前列腺癌与良性前列腺增生患者血清细胞因子差异的蛋白质组学研究

目的:探讨前列腺癌与BPH患者血清细胞因子的差异,为前列腺癌的早期诊断提供血清蛋白质组学依据。方法:应用细胞因子抗体芯片技术,对12例PSA在灰度范围内、经穿刺活检证实的前列腺癌和BPH患者的血清进行细胞因子芯片检测。结果:筛选出19种有明显差异表达的蛋白质(差异>1.5倍),其中前列腺癌组表达明显上调的有IL-3、IL-6、IL-16等16个细胞因子,表达明显下调的有Fas/TNFRSF6、TRALR-3、IGFBP-6等3个细胞因子。其中多个蛋白与细胞的转录、增殖、信号转导和细胞凋亡等生物过程有关。结论:细胞因子抗体芯片技术能够对较小血清样本同时检测多个指标,能够筛选出与癌细胞生物学行为密切相关的"关键细胞因子",有助于寻找用于前列腺癌早期诊断、判断疗效和预后的分子标志物。     

Kallikrein 10基因在前列腺癌组织中的表达及意义

目的：探讨Kallikrein10（KLK10）基因在不同前列腺组织中的表达情况。方法：采用荧光定量PCR方法检测3例正常前列腺组织、5例BPH组织、6例前列腺癌细胞株、35例前列腺癌组织中KLK10mRNA的表达水平。结果：正常前列腺组织、良性前列腺增生组织、前列腺癌细胞株、前列腺癌组织KLK10 mRNA表达相对值分别为0．521、0．487、0．021、0．018,组间比较差异有统计学意义（P〈0．01）。骨转移前列腺癌与未转移前列腺癌KLKIOmRNA表达相对值分别为0．003、0．023,两组比较差异有统计学意义（P〈0．05）。结论：KLK10在前列腺癌组织中表达下调,在转移性前列腺癌中表达更低。KLK10表达下调可促进肿瘤的发生与进展。     

Effects of the Bowman-Birk inhibitor on growth, invasion, and clonogenic survival of human prostate epithelial cells and prostate cancer cells

BACKGROUND: The Bowman-Birk inhibitor (BBI) is a soybean-derived serine protease inhibitor with demonstrated anticarcinogenic activity in both in vitro and in vivo systems. METHODS: The effects of BBI and BBI Concentrate (BBIC), a soybean concentrate enriched in BBI, on cell growth, invasion, and/or survival were evaluated by the sulforhodamine B assay, a colony formation assay, the trypan blue dye exclusion assay and an in vitro invasion assay. The cells used in these studies were normal human prostate epithelial cells and prostate epithelial cell lines derived from embryonic prostate tissue (267B1) or benign prostatic hyperplasia (BPH) tissue (BRF-55T) and human prostate cancer cells established by Ki-ras oncogene transfection of 267B1 cells (267B1/Ki-ras) or from metastatic lesions of human prostate cancer (LNCaP and PC-3). RESULTS: BBIC had a statistically significant inhibitory effect on the growth and clonogenic survival of BRF-55T, 267B1/Ki-ras, LNCaP, and PC-3 cells. BBI also inhibited the growth of LNCaP cells and the clonogenic survival of BRF-55T and 267B1/Ki-ras cells and decreased the ability of LNCaP cells to invade across reconstituted basement membrane (Matrigel) when PC-3 cell-conditioned medium was utilized as the chemoattractant. BBI or BBIC did not affect the growth of normal prostate epithelial cells. CONCLUSION: BBI and/or BBIC could be a useful agent for treatment of prostate diseases.     

TRPC6在人良性与恶性前列腺组织中的表达

观察瞬时受体电位通道C6（TRPC6）在人良性与恶性前列腺组织及前列腺癌细胞系中的表达,进一步探讨TRPC6的表达与前列腺癌分期、分级及激素依赖性的关系。利用免疫组织化学技术,检测发现45．0％的前列腺增生和86．6％的前列腺癌病例表达TRPC6,两者比较有显著性差异沪〈0．01）。TRPC6的表达与前列腺癌分级和前列腺外转移有关（P〈0．01）。前列腺癌分期增高,TRPC6表达增多,但在T2、T3和DT4期肿瘤病例中,TRPC6表达无显著差异。此外TRPC6在激素依赖性前列腺癌与激素非依赖性前列腺癌中的表达也无显著差异。应用RT-PCR及Westernblot,检测到TRPC6在前列腺癌细胞系中的表达。本研究发现,TRPC6在良性与恶性前列腺组织及前列腺癌细胞系中表达。TRPC6的表达与前列腺癌的组织分级、Gleason评分及前列腺外转移有关。     

