effective therapies for advanced prostate cancer (PCa). Several groups investigated protein-glycan interactions as critical factors for crosstalk between prostate tumors and their microenvironment. This review both discusses whether the "galectin-signature" might serve as a reliable biomarker for the identification of patients with high risk of metastasis and assesses the galectin-glycan lattices as potential novel targets for anticancer therapies. The ultimate goal of this review is to convey how basic findings related to galectins could be in turn translated into clinical settings for patients with advanced PCa.

需要更好地了解肿瘤传播过程中的多分子相互作用,以确定晚期前列腺癌(PCa)的新有效治疗方法。几个小组研究了蛋白质-聚糖相互作用作为前列腺肿瘤及其微环境之间串扰的关键因素。这篇综述讨论了“半乳糖凝集素特征”是否可以作为鉴别转移高风险患者的可靠生物标志物,并评估了半乳糖凝集素-聚糖晶格作为抗癌治疗的潜在新靶点。本综述的最终目的是传达与凝集素相关的基本发现如何转化为晚期PCa患者的临床环境。
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引用次数: 17
Hypofractionated external-beam radiotherapy for prostate cancer. 低分割外束放射治疗前列腺癌。
IF 4.2 Q2 Medicine Pub Date : 2013-01-01 Epub Date: 2013-03-07 DOI: 10.1155/2013/103547
L Chinsoo Cho, Robert Timmerman, Brian Kavanagh

There are radiobiological rationales supporting hypofractionated radiotherapy for prostate cancer. The recent advancements in treatment planning and delivery allow sophisticated radiation treatments to take advantage of the differences in radiobiology of prostate cancer and the surrounding normal tissues. The preliminary results from clinical studies indicate that abbreviated fractionation programs can result in successful treatment of localized prostate cancer without escalation of late toxicity.

有放射生物学依据支持前列腺癌的低分割放疗。最近在治疗计划和交付方面的进展使得复杂的放射治疗能够利用前列腺癌和周围正常组织的放射生物学差异。临床研究的初步结果表明,缩短分割程序可以成功地治疗局限性前列腺癌,而不会增加晚期毒性。
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引用次数: 17
Emerging molecularly targeted therapies in castration refractory prostate cancer. 去势难治性前列腺癌新出现的分子靶向治疗。
IF 4.2 Q2 Medicine Pub Date : 2013-01-01 Epub Date: 2013-05-08 DOI: 10.1155/2013/981684
Jesal C Patel, Benjamin L Maughan, Archana M Agarwal, Julia A Batten, Tian Y Zhang, Neeraj Agarwal

Androgen deprivation therapy (ADT) with medical or surgical castration is the mainstay of therapy in men with metastatic prostate cancer. However, despite initial responses, almost all men eventually develop castration refractory metastatic prostate cancer (CRPC) and die of their disease. Over the last decade, it has been recognized that despite the failure of ADT, most prostate cancers maintain some dependence on androgen and/or androgen receptor (AR) signaling for proliferation. Furthermore, androgen independent molecular pathways have been identified as drivers of continued progression of CRPC. Subsequently, drugs have been developed targeting these pathways, many of which have received regulatory approval. Agents such as abiraterone, enzalutamide, orteronel (TAK-700), and ARN-509 target androgen signaling. Sipuleucel-T, ipilimumab, and tasquinimod augment immune-mediated tumor killing. Agents targeting classic tumorogenesis pathways including vascular endothelial growth factor, hepatocyte growth factor, insulin like growth factor-1, tumor suppressor, and those which regulate apoptosis and cell cycles are currently being developed. This paper aims to focus on emerging molecular pathways underlying progression of CRPC, and the drugs targeting these pathways, which have recently been approved or have reached advanced stages of development in either phase II or phase III clinical trials.

