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Asian Journal of Andrology 2022年第4期24卷 406-410页

作者： Jia-Qi Yan Da Huang Jing-Yi Huang Xiao-Hao Ruan Xiao-Ling Lin Zu-Jun Fang Yi Gao Hao-Wen Jiang Yi-Shuo Wu Rong Na Dan-Feng Xu Department of Urology Ruijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China Department of Urology Huashan HospitalFudan UniversityShanghai 200040China.

To analyze the performance of the Prostate Health Index(phi)and its derivatives for predicting Gleason score(GS)upgrading between prostate biopsy and radical prostatectomy(RP)in the Chinese population,an observational,prospective RP cohort consisting of 351 patients from two medical centers was established from January 2017 to September 2020.Pathological reclassification was determined by the gleason Grade Group(GG).The area under the receiver operating characteristic curve(AUC)and logistic regression(LR)models were used to evaluate the predictive performance of predictors.In clinically low-risk patients with biopsy GG≤2,phi(odds ratio[OR]=1.80,95%confidence interval[95%CI]:1.14-2.82,P=0.01)and its derivative phi density(PHID;OR=2.34,95%CI:1.30-4.20,P=0.005)were significantly associated with upgrading to GG≥3 after RP,and the results were confirmed by multivariable analysis.Similar results were observed in patients with biopsy GG of 1 for the prediction of upgrading to RP GG≥2.Compared to the base model(AUC=0.59),addition of the phi or PHID could provide additional predictive value for GS upgrading in low-risk patients(AUC=0.69 and 0.71,respectively,both P<0.05).In conclusion,phi and PHID could predict GS upgrading after RP in clinically low-risk patients.

关键词： Gleason score Prostate Health Index prostate biopsy prostate cancer radical prostatectomy upgrading

Prognostic value of ECOG performance status and Gleason score in the survival of castration-resistant prostate cancer:a systematic review

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Asian Journal of Andrology 2021年第2期23卷 163-169页

作者： Wen-Jun Chen Da-Ming Kong Liang Li Center of Clinical Pharmacology The Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009China Beijing Key Laboratory of Molecular Pharmaceutics and New Drug Delivery System Department of PharmaceuticsSchool of Pharmaceutical SciencesPeking UniversityBeijing 100191China

Eastern Cooperative Oncology Group(ECOG)performance status and Gleason score are commonly investigated factors for overall survival(OS)in men with castration-resistant prostate cancer(CRPC).However,there is a lack of consistency regarding their prognostic or predictive value for OS.Therefore,we performed this meta-analysis to assess the associations of ECOG performance status and Gleason score with OS in CRPC patients and compare the two markers in patients under different treatment regimens or with different chemotherapy histories.A systematic literature review of monotherapy studies in CRPC patients was conducted in the PubMed database until May 2019.The data from 8247 patients in 34 studies,including clinical trials and real-world data,were included in our meta-analysis.Of these,twenty studies reported multivariate results and were included in our main analysis.CRPC patients with higher ECOG performance statuses(≥2)had a significantly increased mortality risk than those with lower ECOG performance statuses(Gleason score was 1.01,with a 95%CI of 0.62-1.67(Gleason score≥8 vsGleason score showed a weak prognostic value for OS based on the available data in our meta-analysis.

关键词： castration-resistant prostate cancer Eastern Cooperative Oncology Group performance status Gleason score meta-analysis overall survival

The characteristics of ultrasonic image and relatinoship of serum PSA and Gleason score,clinical stage in patients with prostatic cancers

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The characteristics of ultrasonic image and relatinoship of ...

Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios alone or combined with prostate-specific antigen for the diagnosis of prostate cancer and clinically significant prostate cancer

第十五届全国泌尿外科学术会议

作者： CHEN Xing-fa ,HE Da-lin ,WANG Ming-Zhu ,HE Hui ,YANG Zhi-Shang,XING Jun-Ping,NAN Xun-Yi (Department of Urology,the First Hospital of Xi’an Jiao Tong University 710061)

Objective:To evaluate the ultrasonic image and the relationships among Gleason score, clinical stage and serum PSA in patients with prostate cancer. Methods:The characteristics of the ultrasonic image and clinical data were analyzed retrospectively in the 220 prostate cancer diagnosed by transrectal ultrasound(TRUS) guided biopsies.

