Is there a link between BPH and prostate cancer?

BPH is one of the most common diseases of older men, with more than 70% of men over 70 years affected, and prostate cancer is the most common cancer in men in the UK. Prostate cancer generally presents in one of three ways: asymptomatic patients who are screened (usually by a PSA test); men with LUTS who are investigated and undergo prostate biopsy; or patients with symptoms of metastasis such as bone pain. Men can be reassured that the main cause of LUTS is BPH. Only a small proportion of men have LUTS that are directly attributable to prostate cancer. Digital rectal examination (DRE) gives an evaluation of prostate size, which is relevant in particular to BPH management, and along with PSA testing it is one of the only ways of differentiating clinically between BPH and prostate cancer. If a nodular abnormality is present there is around a 50% chance of a diagnosis of prostate cancer being made on biopsy. Raised levels of serum PSA may be suggestive of prostate cancer, but diagnosis requires histological confirmation in almost every case. A normal PSA, PSA density and DRE can give reasonable confidence with regards to excluding clinically significant prostate cancer. BPH is not a known risk factor for prostate cancer, although the two frequently coexist. Age is the strongest predictor of prostate cancer risk, along with family history. BPH is not considered to be a precursor of prostate cancer. It is likely that although BPH may not make prostate cancer more likely to occur, it may increase the chance of diagnosing an incidental cancer.     

Hereditary prostate cancer

Familial prostate cancer patients are sometimes encountered. Hereditary prostate cancer is a more specific form of familial prostate cancer that is inherited by a susceptibility gene consistent with Mendelian inheritance. Early age at onset is the most important characteristic. No clear differences in either stage, grade or prognosis have been found between hereditary and sporadic prostate cancer. No susceptibility genes have been isolated yet, but several genes may exist. In Japan, doctors are not generally aware of hereditary and familial prostate cancer. Family history is one of the most important risk factors of prostate cancer. We should make an effort to find prostate cancer patients at an early stage in the high risk families.     

Radical prostatectomy with neoadjuvant hormone therapy for cT3 prostate cancer

The efficacy of neoadjuvant hormone therapy and radical prostatectomy for cT1-2 prostate cancer have been reported to be negative from some randomized prospective studies. On the other hand, radical prostatectomy alone for cT3 prostate cancer is understood as out of indication because of high rate of positive surgical margin and PSA failure. Several investigators have examined the role of neoadjuvant hormone therapy before radical prostatectomy for cT3 prostate cancer to improve outcome. This document was reviewed the literature whether neoadjuvant hormone therapy is beneficial or not, for organ confined prostate cancer and for locally advanced prostate cancer, and presented our extended resection of prostate with neoadjuvant hormone therapy is improved the results in cT3 prostate cancer.     

前列腺穿刺术后感染并发症的研究进展

前列腺癌,顾名思义是发生于前列腺的恶性肿瘤,美国2019年预计前列腺癌新发率20%,位居男性恶性肿瘤之首,死亡率居第二位10%[1]。近年来我国前列腺癌的发病率逐年增高,国内对于前列腺癌的认识以及科普工作的不足导致许多基层老龄人口对前列腺癌的认知程度几乎为零,因而早期确诊和治疗前列腺癌对于患者的生存就显得尤为重要。目前我国人口老龄化问题与世界上许多国家地区一样逐年升高,人口结构的巨大改变,前列腺癌的发病及诊出率越来越高,因此前列腺癌又被冠以"老年男性头号杀手"的称号,并且有资料统计我国的前列腺癌增长速度比欧美发达国家更为迅速[2]。症状出现较晚是前列腺癌的一个显著的临床特点,早期患者可无明显症状或者仅有一些前列腺增生的临床表现,部分患者疾病已进入了晚期才会出现如骨痛、血尿等明显症状,此时已经不能通过手术方法治愈肿瘤了,患者也已失去了最佳的治疗时机。因此前列腺癌如果不能被早期诊断,患者往往会遭受较大的痛苦,进而危及生命。     

Computer-aided diagnosis of prostate cancer with emphasis on ultrasound-based approaches: a review

This paper reviews the state of the art in computer-aided diagnosis of prostate cancer and focuses, in particular, on ultrasound-based techniques for detection of cancer in prostate tissue. The current standard procedure for diagnosis of prostate cancer, i.e., ultrasound-guided biopsy followed by histopathological analysis of tissue samples, is invasive and produces a high rate of false negatives resulting in the need for repeated trials. It is against these backdrops that the search for new methods to diagnose prostate cancer continues. Image-based approaches (such as MRI, ultrasound and elastography) represent a major research trend for diagnosis of prostate cancer. Due to the integration of ultrasound imaging in the current clinical procedure for detection of prostate cancer, we specifically provide a more detailed review of methodologies that use ultrasound RF-spectrum parameters, B-scan texture features and Doppler measures for prostate tissue characterization. We present current and future directions of research aimed at computer-aided detection of prostate cancer and conclude that ultrasound is likely to play an important role in the field.     

