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Hormone naive prostate cancer： predicting and maximizing response intervals

Asian Journal of Andrology 2015年第6期17卷 929-935,I0007,I0008页

作者： judd w moul Division of Urology Department of Urology Duke Cancer Institute Duke South Duke University Medical Center Durham NC 27710 USA.

Hormone naive advanced prostate cancer is subdivided into two disease states： biochemical recurrence and traditional M 1 （metastatic） prostate cancer and characterized by no prior hormonal therapy or androgen deprivation therapy （ADT）. In biochemical recurrence/ prostate-specific antigen （PSA） recurrence, men should be risk-stratified based on their PSA doubling time, the Gleason score and the timing of the recurrence. In general, only men who are at high risk should be considered for early/immediate ADT although this is best done using shared decision with the patient. The type of ADT to be used in biochemical recurrence ranging from oral-only peripheral blockade （peripheral androgen deprivation） to complete hormonal therapy （combined androgen blockade [CAB]） remains in debate owing to lack of randomized controlled trials （RCT）. However, there is good RCT support for use of intermittent hormonal therapy （IHT）. There is also limited research on biomarker response （PSA and testosterone decline） to predict prognosis. On the other hand, in the setting of M1 hormone naive prostate cancer, there are many more RCT＇s to inform our decisions. CAB and gonadotrophin-releasing hormone antagonists perhaps provide a slight efficacy advantage while IHT may be slightly inferior with minimal M1 disease. The PSA nadir at 7 months after starting ADT is a powerful prognostic tool for M1 patients. There is growing recognition that serum testosterone （T） control while on ADT is linked to the development of castrate-resistant prostate cancer. Especially for a M 1 patient, maintaining a serum T below 20-30 ng d1-1 prolongs the response to ADT. Novel oral agents （abiraterone and enzalutamide） may soon find use in hormone naive disease and may alter the treatment landscape. Despite over 75 years of experience with ADT, many questions remain, and the field continues to evolve.

关键词： androgen deprivation therapy cancer gonadotrophin-releasing hormone antagonists hormonal therapy luteinizing hormone-releasing hormone agonists prostate prostate-specific antigen testosterone

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Quantitative Analysis of a Panel of Gene Expression in Matched Benign and Neoplastic Prostate Epithelial Cells from Patients with“Aggressive”and“Nonaggressive”Prostate Cancer

Quantitative Analysis of a Panel of Gene Expression in Match...

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中华医学会病理学分会2005年学术年会

作者：刘爱军 Bungo Furusato Lakshmi Ravindranath Syed Shaheduzzaman Vasantha Srikantan Iabell A.Sesterhenn David G.McLeod judd w.moul Shiv Srivastava Gyorgy Petrovics Centerfor Prostate Disease Research Uniformed Services University of the Health Sciences Center for Prostate Disease Research Uniformed Services University of the Health Sciences Department of Genitourinary Pathology Armed Forces Institute of Pathology Urology Service Walter Reed Army Medical Center Center for Prostate Disease Research Uniformed Services University of the Health Sciences Urology ServiceWalter Reed Army Medical Center

Prostate cancer (CaP) is a complex, multifactorialdisease with heterogeneous tumor types, making the prediction of the clinical course for individual CaP patients a challenge. To better understand the molecular basis of CaP and potentially provide information toward more accurate prognosis/diagnosis, we have defined a set of laser capture microdissected (LCM) specimens that are being used for quantitative parallel expression analysis of a panel of genes frequently altered in CaP. Experimental Design: From 300 CaP patients undergo-

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Frequent Expression Alterations of ETS Related Gene-1(ERG1)in Prostate Cancer Transcriptome Reveal Diagnostic and Prognostic Biomarker Potential

Frequent Expression Alterations of ETS Related Gene-1(ERG1)i...

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中华医学会病理学分会2005年学术年会

作者：刘爱军 Gyorgy Petrovics Syed Shaheduzzaman Bungo Furasato Martin Nau Lakshmi Ravindranath Albert Dobi Vasantha Srikantan Isabell A Sesterhenn David G McLeod Maryanne Vahey judd w moul Shiv Srivastava Centerfor Prostate Disease Research US Military Cancer InstituteUniformed Services University Center for Prostate Disease Research US Military Cancer InstituteUniformed Services University Department of Genitourinary Pathology Armed Forces Institute of Pathology Laboratory of Functional Genomics Walter Reed Army Institute of Research Urology Service Walter Reed Army Medical Center

