Prostate Cancer Group Research Articles

Current Evidence for the Involvement of Hypogonadism and Modulation of Steroid Receptors in Prostate Carcinoma

Prostate cancer (PCa) is the most prevalent cancer in the Nigerian male population, similar to other black populations. It is postulated that exposure to endogenous or environmental steroids prompts prostatic mediated changes via steroid receptors as well as a decrease in the androgen/estrogen ratio and aging. Thereby contributing to prostatic carcinogenesis and disease progression. This study is aimed to determine the plasma levels of testosterone, 17β-estradiol as well as the pattern of expression of steroid receptors in subjects with prostate cancer, benign prostatic hyperplasia, and controls. Study participants are made up of a total of 195 consented volunteers consisting of 65 Prostate cancer (PCa) and 65 benign prostatic hyperplasia (BPH) treatment naïve participants and 65 apparently healthy subjects as controls. Anthropometric data were measured using standard methods and biochemical parameters determined by enzyme-linked immunosorbent assay (ELISA). The gene expression is quantified by Real-Time PCR with PerfeCTa SYBR Green SuperMix on CFX96 Bio-Rad, USA. The results of this study showed increased levels of 17β-estradiol, total androgen receptor (AR) and estrogen receptor-beta (Erβ) in prostate cancer participants compared with controls (P<0.05). A Significant reduction in plasma levels of testosterone in prostate cancer subjects compared with BPH and controls was observed (P<0.001). The plasma levels of androgen receptors were significantly increased in PCa and BPH participants (p<0.05). We observed a positive correlation between ERβ levels and PSA levels in the PCa group (r=0.32, p=0.02). There was a differential expression of AR, ESR1 and ESR2 in the studied group. This study shows hypogonadism and an increased 17β-estradiol, ERβ, and AR levels in subjects with prostate cancer. This data suggests that modulation of these hormones and their receptors may be associated with initiation and progression of prostate cancer and could be valuable in the interpretation of PSA kinetics and stratification of cases after screening.

Application of Real-Time Ultrasound Elastography Combined with Prostate Calcification in Differential Diagnosis of Prostate Cancer.

This study aimed to explore the clinical and differential diagnostic value of real-time ultrasound elastography combined with transabdominal prostate calcification in prostate cancer (PCa). This study retrospectively analysed the clinical pathological data of 97 patients with PCa and 105 patients with benign prostatic hyperplasia (BPH) diagnosed by postoperative pathology in our hospital from May 2020 to May 2021; Comparatively analysed the clinical data of the two groups, including the elastic strain ratio, elastic image compression index, types of prostate calcification and calcification diameter; And used logistic regression analysis to screen out the independent risk factors for identifying PCa and BPH. No significant difference in age, body weight, body mass index, location of calcification and calcification diameter was observed between the two groups (p > 0.05), and overt differences in elastic strain ratio, elastic image compression index, types of calcification, and testosterone were found between the PCa group and BPH group (p < 0.05). Logistic regression analysis showed that the elastic strain ratio, elastic image compression index and types of calcification were independent risk factors for identifying PCa (p < 0.05). The area under curve value of combined diagnosis under receiver operating characteristic curve was as high as 0.756 (95% CI: 0.691-0.813), with a sensitivity of 67.60% and a specificity of 76.30%. A certain correlation is observed amongst elastic strain ratio, elastic image compression index, types of prostate calcification and the occurrence and development of PCa. The application of real-time ultrasound elastography combined with the detection of transabdominal prostate calcification in clinical diagnosis can improve the detection rate of PCa, which has an important clinical application value.

CD44 rs13347C>T Variants in 3'UTR and Prostate Neoplasms: A Case-control Study and Bioinformatics Approach.

