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Background:Magnetic Resonance Imaging (MRI) plays a vital role in diagnosing prostatic cancer routinely done before biopsy for the lesion's extent and defining the correct path for ultrasound-guided prostate biopsy. Diffusion-Weighted Imaging (DWI) is a non-invasive MRI sequence that shows improved sensitivity and specificity in the same setting with no additional cost. The study aims to evaluate the diagnostic accuracy(DA)of DWI in the detection of prostatic cancer.Methodology:A cross-sectional study was conducted at the radiology department of Dr. Ziauddin UniversityHospital between 15/ 04 /2016 to 15/ 4 /2017. A total of 201 patients who were clinically suspected of having prostatic tumors were in this study's inclusion criteria. MRI, including DWI, was done. The final diagnosis was based on an analysis of the histopathology report.Results:Out of 201 males with clinical suspicious of prostatic cancer,160 were diagnosed with prostatic cancer on histopathology. Of these, 150 were positive on DWI. The sensitivity of diffusion-weighted MRI wasfound to be93.7%, 75.60% specificity, and 90.0% DAfor the diagnosis of prostatic cancer.Conclusion:Diffusion-weighted sequence in MRI examination has a vital role in diagnosing prostatic cancer and should be considered a routine pre-biopsy investigation along with MRI in clinically suspected cases of prostate cancer.

Abstract Background Tumor cells exhibit enhanced metabolism of nutrients to satisfy the demand of sustained proliferation in vivo. Seminal reports have presented evidence that tryptophan (Trp) metabolic reprogramming induced by aberrant indoleamine 2,3-dioxygenases could promote tumor development in several cancer types. However, the underlying mechanism of Trp metabolism associated tumor progression is not fully understood. Materials and methods Prostatic cell lines LNCaP and VCaP were purchased from the Cell Bank of the Chinese Academy of Sciences (China). Human prostatic tumor tissue samples were obtained from the Tongji Hospital. Female NOD-SCID mice (6 ~ 8 weeks) were purchased from Huafukang Co. (China) and raised in SPF room. Commercial kits and instruments were used for cell apoptosis analysis, real-time PCR, western blotting, ELISA analysis and other experiments. Result Comparing the tumor tissues from prostatic cancer patients, we found elevated expression of tryptophan 2, 3-dioxygenase 2 (TDO2), and elevated Trp metabolism in chemo-resistant tumor tissues. In vitro, overexpression of TDO2 significantly promoted the Trp metabolism in prostatic cancer cell lines LNCaP and VCap, resulting in the multidrug resistance development. Mechanistically, we demonstrated that Trp metabolite kynurenine (Kyn) promoted the upregulation and nuclear translocation of transcription factor aryl hydrocarbon receptor (AhR). Subsequently, AhR collaborated with NF-κB to facilitate the activation of c-Myc. In turn, c-Myc promoted the up-regulation of ATP-binding cassette (ABC) transporters and Trp transporters, thereby contributing to chemoresistance and strengthened Trp metabolism in prostatic cancer. Interrupt of Trp/TDO2/Kyn/AhR/c-Myc loop with c-Myc inhibitor Mycro-3 efficiently suppressed the chemoresistance and improved the outcome of chemotherapy, which described a new strategy in clinical prostatic cancer treatment. Conclusion Our study demonstrates that elevated TOD2 expression promoted Trp metabolism and metabolite Kyn production, thus resulting in the activation of AhR/c-Myc/ABC-SLC transporters signaling pathway. Interrupt of Trp metabolism/c-Myc loop efficiently suppressed the drugs resistance induced by TDO2, which represented potential target to improve the outcome in drug-resistant prostatic cancer treatment.

Objectives: To compare the cost-effectiveness of a short biparametric MRI (BP-MRI) with that of contrast-enhanced multiparametric MRI (MP-MRI) for the detection of prostate cancer in men with elevated prostatespecific antigen (PSA) levels. Materials and methods: We compared two diagnostic procedures for detection of prostate cancer (Pca), BP-MRI and MP-MRI, in terms of quality-adjusted life years (QALY), incremental costeffectiveness ratio (ICER) and net monetary benefit (NMB) for a hypothetical cohort of 10,000 patients. We compared two scenarios in which different protocols would be used for the early diagnosis of prostate cancer in relation to PSA values. Scenario 1. BP-MRI/MP-MRI yearly if > 3.0 ng/ml, every 2 years otherwise; Scenario 2. BP-MRI/MP-MRI yearly with age-dependent threshold 3.5 ng/ml (50-59 years), 4.5 ng/ml (60-69 years), 6.5 ng/ml (70-79 years). Results: BP-MRI was more effective than the comparator in terms of cost (160.10 € vs 249.99€) QALYs (a mean of 9.12 vs 8.46), ICER (a mean of 232.45) and NMB (a mean of 273.439 vs 251.863). BP-MRI was dominant, being more effective and less expensive, with a lower social cost. Scenario 2 was more cost-effective compared to scenario 1. Conclusions: Our results confirmed the hypothesis that a short bi-parametric MRI protocol represents a cost-efficient procedure, optimizing resources in a policy perspective. [ABSTRACT FROM AUTHOR]

Traditionally, atherosclerotic risk factors for cardiovascular disease and cancer are assessed using coronary artery calcium scoring. However, this neglects the impact of atherosclerotic disease more proximal to the cancer site. This study assesses whether aortoiliac atherosclerotic plaque is associated with prostate cancer. The dataset consisted of abdominopelvic CT of 93 patients with prostate cancer and 186 asymptomatic patients who underwent CT colonography as an age- and gender-matched control group. Agatston scores were measured in the abdominal aorta, common iliac, and internal iliac arteries. The scores were evaluated for associations with age, Framingham risk score, and prostate cancer-related biomarkers, including prostate-specific antigen, Gleason score, tumor location, prostatectomy, androgen deprivation therapy, mortality, and bone metastasis. The atherosclerotic plaque of prostate cancer patients did not differ from the control group (p = 0.22) and was not correlated with any of the prostate cancer-related biomarkers (p > 0.05). However, Agatston scores of abdominal plaques correlated well with age (p < 0.001) and Framingham risk scores (p = 0.002). [ABSTRACT FROM AUTHOR]

Abstract Background The aim of this study is to investigate whether quantitative DW metrics can provide additive value to the reliable categorization of lesions within existing PI-RADSv2 guidelines. Fifty-eight patients with clinically suspicious prostate cancer who underwent PR examination, PSA serum levels, sextant TRUS-guided biopsies, and bi-parametric MR imaging were included in the study. Results Sixty-six lesions were detected by histopathological analysis of surgical specimens. The mean ADC values were significantly lower in tumor than non-tumor tissue. The mean ADC value inversely correlated with Gleason score of tumors with a significant p value < 0.001.Conversely, a positive relationship was found between the ADC ratio (ADC of benign prostatic tissue to prostate cancer) and the pathologic Gleason score with a significant elevation of the ADC ratio along with an increase of the pathologic Gleason score (p < 0.001). ROC curves constructed for the tumor ADC and ADC ratio helped to distinguish pathologically aggressive (Gleason score ≥ 7) from non-aggressive (Gleason score ≤ 6) tumors and to correlate it with PIRADSv2 scoring to predict the presence of clinically significant PCA (PIRADSv2 DW ≥ 4). The ability of the tumor ADC and ADC ratio to predict highly aggressive tumors (GS> 7) was high (AUC for ADC and ADC ratio, 0.946 and 0.897; p = 0.014 and 0.039, respectively). The ADC cut-off value for GS ≥ 7 was < 0.7725 and for GS ≤ 6 was > 0.8620 with sensitivity and specificity 97 and 94%. The cutoff ADC ratio for predicting (GS > 7) was 1.42 and for GS ≤ 6 was > 1.320 with sensitivity and specificity 97 and 92%. By applying this ADC ratio cut-off value the sensitivity and specificity of reader 1 for correct categorization of PIRADSv2 DW > 4 increased from 90 and 68% to 95 and 90% and that of reader 2 increased from 94 and 88% to 97 and 92%, respectively. Conclusion Estimation of DW metrics (ADC and ADC ratio between benign prostatic tissue and prostate cancer) allow the non-invasive assessment of biological aggressiveness of prostate cancer and allow reliable application of the PIRADSv2 scoring to determine clinically significant cancer (DW score > 4) which may contribute in planning initial treatment strategies.

