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.
ObjectiveTo assess whether hyperlipoidemia affects the occurrence and progression of prostate cancer (PCA). MethodsA hospital based retrospective study was carried out in Zhangzhou Affiliated Hospital of Fujian Medical University using data from a total of 112 cases of PCA, which underwent radical prostatectomy due to suspected PCA and confirmed by prostate biopsy pathology. ResultsOf the 112 PCA patients, 64 (57.14%) were PCA with hyperlipoidemia (PCA-H). Compared with PCA patients, the patients of PCA-H patients had younger onset age (65.0±5.0 vs. 67.8±3.7, P=0.001), increased prostate volume (75.0±11.7 mL vs. 54.5±8.5 mL, P < 0.001), increased level of TPSA (61.4±23.3 ng/mL vs. 33.4±14.9 ng/mL, P < 0.001), and Gleason grade (6.9±1.8 vs. 5.0±1.9, P < 0.001), later clinical stage (P < 0.001), shorter survival time (49.8±12.7 months vs. 57.3±6.2 months, P < 0.001) and decreased 5 years of survival rate (51.6% vs. 77.1%, P=0.006). The level of cholesterol, triglyceride and high density lipoprotein was significantly associated with the rejuvenation of onset age, the enlargement of prostate volume, increasing of serum TPSA, the progression of TNM clinical stage, increasing of Gleason grade, shorten of survival time and dropping of 5 years of survival rate (P < 0.05). In multiplefactor regression analysis, only hyperlipoidemia (OR=3.204, P=0.022) and Gleason grade (OR=8.611, P < 0.001) were the independent risk factors of prognosis. ConclusionThe situation of PCA with hyperlipoidemia is frequently noted in clinics, and hyperlipoidemia may be one of the risk factors in the processes of PCA growth and progression.
ObjectiveTo systematically review the relationship between T309G polymorphism of murine double minute 2 (MDM2) gene and susceptibility of prostate cancer. MethodsThe PubMed, Embase, WanFang Data, CNKI databases were electronically searched to collect case-control studies related to the objectives from inception to May, 2023. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 14.0 software. ResultsA total of 10 studies involving 5 781 patients and 5 477 healthy controls were included. The results of meta-analysis showed that the MDM2 gene T309G polymorphism was not associated with preeclampsia (allele model G vs. T: OR=0.89, 95%CI 0.77 to 1.04, P=0.13; homozygote model GG vs. TT: OR=0.86, 95%CI 0.64 to 1.16, P=0.32; heterozygote model TG vs. TT: OR=1.04, 95%CI 0.86 to 1.26, P=0.12; dominant model GG+TG vs. TT: OR=0.96, 95%CI 0.89 to 1.04, P=0.36; recessive model GG vs. TG+TT: OR=0.84, 95%CI 0.63 to 1.14, P=0.27). The results of subgroup analysis based on ethnicity and source of control were similar to the overall results. Sensitivity analysis showed that the results were robust. Conclusion Current evidence shows that the MDM2 gene T309G polymorphism is not associated with prostate cancer susceptibility. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo investigate the expression of tumor necrosis factor-α (TNF-α) in prostate cancer tissue and explore its relations with tumor angiogenesis. MethodsThe expression of TNF-α and CD105 were detected with two-step immunohistochemical staining technique in 20 cases of benign prostatic hyperplasia and 50 cases of prostate cancer between January 2010 and January 2012, and microvessel density (MVD) marked with CD105 was also measured. ResultsThe expressions of TNF-α and CD105 were higher in prostate cancer (41.72±8.67, 20.15±2.67) than those in benign prostatic hyperplasia (21.01±3.85, 4.34±1.67) (t'=13.990, P<0.001; t'=29.771, P<0.001). TNF-α and MVD were not correlated with age and size of tumor, but were positively correlated with tumor differentiation degree (rs=0.847, P<0.001; rs=0.776, P<0.001) and negatively correlated with clinical grades (rs=-0.769, P<0.001; rs=-0.842, P<0.001). ConclusionThe result indicates that over expression of TNF-α exists in prostate cancer. It may play an important role in the anginogenesis and carcinogenesis of prostate cancer.
Objective To systematically review the effectiveness and safety of radiotherapy combined with short-term or long-term hormonal therapy for prostate cancer. Methods Databases including EMbase, PubMed, Web of Science, CENTRAL and CBM were searched from inception to August 2012 to collect the randomized controlled trials (RCTs) on radiotherapy combined with short-term or long-term hormonal therapy for prostate cancer. According to the inclusion and exclusion criteria, data of the included studies were extracted, and the methodological quality was evaluated. Then meta-analysis was performed using RevMan 5.1, and the evidence qualities and recommendation levels were determined according to the GRADE System. Results A total of 6 RCTs involving 3157 patients were included. The results of meta-analysis showed that there were no significant differences in the overall survival rate (RR=0.95, 95%CI 0.91 to 1.00) and the disease-free survival rate (RR=0.73, 95%CI 0.46 to 1.13) between the radiotherapy plus short-term hormonal therapy group (the short-term group) and the radiotherapy plus long-term hormonal therapy group (the long-term group). The long-term group was superior to the short-term group in biochemical failure-free survival rate (RR=0.81, 95%CI 0.68 to 0.97), clinical progression rate (RR=1.61, 95%CI 1.44 to 1.80), and prostate cancer-specific mortality (RR=1.44, 95%CI 1.16 to 1.80). Based on the GRADE system, the evidence level of biochemical failure-free survival was moderate with a weak recommendation; the evidence level of disease-free survival was low with a weak recommendation; the evidence level of overall survival was high with a weak recommendation; and the evidence levels of clinical progression rate and prostate cancer-specific mortality were high with a b recommendation. Conclusion Currently, the limited evidence shows extending the length of hormone therapy is beneficial for patients with localized prostate cancer and locally advanced prostate cancer, especially for patients with high Gleason score, but it cannot raise overall survival rate and disease-free survival rate. This conclusion still needs to be further proved by more high-quality and large-scale RCTs.
