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1.

Background

Available models for predicting lymph node invasion (LNI) in prostate cancer (PCa) patients undergoing radical prostatectomy (RP) might not be applicable to men diagnosed via magnetic resonance imaging (MRI)-targeted biopsies.

Objective

To assess the accuracy of available tools to predict LNI and to develop a novel model for men diagnosed via MRI-targeted biopsies.

Design, setting, and participants

A total of 497 patients diagnosed via MRI-targeted biopsies and treated with RP and extended pelvic lymph node dissection (ePLND) at five institutions were retrospectively identified.

Outcome measurements and statistical analyses

Three available models predicting LNI were evaluated using the area under the receiver operating characteristic curve (AUC), calibration plots, and decision curve analyses. A nomogram predicting LNI was developed and internally validated.

Results and limitations

Overall, 62 patients (12.5%) had LNI. The median number of nodes removed was 15. The AUC for the Briganti 2012, Briganti 2017, and MSKCC nomograms was 82%, 82%, and 81%, respectively, and their calibration characteristics were suboptimal. A model including PSA, clinical stage and maximum diameter of the index lesion on multiparametric MRI (mpMRI), grade group on targeted biopsy, and the presence of clinically significant PCa on concomitant systematic biopsy had an AUC of 86% and represented the basis for a coefficient-based nomogram. This tool exhibited a higher AUC and higher net benefit compared to available models developed using standard biopsies. Using a cutoff of 7%, 244 ePLNDs (57%) would be spared and a lower number of LNIs would be missed compared to available nomograms (1.6% vs 4.6% vs 4.5% vs 4.2% for the new nomogram vs Briganti 2012 vs Briganti 2017 vs MSKCC).

Conclusions

Available models predicting LNI are characterized by suboptimal accuracy and clinical net benefit for patients diagnosed via MRI-targeted biopsies. A novel nomogram including mpMRI and MRI-targeted biopsy data should be used to identify candidates for ePLND in this setting.