Urinary incontinence is the most common adverse effects after radical prostatectomy, and it significantly impacts patients' quality of life after surgery. With the discovery of the fine anatomical structure of the prostate and the popularization of the concept of neurovascular bundle-sparing during surgery, the incidence of urinary incontinence after radical prostatectomy has been significantly reduced. Depending on the degree of urinary incontinence, the current treatment strategies include conservative treatment, behavioral therapy, pharmacotherapy, urethral bulking agents injection, male sling and artificial urethral sphincter. This article reviews the current status of treatment of urinary incontinence after radical prostatectomy, summarizes the scope of application, advantages and disadvantages of different treatment options and prospects for new treatment options in the future.

Abstract Background Studies have shown diverse results regarding the association between H. pylori (HP) infection and the risk of malignancy. There is accumulating evidence relating HP infection to urological diseases. We investigated whether there was an association between HP-infected peptic ulcers and the subsequent risk of prostate cancer. Methods We collected HP-infected male patients from 1998 to 2008 from the Longitudinal Health Insurance Database (LHID). HP-infected patients were identified as those who had a diagnosis of peptic ulcers upon admission and received HP eradication therapy within 1 year after diagnosis. The date of HP infection diagnosis upon admission was defined as the index date. Patients aged

Abstract Background The aim of this study is to investigate the role of PET/CT imaging with the 68Ga-labeled PSMA-ligand in the follow up assessment of post-operative and post-therapeutic cases of prostate cancer. All data were collected and analyzed retrospectively, enrolling 30 patients (their age range from 53 to 80 years with a mean age 67.8). The patients had been referred to a private imaging center for their assessment by 68Ga-labeled PSMA-ligand PET/CT. Results By 68Ga-labeled PSMA-ligand PET/CT, prostatic recurrent/residual neoplastic lesion was depicted in 23 (76.6%) patients, nodal metastases was present in 7 (23.3%) patients, and distant metastasis was present in 11 (36.6%) patients. The clinical and/or PSA level and/or radiological follow-up and/or the histopathological assessment for the patients served as a reference in the present study.The 68Ga-labeled PSMA-ligand PET/CT had sensitivity, specificity, positive predictive value, negative predictive value, and an overall accuracy (96.5%, 100%, 100%, 50%, and 96.6%) respectively. Conclusion 68Ga-labeled PSMA-ligand PET/CT is a very helpful tool for detection of prostatic cancer residual/recurrent lesions and restaging which can help in performing treatment plans and improve the clinical outcome and survival of the patients.

The goal of our study was to find out whether the immunohistochemical expression of nuclear factor-kappa beta (NF-κB) p65 in biopsy samples with Gleason score 3 + 3 = 6 (GS 6) can be a negative predictive factor for Prostate cancer (PCa) indolence.

Purpose The goal of this study was to retrospectively compare systematic ultrasound-guided prostate biopsy (US-PB) and multiparametric magnetic resonance imaging-ultrasound fusion prostate biopsy (MRI-PB) in men undergoing primary or repeated biopsies. Methods A population of 2,200 patients with a prostate-specific antigen (PSA) level >4.0 ng/ dL and/or an abnormal rectal examination was divided into two groups. All patients underwent US-PB (n=1,021) or MRI-PB (n=1,179) between April 2015 and April 2019. Population demographics, including age, PSA level, digital rectal examination results, prostate volume, number of previous negative biopsies, Prostate Imaging Reporting and Data System (PI-RADS) version 2 (V2) score, and biopsy results, were acquired and compared with respect to these variables. Univariate regression analysis of the risk factors for a higher Gleason score (GS) was performed. Results The cancer detection rate (CDR) was 23.8% (243 of 1,021) in the US-PB group and 31.3% (399 of 1,179) in the MRI-PB group. Of those, 225 patients (22.0%) in the US-PB group and 374 patients (31.7%) in the MRI-PB group had clinically significant prostate cancer (csPCa). The patients with csPCa in the MRI-PB group included 10 (40%), 50 (62.5%), 184 (94.8%), and 32 (94.1%) patients with PI-RADS V2 scores of 2, 3, 4, and 5, respectively. Of the patients with csPCa, 155 (91.7%) in the US-PB group were diagnosed on the basis of the primary biopsy, compared to 308 (94.4%) in the MRI-PB group. We found the PI-RADS V2 score to be the best predictor of a higher GS. Conclusion MRI-PB showed a high CDR for csPCa. MRI-PB could be a reasonable approach in patients with high PI-RADS V2 scores at primary biopsy.

Metastasis of malignant tumors to the temporal bone is relatively rare. We report a case of facial nerve palsy due to the metastatic prostatic cancer to the temporal bone with favorable and functional results. A 76-year-old man with no history of malignant tumor was referred to our hospital with a complaint of right facial nerve palsy. Based on radiological findings and a biopsy from the prostate, the patient was finally diagnosed as having metastatic prostatic cancer to the right temporal bone. More than 18 months had passed after start of the hormonal therapy, the metastatic lesion of the temporal bone had diminished, and the facial nerve palsy gradually improved. The present case suggests that favorable and functional results even in advanced metastatic prostatic cancers to temporal bone, if hormonal therapy is effective. We must keep in mind the possibility of metastatic tumor in the treatment of facial nerve palsy. [ABSTRACT FROM AUTHOR]

Background: Tumor cells exhibit enhanced metabolism of nutrients to satisfy the demand of sustained proliferation in vivo. Seminal reports have presented evidence that tryptophan (Trp) metabolic reprogramming induced by aberrant indoleamine 2,3-dioxygenases could promote tumor development in several cancer types. However, the underlying mechanism of Trp metabolism associated tumor progression is not fully understood.Materials and Methods: Prostatic cell lines LNCaP and VCaP were purchased from the Cell Bank of the Chinese Academy of Sciences (China). Human prostatic tumor tissue samples were obtained from the Tongji Hospital. Female NOD-SCID mice (6 ~ 8 weeks) were purchased from Huafukang Co. (China) and raised in SPF room. Commercial kits and instruments were used for cell apoptosis analysis, real-time PCR, western blotting, ELISA analysis and other experiments.Result: Comparing the tumor tissues from prostatic cancer patients, we found elevated expression of tryptophan 2, 3-dioxygenase 2 (TDO2), and elevated Trp metabolism in chemo-resistant tumor tissues. In vitro, overexpression of TDO2 significantly promoted the Trp metabolism in prostatic cancer cell lines LNCaP and VCap, resulting in the multidrug resistance development. Mechanistically, we demonstrated that Trp metabolite kynurenine (Kyn) promoted the upregulation and nuclear translocation of transcription factor aryl hydrocarbon receptor (AhR). Subsequently, AhR collaborated with NF-κB to facilitate the activation of c-Myc. In turn, c-Myc promoted the up-regulation of ATP-binding cassette (ABC) transporters and Trp transporters, thereby contributing to chemoresistance and strengthened Trp metabolism in prostatic cancer. Interrupt of Trp/TDO2/Kyn/AhR/c-Myc loop with c-Myc inhibitor Mycro-3 efficiently suppressed the chemoresistance and improved the outcome of chemotherapy, which described a new strategy in clinical prostatic cancer treatment.Conclusion: Our study demonstrates that elevated TOD2 expression promoted Trp metabolism and metabolite Kyn production, thus resulting in the activation of AhR/c-Myc/ABC-SLC transporters signaling pathway. Interrupt of Trp metabolism/c-Myc loop efficiently suppressed the drugs resistance induced by TDO2, which represented potential target to improve the outcome in drug-resistant prostatic cancer treatment. [ABSTRACT FROM AUTHOR]

Purpose: To provide a systematic analysis of the comparative outcomes of robot-assisted radical prostatectomy (RARP) versus laparoscopic radical prostatectomy (LRP) in the treatment of prostate cancer based on the best currently available evidence. Methods: An independent systematic review of the literature was performed up to February 2021, using MEDLINE®, EMBASE®, and Web of Science® databases. Preferred reporting items for systematic review and meta-analysis (PRISMA) recommendations were followed to design search strategies, selection criteria, and evidence reports. The quality of the included studies was determined using the Newcastle–Ottawa scale for non-randomized controlled trials. Demographics and clinical characteristics, surgical, pathological, and functional outcomes were collected. Results: Twenty-six studies were identified. Only 16 "high-quality" (RCTs and Newcastle–Ottawa scale 8–9) studies were included in the meta-analysis. Among the 13,752 patients included, 6135 (44.6%) and 7617 (55.4%) were RARP and LRP, respectively. There was no difference between groups in terms of demographics and clinical characteristics. Overall and major complication (Clavien–Dindo ≥ III) rates were similar in LRP than RARP group. The biochemical recurrence (BCR) rate at 12months was significantly lower for RARP (OR: 0.52; 95% CI 0.43–0.63; p < 0.00001). RARP reported lower urinary incontinence rate at 12months (OR: 0.38; 95% CI 0.18–0.8; p = 0.01). The erectile function recovery rate at 12months was higher for RARP (OR: 2.16; 95% CI 1.23–3.78; p = 0.007). Conclusion: Current evidence shows that RARP offers favorable outcomes compared with LRP, including higher potency and continence rates, and less likelihood of BCR. An assessment of longer-term outcomes is lacking, and higher cost remains a concern of robotic versus laparoscopic prostate cancer surgery. [ABSTRACT FROM AUTHOR]

