PSAD联合PI-RADS v2在前列腺穿刺活检灰区的效用评估

目的:探讨前列腺特异性抗原密度(PSAD)联合前列腺影像报告和数据系统第2版(PI-RADS v2)在前列腺穿刺活检灰区的价值.方法:回顾分析行前列腺穿刺活检患者85例,穿刺前行多参数磁共振成像(mpMRI)检查且血清前列腺特异性抗原(PSA)质量浓度为4~10 ng/m L的患者纳入研究,进行PI-RADS v2评分和计算PSAD值,再根据穿刺病理结果,基于Gleason评分,对患者的PSAD联合PI-RADS v2评分进行统计学分析,使用受试者工作特征曲线(ROC)计算曲线下面积(AUC),评估PSAD联合PI-RADS v2在前列腺穿刺活检灰区的诊断价值.结果:85例血清PSA质量浓度为4~10 ng/m L的患者中,穿刺活检病理结果显示前列腺良性病变(包括前列腺增生、前列腺肉芽肿性病变和前列腺炎)70例(82.35%,70/85),前列腺癌15例(17.65%,15/85).前列腺癌(PCa)组和前列腺良性组PSAD、PI-RADS v2评分独立样本t检验结果显示PCa组和前列腺良性组间PSAD、PI-RADS v2评分均有统计学差异(P值分别为0.008、0.001,均0.05).PSAD、PI-RADS v2、PSAD+PI-RADS v2在诊断前列腺癌受试者工作特征曲线(ROC)下面积(AUC)逐渐增高,分别为0.721、0.842和0.869.当以PSAD质量浓度0.17ng/m L/cm3或PI-RADS v2评分≥4分为最佳截断点(cut off)时,PSAD+PI-RADS v2评分联合应用,前列腺穿刺活检灰区诊断PCa的敏感性为86.69%,特异性为64.29%.结论:血清PSA质量浓度为4~10 ng/m L前列腺穿刺活检灰区中,以前列腺穿刺病理Gleason评分为金标准,PSAD+PI-RADS v2评分联合应用,对前列腺穿刺活检灰区诊断PCa有较显著的临床价值,能够优化PSA筛查后的临床决策.     

电化学发光法检测前列腺癌特异性抗原标志物的研究

目的：探讨总前列腺特异性抗原（T-PSA）、游离前列腺特异性抗原（F-PSA）及 F-PSA/T-PSA 比值在前列腺癌及前列腺增生的诊断和鉴别诊断中的应用价值。方法收集病理确诊为前列腺癌患者86例、前列腺增生患者487例和健康体检者188例的血液样本,采用电化学发光法检测检测血清中 T-PSA、F-PSA 浓度,计算F-PSA/T-PSA 比值,比较 T-PSA、F-PSA 和 F-PSA/T-PSA 比值在前列腺癌组、前列腺增生组及正常对照组之间的差异。结果与正常对照组相比,前列腺增生组和前列腺癌组的 T-PSA、F-PSA、F-PSA/T-PSA 的比值差异具有高度统计学意义（p＆lt;0.01）;与前列腺增生组相比,前列腺癌组的 T-PSA、F-PSA、F-PSA/T- PSA 的比值差异也具有高度统计学意义（p〈0.01）。 T-PSA 在4.0～10.0 ng/mL 时,与前列腺增生组相比,前列腺癌组的 T-PSA 差异无显著性（p〈0.05）,F-PSA 差异有显著性（p〉0.05）,而 F-PSA/T- PSA 比值差异具有高度统计学意义（p〈0.01）。结论T-PSA 可作为前列腺癌筛选的一个重要的指标,当 T-PSA 在4.0～10.0 ng/mL 时,F-PSA/T-PSA 用于筛选前列腺癌优于 T-PSA,选择0.15作为 F-PSA/T-PSA 的临界值对前列腺癌诊断有较高的灵敏度和特异度。     

检测前列腺特异抗原在前列腺疾病患者中临床价值的探讨

目的 探讨前列腺特异性抗原（PSA）浓度变化在前列腺疾病诊断中的应用价值。方法采用电化学发光免疫分析（ECL）法检测71例健康对照者、48例前列腺炎患者、111例良性前列腺增生（BPH）患者和59例前列腺癌（PCa）患者血清巾的PSA浓度，对检测结果进行统计分析：结果前列腺癌组患者血清PSA浓度明显高于其它各组（P〈0．001）；前列腺增生组部分病人血清PSA浓度升高，但局限在一定范围，一般不超过10．0mg/ml；前列腺炎组和健康对照组均在正常范嗣（〈4．0ng／ml）．结论PSA是筛查前列腺癌的灵敏的肿瘤标志物，对良、恶性前列腺疾病有一定的鉴别诊断意义。     

