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Predictors of efficacy of corticosteroid switching from abiraterone plus prednisone to dexamethasone in patients with metastatic castration-resistant prostate cancer

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Asian Journal of Andrology 2022年第2期24卷 154-160页

作者： Yu-Chao Ni Jin-Ge Zhao Meng-Ni Zhang Yi-Jun Zhang Zhen-Yu Yang Ni Chen Jun-Ru Chen Peng-Fei Shen Guang-Xi Sun Xing-Ming Zhang Yong-Hong Li Hao Zeng department of urology Institute of UrologyWest China HospitalSichuan UniversityChengdu 610041China department of Pathology West China HospitalSichuan UniversityChengdu 610041China department of Pathology Sun Yat-Sen University Cancer CenterGuangzhou 510060China department of urology Sun Yat-Sen University Cancer CenterGuangzhou 510060China

Corticosteroid switching can reverse abiraterone resistance in some patients with metastatic castration-resistant prostate cancer(mCRPC).Here,we investigated the potential biomarkers for predicting the efficacy of corticosteroid switching during treatment with abiraterone acetate(AA).We retrospectively analyzed 101 mCRPC patients receiving corticosteroid switching from West China Hospital and Sun Yat-Sen University Cancer Center between January 2016 and December 2018.All cases received AA plus prednisone as first-line therapy during mCRPC.Primary end points were biochemical progression-free survival(bPFS)and overall survival(OS).The risk groups were defined based on multivariate analysis.A total of 42(41.6%)and 25(24.8%)patients achieved 30%and 50%decline in prostate-specific antigen(PSA),respectively,after corticosteroid switching.The median bPFS and median OS on AA plus dexamethasone were 4.9(95%confidence interval[CI]:3.7–6.0)months and 18.8(95%CI:16.2–30.2)months,respectively.Aldo-keto reductase family 1 member C3(AKR1C3)expression(hazard ratio[HR]:2.15,95%Cl:1.22–3.80,P=0.008)and baseline serum alkaline phosphatase(ALP;HR:4.95,95%Cl:2.40–10.19,P160 IU l−1(HR:3.41,95%Cl:1.57–7.38,P=0.002)together with PSA level at switch≥50 ng ml−1(HR:2.59,95%Cl:1.22–5.47,P=0.013)independently predicted poorer OS.Based on the predictive factors in multivariate analysis,we developed two risk stratification tools to select candidates for corticosteroid switching.Detection of serum ALP level,PSA level,and tissue AKR1C3 expression in mCRPC patients could help make clinical decisions for corticosteroid switching.

关键词： abiraterone acetate alkaline phosphatase corticosteroid switching dexamethasone metastatic castration-resistant prostate cancer

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Clinical implications of endogenous testosterone density on prostate cancer progression in patients with very favorable low and intermediate risk treated with radical prostatectomy

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Asian Journal of Andrology 2023年第5期25卷 556-563页

作者： Antonio Benito Porcaro Alessandro Tafuri Andrea Panunzio Clara Cerrato Alberto Bianchi Sebastian Gallina Stefano Vidiri Damiano D'Aietti Emanuele Serafin Giovanni Mazzucato Alessandro Princiotta Davide Brusa Matteo Brunelli Vincenzo Pagliarulo Maria Angela Cerruto AlessandroAntonelli department of urology University of VeronaIntegrated University Hospital of VeronaVerona 37126Italy department of urology Vito Fazzi HospitalLecce 73100Italy department of Pathology University of VeronaIntegrated University Hospital of VeronaVerona 37126Italy

We tested the association between endogenous testosterone density(ETD;the ratio between endogenous testosterone[ET]and prostate volume)and prostate cancer(PCa)aggressiveness in very favorable low-and intermediate-risk PCa patients who underwent radical prostatectomy(RP).Only patients with prostate-specific antigen(PSA)within 10 ng ml^(-1),clinical stage T1c,and International Society of Urological Pathology(IsUP)grade group 1 or 2 were included.Preoperative ET levels up to 350 ng dl^(-1)were classified as abnormal.Tumor quantitation density factors were evaluated as the ratio between percentage of biopsy-positive cores and prostate volume(biopsy-positive cores density,BPCD)and the ratio between percentage of cancer invasion at final pathology and prostate weight(tumor load density,TLD).Disease upgrading was coded as ISUP grade group>2,and progression as recurrence(biochemical and/or local and/or distant).Risk associations were evaluated by multivariable Cox and logistic regression models.Of 320 patients,151(47.2%)had intermediate-risk PCa.ET(median:402.3 ng dl^(-1))resulted abnormal in 111(34.7%)cases(median ETD:9.8 ng dl^(-1)ml^(-1)).Upgrading and progression occurred in 109(34.1%)and 32(10.6%)cases,respectively.Progression was predicted by ISUP grade group 2(hazard ratio[HR]:2.290;P=0.029)and upgrading(HR:3.098;P=0.003),which was associated with ISUP grade group 2(odds ratio[OR]:1.785;P=0.017)and TLD above the median(OR:2.261;P=0.001).After adjustment for PSAdensity and bodymass index(BMI),ETDabovethemedianwas positivelyassociatedwithBPCD(OR:3.404;P<0.001)and TLD(OR:5.238;P<0.001).Notably,subjects with abnormal ET were more likely to have higher BPCD(OR:5.566;P=0.002),as well as TLD(OR:14.998;P=0.016).Independently by routinely evaluated factors,as ETD increased,BPCD and TLD increased,but increments were higher for abnormal ET levels.In very favorable cohorts,ETD may further stratify the risk of aggressive PCa.