雄激素剥夺疗法(ADT)结合药物或手术阉割是男性转移性前列腺癌的主要治疗方法。然而,尽管最初有反应,但几乎所有男性最终都会发展为去势难治性转移性前列腺癌(CRPC)并死于疾病。在过去的十年中,人们已经认识到,尽管ADT失败,大多数前列腺癌仍然依赖雄激素和/或雄激素受体(AR)信号传导来增殖。此外,雄激素独立的分子途径已被确定为CRPC持续进展的驱动因素。随后,针对这些途径的药物被开发出来,其中许多已获得监管部门的批准。阿比特龙、恩杂鲁胺、奥特龙(TAK-700)和ARN-509等药物靶向雄激素信号传导。Sipuleucel-T, ipilimumab和tasquinimod增强免疫介导的肿瘤杀伤。目前正在开发针对血管内皮生长因子、肝细胞生长因子、胰岛素样生长因子-1、肿瘤抑制因子等经典肿瘤发生途径的药物,以及调节细胞凋亡和细胞周期的药物。本文旨在重点关注CRPC进展的新兴分子途径,以及针对这些途径的药物,这些药物最近已被批准或已进入II期或III期临床试验的后期开发阶段。
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引用次数: 25
Advances in Robotic-Assisted Radical Prostatectomy over Time. 机器人辅助根治性前列腺切除术的进步。
IF 4.2 Q2 Medicine Pub Date : 2013-01-01 Epub Date: 2013-11-12 DOI: 10.1155/2013/902686
Emma F P Jacobs, Ronald Boris, Timothy A Masterson

Since the introduction of robot-assisted radical prostatectomy (RALP), robotics has become increasingly more commonplace in the armamentarium of the urologic surgeon. Robotic utilization has exploded across surgical disciplines well beyond the fields of urology and prostate surgery. The literature detailing technical steps, comparison of large surgical series, and even robotically focused randomized control trials are available for review. RALP, the first robot-assisted surgical procedure to achieve widespread use, has recently become the primary approach for the surgical management of localized prostate cancer. As a result, surgeons are constantly trying to refine and improve upon current technical aspects of the operation. Recent areas of published modifications include bladder neck anastomosis and reconstruction, bladder drainage, nerve sparing approaches and techniques, and perioperative and postoperative management including penile rehabilitation. In this review, we summarize recent advances in perioperative management and surgical technique for RALP.

自机器人辅助根治性前列腺切除术(RALP)问世以来,机器人技术在泌尿外科外科医生的装备中变得越来越普遍。在泌尿外科和前列腺外科以外的其他外科领域,机器人的应用也呈爆炸式增长。详细介绍技术步骤、大型手术系列比较、甚至以机器人为重点的随机对照试验的文献可供查阅。RALP是第一个得到广泛应用的机器人辅助手术,最近已成为手术治疗局部前列腺癌的主要方法。因此,外科医生一直在努力完善和改进手术的现有技术。最近发表的修改领域包括膀胱颈吻合和重建、膀胱引流、神经保留方法和技术以及围手术期和术后管理(包括阴茎康复)。在这篇综述中,我们总结了 RALP 围手术期管理和手术技术的最新进展。
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引用次数: 0
Circulating MicroRNAs as Biomarkers of Prostate Cancer: The State of Play. 循环microrna作为前列腺癌的生物标志物:研究进展。
IF 4.2 Q2 Medicine Pub Date : 2013-01-01 Epub Date: 2013-03-12 DOI: 10.1155/2013/539680
Nikhil Sapre, Luke A Selth

MicroRNAs are key regulators of gene expression and play critical roles in both normal physiology and pathology. Recent research has demonstrated that these molecules are present in body fluids, such as serum, plasma, and urine, and can be readily measured using a variety of techniques. More importantly, emerging evidence suggests that circulating or urine miRNAs are useful indicators of disease. Here, we consider the potential utility of such miRNAs as noninvasive biomarkers of prostate cancer, a disease that would benefit substantially from novel diagnostic and prognostic tools. The studies aimed at identifying diagnostic, prognostic, and/or predictive miRNAs for prostate cancer are summarised and reviewed. Finally, practical considerations that will influence the translation of this recent research into clinical implementation are discussed.