血清TPSA、FPSA/TPSA及PSAD对前列腺癌的诊断价值

目的:探讨血清总前列腺特异抗原(TPSA)、游离前列腺特异抗原(FPSA)与TFSA的比值(FPSA/TPSA)、前列腺特异抗原密度(PSAD)对前列腺癌的诊断价值.方法:用全自动化学发光免疫分析仪检测经病理诊断的28例前列腺癌、149例前列腺增生患者和142例健康男性体检者的血清TPSA、FPSA和FPSA/TPSA,通过腹部B超测定其前列腺的体积(PV),并计算PSAD.结果:(1)前列腺癌组患者的TPSA、PSAD明显高于前列腺增生组及正常对照组,FPSA/TPSA明显低于前列腺增生组及正常对照组;(2)TPSA、FPSA/TPSA、PSAD在工作特征曲线(ROC曲线)下的面积大小分别为0.943、0.765、0.954;由ROC曲线确定的诊断前列腺癌的最佳临床判断值为TPSA＞8.35 ng/mL、FPSA/TPSA＜0.21、PSAD＞0.15 ng/(mL·cm3);据此临界值诊断前列腺癌的敏感度、特异度、准确度分别为:TPSA为96.4%、70.5%、74.6%,FPSA/TPSA为82.1%、61.1%、61.6%,PSAD为100%、71.8%、76.3%;(3)TPSA、PSAD与前列腺癌分期存在正相关性(rs=0.732和rs=0.821,P＜0.001),Ⅲ～Ⅳ期患者的TPSA、PSAD明显高于Ⅰ～Ⅱ期,而PV、FPSA/TPSA与前列腺癌分期无相关性.结论:TPSA、PSAD对前列腺癌有较高的诊断价值,FPSA/TPSA具有中等诊断价值.     

前列腺癌的IVIM-DWI及其与MVD的相关性分析

目的:探讨体素内不相干运动弥散加权成像(IVIM-DWI)技术在前列腺癌中的诊断价值,并结合CD34病理染色结果,分析IVIM-DWI各灌注相关参数的病理生理学基础.方法:采用3.0T核磁共振对符合纳入标准的前列腺癌患者(PCa组)24例[平均年龄(74.29±7.77)岁]及良性前列腺增生患者(BPH组)21例[平均年龄(70.48±9.40)岁],行IVIM-DWI检查,应用经典双指数函数模型对所得数据进行处理分析得到相关定量参数D、D*、f值.对行根治性切除手术的前列腺癌及良性前列腺增生患者的病理切片行CD34染色并计算微血管密度(MVD).结果:PCa组中D值及f值较BPH组明显减低,而D*值明显升高,差异有统计学意义(P0.05).PCa组中D*值与MVD显著正相关(r=0.793,P0.05),BPH组中f值与MVD显著正相关(r=0.766,P0.05).结论:IVIM-DWI各相关参数(D、D*、f值)在前列腺癌与良性前列腺增生的鉴别中具有明确的诊断价值.前列腺癌中D*值的升高与前列腺癌组织内微血管密度密切相关,而f值的减低可能与癌灶中血管通透性的异常有关.     

基于MRI影像组学及PSA结合机器学习对前列腺中央区良恶性结节的鉴别诊断

目的:探讨基于核磁共振影像(MRI)T2WI或表观扩散系数(ADC)影像组学特征,以及血清前列腺特异性抗原(PSA)联合机器学习在鉴别中央区前列腺癌及前列腺增生中的价值.方法:回顾性分析术前行MRI检查并经病理证实的中央区前列腺增生61例及前列腺癌51例.采用MaZda软件提取所有患者T2WI与ADC图像的纹理特征,建...     