关键词： Prostatic neoplasms transrectal ultrasonography prostate specific antigen Gleason score clinical stage

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Asian Journal of Urology 2023年第2期10卷 158-165页

作者： Sat Prasad Nepal Takehiko Nakasato Takashi Fukagai Yoshio Ogawa Yoshihiro Nakagami Takeshi Shichijo Jun Morita Yoshiko Maeda Kazuhiko Oshinomi Tsutomu Unoki Tetsuo Noguchi Tatsuki Inoue Ryosuke Kato Satoshi Amano Moyuru Mizunuma Masahiro Kurokawa Yoshiki Tsunokawa Sou Yasuda Department of Urology Department of MedicineShowa University School of Medicine1-5-8 HatanodaiShinagawa-kuTokyoJapan

Objective:We evaluated whether the blood parameters before prostate biopsy can diagnose prostate cancer(PCa)and clinically significant PCa(Gleason score[GS]7)in our hospital.Methods:This study included patients with increased prostate-specific antigen(PSA)up to 20 ng/mL.The associations of neutrophil-to-lymphocyte ratio(NLR)and platelet-tolymphocyte ratio(PLR)alone or with PSA with PCa and clinically significant PCa were analyzed.Results:We included 365 patients,of whom 52.9%(193)had PCa including 66.8%(129)with GS of≥7.PSA density(PSAD)and PSA had better the area under the curve(AUC)of 0.722 and 0.585,respectively with pZ0.001 for detecting PCa compared with other blood parameters.PSA combined with PLR(PsPLR)and PSA with NLR(PsNLR)had better AUC of 0.608 and 0.610,respectively with p<0.05,for diagnosing GS≥7 population,compared with PSA,free/total PSA,NLR,PLR,and PsNPLR(PSA combined with NLR and PLR).NLR and PLR did not predict PCa on multivariate analysis.For GS≥7 cancer detection,in the multivariate analysis,separate models with PSA and NLR(Model 1:PsNLRþbaseline parameters)or PSA and PLR(Moder 2:PsPLRþbaseline parameters)were made.Baseline parameters comprised age,digital rectal exam-positive lesions,PSA density,free/total PSA,and magnetic resonance imaging.Model 2 containing PsPLR was statistically significant(odds ratio:2.862,95% confidence interval:1.174-6.975,p=0.021)in finding aggressive PCa.The predictive accuracy of Model 2 was increased(AUC:0.734,p<0.001)than that when only baseline parameters were used(AUC:0.693,p<0.001).Conclusion:NLR or PLR,either alone or combined with PSA,did not detect PCa.However,the combined use of PSA with PLR could find the differences between clinically significant and insignificant PCa in our retrospective study limited by the small number of samples.

关键词： Blood parameter Gleason score Neutrophil-tolymphocyte ratio Platelet-tolymphocyte ratio Prostate cancer

A novel screening strategy for clinically significant prostate cancer in elderly men over 75 years of age

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Asian Journal of Andrology 2021年第1期23卷 36-40页

作者： Hiroaki Iwamoto Kouji Izumi Suguru Kadomoto Tomoyuki Makino Renato Naito Hiroshi Yaegashi Kazuyoshi Shigehara Yoshifumi Kadono Atsushi Mizokami Department of Integrative Cancer Therapy and Urology Kanazawa University Graduate School of Medical ScienceKanazawa 920-8640Japan

A standard modality for prostate cancer detection in men 75 years and older has not been established.A simple screening method for elderly patients is needed to avoid unnecessary biopsies and to effectively diagnose prostate cancer.A retrospective study was conducted on elderly patients who had prostate biopsy at Kanazawa University Hospital(Kanazawa,Japan)between 2000 and 2017.Of the 2251 patients who underwent prostate biopsy,254 had clinically significant prostate cancer(CSPC)with a Gleason score(GS)of≥7 and 273 had a GS of24,PSA density≥0.24 ng ml^(-2),positive findings on digital rectal examination,and transrectal with 90.0%sensitivity and 67.4%specificity.In this study,we found that raising the PSA cutoff to 12 ng ml^(-1)for CSPC in elderly individuals can significantly reduce unnecessary prostate biopsies.Furthermore,CSPC could be efficiently discovered by combining the four supplementary markers in patients with a PSA level of 4-12 ng ml^(-1).By performing this screening for elderly men over 75 years of age,unnecessary biopsies may be reduced and CSPC may be detected efficiently.