关键词： endogenous testosterone density prostate cancer radical prostatectomy tumor progression

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Application of fluorescence in situ hybridization in the detection of bladder transitional-cell carcinoma: A multi-center clinical study based on Chinese population

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Asian Journal of urology 2019年第1期6卷 114-121页

作者： Liqun Zhou Kaiwei Yang Xuesong Li Yi Ding Dawei Mu Hanzhong Li Yong Yan Jinyi Li Dongwen Wang Wei Li Yulong Cong Jiangping Gao Kewei Ma Yajun Xiao Sheng Zhang Hongyi Jiang Weilie Hu Qiang Wei Xunbo Jin Zhichen Guan Qingyong Liu Danfeng Xu Xin Gao Yongguang Jiang Weimin Gan Guang Sun Qing Wang Yanhui Liu Jianquan Hou Liping Xie Xishuang Song Fengshuo Jin Jiafu Feng Ming Cai Zhaozhao Liang Jie Zhang Dingwei Ye Lin Qi Lulin Ma Jianzhong Shou Yuping Dai Jianyong Shao Ye Tian Shizhe Hong Tao Xu Chuize Kong Zefeng Kang Yuexin Liu Xun Qu Benkang Shi Shaobin Zheng Yi Lin Shujie Xia Dong Wei Jianbo Wu Weiling Fu Zhiping Wang Jianbo Liang department of urology Peking University First HospitalBeijingChina Institute of urology Peking UniversityBeijingChina National Urological Cancer Center BeijingChina Air Force General Hospital PLABeijingChina department of urology Peking Union Medical College HospitalBeijingChina department of urology Beijing Chao-Yang HospitalBeijingChina department of urology Armed-Police General HospitalBeijingChina department of urology Shanxi Medical University First HospitalTaiyuanChina department of urology Hebei Medical University Second HospitalShijiazhuangChina department of urology The General Hospital of the People’s Liberation ArmyBeijingChina department of urology First Affiliated Hospital of Jilin UniversityChangchunChina department of urology Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina department of Pathology The First Affiliated Hospital of Fujian Medical UniversityFuzhouChina department of urology The Second Xiangya Hospital of Central South UniversityChangshaChina department of urology General Hospital of Guangzhou Military Command of PLAGuangzhouChina department of urology West China School of MedicineChengduChina department of urology Shangdong Province-owned HospitalJinanChina department of urology Peking University Shenzhen HospitalShenzhenChina department of urology The Central Hospital of Jinan CityJinanChina department of urology Shanghai Changzheng HospitalShanghaiChina department of urology The Third Affiliated Hospital of Sun Yat-sen UniversityGuangzhouChina department of urology Beijing Anzhen Hospital of Capital Medical UniversityBeijingChina department of urology The Second Affiliated Hospital of Xi’an Jiaotong UniversityXi’anChina department of urology The Second Hospital of Tianjin Medical UniversityTianjinChina department of urology People’s Hospital of Xinjiang Uygur Autonomous RegionWulumuqiChina department of urology Guangdong General HospitalGuangzhouChina department of urology The First Affil