Prostate cancer – presentation,diagnosis and treatment: what does the literature say?

Although previously known as the Cinderella of cancers, in recent years, prostate cancer has become a significant public health problem with considerable social and economic consequences. It is currently the most commonly diagnosed male cancer in the UK and is second only to lung cancer as a cause of male cancer deaths. In this literature review, evidence‐based literature related to the anatomical, diagnostic and therapeutic perspective of prostate cancer is presented. Associated areas of controversy related to prostate cancer are also fully discussed. It is essential that urology nurses have a strong foundation in their knowledge related to these aspects of prostate cancer. Only when they have this knowledge in their armoury are they able to confidently help patients make informed choices and participate in shared decision‐making regarding their care. This should help ensure that urology nurses rise to the challenge of providing patients with prostate cancer with high quality care by helping these patients through the minefield of information associated with prostate cancer.     

Prostate cancer. Introduction

Basic, epidemiological and clinical issues to be solved on prostate cancer were discussed as a preface. Sharp increase of prostate cancer incidence in Asian countries, almost constant level of latent cancer are intriguing epidemiological and pathological issues. Treatment of locally advanced prostate cancer, hormone-refractory prostate cancer has been a long-standing clinical challenge. New radiotherapy is expected for further advancement. Heterogeneity, clonility, multiplicity of prostate cancer are interesting pathological challenges.     

Barriers to prostate cancer screening

The revised prostate cancer screening guidelines of the American Cancer Society recommend that men be informed of the risks associated with prostate cancer screening. However, there are no published studies on men's fear of impotence and its impact on prostate cancer screening. In addition, little is known about barriers to prostate cancer screening when the two main barriers of cost and lack of knowledge are eliminated. This study reports the association between barriers and free prostate cancer screening after a prostate cancer education program. All men were called 1 month after a prostate cancer education program and asked: "What would (or did) make it hard for you to get your prostate checkup done?" A total postbarrier score was created to measure how many barriers each man indicated. The following barriers were significant in predicting participation in prostate cancer screening: "put it off," "doctor hours not convenient," "didn't know kind of doctor," "didn't know where to go," and "refuse to go." Fear of impotence was not a significant barrier. Suggestions for reducing barriers to prostate cancer screening are given.     

The efficacy of transrectal ultrasound and prostate cancer

An increased interest in the diagnosis and treatment of prostate cancer, particularly in the last few years, is reflected in the literature. Numerous articles have been published since 1980 on the subject of imaging of the prostate gland. This article is a review of transrectal ultrasound and its efficacy in the diagnosis and treatment of prostate cancer. Included is a review of the normal prostate anatomy, typical and atypical sonographic features, clinical and radiographic staging of prostate cancer, efficacy of the digital rectal examination, role of ultrasound in prostate cancer screening, surgical treatment, and radiotherapy of prostate cancer.     

高强度聚焦超声治疗特殊前列腺癌的现状及进展

前列腺癌现已成为危害男性健康的常见泌尿系统肿瘤之一,我国前列腺癌的发病率不断上升。前列腺癌的治疗已成为目前的热门话题。高强度聚焦超声（high intensity focused ultrasound, HIFU）是一种将超声聚焦形成高能量的焦域从而杀灭靶组织新技术。HIFU在一些报道中已单独用来治疗早期局限性前列腺癌,疗效确切。同时,HIFU对于几种特殊的前列腺癌,如激素非依赖性前列腺癌、放疗后复发前列腺癌以及HIFU治疗后复发的前列腺癌也起到了一定的作用。      

Interest in genetic prostate cancer susceptibility testing among african American men

Six regions for prostate cancer genes have been identified, and it is anticipated that prostate cancer susceptibility testing will be available in the future. This correlational study identified predictors for interest in prostate cancer susceptibility testing among African American men. Participants were 320 African American men from the African American Hereditary Prostate Cancer Study and the South Carolina Prostate Cancer Education and Screening Study participated. Two questions measured interest in genetic prostate cancer susceptibility testing and family history of prostate cancer. Chi-square analyses by family history as well as demographics (age, education, marital status) were performed. Most of the men (277 [87%]) indicated an interest in genetic prostate cancer susceptibility testing. Interest in undergoing testing did not vary by family history, age, or education. Marital status was the only significant demographic predictor. Men who were married were significantly more likely to respond with a "yes" to interest in prostate cancer susceptibility testing than were men who were not married. The high "yes" response rate and the men's confusion between the genetic prostate cancer susceptibility testing and prostate cancer screening highlight the need for public education once prostate cancer genes are identified and available for public testing.     