关键词： biopsy elderly Gleason score percent free prostate-specific antigen prostate cancer prostate-specific antigen

ARHGEF38 as a novel biomarker to predict aggressive prostate cancer

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Genes & Diseases 2020年第2期7卷 217-224页

作者： Kun Liu Aixiang Wang Longke Ran Wanfeng Zhang Song Jing Yujing Wang Xianqin Zhang Geli Liu Wang Sen Fangzhou Song Molecular Medicine and Cancer Research Center Chongqing Medical UniversityChongqing400016China Tianjin Key Institute of Urology Department of UrologySecond Hospital of Tianjin Medical University300162TianjinChina Department of Bioinformatics Chongqing Medical UniversityChongqing400016China

Prostate cancer(PCa)metastasis is considered the leading cause of cancer death in males.Therapeutic strategies and diagnosis for stage-specific PCa have not been well understood.Rho guanine nucleotide exchange factor 38(ARHGEF38)is related to tumor cell polarization and is frequently expressed in PCa.Microarray data of PCa were downloaded from GEO and TCGA databases.A total of 243 DEGs were screened,of which,32 genes were upregulated.The results of enrichment analysis showed the participation of these DEGs in the tumor cell metastasis pathway.ARHGEF38 was significantly up-regulated in the four most prevalent cancers worldwide(pGleason score(GS).IHC,qRT-PCR,and western-blot analyses showed the higher expression of ARHGEF38 in PCa than benign prostatic hyperplasia(BPH).In addition,IHC results demonstrated a higher expression of ARHGEF38 in high-grade PCa than the low-grade PCa.

关键词： Gleason score Immunohistochemistry KaplaneMeier survival PCa

Multiparametric MRI reporting using Prostate Imaging Reporting and Data System version 2.0 (PI-RADSv2) retains clinical efficacy in a predominantly post-biopsy patient population

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Asian Journal of Urology 2019年第3期6卷 256-263页

作者： Edwin Jonathan Aslim Yan Mee Law Puay Hoon Tan John Carson Allen Jr Lionel Tim-Ee Cheng Viswanath Anand Chidambaram Li Yan Khor Benjamin Yongcheng Tan Ernest Wencong Eu Christopher Wai Sam Cheng John Shyi Peng Yuen Henry Sun Sien Ho Lui Shiong Lee Department of Urology Singapore General HospitalSingapore Department of Diagnostic Radiology Singapore General HospitalSingapore Division of Pathology Singapore General HospitalSingapore Centre of Quantitative Medicine DUKE-NUS Medical SchoolSingapore Department of Anatomical Pathology Singapore General HospitalSingapore