MicroRNAs是基因表达的关键调控因子,在正常生理和病理中都起着关键作用。最近的研究表明,这些分子存在于体液中,如血清、血浆和尿液,并且可以很容易地使用各种技术进行测量。更重要的是,新出现的证据表明,循环或尿液中的mirna是疾病的有用指标。在这里,我们考虑这些mirna作为前列腺癌的非侵入性生物标志物的潜在效用,这种疾病将从新的诊断和预后工具中获益。本文总结和回顾了旨在确定前列腺癌诊断、预后和/或预测性mirna的研究。最后,讨论了将影响这项最新研究转化为临床实施的实际考虑因素。
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引用次数: 53
Blood level omega-3 Fatty acids as risk determinant molecular biomarker for prostate cancer. 血液中omega-3脂肪酸作为前列腺癌风险决定因素的分子生物标志物。
IF 4.2 Q2 Medicine Pub Date : 2013-01-01 Epub Date: 2013-03-25 DOI: 10.1155/2013/875615
Mishell Kris Sorongon-Legaspi, Michael Chua, Maria Christina Sio, Marcelino Morales

Previous researches involving dietary methods have shown conflicting findings. Authors sought to assess the association of prostate cancer risk with blood levels of omega-3 polyunsaturated fatty acids (n-3 PUFA) through a meta-analysis of human epidemiological studies in available online databases (July, 2012). After critical appraisal by two independent reviewers, Newcastle-Ottawa Quality Assessment Scale (NOQAS) was used to grade the studies. Six case control and six nested case control studies were included. Results showed nonsignificant association of overall effect estimates with total or advanced prostate cancer or high-grade tumor. High blood level of alpha-linolenic acid (ALA) had nonsignificant positive association with total prostate cancer risk. High blood level of docosapentaenoic acid (DPA) had significant negative association with total prostate cancer risk. Specific n-3 PUFA in fish oil, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) had positive association with high-grade prostate tumor risk only after adjustment of interstudy variability. There is evidence that high blood level of DPA that is linked with reduced total prostate cancer risk and elevated blood levels of fish oils, EPA, and DHA is associated with high-grade prostate tumor, but careful interpretation is needed due to intricate details involved in prostate carcinogenesis and N-3 PUFA metabolism.

先前有关饮食方法的研究显示出相互矛盾的结果。作者试图通过在线数据库中人类流行病学研究的荟萃分析,评估前列腺癌风险与血液中omega-3多不饱和脂肪酸(n-3 PUFA)水平的关系(2012年7月)。经过两位独立评审员的严格评估,使用纽卡斯尔-渥太华质量评估量表(NOQAS)对研究进行评分。包括6个病例对照研究和6个嵌套病例对照研究。结果显示,总体效果估计与全部或晚期前列腺癌或高级别肿瘤无显著关联。高血中α -亚麻酸(ALA)水平与前列腺癌总风险无显著正相关。高血中二十二碳五烯酸(DPA)水平与前列腺癌总风险呈显著负相关。在调整研究间变异性后,鱼油、二十碳五烯酸(EPA)和二十二碳六烯酸(DHA)中特异性n-3 PUFA与高级别前列腺肿瘤风险呈正相关。有证据表明,高水平的DPA与降低前列腺癌的总风险有关,而高水平的鱼油、EPA和DHA与高级别前列腺肿瘤有关,但由于前列腺癌发生和N-3 PUFA代谢的复杂细节,需要仔细解释。
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引用次数: 19
Bone-targeted therapies in metastatic castration-resistant prostate cancer: evolving paradigms. 骨靶向治疗转移性去势抵抗性前列腺癌:不断发展的范式。
IF 4.2 Q2 Medicine Pub Date : 2013-01-01 Epub Date: 2013-08-28 DOI: 10.1155/2013/210686
Joelle El-Amm, Ashley Freeman, Nihar Patel, Jeanny B Aragon-Ching

Majority of patients with metastatic castrate resistant prostate cancer (mCRPC) develop bone metastases which results in significant morbidity and mortality as a result of skeletal-related events (SREs). Several bone-targeted agents are either in clinical use or in development for prevention of SREs. Bisphosphonates were the first class of drugs investigated for prevention of SREs and zoledronic acid is the only bisphosphonate that is FDA-approved for this indication. Another bone-targeted agent is denosumab which is a fully humanized monoclonal antibody that binds to the RANK-L thereby inhibiting RANK-L mediated bone resorption. While several radiopharmaceuticals were approved for pain palliation in mCRPC including strontium and samarium, alpharadin is the first radiopharmaceutical to show significant overall survival benefit. Contemporary therapeutic options including enzalutamide and abiraterone have effects on pain palliation and SREs as well. Other novel bone-targeted agents are currently in development, including the receptor tyrosine kinase inhibitors cabozantinib and dasatinib. Emerging therapeutics in mCRPC has resulted in great strides in preventing one of the most significant sources of complications of bone metastases.