ObjectiveTo systematically review the correlation between E-cadherin expression and prostate cancer, as well as its clinicopathologic features in Chinese population. MethodsSuch databases as PubMed, EMbase, CBM, CNKI, VIP and WanFang Data were electronically searched from their inception to December, 2015 to collect case-control studies about the correlation between E-cadherin expression and prostate cancer, as well as its clinically pathologic features in Chinese population. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 21 studies were included, involving 920 prostate cancer cases, 415 benign prostatic hyperplasia cases, and 48 controls. The results of meta-analysis showed that the prostate cancer group had a lower E-cadherin expression level when compared with the benign prostatic hyperplasia group (OR=0.07, 95%CI 0.05 to 0.11, P<0.00001) or the control group (OR=0.04, 95%CI 0.01 to 0.18, P<0.00001). Moreover, the expression level of E-cadherin was lower in the low and medium differentiation group than in the high differentiation group (OR=0.13, 95%CI 0.08 to 0.23, P<0.00001), lower in the stage of C+D than in the stage of A+B (OR=0.23, 95%CI 0.15 to 0.34, P<0.00001), and lower in the prostate cancer with metastasis (OR=0.46, 95%CI 0.27 to 0.79, P=0.005) and it was decreased gradually with the increment of pathological differentiation and clinical stage of prostate cancer and with the decrement of lymph node or bone metastasis and serum PSA level. ConclusionCurrent evidence indicates that the expression level of E-cadherin is significantly correlated with prostate cancer and its clinicopathologic features in Chinese population. Due to limited sample size and quality of included studies, the conclusion needs to be verified by conducting more high quality studies.
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.
Objective To analyze the epidemic trend of prostate cancer in China from 1992 to 2021, and predict its epidemic trends from 2022 to 2032. Methods Based on the data of Chinese population and prostate cancer incidence and mortality from Global Burden of Disease Database, the Joinpoint log-linear model was used to analyze the trends of prostate cancer incidence and mortality, use the age-period-cohort model to analyze the effects of age, period and cohort on changes in incidence and mortality, and the gray prediction model was used to predict the trends of prostate cancer. Results From 1992 to 2021, the incidence and mortality of prostate cancer in China showed an upward trend, with AAPC of 5.652% (P<0.001) and 3.466% (P<0.001), and the AAPC of age-standardized incidence decreased to 1.990% (P<0.001), the age-standardized mortality showed a downward trend and was not statistically significant. The results of the age-period-cohort model showed that the net drift values of prostate cancer incidence and mortality were 3.03% and −1.06%, respectively, and the risk of incidence and mortality gradually increased with age and period. The results of the grey prediction model showed that the incidence and mortality of prostate cancer showed an upward trend from 2022 to 2032, and the incidence trend was more obvious. Conclusion The incidence and mortality of prostate cancer in China showed an increasing trend, with a heavy disease burden and severe forms of prevention and control, so it is necessary to do a good job in monitoring the incidence and mortality of prostate cancer, and strengthen the efficient screening, early diagnosis and treatment of prostate cancer.
Objective To comprehensively evaluate the association between TNF-α gene −308 G/A polymorphism and the risk of prostate cancer. Methods A meta-analysis was performed to analyze the association between −308 G/A polymorphism and the risk of prostate cancer risk. Results A total of 11 case-control studies (4 919 cases and 5 210 controls) were included in this meta-analysis. The result showed no statistically significant differences in all genotype distribution between prostate cancer cases and controls: dominant model (OR=1.11, 95%CI 0.90 to 1.36, P=0.33), recessive model (OR=0.91, 95%CI 0.70 to 1.18, P=0.47), GA versus GG (OR=1.11, 95%CI 0.90 to 1.37, P=0.33), AA versus GG (OR=0.92, 95%CI 0.71 to 1.20, P=0.55), A versus G (OR=1.07, 95%CI 0.91 to 1.26, P=0.39). In the subgroup analysis by ethnicity, no statistically differences were found between prostate cancer cases and controls. Conclusion This results of meta-analysis suggests that TNF-α gene –308G/A polymorphism may not be a risk factor of prostate cancer. Due to the limited quantity of the includied studies, further studies are needed to validate the above conclusion.
Prostate cancer is a common disease in the USA and Europe, with a gradually increasing incidence in China, and presents a significant health burden for older men. The lack of modifiable risk factors has made early detection as a strategy to reduce mortality. Current methods of screening involve the measurement of serum prostate-specific antigen (PSA) and digital rectal examination followed by biopsy. With PSA screening evidence of level I absent, the evidence on the use of PSA as a screening test is still highly controversial. Furthermore, there is controversy over whether screen-detected lesions will become clinically significant. There are three major treatment options for localized disease: radical prostatectomy, radical radiotherapy and monitoring with treatment if required. There is no evidence of randomized controlled trial (RCT) to suggest a survival advantage of any of these treatments. Opinions about the related benefits and risks of screening vary widely. In the absence of RCT of benefit for screening, many now suggest “informed consensus” screening, which encourages a discussion between the patient and his physician with both sides informed of all of the issues.