Objective:To evaluate the efficacy of multiparametric magnetic resonance imaging(mp-MRI)using Prostate Imaging Reporting and Data System version 2.0(PI-RADSv2)definitions in detecting organ-confined prostate cancer.Methods:All patients who underwent radical prostatectomy between January 1,2014 and December 30,2014 were identified.All underwent mp-MRI within 180 days before surgery.Those with prior pelvic irradiation or androgen deprivation therapy were excluded.Fully embedded,whole-mount histopathology was centrally reviewed and correlated with imaging for tumour location,Gleason score(GS)and stage.Results:There were 39 patients included,of which 35(90%)had mp-MRI done post-biopsy.A total of 93 cancer foci were identified on whole-mount pathology,of which mp-MRI detected 63(68%).Of those detected by mp-MRI,14 were PI-RADS 3(n=6 for GS 6,n=8 for GS 7,no GS≥8)and 49 were PI-RADS 4e5(nZ7 for GS 6,nZ33 for GS 7,and nZ9 for GS≥8).There were 30(32%)cancer foci missed by mp-MRI(n=15 for GS 6,n=13 for GS 7 and n=2 for GS≥8).A lesion classified as PI-RADS 4e5 predicted a higher grade cancer on pathology as compared to PI-RADS 3(for GS 7 lesions,odds ratio[OR]=3.53,95%CI:0.93e13.45,p=0.064).The mp-MRI size detection limit was 20 mm2 and 100 mm2 for 50%and 75%probability of cancer,respectively.In associating with radiological and pathologic stage,the weighted Kappa value was 0.69(p<0.0001).The sensitivity and positive predictive values for this study were 68%(95%CI:57%e77%)and 78%(95%CI:67%e86%),respectively.Conclusion:In this predominantly post-biopsy cohort,mp-MRI using PI-RADSv2 reporting has a reasonably high diagnostic accuracy in detecting clinically significant prostate cancer.

关键词： Gleason score Histopathology Magnetic resonance imaging Prostatectomy Prostatic cancer

Role of multi-parametric MRI of the prostate for screening and staging:Experience with over 1500 cases

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Asian Journal of Urology 2017年第1期4卷 68-74页

作者： Geoffrey Gaunay Vinay Patel Paras Shah Daniel Moreira Simon J.Hall Manish A.Vira Michael Schwartz Jessica Kreshover Eran Ben-Levi Robert Villani Ardeshir Rastinehad Lee Richstone Department of Urology The Smith Institute for UrologyNorthwell HealthNew Hyde ParkNYUSA Department of Urology University of Illinois ChicagoChicagoILUSA Department of Urology&Interventional Radiology Mount Sinai Health SystemNew York CityNYUSA

Objective:Contemporary prostate cancer(PCa)screening modalities such as prostate specific antigen(PSA)and digital rectal examination(DRE)are limited in their ability to predict the detection of clinically significant disease.Multi-parametric magnetic resonance imaging(mpMRI)of the prostate has been explored as a staging modality for PCa.Less is known regarding its utility as a primary screening modality.We examined our experience with mpMRI as both a screening and staging instrument.Methods:mpMRI studies performed between 2012 and 2014 in patients without PCa were cross-referenced with transrectal ultrasonography(TRUS)biopsy findings.Statistical analyses were performed to determine association of mpMRI findings with overall cancer diagnoses and clinically significant(Gleason score≥7)disease.Subgroup analyses were then performed on patients with a history of prior negative biopsy and those without a history of TRUS biopsy.mpMRI studies were also cross-referenced with RP specimens.Statistical analyses determined predictive ability of extracapsular extension(ECE),seminal vesicle involvement(SVI),and pathologic evidence of clinically significant disease(Gleason score7).Results:Four hundred biopsy naive or prior negative biopsy patients had positive mpMRI studies.Overall sensitivity,specificity,positive and negative predictive values were 94%,37%,58%,and 87%,respectively and 95%,31%,42%,and 93%,respectively for overall cancer detection and Gleason score≥7 disease.In patients with no prior biopsy history,mpMRI sensitivity,specificity,positive and negative predictive values were 94%,36%,65%,and 82%,for all cancers,and 95%,30%,50%,and 89%for Gleason score7 lesions,respectively.In those with prior negative biopsy sensitivity,specificity,positive and negative predictive values were 94%,37%,52%,and 90% for all cancers,and 96%,32%,36%,and 96% for Gleason score7 lesions,respectively.Seventy-four patients underwent radical prostatectomy(RP)after mpMRI.Lesion size on mpMRI correlated with the presence of Gleason score7 canc

关键词： Prostate cancer Magnetic resonance imaging Staging Prostatectomy Screening Margins Gleason score Novel use

Impact of tertiary gleason pattern 5 on prostate cancer aggressiveness:Lessons from a contemporary single institution radical prostatectomy series

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Asian Journal of Urology 2015年第1期2卷 53-58页