磁共振波谱成像在前列腺癌中的应用

前列腺癌在男性已成为第二个最常见的被诊断的癌症。前列腺癌的早期检测对该病的治疗尤为重要。有许多方法来检测前列腺癌。MR波谱成像(MRS)可较好地早期检测前列腺癌。作者将讨论MRS的原理,前列腺癌的不同诊断前方法,以及目前已应用于临床的不同的机器和设备。     

应用磁珠联合MALDI-TOF MS技术建立前列腺癌血清差异蛋白诊断模型

  目的  应用蛋白组学技术对前列腺癌血清差异蛋白进行筛选, 并建立前列腺癌诊断模型。  方法  2010年3月至5月间于北京协和医院泌尿外科病房采集12例前列腺癌患者及11例非前列腺癌对照者血清样本, 应用弱阳离子磁珠联合基质辅助激光解吸电离飞行时间质谱(matrix-assisted laser desorption/ionization time of flight mass spectrometry, MALDI-TOF MS)技术对前列腺癌患者和对照者血清进行差异蛋白研究, 筛选出多个前列腺癌血清差异蛋白, 并应用ClinProTools 2.2软件通过遗传算法建立诊断模型。  结果  共筛选出前列腺癌与对照组之间差异蛋白峰126个, 具有较明显差异的蛋白峰24个(P=0.178)。通过遗传算法优化选择, 筛选出符合条件的15个差异蛋白峰建立诊断模型, 交叉验证准确性为81.82%, 识别能力为100%。  结论  应用磁珠联合MALDI-TOF MS技术及遗传算法成功建立前列腺癌血清差异蛋白的诊断模型, 该模型识别能力高, 有助于减少前列腺癌的漏诊率。     

经直肠超声引导下前列腺穿刺活检临床分析

目的探讨经直肠超声引导下前列腺穿刺活检阳性率的临床影响因素。方法回顾性分析1996至2009年解放军总医院行经直肠超声引导下前列腺穿刺活检的2 364例患者的临床资料。结果 （1）1996至2009年解放军总医院经直肠超声引导下前列腺穿刺活检阳性率逐年升高。（2）年龄≥80岁的患者前列腺癌检出率高达46.73%（143/306）;年龄〈50岁的患者前列腺癌检出率较低,仅为16.22%（12/74）。（3）前列腺特异性抗原（PSA）浓度≤4、4~、10~、20~、50~、〉100μg/L的患者前列腺癌检出率分别为16.12%（49/304）、26.01%（129/496）、33.80%（195/577）、47.15%（174/369）、78.23%（97/124）、95.06%（154/162）。随着患者PSA浓度的上升,前列腺癌检出率逐渐增高。（4）前列腺体积≤20 ml的患者前列腺癌检出率为37.14%（55/147）;前列腺体积为20~30 ml的患者前列腺癌检出率为48.06%（173/360）;前列腺体积为30~40 ml的患者前列腺癌检出率最高,为50.84%（181/356）;而后随着患者前列腺体积的增大,前列腺癌检出率逐渐降低。（5）前列腺癌患者（n=285）游离PSA/总PSA（f/t PSA）低于非前列腺癌患者（n=431）（0.14±0.11 vs 0.19±0.11）,而PSA密度（PSAD）高于非前列腺癌患者（0.70±0.68 vs 0.25±0.32）,且差异均有统计学意义（t=3.969、7.219,均P〈0.05）。结论经直肠超声引导下前列腺穿刺活检阳性率可受多种因素如年龄、PSA浓度、前列腺体积、f/t-PSA与PSAD的影响,联合检测对前列腺癌的临床诊断有重要的价值和意义。     

Comparison of the percent free prostate-specific antigen levels in the serum of healthy men and in men with recurrent prostate cancer after radical prostatectomy

The percentage of free PSA in serum is currently used to better discriminate between patients with prostate cancer and patients with benign prostatic hyperplasia, in prostate cancer screening programs. We measured using non-competitive immunological techniques, the total PSA and free PSA in post-surgical serum of prostate cancer patients who underwent radical prostatectomy and then relapsed. We compared these data with those of a group of 40 age-matched men with no evidence of prostatic disease. Although in general, patients with prostate cancer had lower percentage of free PSA in serum in comparison to the controls, a subset of these patients (approximately 20%) had percent free PSA significantly higher than the levels considered as exclusive of prostate cancer in screening programs. We also found that percent free PSA does not correlate significantly with most of the standard clinical or pathological indicators of prostate cancer aggressiveness. Only a weak negative association with Gleason Score was observed. The percent free PSA in serum of relapsing prostate cancer patients varies within a relatively wide range and does not correlate significantly with indicators of cancer aggressiveness. The use of percent free PSA for excluding prostate cancer in screening programs must be approached with caution until the mechanism of low percent free PSA in the majority but not all prostate cancer patients is elucidated.     