The influence of finasteride on the volume of the peripheral and periurethral zones of the prostate in men with benign prostatic hyperplasia

To determine the influence of androgen deprivation induced by the potent 5α-reductase inhibitor finasteride on the volume of the zones of the prostate, 20 symptomatic men with established BPH were randomized to one of three groups: placebo, finasteride 1 mg, and finasteride 5 mg/day. The volume of the entire prostate gland, periurethral zone, and peripheral zone and the seminal vesicles were determined by three dimensional reconstructions of magnetic resonance contoured images of the prostate. There was no significant difference between the results achieved with 1 and 5 mg of finasteride per day; thus the results in these two groups were combined. In the placebo group there was no significant change in the volume of any structure. Following treatment for 1 year with finasteride there was a significant (P <0.02) 17% decrease in total gland size (11.5 ± 3.2 cc). Similarly, there was a significant (P <0.03) decrease in the size of the periurethral zone of the prostate (6.2 ± 3 cc). Although there was also a decrease in the size of the peripheral zone of the prostate (2.8 ± 1.2 cc) this did not reach statistical significance. There was no significant change in the volume of the seminal vesicles. These findings indicate for the first time that androgen deprivation induces a significant decrease in the size of the periurethral zone of the prostate in men with established BPH. © 1993 Wiley-Liss, Inc.     

Caspase-3在前列腺组织中的表达和意义

目的 研究Caspase-3在良性前列腺增生(BPH)和前列腺癌(Pca)组织中的表达,了解Caspase-3在BPH和Pca发病及细胞凋亡中的作用。方法 30例BPH组织、22例Pca组织及7例正常前列腺石蜡切片组织用多克隆抗体Caspase-3行LSAB免疫组化染色,按表达的阳性率分0(阴性)、1 (<25％)、2 (25％～75％)、4 (>75％)统计染色等级。结果Caspase-3在93％(28/30)BPH组织有不同程度的表达(0～3 ),主要在分泌性上皮和基底细胞表达,而在基质平滑肌罕见表达,且BPH上皮表达明显少于正常组织。Capase-3在22例Pca组织表达阳性率为100％,普遍表达强阳性(4 ),且明显多于非癌性组织,Caspase-3表达与Pca病理分级无相关。结论 Caspase-3表达异常与BPH上皮与基质增生有关;Caspase-3在国人Pca细胞凋亡中有重要作用。     

MRS对可疑前列腺癌鉴别诊断价值的研究

目的探讨3.0T三维磁共振波谱成像(MRS)影像学检查对可疑前列腺癌患者鉴别诊断的价值。方法收集2013年1月至2014年4月在本院就诊怀疑前列腺癌并行MRI及MRS检查患者的临床资料,根据病理结果分为前列腺癌(Pca)组、前列腺增生(BHP)组。观察两组患者MRS参数胆碱(Choline,Cho)+肌酸(Creatine,Cre)/枸橼酸盐(Citrate,Cit)值(CC/C),并与病理Gleason评分(G)对照;评估MRS对Pca诊断效能,分析CC/C值与病理分级的关系。结果 32例Pca的CC/C平均值为2.52±1.42,而52例BHP的为0.70±0.77(P0.01),MRS对前列腺癌诊断效率:灵敏度87.5%、特异度86.3%、阳性预测值80%、阴性预测值91.6%;G≤7患者CC/C平均值为1.81±1.09,G7患者为3.38±0.98(P0.01)。结论 MRS的应用有助于对可疑前列腺癌患者进行鉴别诊断,且其参数对前列腺癌病理分级有参考意义。     

Natural history of human prostate gland: Morphometric and histopathological analysis of Japanese men

BACKGROUND: To clarify the pathology of the development of prostatic disorders such as inflammation, cancer, and hyperplasia, we compared histopathological findings of the prostate according to age group. METHODS: Whole-mount sections of prostates were used to assess the relationship between age and prostate weight (n=962), prostate histological composition in the transition zone (TZ) and in the peripheral zone (PZ) (n=68), prostate histopathological findings by zone (n=102), and comparison of latent tumor development by age group (n=1,815). RESULTS: A rapid increase in prostate weight from birth to the 20s was followed by a slow rise thereafter. Volume increases (P<0.01) were observed in all components of glandular epithelium, glandular lumen, and stroma in the TZ from the 40s to 70s inclusive. In the PZ, the epithelial and stromal volumes tended to decrease in an age-dependent manner (P<0.05). Calculi and lymphocyte infiltration were detected at a relatively early age, with a tendency towards an age-dependent increase. Glandular dilation and nodular hyperplasia were noted first in the 30s group, also with a tendency towards age-dependent increase. Latent tumors were first detected in the 30s group (5.6%), and slowly increased thereafter. CONCLUSIONS: There was an age-dependent trend towards prostate glandular dilation and prostate enlargement with inflammation. It was demonstrated that tumor and hyperplasia have a long natural history, usually starting in the fourth decade of life, accompanied by dynamic changes with age in glandular tissue composition as well as cell proliferation activity.     