作者： Zachary B.Koloff Daniel A.Hamstra John T.Wei Jeffrey S.Montgomery Scott A.Tomlins Angela J.Wu Todd M.Morgan Javed Siddiqui Kellie Paich Arul M.Chinnaiyan Felix Y.Feng Alon Z.Weizer Lakshmi P.Kunju Brent K.Hollenbeck David C.Miller Ganesh S.Palapattu Rohit Mehra Department of Urology University of Michigan Medical SchoolAnn ArborMIUSA Department of Radiation Oncology University of Michigan Medical SchoolAnn ArborMIUSA Department of Pathology University of Michigan Medical SchoolAnn ArborMIUSA

Objective:To better evaluate tertiary gleason pattern reporting and to evaluate the impact of tertiary gleason pattern 5(TP5)on prostate cancer pathological features and biochemical recurrence at our large single institution.Methods:We retrospectively reviewed 1962 patients who underwent radical prostatectomy(RP)for prostate cancer;TP5 was reported in 159 cases(8.1%).Men with Gleason score(GS)7 and GS 8 disease were divided into subgroups with and without TP5,and histopathological features were compared.Multivariate analyses were conducted to assess the impact on TP5 on biochemical-free survival(BFS).Results:Tumors possessing GS 3+4 with TP5 were more likely to exhibit extraprostatic extension(EPE)and had a larger tumor diameter(TD)than GS 3+4 alone.GS 3+4 with TP5 was also associated with positive surgical margins(SM),seminal vesicle involvement(SVI),and higher pre-operative prostate-specific antigen(PSA)values,but without statistical significance.GS 4+3 with TP5 more commonly presented with EPE,positive SM,SVI,and greater TD and pre-operative PSA level than GS 4+3 alone.In multivariate analysis,Gleason score,EPE,and TP5 were overall independent risk factors for PSA recurrence in this cohort.Additionally,GS 4+3 with TP5 was associated with shorter time to recurrence versus GS 4+3 alone.Conclusion:Our results emphasize the importance of TP5 and suggest that criteria for tertiary pattern reporting in prostate cancer should be standardized.Further studies are needed to evaluate the role of tertiary patterns in prognostic models.

关键词： Tertiary gleason pattern Prostate cancer Prostatic neoplasm Gleason score Radical prostatectomy Disease-free survival

MR多参数成像对前列腺癌的诊断价值及其与gleason评分的相关性研究

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MR多参数成像对前列腺癌的诊断价值及其与Gleason评分的相关性研究

作者：于娟蚌埠医学院

学位级别：硕士

第一部分:MR多参数成像对前列腺癌的诊断价值目的:探讨3.0T扩散加权成像(DWI)及动态增强扫描(DCE-MRI)在前列腺癌外周带及中央带病灶诊断中的价值。方法:1、回顾性分析经 3.0TMRI 扫描(T1WI、T2WI、DWI、DCE-MRI)、由超声引导下穿刺或... 详细信息

