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A novel expressed prostatic secretion(EPS)-urine metabolomic signature for the diagnosis of clinically significant prostate cancer

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Cancer Biology & Medicine 2021年第2期18卷 604-615页

作者： Denise Drago Annapaola Andolfo Ettore Mosca Alessandro Orro luigi nocera Vito Cucchiara MatteoBellone Francesco Montorsi Alberto Briganti ProMeFa Proteomics and Metabolomics FacilityCenter for Omics Sciences(COSR)IRCCS San Raffaele Scientific InstituteMilan 20132Italy Institute of Biomedical Technologies National Research Council(CNR)Milan 20090Italy Department of Urology and Division of Experimental Oncology Urological Research Institute(URI)IRCCS San Raffaele Scientific InstituteMilan 20132Italy Division of Immunology Transplantation and Infectious DiseasesIRCCS San Raffaele Scientific InstituteMilan 20132Italy

Objective:Significant efforts are currently being made to identify novel biomarkers for the diagnosis and risk stratification of prostate cancer(PCa).Metabolomics can be a very useful approach in biomarker discovery because metabolites are an important read-out of the disease when characterized in biological *** aimed to determine a metabolomic signature which can accurately distinguish men with clinically significant PCa from those affected by benign prostatic hyperplasia(BPH).Methods:We first performed untargeted metabolomics using ultrahigh-performance liquid chromatography tandem mass spectrometry on expressed prostatic secretion urine(EPS-urine)from 25 patients affected by BPH and 25 men with clinically significant PCa(defined as Gleason score≥3+4).Diagnosis was histologically confirmed after surgical *** EPS-urine metabolomic approach was then applied to a larger,prospective cohort of 92 consecutive patients undergoing multiparametric magnetic resonance imaging for clinical suspicion of PCa prior to ***:We established a novel metabolomic signature capable of accurately distinguishing PCa from benign tissue.A metabolomic signature was associated with clinically significant PCa in all subgroups of the Prostate Imaging Reporting and Data System(PI-RADS)classification(100%and 89.13%of accuracy when the PI-RADS was in range of 1–2 and 4–5,respectively,and 87.50%in the more critical cases when the PI-RADS was 3).Conclusions:A combination of metabolites and clinical variables can effectively help in identifying PCa patients that might be overlooked by current imaging *** from EPS-urine should help in defining the diagnostic pathway of PCa,thus improving PCa detection and decreasing the number of unnecessary prostate biopsies.

关键词： Prostate cancer EPS-urine metabolomics prediction diagnosis

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Robot-assisted adrenalectomy:Step-by-step technique and surgical outcomes at a high-volume robotic center

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Asian Journal of Urology 2023年第4期10卷 475-481页

作者： Federico Piramide Carlo Andrea Bravi Marco Paciotti Luca Sarchi luigi nocera Adele Piro Maria Peraire Lores Eleonora Balestrazzi Angelo Mottaran Rui Farinha Hubert Nicolas Pieter De Backer Frederiek D'hondt Peter Schatteman Ruben De Groote Geert De Naeyer Alexandre Mottrie Department of Urology Onze-Lieve-VrouwziekenhuisAalstBelgium ORSI Academy GhentBelgium Department of Oncology Division of UrologyUniversity of TurinSan Luigi Gonzaga HospitalTurinItaly Department of Urology Humanitas Research Hospital-IRCCSRozzanoItaly Department of Urology ASST Santi Paolo e CarloUniversity of MilanMilanItaly Unit of Urology Division of Experimental OncologyUrological Research InstituteIRCCS San Raffaele Scientific InstituteVita-Salute San Raffaele UniversityMilanItaly Department of Urology Ospedale Policlinico e Nuovo Ospedale Civile S.Agostino Estense ModenaUniversity of Modena and Reggio EmiliaModenaItaly Division of Urology IRCCS Azienda Ospedaliero-Universitaria di BolognaBolognaItaly Urological Department La CitadelleLiègeBelgium

Objective In the last years,robotic surgery was introduced in several different settings with good perioperative ***,its role in the management of adrenal masses is still *** order to provide a contribution to this field,we described our step-by-step technique for robotic adrenalectomy(RA)and related modifications according to the type of adrenal mass *** We retrospectively analyzed 27 consecutive patients who underwent RA at Onze-Lieve-Vrouw hospital(Aalst,Belgium)between January 2009 and October ***,intra-and post-operative,and pathological data were retrieved from our prospectively maintained institutional *** variables are summarized as median and interquartile range(IQR).Categorical variables are reported as frequencies(percentages).Results Twenty-seven patients underwent RA were included in the *** age,body mass index,and Charlson's comorbidity index were 61(IQR:49-71)years,26(IQR:24-29)kg/m^(2),and 2(IQR:0-3),respectively,and 16(59.3%)patients were *** tumor size at computed tomography scan was 6.0(IQR:3.5-8.0)*** operative time and blood loss were 105(IQR:82-120)min and 175(IQR:94-250)mL,*** intraoperative complications were *** postoperative complications rate was 11.1%,with a postoperative transfusion rate of 3.7%.A total of 10(37.0%)patients harbored malignant adrenal *** them,3(11.1%)had adrenocortical carcinoma,6(22.2%)secondary metastasis,and 1(3.7%)malignant pheochromocytoma on final pathological *** 1(10.0%)patient had positive surgical *** We described our step-by-step technique for RA,which can be safely performed even in case of high challenging settings as malignant tumors,pheochromocytoma,and large *** standardization of perioperative protocol should be encouraged to maximize the outcomes of this complex surgical procedure.

关键词： Robotics Adrenalectomy Pheochromocytoma Malignant Surgical technique

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