The crosstalk between tumor microenvironment and cancer cells is emerging as a critical determinant in tumor progression. However, the underlying mechanism of tumor microenvironment‐induced cancer development remains controversial. Here, our study provides evidence to suggest that tumor‐associated macrophage (TAM) enrichment is found in chemoresistant prostatic tumor tissues. Those TAMs are demonstrated to promote chemoresistance and distant metastasis in prostatic cancer through secretion of CCL5. Mechanistically, TAM coculture or additional CCL5 can mediate the STAT3‐dependent epithelial–mesenchymal transition process, resulting in distant metastasis in prostatic cancer. Meanwhile, activation of STAT3 induced by CCL5 can mediate upregulation of the transcription factor Nanog, leading to drug resistance. In vivo study further demonstrated that blockade of STAT3 signals significantly reverses chemoresistance and suppresses lung metastasis in colorectal tumor‐bearing mice, suggesting a novel strategy for clinical prostatic cancer treatment. [ABSTRACT FROM AUTHOR]

Aim:The aim of this study was to investigate whether serum ischemia-modified albumin (IMA) levels have a diagnostic value in prostate cancer (Pca).Methods:Thirty primary Pca patients and 30 age-matched healthy male subjects were included in this prospective case-control study. The patients were selected from the urology clinic of a tertiary university hospital. Healthy men included in the control group were selected from hospital staff and patient relatives. Patients with severe chronic diseases and other malignancies were excluded. Serum IMA level was measured using the colorimetric method. The results were reported in absorbance unit (ABSU).Results:Serum IMA levels were significantly higher in the study group when compared to the control group (0.843±0.76 and 0.443±0.49 ABSU, respectively; p=0.002). The mean IMA value in patients with a Gleason score ≥7 (1.08±0.053 ABSU) was significantly higher than in patients with Gleason score ≤6 (IMA 0.418±0.64 ABSU). According to the receiving operating characteristic (ROC) analysis, when the cut-off value was ABSU=0.57, the sensitivity and specificity were 80% and 56.7%, respectively.Conclusion:Serum concentrations of IMA are significantly elevated especially in clinically significant Pca patients. Its high sensitivity (80%) in ROC analysis suggests that IMA can be used an ancillary biomarker in diagnosis.

Koudi Bai,1 Yuan Sun,2 Wei Li,3 Lanlan Zhang41Department of Radiology, Yancheng First Peoples’ Hospital, Yancheng City, People’s Republic of China; 2Department of Orthopedics, No.97 Hospital of People’s Liberation Army of China, Xuzhou City, People’s Republic of China; 3Department of Medical Imaging, Jiangsu Vocational College of Medicine, Yancheng City, People’s Republic of China; 4Department of Pediatrics, Yancheng Maternal and Child Health Hospital, Yancheng City, People’s Republic of ChinaObjective: To evaluate the diagnostic performance of apparent diffusion coefficient (ADC) for local staging of prostate cancer.Methods: Databases of Web of Science, MEDLINE (Ovid and PubMed), Cochrane Library, EMBASE, and Google Scholar were searched up to May 31, 2018, with language restricted to English. All studies concerning multiparametric magnet resonance imaging (mpMRI) with ADC for detection of extracapsular extension (ECE, T3a) and/or extraprostatic extension (EPE, overall stage of T3) were identified by two reviewers independently, and quality of included studies was evaluated using Quality Assessment of Diagnostic Accuracy Studies-2 tool. True positive, false positive, false negative and true negative of each study were extracted to reconstruct the 2×2 tables for evaluating diagnostic accuracy. Summary estimates of sensitivity, specificity, and corresponding 95% CIs were calculated with bivariate model and hierarchical summary receiver operating characteristic model, then presented in forest plots. Multiple subgroup analyses and meta-regression were performed, and publication bias was evaluated with Deeks funnel.Results: A total of 18 studies were included, with 6 involved ECE and 12 for EPE. Pooled sensitivity was 80.5% (95% CI 76.5–83.9%) with specificity of 69.1% (95% CI 62.3–75.2%). Multiple subgroup analyses showed that if ADC and length of capsular contact are regarded as independent predictors, pooled sensitivity was 85% (95% CI 77–90%) and 81.1% (95% CI 76.0–85.3%), with specificity of 70.8% (95% CI 56.3–82.0%) and 66.6% (95% CI 57.6–74.5%), respectively. Meta-regression demonstrated that there was no substantially significant difference in types of coil, magnet field strength (1.5T versus 3.0T), and analysis method (per-lesion versus per-patient).Conclusion: By introducing ADC to MRI, we could obtain favorable sensitivity for diagnostic performance of EPE, but with a little decreased specificity.Keywords: apparent diffusion coefficient, prostatic cancer, magnetic resonance imaging, extraprostatic extension, length of capsular contact

Objectives: Although studies have reported that miR-596 extensively participates in multiple cancer progression, the biological mechanisms and effects of miR-596 in prostatic cancer remain unclear. The literature is aimed to reveal the function and possible molecular mechanisms of miR-596 in prostatic cancer carcinogenesis. Materials and methods: qRT-PCR was applied to examine miR-596 expression in prostatic cancer cell lines and samples, also methylation-specific PCR was used to detect the methylation status of the promoter CpG islands in prostatic cancer samples. Meanwhile, the tumor-related effects of miR-596 were detected via cell viability, clone formation assay, migration assay, flow cytometric and AO/EB assay. qRT-PCR and Western blots were applied to investigate the function of miR-596 on malignant behavior in prostatic cancer cells. Results: We found that miR-596 mRNA was decreased in prostatic cancer samples and cell lines. miR-596 mRNA level was also correlated to cancer stage, Gleason scores, while miR-596 promoter methylation was related to cancer tumor stage, Gleason score and preoperative PSA levels. miR-596 inhibited the cell growth and activity by causing cell apoptosis, and also suppressed the migration of prostatic cancer cells by revealing the epithelial-mesenchymal transition process. In addition, Western blot indicates that miR-596 overexpression deregulated Wnt/β-catenin signaling, by restraining phosphorylation levels of β-catenin and expression levels of downstream targets. Conclusions: In summary, this research indicates that miR-596 overexpression could be potentially useful in the cell growth and migration of prostatic cancer and serves as a potential molecular marker in prostatic cancer. [ABSTRACT FROM AUTHOR]

Background and Objectives: This study aims to elucidate the positive rate and the clinicopathological significance of surgical margin after radical prostatectomy (RP) through a meta-analysis. Materials and Methods: This meta-analysis finally used 59 studies, including the information about the positive surgical margin (PSM) and those clinicopathological significances after RP. The subgroup analysis for the estimated rates of PSM was evaluated based on types of surgery, grade groups, and pathological tumor (pT) stages. We compared the clinicopathological correlations between positive and negative surgical margins (NSM). Results: The estimated PSM rate was 25.3% after RP (95% confidence interval [CI] 21.9–29.0%). The PSM rates were 26.0% (95% CI 21.5–31.1%) 28.0% (95% CI 20.2–37.5%) in robot-assisted RP and nerve-sparing RP, respectively. The PSM rate was significantly higher in high-grade groups than in low-grade groups. In addition, the higher pT stage subgroup had a high PSM rate compared to the lower pT stage subgroups. Patients with PSM showed significantly high PSA levels, frequent lymphovascular invasion, lymph node metastasis, and extraprostatic extension. Biochemical recurrences (BCRs) were 28.5% (95% CI 21.4–36.9%) and 11.8% (95% CI 8.1–16.9%) in PSM and NSM subgroups, respectively. Patients with PSM showed worse BCR-free survival than those with NSM (hazard ratio 2.368, 95% CI 2.043–2.744%). Conclusions: Our results showed that PSM was significantly correlated with worse clinicopathological characteristics and biochemical recurrence-free survival. Among the results in preoperative evaluations, grade group and tumor stage are useful for the prediction of PSM.

