【摘要】 目的 探讨放射性核素骨显像和血清前列腺特异抗原（PSA），碱性磷酸酶（ALP），骨特异性碱性磷酸酶（BAP）测定在前列腺癌骨转移诊断中的价值。 方法 回顾性分析2006年10月-2009年10月50例前列腺癌（PCa）患者骨显像结果及PSA、ALP、BAP测定结果。 结果 50例Pca患者骨显像阳性率为70.0%。35例Pca骨转移患者分布在PSAgt;20.0 ng/mL时占97.1%，BAPgt;20.1 μg/L时占88.6%，ALPgt;130.0 μg/L时占94.3%。血清PSA、ALP、BAP水平随着放射性核素骨显像分级的增高而逐步增高，呈高度正相关。 结论 放射性核素骨显像仍然是目前诊断PCa骨转移的主要方法；PSA、ALP、BAP亦是重要的辅助诊断指标；PSAgt;20.0 ng/mL时，患者应常规行全身骨显像检查。【Abstract】 Objective To explore the clinical value of radionuclide bone scintigraphy and measurements of serum prostate-specific antigen (PSA), alkaline phosphatase (ALP) and bone-specific alkaline phosphatase (BAP) in the diagnosis of bone metastasis in prostate cancer (PCa) patients from October 2006 to October 2009. Methods The results of bone scintigraphy, serum PSA, ALP and BAP were analyzed retrospectively in 50 PCa patients. Results The positive rate of bone scintigraphy was 70.0% in 50 PCa patients. In 35 patients with PCa bone metastasis, 97.1% of them were PSAgt;20.0 ng/mL, 88.6% were BAPgt;20.1 μg/L, and 94.3% were ALPgt;130.0 μg/L. The serum levels of PSA, ALP and BAP were increased step by step along with the advancement of bone metastatic grading from M0 to M3. They were significantly positively correlated. Conclusion Radionuclide bone scintigraphy is a major method in the diagnosis of bone metastasis in PCa patients currently. PSA, ALP and BAP are also important auxiliary diagnostic markers. Patients with the level of PSAgt;20.0 ng/mL should take a routine whole-body examination of bone scintigraphy.
【摘要】 目的 观察低频超声（20 kHz）辐照联合静脉注射微泡造影剂SonoVue对裸鼠前列腺癌（Du145）移植瘤的抑瘤效应，并探讨其可能的抑瘤机制。 方法 通过细胞移植和瘤块移植方法建立24只裸鼠前列腺癌Du145移植瘤模型，随机分为超声微泡组、单纯超声组、单纯微泡组和对照组，每组各6只。超声微泡组：尾静脉注射0.2 mL SonoVue的同时对瘤体行20 kHz超声辐照，辐照强度200 mW/cm2；单纯超声组：尾静脉注射生理盐水0.2 mL，同时超声辐照2 min；单纯微泡组：尾静脉注射SonoVue 0.2 mL同时行假照，各组均隔天1次，共3次，对照组不做任何处理。治疗后测量瘤体大小，绘制瘤体生长曲线，计算抑瘤率。首次治疗后14 d剥离瘤体，通过光学显微镜、电子显微镜观察肿瘤组织病理改变。免疫组织化学方法观察CD34阳性染色血管，计算肿瘤微血管密度（micro vessel density，MVD），比较各组间MVD的差异。 结果 24只裸鼠均成功植瘤。治疗后超声微泡组瘤体体积均数明显小于其他3组（Plt;0.05），抑瘤率为62.7%。光学显微镜下超声微泡组瘤体组织大部分损伤坏死，电子显微镜下超声微泡组肿瘤内微血管的内皮细胞损伤，线粒体肿大，基底膜断裂。超声微泡组瘤体内CD34阳性染色微血管数减少，其MVD值显著低于其他各组。 结论 20 kHz低频超声辐照联合微泡造影剂SonoVue可有效抑制裸鼠人前列腺癌移植瘤的生长，其抑瘤机制可能是通过超声空化效应破坏肿瘤的微血管实现的。【Abstract】 Objective To investigate the anti-tumor effect induced by low-frequency ultrasound (20 kHz) radiation combined with intravenous injection of microbubbles on human prostate carcinoma xenograft in nude mice, and to discuss its probable mechanism. Methods Human prostate carcinoma xenograft model in 24 nude mice were established with human prostate carcinoma Du145 cells inoculation and sub-graft through mice, which were randomly divided into ultrasound+microbubble, ultrasound, microbubble, and control group, with 6 mice in each group. In the ultrasound+microbubble group, 0.2 mL SonoVue was injected intravenously, followed by 20 kHz ultrasound exposure of 200 mW/cm2 at every other day for 3 times totally. Mice in the ultrasound group and the microbubbles group were only treated with ultrasound radiation and microbubbles injection, respectively. The volume of gross tumors was measured, and tumor growth curve was drawn. The ratio of anti-tumor growth was calculated. The mice were sacrificed 