大多数转移性去势抵抗性前列腺癌(mCRPC)患者发生骨转移,由于骨骼相关事件(SREs)导致显著的发病率和死亡率。为了预防SREs,有几种骨靶向药物正在临床使用或开发中。双膦酸盐是第一类研究用于预防SREs的药物,唑来膦酸是fda批准用于该适应症的唯一双膦酸盐。另一种骨靶向药物是denosumab,它是一种完全人源化的单克隆抗体,与RANK-L结合,从而抑制RANK-L介导的骨吸收。虽然包括锶和钐在内的几种放射性药物已被批准用于缓解mCRPC患者的疼痛,但alpharadin是第一个显示出显着总体生存益处的放射性药物。包括恩杂鲁胺和阿比特龙在内的当代治疗选择对疼痛缓解和SREs也有影响。其他新的骨靶向药物目前正在开发中,包括受体酪氨酸激酶抑制剂卡博赞替尼和达沙替尼。mCRPC的新兴治疗方法在预防骨转移并发症的最重要来源之一方面取得了巨大进展。
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引用次数: 40
Quantifying the ki-67 heterogeneity profile in prostate cancer. 前列腺癌患者ki-67异质性的定量分析。
IF 4.2 Q2 Medicine Pub Date : 2013-01-01 Epub Date: 2013-10-03 DOI: 10.1155/2013/717080
Shane Mesko, Patrick Kupelian, D Jeffrey Demanes, Jaoti Huang, Pin-Chieh Wang, Mitchell Kamrava

Background: Ki-67 is a robust predictive/prognostic marker in prostate cancer; however, tumor heterogeneity in prostate biopsy samples is not well studied.

Methods: Using an MRI/US fusion device, biopsy cores were obtained systematically and by targeting when indicated by MRI. Prostate cores containing cancer from 77 consecutive men were analyzed. The highest Ki-67 was used to determine interprostatic variation. Ki-67 range (highest minus lowest) was used to determine intraprostatic and intralesion variation. Apparent diffusion coefficient (ADC) values were evaluated in relation to Ki-67.

Results: Interprostatic Ki-67 mean ± standard deviation (SD) values for NCCN low (L), intermediate (I), and high (H) risk patients were 5.1 ± 3.8%, 7.4 ± 6.8%, and 12.0 ± 12.4% (ANOVA P = 0.013). Intraprostatic mean ± SD Ki-67 ranges in L, I, and H risk patients were 2.6 ± 3.6%, 5.3 ± 6.8%, and 10.9 ± 12.3% (ANOVA P = 0.027). Intralesion mean ± SD Ki-67 ranges in L, I, and H risk patients were 1.1 ± 0.9%, 5.2 ± 7.9%, and 8.1 ± 10.8% (ANOVA P = 0.22). ADC values at Ki-67 > and <7.1% were 860 ± 203 and 1036 ± 217, respectively (P = 0.0029).

Conclusions: High risk patients have significantly higher inter- and intraprostatic Ki-67 heterogeneity. This needs to be considered when utilizing Ki-67 clinically.