Objective: To explore the differences of DWI and IVIM DWI related parameters in different prostate tissues, to evaluate the efficiency of each parameter in the differential diagnosis of benign and malignant prostate diseases, and to investigate the predictive value of IVIM DWI parameters for the malignant degree of prostate cancer(PCa). Methods: The data of 62 patients with the visiting reasons such as urgent urination, incomplete urination, frequent urination or hematuria in this hospital from January 2016 to January 2017 were collected. The related data of 16 healthy volunteers were collect ed. The MRI examination was performed in all subjects; the pathological examination results obtained within 1 month after MRI examination. Among 62 cases, 27 cases were PCa and 35 cases were prostatic hyperplasia. The apparent diffusion coefficient(ADC), true diffusion coefficient(D), perfusion fraction (f) and perfusion related diffusion coefficient(D*) were compared between different prostatic tissues; the area under the receiver operating characteristic(ROC) curve was adopted to evaluate the diagnostic values of DWI and IVIM DWI; the Spearman rank correlation test was used to evaluate the correlation between the Gleason score of PCa and the parameters of IVIM DWI. Results: The values of ADC, D and f value in the patients with PCa were lower than those in the prostatic peripheral zone, central gland and the patients with prostatic hyperplasia,and the differences were statistically significant(P<0. 05). AUC of D value for identifying benign and malignant prostate lesions was maximal(0. 954); the D value showed the significantly negative correlation with the Gleason score(r= - O. 7 41,P = 0. 001). Conclusion: In the differential diagnosis of benign and malignant prostate, the values of ADC, f, D and D * all play a certain role, and the D value is the relatively highest diagnostic efficiency and helps to evaluate the malignant degree of PCa. [ABSTRACT FROM AUTHOR]

Objective: To compare the tolerability and feasibility of transrectal(TR) versus transperineal (TP) routes for prostate biopsy under local anaesthesia(LA). To assess the functional outcome and the complication of both procedures., Method: s. A prospective cohort observational study was performed on patients who underwent prostate biopsy under LA. Visual Analogue Scale (VAS) was used during the procedure. International Prostate Symptoms Score (IPSS) and International Index of Erectile dysfunction (IIEF) were assessed before the procedure and in 14 days after the procedure. Complication for each procedure was recorded., Result: A total of 128 patients with 64 patients for each group underwent prostate biopsy by TP and TR under LA. TP targeted biopsy group had comparable pain scores to those who underwent the procedure using the TR routes. The median pain score for the TP group was 2 and TR was 3, (IQR=2, range 0-10 for both groups)with no significant pain difference between both groups (P=0.48). Furthermore, there was no significant difference in urinary function(p=0.68) and sexual function (p=0.19) between the two groups post-procedure. Both groups have similar rates of complications, with no significant difference observed. Urinary tract infection incidents that did occur were rare and did not significantly differ between the groups (p=0.21). None of the patients experienced sepsis postoperatively. AUR was reported in both groups, slightly higher with 9.4%(N=6) in the TP group and 6.3%(N=4) in the TR group however no significant difference(p=0.112) was noted. Haematuria is common in both groups with TP (66%) and TR (59%) but self-limiting with Clavien-Dindo grade I without significant difference (p=0.589)., Conclusion: Our results showed that both Transperineal and transrectal approaches have similar tolerability with no significant difference in functional outcome or complications. Further studies are mandatory to verify our results.

Background: A significant proportion of patients with positive multiparametric magnetic resonance imaging (mpMRI; Prostate Imaging-Reporting and Data System [PI-RADS] scores of 3-5) have negative biopsy results., Objective: To systematically assess all prostate-specific antigen density (PSAD) values and identify an appropriate cutoff for identification of patients with positive mpMRI who could potentially avoid biopsy on the basis of their PI-RADS score., Design, Setting, and Participants: The study included a cohort of 1341 patients with positive mpMRI who underwent combined targeted and systematic biopsies., Outcome Measurements and Statistical Analysis: Multivariable logistic regression analysis (MVA) was used to assess the association between PSAD and the risk of clinically significant prostate cancer (csPCa, grade group ≥2) after adjusting for confounders. We used locally weighted scatterplot smoothing to explore csPCa risk according to PSAD and PI-RADS scores. PSAD utility was observed only for patients with PI-RADS 3 lesions, so we plotted the effect of each PSAD value as a cutoff for this subgroup in terms of biopsies saved, csPCa cases missed, and clinically insignificant PCa (ciPCa, grade group 1) cases not detected., Results and Limitations: Overall, 667 (50%) csPCa cases were identified. On MVA, PSAD independently predicted csPCa (odds ratio 1.57; p < 0.001). For PI-RADS ≥4 lesions, the csPCa risk was ≥40% regardless of PSAD. Conversely, among patients with PI-RADS 3 lesions, csPCa risk ranged from 0% to 60% according to PSAD values, and a PSAD cutoff of 0.10 ng/ml/cm 3 corresponded to a threshold probability of 10% for csPCa. Using this PSAD cutoff for patients with PI-RADS 3 lesions would have saved 32% of biopsies, missed 7% of csPCa cases, and avoided detection of 34% of ciPCa cases. Limitations include selection bias and the high experience of the radiologists and urologists involved., Conclusions: Patients with PI-RADS ≥4 lesions should undergo prostate biopsy regardless of their PSAD, while PSAD should be used to stratify patients with PI-RADS 3 lesions. Using a threshold probability of 10% for csPCa, our data suggest that the appropriate strategy is to avoid biopsy in patients with PI-RADS 3 lesions and PSAD <0.10 ng/ml/cm 3 . Our results also provide information to help in tailoring an appropriate strategy for every patient with positive mpMRI findings., Patient Summary: We investigated whether a cutoff value for PSAD (prostate-specific antigen density) could identify patients with suspicious prostate lesions on MRI (magnetic resonance imaging) who could avoid biopsy according to the PI-RADS score for their scan. We found that patients with PI-RADS ≥4 should undergo prostate biopsy regardless of their PSAD. A PSAD cutoff of 0.10 should be used to stratify patients with PI-RADS 3., (Copyright © 2023 European Association of Urology. Published by Elsevier B.V. All rights reserved.)

Background: Physical exercises play a supportive role in the treatment of prostate cancer by modulating angiogenesis in tumor tissue. The hypoxia-inducible factor-1 (HIF-1) modulates angiogenesis and tumor growth. Prostate specific antigen (PSA) is the most widely available tumor marker for the rapid diagnosis of prostate cancer. The purpose of this study was to investigate the effect of physical exercises in the expression of HIF-1 gene levels in plasma, and the PSA level in the sera of men with prostate cancer. Methods: In this clinical trial study, 20 men with prostate cancer were randomly selected from the pathology department of Baqiyatallah al-Azam subspecialty hospital in Tehran, Iran, during the middle 6 months of 2016. Patients were divided into two groups of experimental [age: 63 ± 10 years, weight: 78 ± 11 kg, body mass index (BMI): 28.5 ± 2.4 kg/m2] and control [age = 62 ± 4 years, weight: 79 ± 11 kg, BMI: 27.9 ± 2.9 kg/m2). The experimental group performed 8 weeks of 60 minutes per session training including 3 sessions per week. The workouts were the combination of exercises with resistance and endurance training per session as 60-75 percent of one repetition maximum, and 60-75 percent of maximum heart rate. The control group did not receive any intervention. Blood samples were tested for PSA and HIF-1 using enzyme-linked immunosorbent assay (ELISA) and real-time polymerase chain reaction (PCR) methods, respectively, and the data were analyzed using dependent and independent t test. Findings: Combined exercise significantly decreased the plasma level (P = 0.007) and gene expression (P = 0.005) of HIF-1, as well as serum PSA level (P = 0.005) in the experimental group compared with control group. Conclusion: Considering the importance of PSA in the diagnosis of prostate cancer, and the role of HIF-1 in tumor angiogenesis, the combined exercise can be effective in reducing the progression of prostate cancer by modifying HIF-1 and PSA.