CD44, a cell-surface receptor and a key player in cellular signaling, can act as both tumor suppressor and promoter. This study aimed to investigate the association of CD44 rs13347C>T variants with prostate neoplasms, including both benign prostatic hyperplasia (BPH) and prostate cancers using a case-control and bioinformatics approach. Genomic DNA was extracted from 545 blood samples (225 BPH, 225 prostate cancers, and 95 control) and the CD44 rs13347C>T genotypes were identified using PCR-RFLP. We explored miRNA interactions using the miRNASNP-v3 database and GeneMANIA for co-expression networks. Results showed cancer patients had significantly higher PSA levels compared to both controls (p= 0.03) and BPH (p= 0.01). Additionally, digital rectal examination-positive and smoker BPH patients showed significantly the increased cancer risk (p= 0.004, p= 0.046). Prostate cancer group indicated significantly higher frequency of CD44 rs13347C>T mutant allele compared to control and BPH groups, particularly in TT and CT+TT genotypes (p < 0.05). miRNA SNP-v3 database predicted the mutant allele of CD44 rs13347C>T could lose 1 and gain 6 miRNAs for a new site created. Co-expression analysis revealed a direct interaction between CD44 and aryl hydrocarbon receptor (AHR), a gene known to be dysregulated in smokers. Furthermore, these genes alone display co-expression interactions with integrin subunit alpha 4 (ITGA4), protein plays a paradoxical role, both suppressing and promoting tumors. Based on the findings, the mutant allele of CD44 rs13347C>T may disrupt miRNA binding, which may potentially impact CD44, AHR, and ITGA4 expression in smokers, possibly contributing to prostate cancer progression.

Quantitative Evaluation of late Gadolinium Enhancement to the Differential Diagnosis of Prostate Cancer and Prostatitis in mpMRI.

To evaluate the late gadolinium enhancement ratio (LGER) quantitatively in late post-contrast images in multiparametric prostate MRI (mpMRI) for the differential diagnosis of chronic prostatitis and prostate cancer (PCa). Descriptive study. Department of Radiology, Suleyman Demirel University, Isparta, Turkey, from January 2018 to October 2021. The data of 111 patients with a diagnosis of PCa and chronic prostatitis, were retrospectively analysed who underwent mpMRI of the prostate were retrospectively analysed. Histopathological verification was available in 57 of 57 prostate carcinoma patients and 20 of 54 chronic prostatitis cases. The detection of lesions from the images and the correlation of the detected lesions with their histopathological diagnoses were made by the joint decision of two radiologists. The LGER measurements were made independently by both radiologists. Signal intensity (SI) values of the lesions were obtained by placing a hand-drawn ROI on pre-contrast and late post-contrast images. Late enhancement ratio was calculated from the ratio of the difference between the pre- and post-contrast SI values to the pre-contrast SI values. The LGER values obtained were statistically compared between the pathologically proven PCa and chronic prostatitis patient groups. The prostatitis LGER values (103.40 ± 31.54%) were significantly higher than the PCa values (79.71±27.39, p<0.001). The LGER values of lesions with a Gleason score <7 were lower than those of lesions scoring ≥7 (p = 0.004). The LGER values of PI-RADS-3 PCa lesions were lower than those of PI-RADS-4 and PI-RADS-5 (p = 0.002). In the late post-contrast phase, low signal measurements in PI-RADS-3 lesions excluded the presence of prostatitis. Late contrast enhancement quantitative SI measurements performed in the late contrast phase of mpMRI may enable the differential diagnosis of PCa/prostatitis and a more accurate evaluation of PI-RADS scores in terms of malignancy. Prostate cancer, Prostatitis, Gadolinium, Dynamic contrast-enhanced magnetic resonance imaging.

Abstract A077: Are anthropometric measures associated with prostate cancer in Nigerian men?