第一部分:MR多参数成像对前列腺癌的诊断价值目的:探讨3.0T扩散加权成像(DWI)及动态增强扫描(DCE-MRI)在前列腺癌外周带及中央带病灶诊断中的价值。方法:1、回顾性分析经 3.0TMRI 扫描(T1WI、T2WI、DWI、DCE-MRI)、由超声引导下穿刺或手术后病理证实的149例前列腺疾病,其中前列腺癌63例(外周带病灶49个、中央带病灶38个),前列腺增生86例,后处理测量外周带、中央带病灶的表观扩散系数(ADC值)、绘制时间-信号强度(TIC)曲线,统计良恶性两组间ADC值及TIC曲线类型差异是否有统计学意义;统计学方法分析ADC值及TIC曲线类型在前列腺良恶性病变中的诊断效能,对结果进行一致性检验;2、综合T2WI、DWI、DCE-MRI得出PI-RADSV2评分,统计良恶性两组间评分差异是否有统计学意义;统计学方法分析PI-RADS V2在前列腺病变中的诊断效能,对结果进行一致性检验。结果:1、利用ROC曲线约登指数最大时得出外周带病灶ADC值诊断前列腺癌的界值为0.995*10-3mm2/S,敏感度90.2%、特异度89.8%,准确度90.1%,约登指数0.800,曲线下面积0.972,两组间差异具有统计学意义;外周带ADC值诊断前列腺癌具有高度一致性;利用ROC曲线约登指数最大时得出中央带病灶ADC值诊断前列腺癌的界值为1.023*10-3mm2/s,敏感度81.4%、特异度84.2%、准确度82.3%,约登指数0.656,曲线下面积0.886,两组间差异具有统计学意义;中央带ADC值诊断前列腺癌具有高度一致性;BPH的ADC值95%可信区间外周带、中央带分别为(1.393±0.071)、(1.222±0.044)*10-3mm2/s;PCa 的 ADC 值 95%可信区间外周带、中央带分别为(0.790±0.042)、(0.856±0.066)*10-3mm2/s;2、63 例 PCa 中,TIC 曲线Ⅰ型3个、Ⅱ型23个、Ⅲ型37个,86例BPH中,TIC曲线Ⅰ型15个、Ⅱ型48个、Ⅲ型23个,Ⅰ、Ⅱ型曲线诊断为良性,Ⅲ型诊断为恶性,敏感度、特异度及准确度分别为61.7%、70.8%、67.1%,两组间差异具有统计学意义;TIC曲线类型诊断前列腺癌的一致性一般;3、63例PCa中,PI-RADSV2无1分、1个2分、7个3分、29个4分、26个5分,86例BPH中,PI-RADS V2无1分、39个2分、37个3分、10个4分、无5分,利用ROC曲线得出PI-RADS V2诊断前列腺癌的界值3.5,本研究1、2、3分诊断为良性,4、5分诊断为恶性,对应的敏感度、特异度及准确度分别为84.6%、90.5%及87.9%,两组间差异具有统计学意义;PI-RADS V2诊断前列腺癌具有高度一致性。结论:1、DWI和DCE-MRI在前列腺癌的诊断中具有重要的价值2、ADC值在诊断外周带癌及中央带癌方面均具有较高的诊断效能3、TIC曲线类型在前列腺良恶性病变中的诊断效能一般4、PI-RADS V2在前列腺癌诊断中具有较高的诊断效能第二部分:MR多参数成像与gleason评分的相关性分析目的:探讨表观扩散系数值、PI-RADSV2评分对前列腺癌gleason评分的预估价值。方法:回顾性分析经3.0TMRI扫描(T1WI、T2WI、DWI、DCE-MRI)、由超声引导下穿刺或手术后病理证实的63例前列腺癌,后处理测量ADC值及TIC曲线类型等,综合T2WI、DWI、DCE-MRI得出PI-RADSV2评分;根据gleason评分高低将PCa分为高级别组(gleason≥7b)和低级别组(gleason≤7a);1、统计分析两组间ADC值差异是否有统计学意义,对ADC值与gleason评分高低进行Spearman相关性分析;2、统计分析两组间PI-RADSV2评分差异是否有统计学意义,对PI-RADS V2评分与gleason评分高低进行Spearman相关性分析。结果:63例PCa,高级别组(gleason≥7b)有35个、低级别组(gleason≤7a)有28个;1、PCa高级别组和低级别组ADC值95%可信区间分别为(0.760±0.049)*10-3mm2/s、(0.860±(0.061)*10-3mm2/s,两组间差异具有统计学意义;PCa 中ADC值与gleason评分呈负相关(r=0.-352);2、高级别组中,PI-RADSv2无1分、2分,1个3分,13个4分,21个5分;低级别组中,PI-RADSv2 1个2分,6个3分,16个4分,5个5分;PI-RADSV2评分与gleason评分高低呈正相关(r=0.471),两组间PI-RADSV2评分差异有统计学意义。结论:1、ADC值对于gleason评分有一定预估价值,ADC值越低,gleason评分越高的可能性越大,前列腺癌恶性级别越高。2、

关键词：扩散加权成像动态增强扫描前列腺癌 PI-RADS V2 表观扩散系数 Gleason score