14 days after the last ultrasound exposure. Specimens of the exposed tumor tissues were obtained and observed pathologically under light microscope and transmission electron microscope. CD34 positive vessels were counted in all the tumor slices by immunohistochemistry, and the micro-vessels density（MVD）of the tumor was also calculated. Results Du145 prostate tumor model was successfully established in all the mice. The average gross tumor volume of the ultrasound+microbubble group was significant lower compared with the other two groups after treatment (Plt;0.05), and the ratio of anti-tumor growth was 62.7%. Histological examination showed signs cell injury in the ultrasound+microbubble group. Electron microscopic examination revealed that the endothelium of vessels in the tumor was injured. The amount of CD34 positive vessels and MVD of the ultrasound+microbubble group was less than that of the other two groups. Conclusion The low-frequency ultrasound of 20 kHz exposure combined with microbubbles can be used to ablate human prostate carcinoma xenograft in nude mice, which is probably realized through micro-vessels destroyed by cavitation effect of ultrasound.
Through searching and evaluating the evidence on advanced prostate cancer, we found that different types of androgen deprivation had similar effect, and immediate androgen deprivation had survival benefit. For the patient with hormone-refractory prostate cancer, therapies including mitoxantrone, prednisone, docetaxel and surmine were more effective. Strontium-89 provided more effective pain relief than external beam radiation. And bisphophonate had no effect. Antiandrogen withdrawal suggested prostate specific antigen would decline, but the clinical outcome wasn’t reported.
目的 探讨在耻骨后前列腺癌根治术中尿控功能和性功能保护的手术技巧和疗效。 方法 2001年8月-2010年1月，行耻骨后前列腺癌根治术21例，其中2例经腹腔镜施行。均早期控制缝扎背静脉复合体，并妥善处理前列腺尖和尿道。21例通过保护控尿神经、保护尿道横纹括约肌等措施，保护尿控功能；17例通过保留神经血管束技术（12例保留双侧，5例仅保留一侧）保护性功能。 结果 手术均成功完成，无围术期严重并发症。2周拔出尿管后，排尿通畅，无尿道狭窄。手术后3、12个月内恢复尿控能力分别为：6例、13例，持续性轻-中度尿失禁2例。21例中，手术前勃起功能正常，并于手术中保留神经血管束17例，手术后3、12个月内勃起功能恢复分别为：2、8例，4例勃起功能减弱，3例不能勃起。手术后病理报告均为前列腺腺癌，未侵及精囊．膀胱颈，双侧淋巴结阴性。后尿道切缘阳性1例。手术后6、24、54个月各有1例出现生化复发。 结论 精细解剖并注意手术技巧，可有效保护性功能和尿控功能，并达到肿瘤根治的疗效。
Prostate cancer is the most common malignant tumor in male urinary system, and the morbidity and mortality rate are increasing year by year. Traditional imaging examinations have some limitations in the diagnosis of prostate cancer, and the advent of molecular imaging probes and imaging technology have provided new ideas for the integration of diagnosis and treatment of prostate cancer. In recent years, prostate-specific membrane antigen (PSMA) has attracted much attention as a target for imaging and treatment of prostate cancer. PSMA ligand positron emission tomography (PET) has important reference value in the diagnosis, initial staging, detection of biochemical recurrence and metastasis, clinical decision-making guidance and efficacy evaluation of prostate cancer. This article briefly reviews the clinical research and application progress on PSMA ligand PET imaging in prostate cancer in recent years, so as to raise the efficiency of clinical applications.