BackgroundMen normally have shorter heart rate-corrected QT interval (QTc) than women, at least in part due to accelerating effects of testosterone on ventricular repolarization. Accumulating data suggest that androgen-deprivation therapy (ADT) used for the treatment of prostatic cancer, may increase Torsades de Pointes (TdP) risk by prolonging QTc. However, the evidence for such an association is currently limited to few case reports, in most cases deriving from the analysis of uncontrolled sources such as pharmacovigilance databases.ObjectiveTo better determine the clinical impact of ADT on TdP development, we examined the prevalence of this therapy in a consecutive cohort of 66 TdP patients, prospectively collected over a ~10 years period.Methods and ResultsWe found and described four patients who were under ADT for prostatic cancer when TdP occurred, and in two cases degenerated to cardiac arrest. Notably, in this unselected population, ADTs unexpectedly represented the second most frequently administered QT-prolonging medication in males (4/24, 17%), after amiodarone. Moreover, in the ADT patients, a blood withdrawal was performed within 24 h from TdP/marked QTc prolongation occurrence and circulating concentration of androgens and gonadothropins were measured. As expected, all cases showed markedly reduced testosterone levels (total, free, and available).ConclusionWe provide evidence that a significant proportion of patients developing TdP were under treatment with ADT for prostatic cancer, thus confirming the clinical relevance of previous pharmacovigilance signals. An accurate assessment of the arrhythmic risk profile should be included in the standard of care of prostatic cancer patients before starting ADT.

Background: Bone metastasis after failure of castration therapy is the main reason of death in patients with prostate cancer (PCa). Therefore, full awareness of the metastasis mechanism of PCa and discovery of new therapeutic targets are necessary. Studies showed that lncRNA was involved in the development of cancer. However, its potential role and molecular mechanism in PCa metastasis are still unclear. YKL-40 is an 18 glycosyl hydrolase family protein encoded by CHI3L1, which is involved in the invasion and metastasis of various tumors. A previous study of the authors found that YKL-40 was related to the invasion and metastasis of PCa cells. However, the cause of its abnormal expression in PCa remains unclear. The present study explored the role of lncRNA KCNQ1OT1/miR-211-5p/CHI3L1 regulatory axis in the proliferation, invasion, and metastasis of PCa. Methods: RT-PCR and Western blot were used to measure the expression profiles of KCNQ1OT1 and YKL. CCK-8 and Transwell assays were used to examine their effects on cell proliferation and migration. Double luciferase reporter assay was used to verify the interactions between miR-211-5p and CHI3L1 3′-UTR. Results: KCNQ1OT1 expression was upregulated in PCa tissues and cells. Downregulating this expression inhibited PCa cell invasion, proliferation, and metastasis. KCNQ1OT1 bound miR-211-5p competitively, and miR-211-5p targeted CHI3L1 3′-UTR. miR-211-5p expression was downregulated, whereas CHI3L1 (YKL-40) expression was upregulated. miR-211-5p levels were negatively correlated with KCNQ1OT1 expression and CHI3L1 mRNA. The decrease in YKL-40 expression in PCa cells induced by the downregulation of KCNQ1OT1 expression could be offset by miR-211-5p inhibitor transfection. Conclusion: This study showed that lncRNA KCNQ1OT1, as a ceRNA, upregulated CHI3L1 and promoted PCa progression through competitive binding to miR-211-5p. [ABSTRACT FROM AUTHOR]

Copyright of Journal of China Medical University is the property of Journal of China Medical University Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In order to explore the diagnostic value of prostate targeted puncture guided by MRI combined with ultrasound fusion imaging (MR-TRUS) in patients with prostate cancer of PI-RADS score ≥ 3 points, 100 patients who sought medical care in our hospital were enrolled. All of them were performed targeted biopsy via both MR-TRUS guided puncture and traditional puncture. And all the patients were tested the level of prostate specific antigen (PSA). According to 4 < PSA ≤ 10 µ g /L, 10 < PSA ≤ 20 µ g /L, 20 < PSA ≤ 50 µ g/L, and PSA > 50 µ g /L, the MR-TRUS guided puncture group (group A) and the traditional puncture group (group B) were both divided into 4 subgroups. The sensitivity, specificity and accuracy of different puncture methods for the diagnosis of prostate cancer were compared according to the postoperative pathological results. The results showed that the diagnostic rates of each subgroup in the group A were 28.57%, 66.67%, 70% and 91.67%, while the diagnostic rates of each subgroup in the group B were 9.52%, 25.00%, 60.00% and 86.11%, respectively. Compared with the traditional puncture method, MR-TRUS guided puncture significantly improved the diagnostic rate in patients of PSA ≤ 10 µ g/L and 10 < PSA ≤ 20 µ g/h (P<0.05). The diagnostic rate of the two puncture methods was not significantly different in patients of 20 < PSA ≤ 50 µ g/L and PSA > 50 µ g/L (P > 0.05). Compared with the traditional puncture method, the sensitivity and accuracy of MR-TRUS guided puncture were significantly improved (P < 0.05). In summary, patients of PSA ≤ 10 µ g/L and 10 PSA ≤ 20 µ g/L should undergo targeted puncture guided by MRI and ultrasound fusion, which can significantly improve the diagnosis rate of prostate cancer. [ABSTRACT FROM AUTHOR]

Copyright of Imaging Science & Photochemistry is the property of Imaging Science & Photochemistry Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cancer of the prostate is one of the commonest cancers in males and is a principal reason of deaths related to malignancies. The prostatic specific antigen(PSA) screening test is not routinely done, so,majority of affected personswill present with progressive level of cancer. Neutrophils to lymphocytes ratio (NLR) was previously proposed as aneasyindicatorin patients needing critical care for the systematic inflammatory response. It was identified also as a crucialindicator of severity for some cancers of the solid type. This ratio can notably easy to be addressed from a full blood count in asample of blood. This study was conducted to estimate the role of NLR as aseverity indicator in patients having prostatic cancer. A retrospective, cross sectional study is this, that contain 425 participants already diagnosed with prostatic cancer, who attended Al-Amal National Hospital of clinical oncology and nuclear medicine in Baghdad-Iraq over the period of June 2013 to June 2015, and on regular follow up until June 2017. The data collected from patients’ files documentation. All patients had pre-treatment complete blood counts (CBC) anda differential leucocyte count; pre-treatment PSA; histopathological report for Gleason’s score (GS) and full documentation of patients’ follow-up. Accordingly, only 100 patients’ documents had these full criteria, and 325 patients with incomplete data were excluded. All participants were then divided into 2 groups according to their pre-treatment NLR: The group with low (<3) NLR (n=36), and the other group are those with high (≥ 3) NLR (n=64). Results demonstrated that there are significant statisticaldifferences between pre-treatment NLR and baseline PSA level (p = 0.0001) and between it and Gleason’s score (p = 0.0001). In addition, no statistical significant difference was found between NLR and T-staging (tumor extension) (p = 0.1), but it showed one with nodal involvement (p = 0.0001), with distant metastasis (p = 0.0001) and with number of organ metastasis (p = 0.0001). Strong association was found between high pre-treatment NLR and Gleason’s score upgrading, high baseline PSA and disease progression. The pre-treatment NLR is an effective, not a costly means, thatcan besimply accessed in various situations of healthcare systems and can be used as a supportive tool in decision-making for treatment of early as well as advanced prostatic cancer cases. [ABSTRACT FROM AUTHOR]

Prostate cancer is the second most frequent cancer diagnosis made in men and the fifth leading cause of death worldwide. Prostate cancer may be asymptomatic at the early stage and often has an indolent course and may require minimal or even no treatment. More advanced stage of the disease may present with urinary retention and back pain, as axis skeleton is the most common site of bony metastatic disease. The aim of this study is to examines the expressin of annexin A5 proteins in prostatic adenocarcinoma in correlation with some clinico-pathological parameters in a sample of Iraqi patients. A retrospective cross-sectional study included 30 patients diagnosed with prostatic adenocarcinoma and other 30 patients diagnosed with benign prostatic hyperplasia BPH in Baghdad, Iraq from Oct. 2018 - Oct. 2019 were evaluated. Of the 60 patients enrolled in this study; 65% of patients showed positive Annexin A5 expression whie 35% was ngative. Although, there's no statistical significant association in Annexin A5 expression between benign and malignant lesions but in prostatic cancer patients we noticed that threre's significant association between perineural invasion and Annexin A5 expression. Annexin A5 expression can be a potential marker for tumor aggressiveness and invasion that make it candidate for more aggressive management. [ABSTRACT FROM AUTHOR]