Abstract Purpose/Objective(s): Despite prostate cancer (PCa) being a public health problem globally, much remains unknown of its etiology. Though obesity is a probable risk factor for prostate cancer measurable by anthropometric indices, its impact on PCa development with other risk factors has not been explored among Nigerian men. This study was designed to test the hypothesis that anthropometric indices are higher in prostate cancer patients compared to age-matched healthy controls. Materials/Methods: The study was a case-control study conducted in four tertiary hospitals in Nigeria. The cases were newly diagnosed prostate cancer patients, while the controls were age-matched healthy men confirmed to be cancer-free with normal PSA. Patients with weight loss (self-reported) in the past month, ECOG ≥3, and uncontrolled comorbidities (diabetes and hypertension) were not eligible. Socio-demographics (age, marital status, ethnicity, the highest level of education, occupation, and employment status) and clinical history (high-fat diet, physical activity, cigarette smoking, alcohol, family history of prostate cancer, and Gleason score [for cases]) using an interviewer-administered questionnaire, and anthropometric measures (weight, height, body mass index, waist circumference, hip circumference, and waist-hip ratio [WHR]) physically measured were obtained from all participants. The socio-demographics and the clinical history were compared between cases and controls using a chi-square test. The comparison of the anthropometric measures between the groups and their correlation with Gleason's score were determined using a t-test. Results: Seventy-three prostate cancer cases (PCa) and seventy-three age-matched healthy controls (Co) were recruited for the study. The mean age was 64.20 years (SD = 6.184). Only the mean WHR was of significant difference between the PCa and the Co (0.98 [SD=0.07] PCa: 0.93 [SD=0.06] Co, p=&amp;lt;0.0001). Forty-three (58.9%) of the cases had high-grade diseases (Gleason Score 8-10). No significant association was found between anthropometric indices and the disease grade. PCa and Co groups differ by regular exercise (32PCa [43.8%]:47Co [64.4%]; p=0.013), family history of PCa (14PCa [19.2%]:2Co [2.7%]; p=0.001), tobacco smoking (28PCa [38.4%]:15Co [20.5%]; p=0.018), and alcohol consumption (57PCa [78.1%]:43Co [58.9%]; p=0.013). Conclusion: Patients with PCa had higher WHR and were more likely physically inactive, have a family history of prostate cancer, smoke tobacco, or drink alcohol. PCa in Nigerian men are predominantly high-grade, and there was no association between Gleason grade and anthropometric indices. Citation Format: Kehinde O. Adeyinka. Are anthropometric measures associated with prostate cancer in Nigerian men? [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A077.

DCE-MRI and DWI can differentiate benign from malignant prostate tumors when serum PSA is ≥10 ng/ml.

This study investigated the diagnostic utility of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) parameters for distinguishing between benign and malignant prostate tumors when serum prostate-specific antigen (PSA) level is ≥10 ng/ml. Patients with prostate cancer (PCa) and benign prostatic hyperplasia (BPH) with serum PSA ≥10 ng/ml before treatment were recruited. Transrectal ultrasound-guided biopsy or surgery was performed for tumor classification and patients were stratified accordingly into PCa and BPH groups. Patients underwent DCE-MRI and DWI scanning and the transfer constant (Ktrans), rate constant (Kep), fractional volume of the extravascular extracellular space, plasma volume (Vp), and Prostate Imaging Reporting and Data System Version 2 (PI-RADS v2) score were determined. The apparent diffusion coefficient (ADC) was calculated from DWI. The diagnostic performance of these parameters was assessed by receiver operating characteristic (ROC) curve analysis, and those showing a significant difference between the PCa and BPH groups were combined into a multivariate logistic regression model for PCa diagnosis. Spearman's correlation was used to analyze the relationship between Gleason score and imaging parameters. The study enrolled 65 patients including 32 with PCa and 33 with BPH. Ktrans (P=0.006), Kep (P=0.001), and Vp (P=0.009) from DCE-MRI and ADC (P<0.001) from DWI could distinguish between the 2 groups when PSA was ≥10 ng/ml. PI-RADS score (area under the ROC curve [AUC]=0.705), Ktrans (AUC=0.700), Kep (AUC=0.737), Vp (AUC=0.688), and ADC (AUC=0.999) showed high diagnostic performance for discriminating PCa from BPH. A combined model based on PI-RADS score, Ktrans, Kep, Vp, and ADC had a higher AUC (1.000), with a sensitivity of 0.998 and specificity of 0.999. Imaging markers showed no significant correlation with Gleason score in PCa. DCE-MRI and DWI parameters can distinguish between benign and malignant prostate tumors in patients with serum PSA ≥10 ng/ml.

Role of the elastography strain ratio using transrectal ultrasonography in the diagnosis of prostate cancer and clinically significant prostate cancer

This study investigated the efficacy of the elastography strain ratio (ESR) as a predictor of prostate cancer (PCa) in targeted prostate biopsy. In total, 257 patients who underwent magnetic resonance imaging-targeted biopsy were enrolled. Before biopsy, we placed regions of interest (zone A and B) in the lesion and levator ani. The ESR was measured as zone A/zone B. Multivariate analyses were performed to predict PCa and clinically significant PCa. There were 206 (71.5%) positive cancer lesions. No difference in digit rectal examination findings was found between patients with and without PCa. For predicting clinically significant PCa, an ESR ≥ 6.8 was significantly higher in the PCa (+) group than in the PCa (−) group (p < 0.001). The area under the receiver operating characteristic curve (AUC) for the conventional variables (model 1) plus the ESR was 0.845, which was significantly higher than that for model 1 (p = 0.001). In prostate imaging reporting and data system score 3 lesions, an ESR ≥ 4.6 was a significant predictor of PCa (p = 0.002). The AUC in model 1 plus the ESR was 0.856, which was significantly higher than that in model 1 alone (p = 0.017). The ESR is useful for predicting clinically significant PCa.