Patient summary

We developed the first nomogram to predict lymph node invasion (LNI) in prostate cancer patients diagnosed via magnetic resonance imaging-targeted biopsy undergoing radical prostatectomy. Adoption of this model to identify candidates for extended pelvic lymph node dissection could avoid up to 60% of these procedures at the cost of missing only 1.6% patients with LNI.  相似文献   
2.
目的:探讨nm23-H1基因转染对人胆管癌细胞系QBC939体外浸润能力的影响。方法:将含有全长nm23-H1 cDNA的真核表达载体通过脂腩体法转染人胆管癌细胞系。结果:转染成功的QBC939细胞,其nm23-Hl基因的mRNA、蛋白表达明显增加,转染nm23-H1基因的胆管癌细胞体外浸润能力下降,穿越matrigel的细胞数明显低于亲本QBC939细胞,代表浸润能力的IV型胶原酶(MMP-9)分泌量下降。结论:nm23-Hl基因可以抑制胆管癌细胞的体外浸润能力。  相似文献   
3.
BACKGROUND: Although it is clear that dissemination via the blood system involves angiogenesis, it is uncertain whether tumors also induce lymphangiogenesis or simply invade existing peritumoral vessels. The purpose of this study was to elucidate changes in tumor blood and lymph vessels in cases involving the invasion of squamous cell carcinoma in the oral cavity, and its significance. Blood and lymph vessels densities in tongue carcinomas induced in hamsters were investigated. METHODS: Tongue cancer was induced by abrading the right margin of the tongue of each hamster with an endodontic barbed broach and subsequently applying 1.0% 9,10-dimenthl-1,2-benzanthracene (DMBA) dissolved in acetone, three times a week, at the same site. Fresh frozen sections were prepared and blood vessels stained blue by perfusion with Coomassie Brilliant Blue and lymph vessels stained brown for 5'-nucleotidase. The effects on the blood vessels and lymph vessels were observed. RESULTS: The results showed that blood and lymph vessel densities were greater in the advanced carcinoma tissues than in normal tissue. These were compared in terms of the mode of cancer invasion. As tumor invasion progressed, the blood vessel density decreased but lymph vessel density tended to be higher in high-degree tumor invasion than in low-degree tumor invasion. The expression of vascular endothelial growth factor-C was seen more frequently as tumor invasion progressed. CONCLUSIONS: The present findings indicated that angiogenesis and lymphangiogenesis are affected by cancerous invasion.  相似文献   
4.
A cDNA encoding a transmembrane 140 kDa isoform of the neural cell adhesion molecule, NCAM, was transfected into the rat glioma cell line BT4Cn. Transfectants with a homogeneously high expression of NCAM-B showed a decreased capacity for penetration of an artificial basement membrane when compared to cells transfected with expression-vector alone or untransfected cells. However, when injected subcutaneously into nude mice, both NCAM expressing cells and control cells produced invasive tumors. Nude mice injected with NCAM positive cells developed tumors with slower growth rates as compared to those induced by NCAM negative cells. This implies that NCAM may not only be involved in adhesive and motile behaviour of glioma cells, but also in their growth regulation.  相似文献   
5.
Invasion of the reconstituted extracellular matrix composite, Matrigel, by eight human glioma–derived cell lines and human fetal brain cells was assessed in vitro using 8 um polycarbonate filters in a modified Boyden migration chamber. With the exception of one low grade glioma derived cell line, all lines studied proved to be invasive while normal fetal brain cells failed to invade. This invasive potential was independent of the histological grade of the tumour from which the cell lines originated. In addition, the expression of the metastasis–associated gene 18A2lmts1 as well as the tissue inhibitor of metalloproteinases–2 (TIMP–2) was analysed in each of the glioma–derived cell lines. The 18A2/mtsl was expressed in all the cells studied with the exception of fetal brain cells and the low grade non–invasive glioma derived IPRK–7 cell line. The 18A2/mtsl related genes coding for the S100 subfamily of calcium binding proteins were found to be differentially and overexpressed in invasive cell lines. TIMP–2 was expressed only in noninvasive cell lines. These results suggest that the 18A2/ mtsl and TIMP–2 genes could play an important role in the invasive behaviour of human glioma cells in vitro. .  相似文献   
6.
Basosquamous carcinoma of the skin is a rare malignancy with specific histopathological features of both basal cell carcinoma and squamous cell carcinoma. Some authors believe that basosquamous carcinoma is a variant of basal cell carcinoma, while others suggest that this tumour may behave more aggressively. We present a 44-year-old female patient who was diagnosed with a basosquamous carcinoma histopathologically. She had extensive ulcero-vegetative lesions, involving the anterior half of the scalp, the left orbit and the left side of the face. With this case we aim to emphasize the aggressive nature of basosquamous carcinoma and review the literature.  相似文献   
7.
员晋  兰海  李开南  赵平  张进军 《四川医学》2010,31(10):1480-1481
目的探讨关节镜辅助下微创髌前"8"字张力钢丝内固定治疗髌骨骨折的手术方法及疗效。方法对我科2005年5月~2009年12月髌骨骨折的29例行关节镜辅助下微创髌前"8"字张力钢丝内固定治疗,总结手术经验。结果 27例完成微创手术,2例中转开放手术,平均手术时间48min。均获得12个月随访,髌骨骨折均愈合,未形成髌骨关节面"阶梯",无内固定断裂,关节功能优。结论关节镜辅助下髌前"8"字张力钢丝内固定治疗髌骨骨折内固定可靠,术中能直观评估关节面复位情况,手术创伤小,有利于早期功能锻炼。  相似文献   
8.
The Boyden chamber assay is widely used for in vitro measurement of the invasive capacity of cells. However, results can be affected significantly if certain precautions are not taken. Using the Boyden chamber assay we investigated in vitro the invasive potential of a variety of human gynecological tumor cell lines to degrade and migrate through the artificial basement membrane matrix Matrigel. However, in the absence of this Matrigel layer large differences were observed in the ability of cells to adhere to, migrate through and attach to the lower side of the filter membranes. These differences were influenced by cell density, degree of directional locomotion, and the size of the filter pores. To adjust for these influences (which are not directly correlated to the capacity of cells to traverse the Matrigel layer), invasion results were corrected for the ability of cells to migrate through the filter membrane. In addition, the invasion of MDA-MB-231 cells was used as an internal standard to compensate for variations in the Matrigel layer between different experiments. Overall, in our experimental set up, the five human breast cancer cell lines were the most invasive (mean invasion ± SEM relative to MDA-MB-231 invasion: 104.7 ± 6.1%), the five human ovarian cancer cell lines the least invasive (60.2 ± 2.2%) and the six human endometrial cancer cell lines showed an intermediate capacity (79.1 ± 3.5%). In conclusion, the Boyden chamber assay can be used reliably for studying the invasive potential of cells in vitro, if the ability of the cells to migrate through the filter is taken into account, and a reference cell line is included to enable comparison of the data obtained from independently performed experiments on different cell lines.  相似文献   
9.
目的 探讨微血管侵犯在肾癌根治术后患者预后判断中的作用。 方法 选取局限性肾癌患者肾癌根治术后标本 70例。临床分期 :PT15例 ,PT2 5 0例 ,PT3 14例 ,PT41例 ;组织学分级 :G17例 ,G2 38例 ,G3 19例 ,G46例。 70例肿瘤平均直径 7.2cm。采用HE染色、弹力纤维染色、Schiff染色制片 ,观察肾癌微血管侵犯情况 ,并与分期、分级等病理因素进行比较研究。 结果 微血管侵犯者 2 4例 (34.3% ) ,其中出现转移 11例 (4 5 .8% ) ,死于肿瘤复发 7例 ,4例仍带瘤存活 ,死于其他疾病者 2例 ;4 6例无微血管侵犯者中出现转移 4例 (8.7% ) ,两组生存时间比较 ,差异有显著性意义 (P <0 .0 1)。微血管侵犯和肿瘤分期、分级、体积均相关 ,多因素分析表明 :微血管侵犯、肿瘤体积均是预测生存率的重要因素 ,微血管侵犯为影响患者预后的最重要的相关因素。 结论 微血管侵犯可作为局限性肾癌根治性肾切除术后重要的预后因素之一 ,并可作为肾癌常规临床病理检查的一种补充形式 ,按照有、无微血管侵犯作进一步分型 ,可为肾癌患者的预后提供更全面的预测。  相似文献   
10.
Matrix Metalloproteinases in Breast Cancer   总被引:1,自引:0,他引:1  
Abstract: Matrix metalloproteinases (MMPs) represent a class of enzymes able to degrade numerous extracellular matrix macromolecules facilitating tumor invasion and metastasis. The principal MMPs involved in breast pathology are analyzed with their various roles and functions: gelatinases A and B, stromelysin-3, collagenase-3, and MT-MMP1 (membrane type MMP). In vivo and in vitro studies clearly demonstrate an important cooperation between tumor and stromal cells for the expression of these MMPs in breast carcinomas. The large expression of MMPs plead in favor of a major role of these enzymes in breast carcinoma progression and their detection may be used in some cases as a prognostic indicator. Studies now are in progress, directed toward the modulation of these MMPs and their inhibitors with new therapeutic agents to block tumoral invasion and metastasis due to these enzymes.?  相似文献   
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