人类腺体激肽释放酶2的研究进展

以往人们一直用前列腺特异性抗原(PSA）作为前列腺癌(Pca)的标志物，但是PsA缺乏特异性，在良性前列腺增生(BPH)时PsA也会增高．尤其是PsA在4—10ng/L范围内，就很难区分BPH和Pca，最近研究证明，人类腺体激肽释放酶2(hK2)及其相关指标对Pca的诊断更为准确，成为一种有前景的标志物，本文就hK2的生物学活性，hK2与Pca的关系，hK2的检测方法和hK2及其相关指标在Pca诊断中的应用作一综述。     

转录抑制因子锌指蛋白57在前列腺癌组织中的表达

目的探讨转录抑制因子锌指蛋白57(ZFP57)在前列腺癌组织中的表达及意义.方法收集行前列腺穿刺活检的石蜡包埋组织标本,其中前列腺癌组织92例,癌旁组织24例,良性增生组织24例,正常前列腺组织24例.使用免疫组化法半定量检测组织标本中ZFP57的表达情况;Western blot定量检测ZFP57蛋白的相对表达量.收集前列腺癌患者TNM分期、Gleason评分、转移情况、前列腺癌特异性抗原(PSA)血清水平,分析与ZFP57表达的关系.结果免疫组化检测显示:前列腺癌组织中ZFP57阳性率明显低于本研究中其他组织标本,差异具有统计学意义(P0.01);ZFP57阳性率在正常前列腺组织、良性增生组织、癌旁组织间比较差异无统计学意义(P0.05).Western blot检测显示:前列腺癌组织中ZFP57的相对表达量明显低于本研究中其他组织标本,差异具有统计学意义(P0.01).不同TNM分期、Gleason评分、转移情况、PSA水平的前列腺癌患者ZFP57阳性率之间差异均具有统计学意义(P0.01),其中,TNM分期增加、Gleason评分增加、癌细胞转移、ρ(PSA)20 ng/m L的前列腺癌患者ZFP57阳性率明显降低.结论前列腺癌组织中ZFP57呈低表达,且与临床病理指标呈负相关;ZFP57可能作为抑癌基因参与前列腺癌的发生与发展.     

前列腺癌组织中PSA、IL-6、IL-8的表达及作用机制分析

目的探讨前列腺癌(PCa)组织中前列腺特异性抗原(PSA)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)的表达及作用机制.方法选取60例PCa患者,另选取60例前列腺增生(BPH)患者作为对照,分别取受试者的PCa及BPH组织标本,应用免疫组织化学法检测不同组织中PSA、IL-6及IL-8的表达情况,并分析PSA、IL-6及IL-8的表达与PCa患者的临床病理特征关系.结果 PCa组织中PSA、IL-6及IL-8的表达率均高于BPH组织(P0.05).临床分期T3～T4期、低分化、淋巴结转移PCa组织中PSA、IL-6、IL-8表达率显著高于临床分期T1～T2期、中高分化、无淋巴结转移组织(P0.05).经Pearson相关性分析:PCa组织中PSA与IL-6、PSA与IL-8、IL-6与IL-8均呈正相关关系(P0.05).结论 PSA、IL-6、IL-8在PCa组织中呈明显高表达,且均与PCa患者的临床分期、分化程度及淋巴结转移密切相关.     

MRI弥散张量成像对前列腺疾病的诊断价值

目的:初步探讨弥散张量成像(diffusion tensor imaging,DTI)对前列腺癌(prostate carcinoma,Pea)和良性前列腺增生(benign pmstate hyperplasia,BPH)的诊断及鉴别诊断价值.方法:分别对22例PCa和31例BPH患者及20名健康志愿者进行前列腺DT...     

Study of prostate biopsy robot system

A system for prostate biopsy with robot assistance was proposed. The system consists of Motoman robot, needle insertion mechanism, and control software. A experiment was held with this software, and it proved that the whole system is simple, reliable and good application.     

Study of prostate biopsy robot system

A system for prostate biopsy with robot assistance was proposed.The system consists of Motoman robot,needle insertion mechanism,and control software.A experiment was held with this software,and it proved that the whole system is simple,reliable and good application.     