Role of serum cathelicidin in diagnosis of patient with prostatitis and prostate carcinoma

BackgroundThis study investigated the diagnostic role of 75 levels measured in serum prostatitis and prostate carcinoma and in the differentiation of these two conditions.MethodsThe study was conducted with 75 patients histopathologically diagnosed with prostate carcinoma or prostatitis and followed up at the Departments of Urology and Medical Oncology and 21 healthy male subjects. Serum cathelicidin levels were investigated using the ELISA method. Statistical analyses were performed using the SPSS for Windows 22.0 package software. Compliance of the variables to normal distribution was examined using visual and analytic methods. In the Kolmogorov–Smirnov test, cases with a p value of greater than 0.05 were accepted as normal distribution.ResultsA total of 75 patients including 45 diagnosed with prostate carcinoma and 30 diagnosed with prostatitis, as well as 21 healthy control subjects were included in the study. Prostate-specific antigen (PSA) was detected as 23 (4–1200) ng/mL in the patients with prostate carcinoma and as 9.85 (3.9–405 ng/mL) in the patients with prostatitis. The cathelicidin levels were diagnostically significant when assessed by ROC analysis in the prostate cancer, prostatitis and control groups (p = 0.005). The cutoff values derived from the ROC curve analysis were 3.5151 ng/mL for distinguishing prostate cancer from prostatitis, 2.2620 ng/mL for prostate cancer versus control group and 1.2340 ng/mL for prostatitis versus control group.ConclusionsIn this study we showed that the serum cathelicidin levels were significantly higher in the patients diagnosed with prostate carcinoma. Measurement of serum cathelicidin levels could be used as a diagnostic marker in prostate carcinoma as well as facilitating differential diagnosis to strengthen the diagnostic suspicion before prostate biopsy and distinguish the diagnosis from prostatitis cases.

Time without PSA recurrence after radical prostatectomy as a predictor of future biochemical recurrence, metastatic disease and prostate cancer death: a prospective Scandinavian cohort study

ObjectiveAlthough surveillance after radical prostatectomy routinely includes repeated prostate specific antigen (PSA)-testing for many years, biochemical recurrence often occurs without further clinical progression. We therefore hypothesised that follow-up can be...

Correlation of Intravoxel Incoherent Motion and Diffusion Kurtosis MR Imaging Models With Reactive Stromal Grade in Prostate Cancer.

Reactive stroma is recognized as one of the independent prognostic factors in prostate cancer (PCa). Intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) may be useful for assessing the reactive stromal grade (RSG). To investigate whether IVIM and DKI models can evaluate RSG in PCa patients. Retrospective. A total of 56 PCa patients aged 73 years on average confirmed by MRI and transrectal ultrasound (MRI/TRUS) fusion biopsy divided into two subgroups (18 high RSG and 38 low RSG). A 3 T/T1 WI-fs, T1 WI, T2 WI-fs, T2 WI, DWI, IVIM, and DKI. Apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), mean diffusion (MD), mean kurtosis (MK) were obtained. Patients were divided into high RSG PCa (>50% reactive stroma) and low RSG PCa (≤50% reactive stroma) groups on hematoxylin and eosin (H&E) stained sections. Spearman correlation and independent sample t-test or Wilcoxon's rank sum test was used to investigate the relationship between each imaging parameter and RSG. The combined parameters were calculated using a binary logistic regression model. Receiver operating characteristic (ROC) analysis was used to explore the value of individual and combined parameters to differentiate between high and low RSG group. Area under the ROC curves (AUC) > 0.7 were used as reference standards. ADC, D, f, and MD values showed positive correlation with RSG (r=0.489, 0.619, 0.318, and 0.544, respectively); MK showed negative correlation with RSG (r=-0.444). ADC, D, f, and MD values were significantly lower in the low RSG group than in the high RSG group. The combined model showed the best diagnostic ability to differentiate low and high RSG groups (AUC=0.887). Parameters of IVIM and DKI may be promising methods for assessment of RSG in PCa patients. 3. Stage 3.