Objective To explore the effect of S100P over-expression on proliferation and invasion ability of prostate cancer PC-3 cells. Methods Prostate cnacer PC-3 cells were divided into the blank control group(do noting), negative control group (transfection with pcDNA3.1 empty solution) and S100P over-expression group(transfection with pcDNA3. 1-S100P recombinant vector virus solution). 48 h after transfection, the expression levels of S100P mRNA and protein were detected by qRT-PCR and western blotting, respectively. The proliferation ability of each group cells was tested by MTT assay and clone formation assay, and the invasion ability of each group cells was tested by Transwell chamber assay. Results The expression levels of S100P mRNA and protein in the S100P over-expression group were significantly higher than those in the blank control group and the negative control group, the differences were statistically significant (P <0.05). Compared with the blank control group and the negative control group, the proliferation viability, clone formation ability and invasion ability of PC-3 cells in the overexpression S100P group were enhanced, and the differences were statistically significant (P <0.05). Conclusion Over-expression of S100P in prostate cancer PC3 cells can enhance the proliferation and invasion of PC3 cells. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to investigate the role of PET/CT imaging with the 68Ga-labeled PSMA-ligand in the follow up assessment of post-operative and post-therapeutic cases of prostate cancer. All data were collected and analyzed retrospectively, enrolling 30 patients (their age range from 53 to 80 years with a mean age 67.8). The patients had been referred to a private imaging center for their assessment by 68Ga-labeled PSMA-ligand PET/CT. Results: By 68Ga-labeled PSMA-ligand PET/CT, prostatic recurrent/residual neoplastic lesion was depicted in 23 (76.6%) patients, nodal metastases was present in 7 (23.3%) patients, and distant metastasis was present in 11 (36.6%) patients. The clinical and/or PSA level and/or radiological follow-up and/or the histopathological assessment for the patients served as a reference in the present study.The 68Ga-labeled PSMA-ligand PET/CT had sensitivity, specificity, positive predictive value, negative predictive value, and an overall accuracy (96.5%, 100%, 100%, 50%, and 96.6%) respectively. Conclusion: 68Ga-labeled PSMA-ligand PET/CT is a very helpful tool for detection of prostatic cancer residual/recurrent lesions and restaging which can help in performing treatment plans and improve the clinical outcome and survival of the patients. [ABSTRACT FROM AUTHOR]

Purpose: Salvage radiotherapy is generally considered as the standard treatment for biochemical relapse after surgery. Best results have been obtained with a PSA value < 0.5 ng/ml at relapse, while 60–66 Gy is deemed as standard total dose. Modern imaging, as dynamic-18F-choline PET/CT may identify site of recurrence, allowing dose escalation to a biological target volume. Methods: Hundred and fifty patients showed a local relapse at dynamic-18F-choline PET/CT at time of biochemical recurrence. High-dose salvage radiotherapy was delivered up to total dose of 80 Gy to 18F-choline PET/CT positive area. Toxicity and relapse-free survival were recorded. Results: Median PSA value at the beginning of salvage radiotherapy was 0.47 ng/ml (range 0.2–17.5 ng/ml). One-hundred and thirty nine patients (93%) completed salvage radiotherapy without interruptions. Acute gastrointestinal grade ≥ 2 toxicity was recorded in 13 patients (9%), acute genitourinary grade ≥ 2 toxicity in 2 patients (1.4%). One patient (0.7%) experienced late gastrointestinal grade 4 toxicity and 2 patients (1.4%) late acute genitourinary grade 3 toxicity. With a median follow-up of 63.5 months, 5 and 7-years relapse-free survival were 70% and 60.7%, respectively. Conclusion: With a median follow-up of 5 years the present study confirms that high-dose salvage radiotherapy to a biological target volume is feasible, with low rate of late toxicity and promising activity. [ABSTRACT FROM AUTHOR]

Background: Men normally have shorter heart rate-corrected QT interval (QTc) than women, at least in part due to accelerating effects of testosterone on ventricular repolarization. Accumulating data suggest that androgen-deprivation therapy (ADT) used for the treatment of prostatic cancer, may increase Torsades de Pointes (TdP) risk by prolonging QTc. However, the evidence for such an association is currently limited to few case reports, in most cases deriving from the analysis of uncontrolled sources such as pharmacovigilance databases. Objective: To better determine the clinical impact of ADT on TdP development, we examined the prevalence of this therapy in a consecutive cohort of 66 TdP patients, prospectively collected over a ~10 years period. Methods and Results: We found and described four patients who were under ADT for prostatic cancer when TdP occurred, and in two cases degenerated to cardiac arrest. Notably, in this unselected population, ADTs unexpectedly represented the second most frequently administered QT-prolonging medication in males (4/24, 17%), after amiodarone. Moreover, in the ADT patients, a blood withdrawal was performed within 24 h from TdP/marked QTc prolongation occurrence and circulating concentration of androgens and gonadothropins were measured. As expected, all cases showed markedly reduced testosterone levels (total, free, and available). Conclusion: We provide evidence that a significant proportion of patients developing TdP were under treatment with ADT for prostatic cancer, thus confirming the clinical relevance of previous pharmacovigilance signals. An accurate assessment of the arrhythmic risk profile should be included in the standard of care of prostatic cancer patients before starting ADT. [ABSTRACT FROM AUTHOR]

Copyright of Imaging Science & Photochemistry is the property of Imaging Science & Photochemistry Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To study the sedative effect of dexmedetomidine in elderly patients with prostate cancer undergoing three hole LRP, and its effect on nerve function and brain oxygen metabolism. Methods:From August 2016 to December 2019, 78 patients with LRP under general anesthesia in our hospital were randomly selected and divided into control group and observation group according to the random number table method, 39 cases in each group. During the operation, the observation group was given dextromethoridine, while the control group was given the same amount of normal saline. The changes of cognitive function index (MoCA score, POCD incidence rate), neurological function index (TGF - β 1, NSE, IGF-1), brain oxygen metabolism index (PaO2, map, PaCO2, rSO2) before and after operation were compared between the two groups. The visual analogue score (VAS), the amount of analgesic drugs and the times of pressing the analgesic pump were compared between the two groups. The incidence of adverse reactions was compared between the two groups. Results:Before operation, there was no significant difference in cognitive function index, neurological function index and brain oxygen metabolism index between the two groups (P > 0.05). On the first and third days after operation, MOCA score of the two groups was significantly lower, MOCA score of the observation group was significantly higher than that of the control group, POCD incidence of the observation group was significantly lower than that of the control group; on the third day after operation, TGF - β 1 and IGF-1 of the two groups were significantly lower, TGF - β 1 and IGF-1 of the observation group were significantly lower -The NSE in the observation group was significantly lower than that in the control group (P < 0.05). In this study, 1 hour after the establishment of pneumoperitoneum, PaCO2 and rSO2 in the two groups were significantly increased, 6 hours and 12 hours after the operation, the VAS score of the observation group was lower than that of the control group, and the dosage of analgesic pump and the number of times of compression of the analgesic pump were significantly lower than that of the control group (P < 0.05). There was no difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion:DEX has a good sedative effect on the elderly prostate cancer patients undergoing LRP with three hole method. It has little effect on nerve function and brain oxygen metabolism, and has a good safety. [ABSTRACT FROM AUTHOR]

Abstract Background c-KIT expression has been related to bone metastasis in human prostate cancer, but whether c-KIT expression can be similarly classified in canine prostatic tissue is unknown. This study assessed c-KIT and Ki67 expression in canine prostate cancer (PC). c-KIT gene and protein expression and Ki67 expression were evaluated in forty-four canine prostatic tissues by immunohistochemistry, RT-qPCR and western blot. Additionally, we have investigated c-KIT protein expression by immunoblotting in two primary canine prostate cancer cell lines. Results Eleven normal prostates, 12 proliferative inflammatory atrophy (PIA) prostates, 18 PC, 3 metastatic lesions and two prostate cancer cell cultures (PC1 and PC2) were analysed. The prostatic tissue exhibited varying degrees of membranous, cytoplasmic or membranous/cytoplasmic c-KIT staining. Four normal prostates, 4 PIA and 5 prostatic carcinomas showed positive c-KIT expression. No c-KIT immunoexpression was observed in metastases. Canine prostate cancer and PIA samples contained a higher number of Ki67-positive cells compared to normal samples. The median relative quantification (RQ) for c-KIT expression in normal, PIA and prostate cancer and metastatic samples were 0.6 (0.1-2.5), 0.7 (0.09-2.1), 0.7 (0.09-5.1) and 0.1 (0.07-0.6), respectively. A positive correlation between the number of Ki67-positive cells and c-KIT transcript levels was observed in prostate cancer samples. In the cell line, PC1 was negative for c-KIT protein expression, while PC2 was weakly positive. Conclusion The present study identified a strong correlation between c-KIT expression and proliferative index, suggesting that c-KIT may influence cell proliferation. Therefore, c-KIT heterogeneous protein expression among the samples (five positive and thirteen negative prostate cancer samples) indicates a personalized approach for canine prostate cancer.