Transcription factors encoded by the ETS family of genes are central in integrating signals that regulate cell growth and differentiation, stress responses and tumorigenesis. This study, using laser microdissected paired benign and malignant prostate epithelial cells from prostate cancer (CaP) patients (n=114), identifies ERG, a member of the ETS transcription factor family, as the most frequently overexpressed poto-oncogene in the transcriptome of malignant prostate epithelial cells. Combined quantitative expression analysis of ERG with two other genes commonly overexpressed in CaP, AMACR and DD3, revealed overexpression of at least one of these three genes in virtually all cancer specimen (54 of 55). Therefore,

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经皮尼古丁用于耻骨后前列腺根治术术后镇痛

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麻醉与镇痛 2009年第5期5卷 72-77页

作者： Ashraf S. Habib william D. white Magdi A. EI Gasim Gamal Saleh Thomas J. Polascik judd w. moul Tong J. Gan 潘鹏(译) 李文志(校) Department of Anesthesiology Division of Urologic Surgery and Duke Prostate Center Department of Surgery Duke University Medical System Durham North Carolina 不详

背景既住动物实验和人类研究表明尼古丁可能具有抗伤害效应。本研究假设手术前7nag尼古丁缓释贴可能降低全麻下耻骨后前列腺根治术（radicalretropubic prostatectomy，RRP）患者的术后镇痛药物使用剂量。方法全麻下行RRP的非吸烟患者... 详细信息

背景既住动物实验和人类研究表明尼古丁可能具有抗伤害效应。本研究假设手术前7nag尼古丁缓释贴可能降低全麻下耻骨后前列腺根治术（radicalretropubic prostatectomy，RRP）患者的术后镇痛药物使用剂量。方法全麻下行RRP的非吸烟患者纳入此项前瞻性、双盲、安慰剂对照研究。患者于麻醉诱导前30～60分钟随机接受7mg尼古丁缓释贴或安慰剂，麻醉采用标准化流程，手术后镇痛采用标准的吗啡患者自控镇痛（PCA）方案和酮洛酸15nag，每6小时静脉注射。收集麻醉后恢复室（PACu）及手术后4、6、12、24小时的数据。结果90例患者数据纳入分析，尼古丁组44例，安慰剂组46例。两组相比，在年龄、身高、体重、AsA分级、手术时程、手术中芬太尼使用剂量上差异没有统计学意义。吗啡24小时累积使用剂量，尼古丁组明显低于安慰剂组（均数±标准差）：33．3±30．8mg对44．7±26．4mg（P=0．0059，时间与干预措施的交互效应P=0.0031）。然而，重复测量分析发现，静息及咳嗽时疼痛的干预措施以及与时间的交互作用差异均没有统计学意义。Posf而DC分析显示，静息及咳嗽时疼痛在任何两个时间点间差异均无统计学意义。手术后，,5。2心、呕吐及是否需要止吐药物，两组之间比较差异没有统计学意义。尼古丁组患者恶心口述评分的最大值高于安慰剂组（中位数，25％～75％的可信区闻分别为4、0～6对0、0～6，P=0.0158）。24小时尼古丁血浆浓度-tPACU中（P=0．049）、手术后6、12、24小时（均为P=0．002）的吗啡累积使用剂量明显负相关。结论虽然没有降低手术后疼痛评分及恶心、呕吐发生率，但手术前给予7mg尼古丁缓释贴显著降低了全麻下RRP患者手术后吗啡累积使用剂量。

关键词：手术后镇痛前列腺根治术尼古丁耻骨后 prostatectomy 安慰剂对照使用剂量疼痛评分

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Baseline Psa as A Predictor of Prostate Cancer Specific Mortality over the Past Two Decades

Baseline Psa as A Predictor of Prostate Cancer Specific Mort...

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第十七届全国泌尿外科学术会议

作者： Leon Sun Matthew Uhlman Thomas Polascik judd moul Division of Urology Department of Surgery and Duke Prostate CenterDuke University Medical Center

Background Aside from skin cancer,prostate cancer is the most commonly diagnosed new cancer among men and the second most common cause of cancer-related death in men in the United *** 2009,an estimated 192,280 new cas...

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Maspin Down-regulates the Expression of Prostate Specific Antigen in Human Prostate Cancer LNCaP Cells

Maspin Down-regulates the Expression of Prostate Specific An...

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中华医学会病理学分会2005年学术年会

作者：刘爱军 Soyon Oh Leland Davis judd moul Shiv Srivastava 北京301医院病理科 Center for Prostate Disease Research Uniformed Service University of Health Science Urology Service Walter Reed Army Medical Center

Maspin, a member of the serpin superfamily,inhibits cell mobility, invasion and metastasis in breast and prostate cancer. But the role of Maspin as a tumor suppressor is not clear because Maspin is paradoxically over - expressed in pancreatic carcinoma, ovarian carcinoma, gastric carcinoma and other carcinomas. Recent studies indicate that the nuclear Maspin may be associated with favorable clinical outcome of cancer pa-

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