Objective:To evaluate the diagnostic value of fluorescence in situ hybridization(FISH)in bladder cancer.Methods:We enrolled healthy volunteers and patients who were clinically suspected to have bladder cancer and conducted FISH tests and cytology examinations from August 2007 to December 2008.Receiver operating characteristic(ROC)curve analysis was performed and the area under curve(AUC)values were calculated for both the FISH and urine cytology tests.Results:A cohort of 988 healthy volunteers was enrolled to establish a reference range for the normal population.A total of 4807 patients with hematuria were prospectively,randomly enrolled for the simultaneous analysis of urine cytology,FISH testing,and a final diagnosis as determined by the pathologic findings of a biopsy or a surgically-excised specimen.Overall,the sensitivity of FISH in detecting transitional-cell carcinoma was 82.7%,while that of cytology was 33.4%(p<0.001).The sensitivity values of FISH for non-muscle invasive and muscle invasive bladder transitional-cell carcinoma were 81.7%and 89.6%,respectively(p=0.004).The sensitivity values of FISH for low and high grade bladder cancer were 82.6%and 90.1%,respectively(p=0.002).Conclusion:FISH is significantly more sensitive than voided urine cytology for detecting bladder cancer in patients evaluated for gross hematuria at all cancer grades and stages.Higher sensitivity using FISH was obtained in high grade and muscle invasive tumors.

关键词： Bladder transitionalcell carcinoma Fluorescence in situ hybridization Detection Grade Stage

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46 XX karyotype during male fertility evaluation; case series and literature review

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Asian Journal of Andrology 2017年第2期19卷 168-172页

作者： Ahmad Majzoub Mohamed Arafa Christopher Starks Haitham Elbardisi Sami A1 Said Edmund Sabanegh Jr Cleveland Clinic Foundation Department of Urology Cleveland Ohio USA Hamad Medical Corporation Department of Urology Qatar Cairo University Department of Andrology Giza Egypt Reston Hospital Department of Urology Virginia USA

Forty-six XX disorder of sex development is an uncommon medical condition observed at times during the evaluation of a man＇s fertility. The following is a case series and literature review of phenotypically normal men diagnosed with this karyotype. Our goal is to comprehend the patients＇ clinical presentation as well as their laboratory results aiming to explore options available for their management. A formal literature review through PubMed and MEDLINE databases was performed using ＂46 XX man＂ as a word search. A total of 55 patients, including those conveyed in this article were diagnosed with a 46 XX karyotype during their fertility evaluation. The patients＇ mean age _＋ s.d. was 34 ＋ 10 years and their mean height ＋ s.d. was 166 ＋ 6.5 cm. Overall, they presented with hypergonadotropic hypogonadism. Sexual dysfunction, reduced hair distribution, and gynecomastia were reported in 20% （4120）, 25.8% （8/31）, and 42% （13131） of the patients, respectively. The SRYgene was detected in 36 （83.7%） and was absent in the remaining seven （16.3%） patients. We found that a multidisciplinary approach to management is preferred in 46 XX patients. Screening for remnants of the mullerian ducts and for malignant transformation in dysgenetic gonads is imperative. Hypogonadism should be addressed, while fertility options are in vitro fertilization with donor sperm or adoption.

关键词： hypogonadism infertility male sex-determining region XX disorders of sex development

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Real-time transrectal ultrasound-guided seminal vesiculoscopy for the treatment of patients with persistent hematospermia: a single-center, prospective, observational study

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Asian Journal of Andrology 2020年第5期22卷 507-512页

作者： Xue-Sheng Wang Ming Li Guang-Feng Shao Wen-Dong Sun Xiu-Lin Zhang Zhi-Ying Xiao Zhen Ma Ming-Zhen Yuan Li-Qiang Guo department of urology Center for Reproductive MedicineShandong UniversityJinan 250001China department of urology The Second Hospital of Shandong UniversityJinan 250033China Institute of urology Shandong UniversityJinan 250033China department of urology Shandong Provincial Hospital Affiliated to Shandong UniversityJinan 250021China

This study aimed to describe endoscopic anatomy of the seminal tract and summarize our experience of transutricular seminal vesiculoscopy(TSV)guided by rea卜time transrectal ultrasonography(TRUS)in managing persistent hematospermia.A total of 281 consecutive patients with persistent hematospermia who underwent TSV with or without real-time TRUS were enrolled in this single-center,prospective,observational study.The median follow-up period was 36.5(range:8.0-97.5)months.TSV was successfully performed in 272(96.8%)patients.The approach of a 4.5/6 F rigid vesiculoscope entering the seminal tract was categorized into four types on the basis of endoscopic presentation of the ejaculatory duct orifice and verumontanum.Seven(2.6%),74(27.2%),64(23.5%),and 127(46.7%)patients had Types I(through the ejaculatory duct in the urethra),II(through the ejaculatory duct in the prostatic utricle),III(transutricular fenestration through a thin membrane),and IV(real-time transrectal ultrasound-guided transutricular fenestration)approach,respectively.In patients who successfully underwent surgery,bleeding occurred in the seminal vesicle in 249(91.5%)patients.Seminal vesiculitis,calculus in the prostatic utricle,calculus in the ejaculatory duct,calculus in the seminal vesicle,prostatic utricle cysts,and seminal vesicle cysts were observed in 213(78.3%),96(35.3%),22(8.1%),81(29.8%),25(9.2%),and 11(4.0%)patients,respectively.Hematospermia was alleviated or disappeared in 244(89.7%)patients 12 months after surgery.Fifteen patients had recurrent hematospermia,and the median time to recurrence was 7.5(range:2.0-18.5)months.TSV guided by TRUS may contribute to successful postoperative outcomes in managing persistent hematospermia.

