转移性激素敏感性前列腺癌外周血AR-V7表达与治疗后PSA动力学的关系研究

目的 评估转移性激素敏感性前列腺癌(mHSPC)患者外周血AR-V7表达水平与雄激素剥夺治疗(ADT)后PSA动力学指标的关系。方法 选取2020年6月至2021年10月在我院新诊断的mHSPC患者57例,患者通过外周血进行AR-V7检测并接受ADT治疗。根据AR-V7检测结果将样本分为AR-V7检出组和未检出组,分析治疗后3个月及6个月时的PSA下降速率(PSADR)和PSA百分比下降速率(PSAPDR)。将样本进行亚组分析,分别分析检出组和未检出组中使用阿比特龙和使用比卡鲁胺患者的PSADR和PSAPDR,并分别分析在使用阿比特龙和使用比卡鲁胺患者中检出AR-V7与未检出AR-V7的PSADR和PSAPDR。结果 AR-V7检出组(30例,52.63%)和未检出组(27例,47.37%)在治疗后3个月时的中位PSADR[1.91(0.69,4.56) vs 3.27(1.65,7.22),P=0.042]和中位PSAPDR[1.08%(1.02%,1.11%) vs 1.10%(1.08%,1.14%),P=0.013],差异都具有统计学意义。但在6个月时两组患者中位PSADR[0...     

性激素对裸鼠移植性人前列腺癌（PC－3m）生长和雄激素受体水平的影响

用己烯雌酚（ＤＥＳ）和不同剂量的丙酸睾丸素（ＴＰ）治疗移植于裸鼠体内的雄激素非依赖性ＰＣ－３ｍ前列腺癌肿瘤模型，并以放射配体结合分析测定肿瘤的雄激素受体（ＡＲ）水平，治疗结束时测量瘤重和瘤体积。ＤＥＳ组的瘤重、瘤体积和ＡＲ水平与对照组的相比，差异不显著，说明ＤＥＳ对肿瘤的生长无明显抑制作用。与对照组的相比，低剂量ＴＰ（５０ｍｇ／ｋｇ）组的瘤重、瘤体积和ＡＲ水平显著增高（Ｐ＜０．０１）；而高剂量ＴＰ（４００ｍｇ／ｋｇ）组的瘤重、瘤体积和ＡＲ水平则显著降低（Ｐ＜０．０１）。这说明丙酸睾丸素对裸鼠体内ＰＣ－３ｍ前列腺癌的生长具有双相效应，即低剂量ＴＰ促进肿瘤的生长，高剂量ＴＰ抑制肿瘤生长。肿瘤的生长受到促进还是抑制可能与雄激素水平、ＡＲ水平的高低有关，低剂量、高剂量ＴＰ各自所具有的促瘤和抑瘤作用可能分别通过升高或降低肿瘤的ＡＲ水平这一环节来实现。     

多西他赛对小鼠肺转移黑色素瘤抑制作用的研究

目的 探讨多西他赛(多西紫杉醇)对小鼠B16-F10黑色素瘤肺转移的抑制作用.方法 MTT法检测多西他赛对小鼠B16-F10细胞生长能力的影响;细胞粘附性实验研究多西他赛对小鼠B16-F10细胞粘附能力的影响;体内实验采用C58BL/6小鼠尾静脉注射B16细胞建立实验性肺转移模型,观察腹腔注射多西他赛对小鼠肺组织肿瘤肺转移结节的影响.结果 20μg/mL多西他赛对小鼠B16-F10细胞的体外生长有一定的抑制作用,并且能够显著降低B16-F10细胞同基质的粘附能力(P＜0.05).15μg/mL、10 μg/mL、20μg/mL的多西他赛24h对小鼠体外B16-F10细胞的抑制率分别是2.34％、16.27％和41.63％.荷黑色素瘤B16-F10肺转移癌小鼠经腹腔注射5μg/mL、10μg,/mL、20μg/mL三个剂量的多西他赛对肿瘤的抑制率分别为42.70％、15.47％和5.45％,高剂量组(20μg,/mL)显示对肺转移黑色素瘤有明显的抑制作用(P＜0.05).结论 多西他赛能够抑制小鼠肺转移黑色素瘤,其机制可能与其对B16-F10细胞的粘附能力和生长能力的抑制作用有关.     