Abstract Objectives The aim of the current report is to provide an update in the imaging interpretation of prostate cancer on multiparametric magnetic resonance imaging (mpMRI), with a special focus on how to discriminate pathological tissue from the most common pitfalls that may be encountered during daily clinical practice using the Prostate Imaging Reporting and Data System (PI-RADS) version 2 guidelines. Methods All the cases that are shown in this pictorial review comply with the European Society of Urogenital Radiology (ESUR) guidelines for technical mpMRI requirements. Results Despite the standardised manner to report mpMRI (PI-RADS v. 2), some para-physiologic appearances of the prostate can mimic cancer. As such, it is crucial to be aware of these pitfalls, in order to avoid the under/overestimation of prostate cancer. Conclusions A detailed knowledge of normal and abnormal findings in mpMRI of the prostate is pivotal for an accurate management of the wide spectrum of clinical scenarios that radiologists may encounter during their daily practice. Teaching Points • Some para-physiologic appearances of the prostate may mimic cancer. • Knowledge of normal and abnormal findings in prostate mpMRI is pivotal. • Any radiologist involved in prostate mpMRI reporting should be aware of pitfalls.

Background & Objective: As the prostate adenocarcinoma is one of the most common malignant tumors in males, looking for a marker to effectively predict aggressiveness and metastatic potential in an apparently localized cancer in initial needle biopsy specimens can help the clinicians to make more appropriate decision for treatment, planning, and choosing appropriate targeted therapy. The present study assessed the value of Endothelin-1 expression to predict prognosis of prostatic cancer Methods: In a cross sectional study, 83 patients who underwent radical prostatectomy in Hasheminejad Kidney Center in 2008 through 2012 were assigned to two groups including 43 with and 40 without extra-prostatic extension (EPE). Endothelin-1 staining was performed on Paraffin Embedded blocks of preoperative needle biopsies. Results: The expression of Endothelin-1 increased in 72% of patients in the group with EPE (P

Background: Metastatic prostate cancer (PCa) constitutes ~5% of all new PCa diagnoses in Western countries. For most cases, primary consideration should be given to systemic therapies as the first-line approach based on evidence from randomized controlled trials (RCTs). Despite the importance of RCTs as the pinnacle of evidence in modern medicine, concerns have been raised about their applicability to real-life scenarios. These trials often feature participants who are younger with better performance statuses and prognoses compared to their real-world counterparts. The PIONEER project falls under the Innovative Medicine Initiative's (IMI) "Big Data for Better Outcomes" initiative, aimed at revolutionizing PCa care in Europe. The central focus lies in improving cancer-related outcomes, enhancing health system efficiency, and elevating the quality of health and social care. This study endeavours to evaluate the generalizability of RCT findings concerning newly diagnosed metastatic PCa., Methods: A systematic review of the literature will be conducted to compile patient characteristics from RCTs addressing this subject within the past decade. To create a real-world benchmark, patients with recently diagnosed metastatic PCa from a network of population-based databases will serve as a comparison group. The objective is to assess the applicability of RCT results in two ways. First, a comparison will be made between the characteristics of patients with newly diagnosed metastatic PCa enroled in RCTs and those with the same condition included in our databases which might represent the real-world setting. Second, an evaluation will be undertaken to determine the proportion of real-world patients with newly diagnosed metastatic PCa who meet the criteria for RCT enrolment. This study will rely on extensive observational data, primarily sourced from population-based registries, electronic health records, and insurance claims data. The study cohort is established upon routinely gathered healthcare data, meticulously mapped to the Observational Medical Outcomes Partnership Common Data Model., Competing Interests: No.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background: To assess the variation of multiparametric magnetic resonance imaging (mpMRI) positive predictive value (PPV) according to each patient's risk of clinically significant prostate cancer (csPCa) based exclusively on clinical factors., Methods: We evaluated 999 patients with positive mpMRI (PI-RADS ≥ 3) receiving targeted (TBx) plus systematic prostate biopsy. We built a multivariable logistic regression analysis (MVA) using clinical risk factors to calculate the individual patients' risk of harboring csPCa at TBx. A second MVA tested the association between individual patients' clinical risk and mpMRI PPV accounting for the PI-RADS score. Finally, we plotted the PPV of each PI-RADS score by the individual patient pretest probability of csPCa using a LOWESS approach., Results: Overall, TBx found csPCa in 21%, 51%, and 80% of patients with PI-RADS 3, 4, and 5 lesions, respectively. At MVA, age, PSA, digital rectal examination (DRE), and prostate volume were significantly associated with the risk of csPCa at biopsy. DRE yielded the highest odds ratio (OR: 2.88; p < 0.001). The individual patient's clinical risk was significantly associated with mpMRI PPV (OR: 2.49; p < 0.001) using MVA. Plotting the mpMRI PPV according to the predicted clinical risks, we observed that for patients with clinical risk close to 0 versus patients with risk higher than 90%, the mpMRI PPV of PI-RADS 3, 4, and 5 ranged from 0% to 75%, from 0% to 96%, and from 45% to 100%, respectively., Conclusion: mpMRI PPV varies according to the individual pretest patient's risk based on clinical factors. These findings should be considered in the decision-making process for patients with suspect MRI findings referred for a prostate biopsy. Moreover, our data support the need for further studies to create an individualized risk prediction tool., (© 2023 Wiley Periodicals LLC.)

Copyright of Medical Bulletin of Haseki / Haseki Tip Bulteni is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

African American men have the highest prostate cancer-related mortality nationally. In response to this disparity, targeted interventions are emerging to enhance African American men's prostate cancer (PrCA) knowledge to ensure they are equipped to make informed decisions about PrCA screening with health-care providers. African American men's PrCA knowledge has been measured inconsistently over time with limited psychometric evidence. The factor structure of this construct in African American men is relatively unknown. This study describes the development and psychometric evaluation of an 18-item Prostate Cancer Knowledge Scale among 352 African American men. Exploratory factor analysis (EFA) was conducted using weighted least square mean and variance estimation with Geomin rotation. EFA yielded three factors: PrCA Anatomy and Screening (6 items), Risk Factors (5 items), Warning Signs (7 items) with good internal consistency reliability at KR-20 = .80 for the total scale and .64, .66, and .75, respectively, for each subscale. Factor loadings ranged from .31 to .86. The standardized root mean square residual (0.08) indicated that the factor structure explained most of the correlations. The three-factor, 18-item Prostate Cancer Knowledge Scale demonstrates that PrCA knowledge is a multidimensional construct and has utility for reliably measuring PrCA knowledge among African American men. Future research is required to confirm this factor structure among sociodemographically diverse African Americans. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Prostatic cancer (PCa) is a common cancer in males. Long non-coding RNA (lncRNA) TTN-AS1 has been reported as an oncogene in diverse cancers. This study aimed to explore the functions and mechanism of TTN-AS1 in PCa. MATERIALS AND METHODS: The levels of TTN-AS1 and miR-193a-5p in PCa cells (DU145, PC3, 22RV1, C4-2B, and LNCaP) were measured by qRT-PCR. The putative target of TTN-AS1 was predicted by starBase v2.0 online database, and this interaction was validated by Dual-Luciferase reporter assay. The cell viability and apoptosis rate in DU145 and PC3 cells were assessed by MTT assay and flow cytometry, respectively. The protein levels of CyclinD1, p21, p27, Bcl-2, Bax, and cleaved-caspase3 were detected by Western blot. RESULTS: The relative expression of TTN-AS1 was apparently up-regulated, and the level of miR-193a-5p was strikingly down-regulated in PCa cells. The interaction between TTN-AS1 and miR-193a-5p was predicted by starBase v2.0 online database and verified by Dual-Luciferase reporter assay. The functional experiments indicated that TTN-ASI knockdown or miR-193a-5p inhibited cell viability and induced cell apoptosis rate in DU145 and PC3 cells. Furthermore, the recuperated experiments exhibited that miR- 193a-5p inhibitor counteracted the inhibitory effect on cell viability and the promotion effect on cell apoptosis rate in DU145 and PC3 cells induced by TTN-AS1 silencing. CONCLUSIONS: These data indicated that TTN-AS1 was dramatically up-regulated, and miR-193a-5p was significantly down-regulated in PCa cells. The functional and mechanistical experiments unraveled that lncRNA TTN-AS1 sponged miR-193a-5p to promote cell proliferation and repress cell apoptosis in prostatic cancer, and this new regulatory pathway may shed light on the mechanism of prostatic cancer. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence and prognostic value of ERG in prostatic cancer. The association of ERG status and other clinic-pathologic features were also studied. Materials and Methods: Tissue paraffin blocks of patients who had diagnosis of prostatic acinar adenocarcinoma during 2006 to 2013 at Faculty of Medicine Vajira Hospital were identified. The original H&E stained slides were reviewed to select 2 areas with the most prominent Gleason pattern for tissue sampling. The selected tissue samples were embedded in tissue microarray (TMA) blocks and processed for ERG staining. Intensity and area of positive ERG stain were evaluated independently by two pathologists. Clinico-pathological data collected were age, pre-operative prostate-specific antigen (PSA), tumor stage, PSA biochemical-relapse, and pathological information of peri-neural or lymphovascular invasion, surgical margin, the International Society of Urological Pathology (ISUP) grade group, and Gleason score were collected and analyzed. Results: Among 107 samples, positive ERG staining was found in 31.8% (34 cases). Features which were significantly associated with ERG positive comparing to those in ERG negative were: younger age, 67.7±8.5 years vs. 72.6±8.6 years (p = 0.008); lower Gleason score (6 and 7), 79.4% (27 cases) vs. 20.6% (7 cases) (p = 0.010) and lower ISUP grade group (group 1, 2 and 3), 82.4% (28 cases) vs. 17.6% (6 cases) (p = 0.004), respectively. No significant different association between ERG status and other clinic-pathologic features including survivals. The 5-year overall survival and 5-year disease-free survival (95% confidence intervals) of the patients with ERG positive and negative were: 84.4% (70.1 to 98.7%) vs. 77.1% (66.1 to 88.1%) (p = 0.399) and 77.4% (60.9 to 93.9%) vs. 78.2% (67.6 to 88.8%) (p = 0.571), respectively. Conclusion: The prevalence of ERG-positive in prostate cancer patients was 31.8%. The patients with ERG positive were younger, more of low Gleason score and low ISUP grade group. No significant association between ERG status and other clinic-pathologic parameters as well as survivals were found. [ABSTRACT FROM AUTHOR]