长链非编码RNA 在前列腺癌治疗抵抗中作用机制的研究进展

前列腺癌（prostate cancer，PCa）是男性泌尿系统中最常见的恶性肿瘤，早期临床表现相对隐匿，不易诊断，中晚期常伴远处转移，预后较差。目前，治疗抵抗是临床治疗前列腺癌患者的主要难题，也是患者复发率高、预后差的重要原因。近年研究显示，长链非编码RNA（long non-coding RNA，LncRNA）与前列腺癌治疗抵抗密切相关，参与前列腺癌内分泌治疗药物耐药、化疗抵抗、免疫耐受和放疗抵抗，有望成为前列腺癌治疗抵抗的新靶标。因此，该文就LncRNA 在前列腺癌治疗抵抗中的发生机制和潜在的临床应用作一综述，为解决前列腺癌治疗抵抗提供新思路。     

PEBP4 silencing inhibits hypoxia-induced epithelial-to-mesenchymal transition in prostate cancer cells

Hypoxia induced epithelial-to-mesenchymal transition (EMT) to facilitate the tumor biology. Phosphatidylethanolamine-binding protein 4 (PEBP4) is a member of the PEBP family and has been reported to be upregulated in various cancer types. The definite function of PEBP4 in regulating the EMT of prostate cancer, however, is still unclear. Here, we examined the functional role of PEBP4 and the underlying molecular mechanisms in hypoxia-induced EMT in prostate cancer cells. Our results showed that PEBP4 mRNA and protein expression was markedly increased in the human prostate cancer tissues and cell lines. Knockdown of PEBP4 significantly inhibited hypoxia-induced migration/invasion and EMT program. Furthermore, knockdown of PEBP4 prevented hypoxia-induced the expression of p-Akt and p-mTOR in prostate cancer cells. Taken together, this study reported here provided evidence that knockdown of PEBP4 inhibited hypoxia-induced EMT in prostate cancer cells. Our study uncovered a novel role for PEBP4 in prostate cancer progression, which might support the potential for PEBP4 targeting in prostate cancer therapy.     

Advances in Transrectal Ultrasound Imaging of the Prostate

Grayscale imaging of the prostate is the basic method for diagnostic evaluation and biopsy guidance. Doppler imaging may improve sensitivity for detection of prostate cancer. Microbubble contrast agents represent a major advance to more selectively demonstrate neovascular flow within the prostate. Recently, real-time elastography has been introduced to improve detection of cancer based upon changes in tissue stiffness. As diagnostic methods improve, the ultimate hope is to eliminate biopsy in patients without cancer. New ultrasound-based treatment systems, such as high-intensity focused ultrasound ablative therapy for prostate cancer, may someday allow diagnosis and treatment of prostate cancer to be completed in one sitting.     

前列腺癌分子影像学诊断与治疗进展

前列腺癌严重威胁着男性健康,近年来我国前列腺癌的发病率也迅速增加,早期发现前列腺癌对于提高生存率具有十分积极的意义。目前各前列腺癌指南中仍需通过超声引导下的前列腺活检确诊,再通过主动监测、根治性切除术、放疗及局部放疗等手段进行治疗。但前列腺活检增加了尿潴留、血尿等不必要的风险,还会遗漏多达1/3的癌组织,且目前的治疗方法因缺乏特异性而对患者进行过度或不足的治疗。近年来,对前列腺癌的诊断和治疗已经迈入分子水平,通过分子影像学进行无创精准的诊断和治疗展现出巨大的发展前景。本文将从核医学分子成像、MR分子成像、光学分子成像、超声分子成像4种常见分子影像学技术在前列腺癌的应用进展进行回顾并作一综述。      

Measurement of quality of life in men with prostate cancer

Prostate cancer continues to be one of the most common cancers diagnosed in men. In light of the excellent survival rates for prostate cancer, quality of life is a primary concern during and following prostate cancer treatment. Quality of life is defined and determined in multiple ways. This article explores quality of life in men with prostate cancer. Quality-of-life dimensions, measurement tools, and implications of quality of life with prostate cancer on clinical practice for oncology nurses will be presented.