Delineation of prognostic biomarkers in prostate cancer

Prostate cancer is the most frequently diagnosed cancer in American men. Screening for prostate-specific antigen (PSA) has led to earlier detection of prostate cancer, but elevated serum PSA levels may be present in non-malignant conditions such as benign prostatic hyperlasia (BPH). Characterization of gene-expression profiles that molecularly distinguish prostatic neoplasms may identify genes involved in prostate carcinogenesis, elucidate clinical biomarkers, and lead to an improved classification of prostate cancer. Using microarrays of complementary DNA, we examined gene-expression profiles of more than 50 normal and neoplastic prostate specimens and three common prostate-cancer cell lines. Signature expression profiles of normal adjacent prostate (NAP), BPH, localized prostate cancer, and metastatic, hormone-refractory prostate cancer were determined. Here we establish many associations between genes and prostate cancer. We assessed two of these genes-hepsin, a transmembrane serine protease, and pim-1, a serine/threonine kinase-at the protein level using tissue microarrays consisting of over 700 clinically stratified prostate-cancer specimens. Expression of hepsin and pim-1 proteins was significantly correlated with measures of clinical outcome. Thus, the integration of cDNA microarray, high-density tissue microarray, and linked clinical and pathology data is a powerful approach to molecular profiling of human cancer.     

基于多参数MRI的前列腺癌计算机辅助检测方法

在前列腺癌的诊断过程中,候选病灶的检测是一项重要步骤,该步骤有时由医生手工完成,这会带来一些问题.为了实现候选病灶的自动检测,训练了一个分类模型用于自动检测候选病灶.获取候选病灶之后,病灶区域的各类特征被用来表征候选病灶,其中,纹理特征在诊断过程中已经被证实是有效的,为了进一步提升性能,仍然需要候选病灶的更高水平的特征.因此,设计了新特征来描述候选病灶:病灶-凸包比,为了证实该特征的有效性,设计了实验:在加入新特征之前和之后分别测试计算机辅助检测方法的性能.实验结果表明,所设计的新特征有助于提升该方法的性能.     

Interaction of cellular-localized signature modules in response to prostate cancer

Rapid progress in high-throughput biotechnologies (e.g. microarrays) and exponential accumulation of gene functional knowledge makes it promising for systematic understanding of complex human diseases at the functional modules level. Current modular categorizations can be defined and selected more specifically and precisely in terms of both biological processes and cellular locations, aiming at uncovering the modular molecular networks highly relevant to cancers. Based on Gene Ontology, we identifed the functional modules enriched with differentially expressed genes and characterized by biological processes and specific cellular locations. Then, according to the ranking of the disease discriminating abilities of the pre-selected functional modules, we further defined and filtered signature modules which have higher relevance to the cancer under study. Applications of the proposed method to the analysis of a prostate cancer dataset revealed insightful biological modules.     

Interaction of cellular-localized signature modules in response to prostate cancer

Rapid progress in high-throughput biotechnologies (e.g. microarrays) and exponential accumulation of gene functional knowledge makes it promising for systematic understanding of complex human diseases at the functional modules level. Current modular categorizations can be defined and selected more specifically and precisely in terms of both biological processes and cellular locations, aiming at uncovering the modular molecular networks highly relevant to cancers. Based on Gene Ontology, we identifed the functional modules enriched with differentially expressed genes and characterized by biological processes and specific cellular locations. Then, according to the ranking of the disease discriminating abilities of the pre-selected functional modules, we further defined and filtered signature modules which have higher relevance to the cancer under study. Applications of the proposed method to the analysis of a prostate cancer dataset revealed insightful biological modules.     

Global histone modification patterns predict risk of prostate cancer recurrence

Aberrations in post-translational modifications of histones have been shown to occur in cancer cells but only at individual promoters; they have not been related to clinical outcome. Other than being targeted to promoters, modifications of histones, such as acetylation and methylation of lysine and arginine residues, also occur over large regions of chromatin including coding regions and non-promoter sequences, which are referred to as global histone modifications. Here we show that changes in global levels of individual histone modifications are also associated with cancer and that these changes are predictive of clinical outcome. Through immunohistochemical staining of primary prostatectomy tissue samples, we determined the percentage of cells that stained for the histone acetylation and dimethylation of five residues in histones H3 and H4. Grouping of samples with similar patterns of modifications identified two disease subtypes with distinct risks of tumour recurrence in patients with low-grade prostate cancer. These histone modification patterns were predictors of outcome independently of tumour stage, preoperative prostate-specific antigen levels, and capsule invasion. Thus, widespread changes in specific histone modifications indicate previously undescribed molecular heterogeneity in prostate cancer and might underlie the broad range of clinical behaviour in cancer patients.