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The aim of this study was to define the pattern of relapse of postoperative prostate cancer in patients by using 68Ga-labeled prostate-specific membrane antigen positron-emission tomography/computed tomography ([68Ga]-PSMA PET/CT). Forty patients received a (68Ga)-PSMA PET/CT for biochemical failure. Following the Radiation Therapy Oncology Group (RTOG) guidelines, the pelvic clinical target volume has been contoured. Bone metastases were considered as outside the clinical target volume. Two subgroups of patients were defined, patients having relapse: (1) inside, or (2) outside the clinical target volume. Globally, eight patients out of 32 presented with a positive lymph node failure inside the clinical target volume according to RTOG guidelines (25%), 22 patients had nodal relapses outside this clinical target volume (68.75%) and in two patients nodal relapses occurred both inside and outside of the clinical target volume (6.25%). Overall, 36 positive lymph node lesions were identified: of these, 23 nodal relapses were identified within the clinical target volume contoured according to RTOG and/or at the lomboaortic level (63%). To cover 95% of these 23 relapses, a hypothetical clinical target volume should encompass the nodal regions of the RTOG-defined clinical target volume as well as the paraaortic lymph node level up to T12-L1. Most of the patients in the present study, presented with distant lymph node and/or bone metastases. Therefore, larger target volumes should be adopted to treat at least 95% of lymph node regions at risk for an occult relapse. [ABSTRACT FROM AUTHOR]

Background: Worldwide prostate cancer is the most common cause of cancer and the second leading cause of cancer death among men. Transrectal ultrasound-guided core needle biopsies are the diagnostic modalities which help in proper categorization and grading of prostatic carcinoma, thus facilitating individualized treatment. These biopsies are the primary source for performance of additional diagnostic immunohistochemical testing for basal cell-associated markers to rule out the morphological mimicker and prognostic markers such as androgen receptor (AR) and human epidermal growth factor receptor 2 (HER2)/neu. Materials and Methods: A prospective, observational study was conducted in the department of pathology in collaboration with department of urosurgery of a tertiary care hospital. One hundred and nineteen patients diagnosed with prostatic nodules were included in this study. Values of serum prostate-specific antigen were recorded. Tissue for histopathological study was obtained in the form of core needle biopsy, and Gleason grade was calculated in all malignant cases. Immunohistochemistry for p63 and alpha-methylacyl-CoA racemase was performed as an additional test in premalignant cases. Prognostication of the prostate cancer cases was done using AR and HER2/neu. Results: A total of 119 cases aged between 20 and 90 years were included in this study. Malignant lesions reveal an increase in the percentage of AR staining in comparison to the benign glandular structure. The Gleason score with higher value (8-9) showed increased expression of HER2/neu receptor. Conclusion: Critical histopathological analysis of core needle biopsy along with immunohistochemical evaluation maximizes the diagnostic accuracy in prostate cancer cases and also helps in prognosis assessment. [ABSTRACT FROM AUTHOR]

The histopathologic diagnosis of prostate cancer (PCa) from biopsies is a current challenge if double or triple staining is needed. Therefore, there is an urgent need for development of a new reliable biomarker to diagnose PCa patients. We aimed to explore and compare the expression of TMTC4 in PCa cells and tissue specimens and evaluate its sensitivity and specificity. The expression of TMTC4 in PCa and normal prostate epithelial cells was determined by real-time PCR and Western blot analyses. Immunohistochemical (IHC) staining of TMTC4 was performed on tissues collected from PCa and benign prostatic hyperplasia (BPH). Our results show a high expression of TMTC4 on mRNA and protein levels in PCa versus BPH1 and normal cells (p < 0.05). IHC results show strong cytoplasmic expressions in PCa cases (p < 0.001) as compared to BPH cases. The overall accuracy as measured by the AUC was 1.0 (p < 0.001). The sensitivity and specificity of the protein were 100% and 96.6%, respectively. Taken together, we report a high TMTC4 expression in PCa cells and tissues and its ability to differentiate between PCa and BPH with high sensitivity and specificity. This finding can be carried over to clinical practice after its confirmation by further studies.

Background: The aim of this study was to analyze the differences between TRUSguided transrectal prostate biopsy (TR) and transperineal prostate biopsy (TP) in the diagnosis of prostate cancer. The two biopsy methods were evaluated in terms of diagnostic sensitivity and of early and late complications. Methods: This retrospective study was realized through the review of clinical records of 219 men that received a prostate biopsy between 2004 and 2014. The biopsy was performed because of elevated prostate-specific antigen (PSA), abnormal digital rectal examination findings (DRE), abnormal transrectal ultrasound (TRUS) findings and symptoms due to prostate diseases. The cohort study was subdivided in two groups: 108 patients received a transrectal biopsy between 2004 and 2006 and 111 received a transperineal biopsy between 2007 and 2014. In both groups, first biopsy was performed with 12 cores scheme whereas second or third biopsy were performed with 18 cores scheme; in this study we excluded patients who underwent to biopsies with different number cores to reduce the bias. Both groups were evaluated on the basis of age, total PSA, PSA ratio (F/T), DRE/TRUS findings, presence/absence of low urinary tracts symptoms (LUTS), presence/absence of benign prostatic hyperplasia (BPH), histologic findings of biopsy cores and immediate/postoperative complications. Then, it was evaluated the overall cancer detection rate and the stratified cancer rate on the basis of the previous reported parameters. Finally, we analyzed the early and late complication rate in both groups. U Mann-Whitney test was used to evaluate the quantitative variables and χ2-test or Fisher exact test for qualitative variables. p < 0.05 was considered statistically significant. Results: 66 cancers were detected in 219 patients of the study; 29 cancers were detected in the TP group and 37 in the TR group. There were no statistically significant differences in the overall cancer rate detected in both groups (26.13% e 34.26% respectively; p = 0.190). However, TP biopsy detected more cancers at first biopsy than TR biopsy (89.7% vs 78.4% respectively; p = 0.021). Moreover, TP biopsy detected more cancers in those patients with low cancer suspect (PSA < 4 ng/ml, F/T > 15%, negative TRUS), instead TR biopsy had more sensitivity in detecting cancer in those patients with high cancer suspect (PSA > 10 ng/ml, F/T < 15%, TRUS with abnormal lesions). The presence of BPH did not influence sensitivity in both cases. There were no significant differences in the early complication rate whereas a statistically significant difference was observed in the late complication rate (4% vs 11% in TP and TR biopsy, respectively; p = 0.019). Conclusions: No statistically significant differences in sensitivity were observed between TP and TR biopsy, but TP biopsy detected more cancers at first time biopsy. Complications rate was lower in the TP group. Therefore, we conclude that the Urologist has the final choice in deciding the most appropriate biopsy technique, considering sensitivity and complications.