趋化因子及其受体CXCL12/CXCR4在人前列腺癌转移机制中的作用

目的 探讨趋化因子及其受体CXCL12/CXCR4在人前列腺癌转移机制中的作用.方法 免疫组织化学技术分析CXCL12/CXCR4蛋白在18例前列腺癌组织中的表达;免疫细胞化学技术分析CXCL12/CXCR4蛋白在人前列腺癌细胞株PC3、DU145和LNCap中的表达;迁移、侵袭试验分析外源性CXCL12对PC3、DU145和LNCap体外侵袭能力的调节作用.结果 18例人前列腺癌组织中,17例不同强度表达CXCR4蛋白,1例阴性表达,同时除1例标本弱表达CXCL12蛋白外,其余不表达CXCL12蛋白.3种前列腺癌细胞株均表达CXCR4蛋白,不表达CXCL12蛋白.外源性CXCLl2可明显促进PC3、DU145及LNCap的体外迁移、侵袭,以抗CXCL12或CXCR4抗体预处理PC3、LNCap细胞可以拮抗CXCL12对它们的促迁移、侵袭作用.结论 人前列腺癌组织表达CXCR4蛋白,CXCL12/CXCR4信号通路可能参与前列腺癌的侵袭、转移.     

前列腺特异性膜抗原蛋白在正常和肿瘤组织中的表达及其在前列腺癌诊断中的敏感性和特异性

前列腺癌主要是通过淋巴道和血道向远处器官转移，人体几乎任何一个器官均可发生前列腺癌转移，其中骨、肝脏和肺是最常转移的器官。另外，前列腺癌也能够直接侵犯邻近器官如膀胱。当怀疑有前列腺癌转移时，免疫组化被常规用于识别肿瘤来源。前列腺特异性抗原（PSA）和前列腺特异性酸性磷酸酶（PAP）是2种最常使用的免疫标记物，     

前列腺癌患者的血清IL-6、性激素和PSA水平的临床评价

目的:探讨前列腺癌(prostate cancer,PCa)患者血清白介素-6(IL-6)、性激素和前列腺特异性抗原(prostate specific antigen,PSA)的水平及其临床评价.方法:采用化学发光免疫分析法测定了178例前列腺疾病[其中68例PCa,43例前列腺增生(BPH),31例BPH+急性尿潴留(AUR)和36例急性前列腺炎(AP)]患者和60例正常对照组血清IL-6、T、FSH和 LH以及PSA的水平,并同时进行比较性分析.结果:在178例前列腺疾病中,68例PCa患者血清IL-6水平较43例BPH、31例BPH+AUR、36例AP患者和60例正常对照组均明显增高(P<0.01、<0.05、<0.05和<0.01).在性激素分析中,68例PCa患者血清T水平较60例正常对照组明显降低(P<0.01),其他各组均正常(P均 >0.05);68例PCa患者血清FSH水平较60例正常对照组明显增高(P<0.01),43例BPH和36例AP患者均正常(P均>0.05),而31例BPH+AUR患者稍增高(P<0.05);68例PCa患者血清LH较60例正常对照组明显增高(P<0.05),而31例AP患者明显降低,有待进一步探讨.在PSA测定中,68例PCa患者血清PSA较其他前列腺疾病组和60例正常对照组非常明显增高(P均<0.01),在68例PCa患者中,37例骨转移患者的血清IL-6和PSA水平较31例未转移患者明显增高(P分别为<0.01和<0.05),性激素之间无明显差异(P均>0.05).结论:PCa患者血清IL-6、FSH、LH和PSA水平明显增高和血清T明显降低是诊断和鉴别前列腺良恶性疾病的有价值的临床指标,而PCa患者骨转移的典型特点是血清IL-6和PSA水平的增高,但与血清性激素水平无关.     

mTOR抑制剂在去势抵抗性前列腺癌中的研究进展

哺乳动物雷帕霉素靶蛋白(mammalian target of rapamycin,mTOR)是磷脂酰肌醇-3羟基激酶/蛋白激酶B/mTOR(PI3K/Akt/mTOR)信号通路中的关键蛋白,与肿瘤细胞的发生发展存在密切联系,参与肿瘤细胞的侵袭与转移.在去势抵抗性前列腺癌(castration resistant pr...     