122. Prostate cancer and other clinical features by polygenic risk score

Prostate cancer is the second most common cancer in American men and the second leading cause of cancer death in the USA. Genome-wide association studies (GWAS) have identified more than 170 single nucleotide polymorphisms (SNPs) associated with prostate cancer, which can be combined to make a Polygenic Risk Score (PRS) and give an individual their risk to develop prostate cancer. To our knowledge, studies have not been done to determine if there is a relationship between PRS and features of prostate cancer in men ascertained in a clinical setting. Thus, this study aims to investigate risk factors associated with prostate cancer including: age of diagnosis, ISUP Grade Group, metastatic status, histology, and family history of prostate cancer, to determine how they correlate with PRS amongst men who do not have a germline pathogenic variant in a known prostate cancer related gene. A quantitative retrospective chart review of 175 men diagnosed with prostate cancer, who received genetic counseling services at the Ohio State University's Genitourinary Cancer Genetics Clinic, and a PRS through Ambry Genetics was generated. Men diagnosed over 60 years of age were more likely to have a low PRS (57%) than a high PRS (32%) (p-value of 0.009). This supports the hypothesis that men diagnosed with prostate cancer at younger ages will have higher PRS and vice versa. We did not find a significant relationship between PRS and ISUP GG, metastatic status, histology, or family history in a first or second-degree relative.

Cumulative Effect Assessment of Common Genetic Variants on Prostate Cancer: Preliminary Studies.

Single nucleotide polymorphisms (SNPs) are the most common type of genetic variation among people. Genome Wide Association studies (GWASs) have generated multiple genetic variants associated with prostate cancer (PC) risk. Taking into account previously identified genetic susceptibility variants, the purpose of our study was to determine the cumulative association between four common SNPs and the overall PC risk. A total of 78 specimens from both PC and benign prostate hyperplasia (BPH) patients were included in the study. Genotyping of all selected SNPs was performed using the TaqMan assay. The association between each SNP and the PC risk was assessed individually and collectively. Analysis of the association between individual SNPs and PC risk revealed that only the rs4054823 polymorphism was significantly associated with PC, and not with BPH (p &lt; 0.001). Statistical analysis also showed that the heterozygous genotype of the rs2735839 polymorphism is more common within the BPH group than in the PC group (p = 0.042). The cumulative effect of high-risk alleles on PC was analyzed using a logistic regression model. As a result, the carriers of at least one risk allele copy in each particular region had a cumulative odd ratio (OR) of 1.42 times, compared to subjects who did not have any of these factors. In addition, the combination of these four genetic variants increased the overall risk of PC by 52%. Our study provides further evidence of the cumulative effects of genetic risk factors on overall PC risk. These results should encourage future research to explain the interactions between known susceptibility variants and their contribution to the development and progression of PC disease.

Determining the reliable feature change in longitudinal radiomics studies: A methodological approach using the reliable change index.