Prostate cancer ranks second among the causes of death of malignant tumors in middle-aged and elderly men. A considerable number of patients are not easily detected in early-stage prostate cancer. Although traditional imaging examinations are of high value in the diagnosis and staging of prostate cancer, they also have certain limitations. With the development of nuclear medicine instruments and molecular probes, molecular imaging is playing an increasingly important role in the diagnosis and treatment of prostate cancer. Positron emission tomography and computed tomography (PET/CT) using prostate-specific membrane antigen (PSMA) as a probe has gained increasing recognition. This article will review the latest progress in the application of PET/CT using probes for targeting PSMA to imaging and treatment of prostate cancer, in order to provide a theoretical basis for the application of probes for targeting PSMA in the diagnosis and treatment of prostate cancer.
ObjectiveTo analyze the disease burden of prostate, bladder and kidney cancers attributable to smoking in China from 1990 to 2019. MethodsBased on the global burden of disease study 2019, the current situation of the disease burden of prostate, bladder and kidney cancers attributable to smoking was analyzed by using the population attributable fraction (PAF), deaths and disability-adjusted life years (DALYs). Furthermore, the annual percent change (APC) and the average annual percent change (AAPC) were calculated by joinpoint regression analysis to describe the long-term trends of the smoking-attributable burden of these three cancers from 1990 to 2019. ResultsThere were an estimated 18 800 cases of deaths and 393 106 person-years of DALYs for bladder cancer caused by smoking in 2019. The age-standardized mortality and DALY rate decreased by 0.41% and 0.39% per year from 1990 to 2019, respectively. For prostate cancer, smoking was estimated to have caused 5 016 cases of deaths and 98 276 person-years of DALYs in 2019. The age-standardized mortality and DALY rate decreased by 0.28% and 0.25% per year from 1990 to 2019, respectively. For kidney cancer, the deaths and DALYs attributable to smoking were 4 935 cases and 120 620 person-years, respectively. The standardized mortality and DALY rates increased by 3.03% and 2.98% per year from 1990 to 2019. Additionally, males suffered from a higher disease burden of these three cancers attributable to smoking than females. The elderly population had a higher smoking-attributable disease burden than the younger population. ConclusionThe situation of the disease burden of bladder, prostate and kidney cancers attributable to smoking is still serious in China, which has substantial disparities in different groups. Specifically, males and the elderly are the high-risk groups for the smoking-attributable burden. Among the three cancers, bladder cancer has the highest burden and kidney cancer has the largest burden increase during 1990-2019.
ObjectiveTo compare the effectiveness of magnetic resonance spectroscopy (MRS) and Dynamic Contrast-enhancement (DCE-MRI) with 1.5 T MR scanner in diagnosing prostate cancer. MethodsFrom April 2011 to December 2012, based on the results of biopsy, we measured 216 regions of interest (ROIs) in images of MRS and DCE-MRI, comprised of 131 ROIs from cancer zone and 85 ROIs from non-cancer zone. The data were analyzed with statistical methods, including receiver operating characteristic (ROC) curve. ResultsThere were significant differences between the malignant group and the benign group (P<0.05) in Cit integral, Cho integral, CC/Cit ratio, the type of time-signal intensity curve, initial value, enhancement rate and ratio of enhancement. According to ROC curve, the area under curve (AUC) of CC/Cit and enhancement rate was 0.853 and 0.719, respectively. AUC of time to peak, time difference, enhancement rate and Cit integral was lower than 0.400. The optimal operating point (OOP) of CC/Cit was 0.775, with a specificity of 0.85 and a sensitivity of 0.79, and the AUC was 0.853. The OOP of the ratio of enhancement was 60.89, with a specificity of 0.66 and a sensitivity of 0.71, and the AUC was 0.719. ConclusionMRS is more sensitive and specific than DCE-MRI to diagnose prostate cancer when an 1.5 T MR scanner is used. On the other hand, MRS is susceptible to interference, but DCE-MRI can make up for these deficiencies.