Effectiveness of Adding Docetaxel to Androgen Deprivation Therapy for Metastatic Hormone-Sensitive Prostate Cancer in Korean Real-World Practice

PurposeEvidence in favor of adding docetaxel in treatment of metastatic hormone-sensitive prostate cancer (mHSPC) has led to docetaxel in conjunction with androgen deprivation therapy (ADT) as standard therapy. The aim of this study was to examine the effectiveness of docetaxel with ADT for Korean patients with mHSPC in real-world practice.Materials and MethodsA retrospective cohort study was performed at six Korean hospitals for patients with mHSPC treated with docetaxel plus ADT. Patients were treated every 3 weeks for up to six cycles with 75 mg/m² of docetaxel. The primary endpoint was time to castration resistant prostate cancer (CRPC).ResultsThis study included 46 eligible patients from June 2016 to February 2021. Median age was 68.5 years (range, 52–84) and all patients present with de novo M1 with high-volume disease. The median prostate-specific antigen (PSA) level at ADT initiation was 205.4 (7.7–1933) ng/mL, and time from ADT to docetaxel was 2.4 months (0–5.3). All six planned cycles of docetaxel were delivered in 36 patients (78%), 7 patients (15%) discontinued treatment due to adverse events, and 3 patients (7%) discontinued due to progression. At the time of the analysis, CRPC had developed in 34 patients (74%), and the median time to CRPC was 18.0 (95% confidence interval, 14.1–21.9) months. PSA <0.2 ng/mL was achieved in 11 patients (24%) after 6 months of ADT and in 10 patients (22%) after 12 months. At last follow-up, 35 patients (76%) were alive; the median overall survival was not reached.ConclusionThe effect of docetaxel combined with ADT for Korean patients with mHSPC is comparable with prior results in Western studies.     

超声引导下经直肠前列腺穿刺诊断前列腺癌的价值研究

目的 研究与分析超声引导下经直肠前列腺穿刺诊断前列腺癌的价值。方法 选取2015年1月~2017年1月我院收治的疑似前列腺癌患者100例,其中经超声引导下行会阴法穿刺诊断者50例为对照组,经超声引导下行直肠前列腺12点穿刺诊断者50例为观察组。比较分析两组诊断结果以及并发症情况。结果 观察组确诊率为72.00%,高于对照组的42.00%,差异具有统计学意义（P＜0.05）。观察组并发症发生率为8.00%,低于对照组的22.00%,差异具有统计学意义（P＜0.05）。结论 超声引导下经直肠前列腺穿刺诊断前列腺癌具有较高的确诊率,且能有效减少患者各种并发症,并为临床诊断前列腺疾病提供一定依据,值得应用推广。     

Body Composition Alterations,Energy Expenditure and Fat Oxidation in Elderly Males Suffering from Prostate Cancer,Pre and Post Orchiectomy

INTRODUCTION

Testosterone is needed for normal male development, muscle strength, bone mineralization, hematopoietic function, and sexual and reproductive functions. The main purpose of androgen deprivation therapy in prostate cancer is to reduce tumor progression, but therapy is often accompanied by significant adverse effects.

OBJECTIVE

This study aimed to determine the effects of androgen deprivation therapy on body composition and resting metabolic rate in patients with prostate cancer.

PATIENTS AND METHODS

A prospective study was performed to evaluate the body composition of 16 elderly males (aged 63–96; median age 71) with prostate cancer scheduled for orchiectomy, one year before and after surgery. Body composition was measured by DEXA, and energy expenditure, fat and carbohydrate oxidation were measured by indirect calorimetry.

RESULTS

Body weight (p=0.01), lean mass (p=0.004), and lipid oxidation (p=0.001) decreased significantly. Carbohydrate oxidation (p=0.02), FSH (p=0.0001) and LH (p=0.0001) levels increased significantly. Changes in fat mass (p=0.06) and bone mineral density (p=0.48) were not significant.

CONCLUSIONS

After 12 months of androgen deprivation therapy, elderly men with metastatic prostate cancer exhibit a decline in lean body mass and lipid oxidation, together with increased carbohydrate oxidation.     

Race and Time to Receipt of Androgen Deprivation Therapy Among Men With Metastatic Prostate Cancer

BackgroundThe Medicare Modernization Act (MMA) drastically reduced reimbursement for androgen deprivation therapy (ADT) in 2005. One unintended consequence of the MMA may be an increase in the racial disparities in receipt of ADT. Given these policy changes, it becomes increasingly important to assess racial disparities in timely receipt of ADT.MethodsThe purpose of this study is to evaluate the associations between race and median time to receipt of ADT among men with metastatic prostate cancer before and after the passage of the MMA. A population-based retrospective cohort was created from the Surveillance, Epidemiology, and End Results-Medicare.ResultsA total of 1,846 African-American and 9,462 Caucasian men diagnosed with metastatic prostate cancer from 2000 through 2011 were included. An accelerated failure time regression model was used to examine factors associated with racial differences in median time to receipt of ADT. Results indicate that African-American men had a longer median time to receipt of ADT both before the MMA (Time Ratio (TR): 1.15; 95% Confidence Interval (CI) [1.05, 1.27]) and after the MMA (TR: 1.29; 95% CI [1.10, 1.53]) as compared to Caucasian men. In addition to race, men residing in South had longer median time to receipt of ADT (TR: 1.26, 1.52; 95% CI [1.01, 1.52; 1.24, 1.87] before and after MMA, respectively) compared to the Northeast region.ConclusionConsidering the palliative benefits of ADT, it is important to develop effective strategies to address racial differences in receipt of treatment for metastatic prostate cancer.     