Determination of reliable change of radiomics feature over time is essential and vital in delta-radiomics, but has not yet been rigorously examined. This study attempts to propose a methodological approach using reliable change index (RCI), a statistical metric to determine the reliability of quantitative biomarker changes by accounting for the baseline measurement standard error, in delta-radiomics. The use of RCI was demonstrated with the MRI data acquired from a group of prostate cancer (PCa) patients treated by 1.5 T MRI-guided radiotherapy (MRgRT). Fifty consecutive PCa patients who underwent five-fractionated MRgRT were retrospectively included, and 1023 radiomics features were extracted from the clinical target volume (CTV) and planning target volume (PTV). The two MRI datasets acquired at the first fraction (MRI11 and MRI21) were used to calculate the baseline feature reliability against image acquisition using intraclass correlation coefficient (ICC). The RCI was constructed based on the baseline feature measurement standard deviation, ICC, and feature value differences at two time points between the fifth (MRI51) and the first fraction MRI (MRI11). The reliable change of features was determined in each patient only if the calculated RCI was over 1.96 or smaller than -1.96. The feature changes between MRI51 and MRI11 were correlated to two patient-reported quality-of-life clinical endpoints of urinary domain summary score (UDSS) and bowel domain summary score (BDSS) in 35 patients using the Spearman correlation test. Only the significant correlations between a feature that was reliably changed in ≥7 patients (20%) by RCI and an endpoint were considered as true significant correlations. The 352 (34.4%) and 386 (37.7%) features among all 1023 features were determined by RCI to be reliably changed in more than five (10%) patients in the CTV and PTV, respectively. Nineteen features were found reliably changed in the CTV and 31 features in the PTV, respectively, in 10 (20%) or more patients. These features were not necessarily associated with significantly different longitudinal feature values (group p-value < 0.05). Most reliably changed features in more than 10 patients had excellent or good baseline test-retest reliability ICC, while none showed poor reliability. The RCI method ruled out the features to be reliably changed when substantial feature measurement bias was presented. After applying the RCI criterion, only four and five true significant correlations were confirmed with UDSS and BDSS in the CTV, respectively, with low true significance correlation rates of 10.8% (4/37) and 17.9% (5/28). No true significant correlations were found in the PTV. The RCI method was proposed for delta-radiomics and demonstrated using PCa MRgRT data. The RCI has advantages over some other statistical metrics commonly used in the previous delta-radiomics studies, and is useful to reliably identify the longitudinal radiomics feature change on an individual basis. This proposed RCI method should be helpful for the development of essential feature selection methodology in delta-radiomics.

Exploring the Association between Gut and Urine Microbiota and Prostatic Disease including Benign Prostatic Hyperplasia and Prostate Cancer Using 16S rRNA Sequencing.

Numerous microorganisms residing in the gastrointestinal and genitourinary tracts affect host health. We investigated stool and voided urine samples collected from patients with benign prostatic hyperplasia (BPH) or prostate cancer (PC) and a control group to explore the potential relationship between human microbiota and prostatic disease, and aimed to identify correlations and pathogenic taxonomic units. We studied microbial composition using 16S rRNA sequencing to identify operational taxonomic units (OTUs). Extracted genome was amplified and filtered sequences were used to classify OTUs based on their specific taxonomy. No statistically significant differences were observed in stool samples among the groups. However, urine samples indicated different microbiota compositions in different patient populations. The top five microbial genera that showed significant differences between the BPH and control groups were Alcaligenes, Pseudomonas, Lactobacillus, Akkermansia, and Cetobacterium. Faecalibacterium, Staphylococcus, Ruminococcaceae_UCG_002, Neisseria, and Agathobacter were the genera with the largest proportion differences when comparing the PC and control groups. We discovered that the urine microbiota composition of the BPH and PC groups was distinct from that of the control group. Due to the impact of microbiota on prostatic disease, it is necessary to identify specific microbes for further research.

Comparison of Gleason score of Prostate Cancer at Ultrasound/MRI Fusion Target Biopsy vs. Systematic Transrectal Ultrasound Guided Biopsy with Final Gleason score at Radical Prostatectomy

Purpose: To compare accuracy in predicting final Gleason Grade Group (GGG) of Prostate Cancer (PCa) of US/MRI fusion guided target (fBx) vs. systematic Transrectal Ultrasound-Guided (TRUS) biopsy, using histopathologic analysis at prostatectomy as the gold standard. Materials and methods: After obtaining IRB approval, we retrospectively reviewed records of patients who underwent Radical Prostatectomy (RP) from January 2014 through May 2019 with prior US/MRI fusion guided target or TRUS biopsy. The rates of upgrading (RP GGG &gt; BX GGG), downgrading (RP GGG &lt; BX GGG), and concordance (RP GGG = BX GGG) were compared between the fBx and TRUS groups. Age, PSA, PSA density, and prostate volume were also noted for all patients. Statistical analysis was utilized to assess the data. Results: A total of 348 men with complete clinical data were included in this study. The rate of downgrading and upgrading in the fBx group was less than in the TRUS biopsy group (14% vs. 19.6%, and 13.2% vs. 19.6%, respectively). The concordance rate was higher in the US-MR fBx group (72.9% vs. 60.7%, p &lt; 0.05)) across all GGG. Notably, lower rates of concordance were found for GGG 1 (24.1%) and GGG 4 (3.6%) in the TRUS Bx group. Patients who underwent US-MR fBx had higher average PSA (9.4 vs. 6.5 ng/ml), higher PSA density (0.3 vs. 0.2 ng/ml2), and lower prostate volume (31 vs. 42 cc). Additionally, biopsy results showed a lower rate of GGG 1 (3.1% vs. 13.2%) and a higher rate of GGG 5 (14.7% vs. 5.5%) in the US-MR fBx group. Conclusions: Target biopsy has a higher GGG concordance compared to TRUS biopsy (72.9% vs. 60.7%, p &lt; 0.05). In addition, there was less downgrading or upgrading of final PCa GGG in the fBx groups compared to TRUS Bx (14% vs. 19.6%, 13.2% vs. 19.6%, respectively). This finding may have important implications for treatment decisions.