关键词： persistent hematospermia seminal vesiculoscopy transrectal ultrasound

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Body composition changes following chemotherapy for testicular germ cell tumor:obesity is the long-term problem

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Asian Journal of Andrology 2022年第5期24卷 458-462页

作者： Yuki Takai Sei Naito Hidenori Kanno Atsushi Yamagishi Mayu Yagi Toshihiko Sakurai Hayato Nishida Takuya Yamanobe Tomoyuki Kato Norihiko Tsuchiya department of urology Yamagata University Faculty of MedicineYamagata 990-9585Japan

Metabolic syndrome is a long-term complication of systemic chemotherapy for testicular germ cell tumor(TGCT).It is believed to be caused by secondary hypogonadism or toxic medicines because of orchidectomy followed by systemic chemotherapy.In this study,changes in the body composition of patients over time were quantitatively analyzed up to 24 months after chemotherapy.This study retrospectively analyzed 44 patients with TGCT who underwent chemotherapy at our institution from January 2008 to December 2016.Subcutaneous and visceral fat areas and psoas and skeletal muscle areas were measured by computed tomography before and immediately after chemotherapy as well as 3 months,6 months,12 months,and 24 months after chemotherapy.The subcutaneous and visceral fat indices and psoas and skeletal muscle indices were calculated as each area divided by body height squared.The total fat area had already significantly increased 3 months after the initiation of chemotherapy(P=0.004).However,it did not return to prechemotherapeutic levels even at 24 months after chemotherapy.The skeletal muscle area was significantly decreased at the end of chemotherapy(P<0.001);however,the value returned to baseline within 12 months.In multivariable analysis,the prechemotherapeutic skeletal muscle index and number of chemotherapy cycles were independently associated with the reduction of skeletal muscle at the end of chemotherapy(P=0.001 and P=0.027,respectively).In patients with TGCT,skeletal muscle mass decreased during chemotherapy and recovered within 12 months,whereas fat mass progressively increased from the initiation of chemotherapy until 24 months after chemotherapy.

关键词： body composition chemotherapy obesity sarcopenia secondary hypogonadism testicular cancer

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The Institute of urology, Peking University prostatectomy score： a simple preoperative classification of prostate cancer for predicting surgical difficulty and risk

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Asian Journal of Andrology 2018年第6期20卷 581-586页

作者： Bing-Lei Ma Lin Yao Wei Yu Yu Wang Hai-Feng Song Zhe-Nan Zhang Si-Meng Lu Qian Zhang Zhi-Song He Jie Jin Li-Qun Zhou department of urology Peking University First Hospital and Institute of Urology Peking University Beijing 100034 China

Traditional laparoscopic radical prostatectomy is a treatment choice in many developing countries and regions for most patients with localized prostate cancer; however, no system for predicting surgical difficulty and risk has been established. This study aimed to propose a simple and standard preoperative classification system of prostate cancer using preoperative data to predict surgical difficulty and risk and to evaluate the relationship between the data and postoperative complications. We collected data from 236 patients and divided them into three groups to evaluate and validate the relationships among preoperative, operative, and postoperative data. This new scoring system is based on the body mass index, ultrasonic prostate volume, preoperative prostate-specific antigen level, middle lobe protrusion, and clinical stage. In the scoring group, we classified 89 patients into two groups： the low-risk group （score of 〈4） and high-risk group （score of ~4）, and then compared the postoperative data between the two groups. The positive surgical margin rate was higher in the high-risk group than low-risk group. The results in validation Groups A and B were similar to those in the scoring group. The focus of our scoring system is to allow for preliminary assessment of surgical difficulty by collecting the patients＇ basic information. Urologists can easily use the scoring system to evaluate the surgical difficulty and predict the risks of a positive surgical margin and urinary incontinence in patients undergoing laparoscopic radical prostatectomy.