糖尿病与结直肠癌患者预后相关研究进展

目前国内外大量研究证实糖尿病是诱发结直肠癌的独立危险因素,其机制与高血糖尧高胰岛素血症尧胰岛素样生长因 子尧胰岛素抵抗等密切相关遥为延长合并糖尿病的结直肠癌患者的生存期,改善患者的生存质量,关于糖尿病与结直肠癌预后 的研究越来越多遥本文就糖尿病与结直肠癌预后相关性的研究进展做一综述遥     

前列腺癌骨转移的疼痛管理

在老年男性中前列腺癌发病率日益增高,晚期骨转移可产生顽固性骨痛,严重影响治疗效果和患者生活质量。对前列腺癌骨转移患者的疼痛管理需要从抗肿瘤治疗和镇痛治疗两方面入手,并防止长期治疗过程中的并发症,全程给予心理治疗。本文从前列腺癌骨转移的治疗入手,对疼痛管理现状作一综述。     

宫颈癌患者生殖道感染的研究进展

宫颈癌是威胁女性身心健康的最常见恶性肿瘤之一。近年来,关于宫颈癌的相关危险因素一直是医学领域研究的热点方向,且宫颈癌与生殖道感染的相关性研究逐渐增多。目前研究表明生殖道感染可能是宫颈癌发生的潜在危险因素,同时阴道微生态失衡在生殖道感染中发挥重要作用。阴道微环境在外界和机体环境中保持一定的动态平衡,当这种平衡遭到破坏,各种生殖道感染就可能发生。生殖道感染与宫颈癌息息相关,本文就宫颈癌与常见的生殖道感染及生殖道感染的微生态状况进行综述。     

前列腺癌患者自我感受负担及其影响因素研究

目的 探讨在调查前列腺癌患者自我感受负担的现状及其相关因素,为临床采取针对性的护理干预措施提供依据,从而提高患者的生活质量。方法 采用一般资料调查表和自我感受负担量表对2014年1月~2017年1月在川北医学院附属医院肿瘤科和泌尿外科就诊的98例前列腺癌患者进行调查。通过询问的方式归纳统计98例研究对象的SPB得分,并对可能影响前列腺癌患者SPB的年龄、婚姻状况、文化程度、家庭人均月收入、疾病临床分期进行单因素分析,观察各影响因素与前列腺癌患者SPB的相关性结果。结果 除去SPB得分＜20分的患者,剩下90.82%的患者存在不同程度的SPB,98例患者的SPB平均得分为（37.16±11.33）分。本组前列腺癌患者在年龄、婚姻状况、家庭人均月收入、疾病临床分期等4个方面的SPB得分对比,差异具有统计学意义（P＜0.05）。结论 前列腺癌患者普遍存在不同程度的SPB,在临床工作中应充分评估影响患者SPB的相关因素,制订有针对性的干预措施,建立良好的护患关系。     

Recent advances in the therapy of castration-resistant prostate cancer: the price of progress

Within the past two years, three agents have garnered approval from the US FDA for the specific treatment of metastatic castration resistant prostate cancer (mCRPC) – (1) abiraterone, (2) cabazitaxel and (3) sipuleucel-T. In separate phase III studies, each agent led to an improvement in overall survival (OS) of 2–4 months over a suitable comparator. With these costly therapies all having potential application in the patient with mCRPC, multiple entities (industry, government, and the general public) must strategize to determine how the cost burden of these agents can be balanced with the potential gains for the individual patient. Herein, we provide a framework with which to approach this dilemma.     

循环肿瘤细胞在肺癌诊疗中的临床研究进展

肺癌现已成为发病率及致死率最高的恶性肿瘤,且呈逐年增高趋势,给人类的身体健康及生命安全带来严重威胁。肺癌的复发与转移是导致患者死亡的最主要原因,可能与循环肿瘤细胞（CTCs）进入血液存在一定关系,CTCs在肺癌患者的早期诊断、治疗指导、疗效评估及预后等方面具有十分重要的作用。本文就CTCs在肺癌诊疗中临床应用及研究进展进行综述。