背景:Ki-67是前列腺癌强有力的预测/预后指标;然而,前列腺活检样本中的肿瘤异质性尚未得到很好的研究。方法:使用MRI/US融合装置,系统地获得活检芯,并在MRI指示时靶向。对连续77名男性的前列腺癌核心进行了分析。Ki-67最高值用于测定前列腺间变异。Ki-67范围(最高减去最低)用于确定前列腺内和病变内的变异。测定表观扩散系数(ADC)与Ki-67的关系。结果:NCCN低(L)、中(I)、高(H)危患者的前列腺间Ki-67均值±标准差(SD)值分别为5.1±3.8%、7.4±6.8%、12.0±12.4% (ANOVA P = 0.013)。L、I、H危患者前列腺内Ki-67均值±SD分别为2.6±3.6%、5.3±6.8%、10.9±12.3% (ANOVA P = 0.027)。L、I、H危患者病灶内Ki-67均值±SD分别为1.1±0.9%、5.2±7.9%、8.1±10.8% (ANOVA P = 0.22)。结论:高危患者前列腺间和前列腺内Ki-67异质性显著增高。在临床应用Ki-67时需要考虑到这一点。
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引用次数: 20
Global patterns of prostate cancer incidence, aggressiveness, and mortality in men of african descent. 非洲裔男性前列腺癌发病率、侵袭性和死亡率的全球模式。
IF 4.2 Q2 Medicine Pub Date : 2013-01-01 Epub Date: 2013-02-13 DOI: 10.1155/2013/560857
Timothy R Rebbeck, Susan S Devesa, Bao-Li Chang, Clareann H Bunker, Iona Cheng, Kathleen Cooney, Rosalind Eeles, Pedro Fernandez, Veda N Giri, Serigne M Gueye, Christopher A Haiman, Brian E Henderson, Chris F Heyns, Jennifer J Hu, Sue Ann Ingles, William Isaacs, Mohamed Jalloh, Esther M John, Adam S Kibel, Lacreis R Kidd, Penelope Layne, Robin J Leach, Christine Neslund-Dudas, Michael N Okobia, Elaine A Ostrander, Jong Y Park, Alan L Patrick, Catherine M Phelan, Camille Ragin, Robin A Roberts, Benjamin A Rybicki, Janet L Stanford, Sara Strom, Ian M Thompson, John Witte, Jianfeng Xu, Edward Yeboah, Ann W Hsing, Charnita M Zeigler-Johnson

Prostate cancer (CaP) is the leading cancer among men of African descent in the USA, Caribbean, and Sub-Saharan Africa (SSA). The estimated number of CaP deaths in SSA during 2008 was more than five times that among African Americans and is expected to double in Africa by 2030. We summarize publicly available CaP data and collected data from the men of African descent and Carcinoma of the Prostate (MADCaP) Consortium and the African Caribbean Cancer Consortium (AC3) to evaluate CaP incidence and mortality in men of African descent worldwide. CaP incidence and mortality are highest in men of African descent in the USA and the Caribbean. Tumor stage and grade were highest in SSA. We report a higher proportion of T1 stage prostate tumors in countries with greater percent gross domestic product spent on health care and physicians per 100,000 persons. We also observed that regions with a higher proportion of advanced tumors reported lower mortality rates. This finding suggests that CaP is underdiagnosed and/or underreported in SSA men. Nonetheless, CaP incidence and mortality represent a significant public health problem in men of African descent around the world.

前列腺癌(CaP)是美国、加勒比海地区和撒哈拉以南非洲地区(SSA)非洲裔男性的主要癌症。据估计,2008 年撒哈拉以南非洲的前列腺癌死亡人数是非裔美国人的五倍多,预计到 2030 年非洲的前列腺癌死亡人数将翻一番。我们总结了可公开获得的前列腺癌数据,并收集了非洲裔男性和前列腺癌联合会(MADCaP)和非洲加勒比海癌症联合会(AC3)的数据,以评估全球非洲裔男性的前列腺癌发病率和死亡率。在美国和加勒比海地区,非洲裔男性的前列腺癌发病率和死亡率最高。非洲撒哈拉以南地区的肿瘤分期和分级最高。我们报告称,在国内生产总值用于医疗保健和每十万人中医生比例较高的国家,T1 期前列腺肿瘤的比例较高。我们还观察到,晚期肿瘤比例较高的地区死亡率较低。这一发现表明,撒哈拉以南非洲男性前列腺癌的诊断和/或报告不足。尽管如此,CaP 的发病率和死亡率仍是全世界非洲裔男性的一个重大公共卫生问题。
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引用次数: 0
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Prostate Cancer
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