Urine-derived exosomal PSMA is a promising diagnostic biomarker for the detection of prostate cancer on initial biopsy.

It is well-established that the lack of accurate diagnostic modalities for prostate cancer (PCa) leads to overdiagnosis and overtreatments. Accordingly, this study aimed to assess the value of urine-derived exosomal prostate-specific membrane antigen (PSMA) as a biomarker for the diagnosis of PCa and clinically significant prostate cancer (csPCa). A total of 284 urine samples were collected from patients after the digital rectal examination (DRE). Urinary exosomes were extracted using commercial kits, and urine-derived exosomal PSMA was determined via enzyme-linked immunosorbent assay (ELISA). Evaluation of diagnostic accuracy of PSMA was performed via receiver operating characteristic (ROC) analysis, decision curve analysis (DCA), and waterfall plots. We found that urine-derived exosomal PSMA was significantly higher in PCa and csPCa than in benign prostatic hyperplasia (BPH) and BPH + non-aggressive prostate cancer (naPCa) groups (P < 0.001). Furthermore, the urine-derived exosome PSMA yielded area under the ROC curve (AUC) values of 0.876 and 0.826 for detecting PCa and csPCa, respectively, suggesting better performance than traditional clinical biomarkers. Besides, when the cutoff value used corresponded to a sensitivity of 95%, urine-derived exosomal PSMA could avoid unnecessary biopsies in 41.2% of cases and missed only 0.7% of csPCa cases. Urine-derived exosomal PSMA exhibits a good diagnostic yield for detecting PCa and csPCa. Findings of the present study provide the foothold for future studies on cancer management and research in this patient population.

Glycosaminoglycan Analysis of FFPE Tissues from Prostate Cancer and Benign Prostate Hyperplasia Patients Reveals Altered Regulatory Functions and Independent Markers for Survival.

Simple SummaryProstate cancer is one of the most frequent cancer types among men. A better understanding of the involved molecular mechanisms is still necessary for the improvement of therapeutic decision making. Glycosaminoglycan disaccharides were investigated on biopsies taken from patients with prostate cancer and benign prostate hyperplasia. We found that the quantity and sulfation of chondroitin sulfate chains significantly differed between benign prostate hyperplasia and the distinct risk groups of prostate cancer. Doubly and triply sulfated heparan sulfate disaccharides were identified as the independent biomarkers for survival.Prostate cancer is one of the most frequent cancer types among men. Several biomarkers and risk assessment methods are already available; however, enhancing their selectivity and sensitivity is still necessary. For improving therapeutic decisions, both basic and clinical research studies are still ongoing for a better understanding of the underlying molecular mechanisms. The enzymatic digests of heparan sulfate (HS) and chondroitin sulfate (CS) chains were investigated in tissue samples taken from patients with prostate cancer (PCa) and benign prostate hyperplasia (BPH) with the HPLC–MS methodology. None of the HS species analyzed showed correlating alterations with currently used markers such as clinical stage, Gleason score, or prostate-specific antigen (PSA) level. The total quantity and sulfation motifs of CS were both significantly different among BPH and different risk groups of PCa. Furthermore, the cancer-specific survival of patients can be predicted based on the levels of non-sulfated and doubly sulfated CS disaccharides as well as the total HS content and the doubly and triply sulfated HS disaccharide ratios. These disaccharide ratios proved to be independent markers from clinical parameters. Further investigations of glycosaminoglycan motifs were proposed for the validation of the results on independent patient cohorts as well.

Do disease status and race affect the efficacy of zoledronic acid in patients with prostate cancer? A systematic review and meta-analysis of randomized control trials.