前列腺神经内分泌细胞与前列腺疾病的关系

前列腺神经内分泌细胞(NECs)是一种非常独特的细胞,它不仅具有神经细胞的特性,同时还具有内分泌细胞和上皮细胞的特性。前列腺组织中存在的少量NECs能分泌神经内分泌肽,参与组成神经内分泌调节系统,通过内分泌、旁分泌、自分泌等多种形式,对前列腺的发育和生长分化及内分泌起着调节作用。在前列腺疾病,如慢性前列腺炎、前列腺增生及前列腺癌的发生、发展及转归中,NECs均起到重要作用。尤其是NECs缺乏雄激素受体,在去势治疗时仍可继续生长,可能通过旁分泌的方式促进肿瘤雄激素非依赖性增值,引起肿瘤复发。本文就近年来对NECs分泌的各种细胞因子及受体进行鉴定、深入研究的进展做一综述。     

良性前列腺增生症与阴茎勃起功能障碍的相关性研究

目的探讨良性前列腺增生症(BPH)与阴茎勃起功能障碍(ED)的相关性。方法应用勃起功能国际问卷表(IIEF-5)对符合入选条件的BPH患者进行评估,根据IIEF-5评分值表,将BPH患者分为正常、轻、中、重度ED4组,比较4组之间的国际前列腺增生症状评分(IPSS)、最大尿流率Qmax、前列腺体积之间的差异,应用方差分析探讨其内在的联系。结果共收集BPH患者80例,年龄52~91岁,平均71.4岁。其中勃起功能正常者6例,轻、中、重度ED的患者分别为20例、22例、32例,ED的发病率高达93%。4组之间的IPSS分别为:16.67±2.73,21.6±7.89,21±7.40,23.06±6.78,Qmax分别为:12.37±1.50,8.91±7.67,7.60±4.60,8.94±4.63,前列腺体积分别为:34.53±8.06,76.61±27.72,91.93±43.37,71.14±35.98,应用SPSSversion.13.0软件包行方差分析,前列腺体积正常组与轻、中、重3组比较,存在着统计学差异;IPSS评分仅正常组与重度ED组间有统计学差异(P<0.05);而各组间Qmax比较未见统计学差异(P>0.05)。结论BPH患者伴有较高的ED发生率,且ED的程度与下尿路症状的严重程度和前列腺体积有一定的关联。     

Bleeding after holmium laser enucleation of the prostate: Lessons learned the hard way

Study Type – Therapy (case series)
Level of Evidence 4 What’s known on the subject? and What does the study add? Holmium laser enucleation of the prostate is rapidly gaining popularity as an alternative and in some institutions a replacement for standard transurethral resection of the prostate. It has been proven to have at least equivalent outcomes to the TURP and noted to be exceptionally hemostatic. This study shares some caveats regarding bleeding after HoLEP.

OBJECTIVE

To examine specific causes of postoperative bleeding requiring transfusion after holmium laser enucleation of the prostate (HoLEP) in order to enhance preoperative screening and counseling.

MATERIALS AND METHODS

After Institutional Review Board (IRB) approval, a retrospective review of a single surgeon’s experience of 130 consecutive HoLEPs was performed to specifically examine patients requiring perioperative blood transfusions. All patients from August 2007 to April 2009 who underwent a HoLEP at our institution since its inception were included. These patients’ charts were reviewed to gain insight into their bleeding diathesis. A case series report was compiled and compared with the relevant published literature.

RESULTS

Of the 130 patients, eight (6.7%) were found to require transfusion postoperatively. Four of these patients required a second operation for completion. These patients had a variety of causes for increased bleeding and subsequent transfusion including: chronic anticoagulation (n = 1), significant cardiac disease requiring maintenance of hemoglobin (n = 4), sepsis with secondary disseminated intravascular coagulation (n = 1), large prostate size (>150 g) (n = 4), underlying prostate cancer (n = 1) and inadequate anesthesia during the procedure leading to patient movement (n = 1). All patients made a full recovery with satisfactory urinary symptom improvement except for one patient with residual incontinence at last follow‐up.

CONCLUSIONS

Despite the many benefits of holmium laser enucleation, all patients should be counseled regarding the real potential for postoperative blood transfusion. When feasible, any known bleeding risk should be minimized by the surgeon as long it is done safely for the benefit of the patient considering their co‐morbidities.