关键词： laparoscopic radical prostatectomy prostate cancer scoring system surgical difficulty and risk

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Genetic variation of the PSCA gene(rs2294008) is not associated with the risk of prostate cancer

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The Journal of Biomedical Research 2017年第3期31卷 226-231页

作者： II-Seok Lee Sung Pil Seo Yun Sok Ha Pildu Jeong Ho Won Kang Won Tae Kim Yong-June Kim Seok Joong Yun Sang Cheol Lee Wun-Jae Kim department of urology Chungbuk National University College of Medicine department of urology School of MedicineKyungpook National University

Prostate stem cell antigen（PSCA） is a cell-membrane glycoprotein consisting of 123 amino acids and highly expressed in the prostate,but there have been few reports on the relationship between rs2294008 of PSCA and prostate cancer in the literature.Therefore,we evaluated the association between rs2294008 and the risk of prostate cancer.A total of 240 prostate cancer patients and 306 controls（patients with benign prostatic hyperplasia） were enrolled.Genotype analysis of rs2294008 of PSCA was performed using PCR.Logistic regression analysis was performed according to the genotype of PSCA rs2294008.We found that CT and TT genotypes were associated with an insignificant risk of prostate cancer compared with the CC genotype（P= 0.627 and 0.397,respectively）.In addition,there was no significant difference in rs2294008 according to clinicopathological parameters,such as age,Gleason score,prostate-specific antigen（PSA）,stage,and metastasis in prostate cancer（P 〉 0.05 for each）.Age,Gleason score,PSA,pathologic stage,and metastasis did not modify the association between PSCA and the risk of prostate cancer（each P 〉 0.05 for each）.Taken together,the genetic polymorphism of PSCA rs2294008 was not associated with the risk of prostate cancer.Our results suggest that rs2294008 may not play a role in prostate carcinogenesis.

关键词： prostatic neoplasms polymorphism genetic risk prostate polymorphism single nucleotide

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Recent advances in prostate cancer: WNT signaling, chromatin regulation, and transcriptional coregulators

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Asian Journal of Andrology 2023年第2期25卷 158-165页

作者： Sayuri Takahashi Ichiro Takada department of urology The Institute of Medical ScienceThe University of TokyoShirokanedaiMinato-kuTokyo 108-8639Japan department of urology The Faculty of MedicineThe University of TokyoHongoBunkyo-kuTokyo 113-8655Japan

Prostate cancer is one of the most common diseases in men worldwide.Surgery,radiation therapy,and hormonal therapy are effective treatments for early-stage prostate cancer.However,the development of castration-resistant prostate cancer has increased the mortality rate of prostate cancer.To develop novel drugs for castration-resistant prostate cancer,the molecular mechanisms of prostate cancer progression must be elucidated.Among the signaling pathways regulating prostate cancer development,recent studies have revealed the importance of noncanonical wingless-type MMTV integration site family(WNT)signaling pathways,mainly that involving WNT5A,in prostate cancer progression and metastasis;however,its role remains controversial.Moreover,chromatin remodelers such as the switch/sucrose nonfermentable(SWI/SNF)complex and chromodomain helicase DNA-binding proteins 1 also play important roles in prostate cancer progression through genome-wide gene expression changes.Here,we review the roles of noncanonical WNT signaling pathways,chromatin remodelers,and epigenetic enzymes in the development and progression of prostate cancer.

关键词： chromatin remodeling histone-modifying enzymes prostate cancer WNT5A

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Management of acquired rectourethral fistulas in adults

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Asian Journal of urology 2018年第3期5卷 149-154页

作者： Shulian Chen Rang Gao Hong Li Kunjie Wang department of urology Institute of Urology(Laboratory of Reconstructive Urology)West China HospitalSichuan UniversityChengduSichuanChina

Rectourethral fistula is an uncommon but devastating condition resulting from surgery,radiation,trauma,inflammation,or occasionally anorectal anomaly.Because of involving the urinary and the digestive system,surgical repair can be challenging.More than 40 different surgical approaches were described in the literature.However,no standardized management exists due to the rarity and complexity of the problem.Spontaneous closure of fistula is rare and most cases need reconstructive procedures.Appropriate preoperative assessment is crucial for the decision of operation time and method.Gradually accumulating evidence indicates surgeons should take fistula size,tissue health and vascularity associated with radiation or infection,urethral stricture,and bladder neck sclerosis into consideration and make a proper treatment plan according to the features of various approaches.Accurate preoperative evaluation and proper approach selection would increase success rates.Multiple surgical team corporation,including colorectal,urological and plastic surgeons,would optimize the outcomes.

关键词： Rectourethral fistula Prostate cancer Radical prostatectomy Radiation therapy Diagnosis Management

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