BackgroundZoledronic acid (ZA) does not improve the overall survival (OS) of metastatic castration-resistant prostate cancer (mCRPC); however, little is known about the efficacy of ZA in to hormone-sensitive prostate cancer (HSPC), metastatic hormone-sensitive prostate cancer (mHSPC), and non- metastatic castration-resistant prostate cancer (nmCRPC). Therefore, we assessed the efficacy of ZA in patients with prostate cancer (PCa) and different disease statuses.MethodsFifteen eligible randomized-control trials (RCTs) with ZA intervention, including 8280 participants with HSPC, mHSPC, nmCRPC, and mCRPC, were analyzed. The primary and secondary outcome were overall survival(OS), and skeletal-related events (SREs), and bone mineral density (BMD).ResultsThe participants included 8280 men (7856 non-Asian and 424 Asian). Seven trials yielded a pooled hazard ratio (HR) of 0.95 (0.88, 1.03; P = 0.19) for OS. Subgroup analysis revealed no significant improvement in OS in the HSPC, castration-resistant prostate cancer (CRPC), M0 and M1(bone metastasis) groups, with pooled HR (95%CI) of 0.96 (0.88,1.05), 0.78 (0.46,1.33), 0.95 (0.81,1.13), 0.85 (0.69,1.04) respectively. The Asian group exhibited improved in OS with an HR of 0.67 (0.48, 0.95; P = 0.02), whereas the non-Asian group showed no improvement in OS with an HR of 0.97 (0.90, 1.06; P = 0.52). Five trials yielded pooled odds ratio (OR) of 0.65 (0.45, 0.95; P = 0.02) for SREs. In the subgroup, SREs were significantly decreased in the M1 and Asian groups with ORs of 0.65 (0.45, 0.95; P = 0.02) and 0.42 (0.24, 0.71; P = 0.001), respectively. Six trials yielded a pooled mean difference (MD) of 8.08 (5.79, 10.37; P < 0.001) for BMD. In the HSPC we observed a stable improvement in increased BMD percentage with an MD (95%CI) of 6.65 (5.67, 7.62) (P = 0.001).ConclusionsZA intervention does not significantly improve OS in patients with prostate cancer (HSPC, CRPC, M0, M1) but probably improves OS in the Asian populations. M1 and Asian groups had exhibit a significant reduction in SREs regardless of the HSPC or CRPC status after ZA administration. Moreover, ZA treatment increases BMD percentage.

Analysis of the Effect of Combined Anesthesia in Laparoscopic Radical Prostate Cancer

Analysis of the Effect of Combined Anesthesia in Laparoscopic Radical Prostate Cancer

Label‐free surface‐enhanced Raman spectroscopy detection of prostate cancer combined with multivariate statistical algorithm

AbstractThe purpose of this study was to detect human plasma for screening prostate cancer (PCa) and benign prostatic hyperplasia (BPH) based on surface‐enhanced Raman spectroscopy (SERS) and multivariate statistical algorithms. The test was to detect 106 plasma samples, which originated from 39 normal subjects, 26 patients with PCa and 41 patients with BPH. Significant differences in peak intensity at 495, 636, 1135, 1205, and 1675 cm−1 can be observed from the difference spectrogram, which contributes to initially distinguish the cancer group from the normal group. Then, the multivariate statistical techniques, including principal component analysis (PCA) and linear discriminant analysis (LDA) diagnostic algorithms, as well as recursive weighted partial least square (PLS) method and support vector machine (SVM) algorithm, were used to analyze the spectral data. For PCa versus normal group and BPH versus normal group, the classification accuracy of PCA‐LDA was 96.80% and 97.50%, respectively, and the classification accuracy of PLS‐SVM was 100.00% and 100.00%, respectively. In the diagnosis of PCa and BPH, the sensitivity, specificity and accuracy of PCA‐LDA were 65.40%, 75.60%, and 71.06% respectively, and the area under the curve (AUC) value of the receiver operating characteristic (ROC) curve was 0.788, while the sensitivity, specificity and accuracy of PLS‐SVM were 88.46%, 87.80%, and 88.06%, respectively, and the AUC value was 0.881. The diagnostic results of PLS‐SVM are better than PCA‐LDA, which supported that PLS‐SVM algorithm has greater potential than PCA‐LDA algorithm in the pre‐diagnosis and screening of PCa.