Percent free prostate-specific antigen for prostate cancer diagnosis in Chinese men with a PSA of 4.0-10.0 ng/mL:Results from the Chinese Prostate Cancer Consortium

Objective:To test the diagnostic performance of percent free prostate-specific antigen(%fPSA)in predicting any prostate cancer(PCa)and high-grade prostate cancer(HGPCa)in a retrospective multi-center biopsy cohort with a PSA level of 4.0e10.0 ng/mL in China.Methods:Consecutive patients with a PSA of 4.0-10.0 ng/mL who underwent transrectal ultrasound-guided biopsy were enrolled at 16 Chinese medical centers from January 1st,2010 to December 31st,2013.Total and free serum PSA determinations were performed using three types of electro-chemiluminescence immunoassays recalibrated to the World Health Organization(WHO)standard.The diagnostic accuracy of PSA,%fPSA,and %fPSA in combination with PSA(%fPSA t PSA)was determined using the area under the receiver operating characteristic(ROC)curve(AUC).Results:A total of 2310 consecutive men with PSA levels between 4.0 and 10.0 ng/mL were included,and the detection rate of PCa was 25.1%.The AUC of%fPSA and %fPSA t PSA in predicting any PCa was superior to PSA alone in men aged≥60 years(0.623 vs.0.534,p<0.0001)but not in men aged 40e59 years(0.517 vs.0.518,p=0.939).Similar result was yield in predicting HGPCa.Conclusion:In a clinical setting of Chinese men with 4.0e10.0 ng/mL PSA undergoing initial prostate biopsy,adding %fPSA to PSA can moderately improve the diagnostic accuracy for any PCa and HGPCa compared with PSA alone in patients≥60 but not in patients aged 40-59 years.

Diagnostic accuracy of cystoscopic biopsy for tumour grade in outpatients with urothelial carcinoma of the bladder and the risk factors of upgrading

Objective:To assess the concordance of tumour grade in specimens obtained from diagnostic cystoscopic biopsy and transurethral resection of bladder tumour(TURBT)and explore the risk factors of upgrading.Methods:The medical records of 205 outpatients who underwent diagnostic cystoscopic biopsy before initial TURBT were retrospectively reviewed.Comparative analysis of the tumour grade of biopsy and operation specimens was performed.Tumour grade changing from low-grade to high-grade with or without variant histology was defined as upgrading.Logistic regression an-alyses were performed to identify the risk factors of upgrading.Results:For the 205 patients,the concordance of tumour grade between specimens obtained from biopsy and operation was 0.639.The concordance for patients who were preoperatively diagnosed with low-grade and high-grade was 0.504 and 0.912,respectively.Univariate and multivariate logistic regression analyses showed that older age,tumour multifocality,high neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and low lymphocyte-to-monocyte ratio(LMR)were significantly associated with upgrading(odds ratio ranging from 0.412 to 4.364).The area under the curve of the different multivariate models was improved from 0.752 to 0.821,and decision curve analysis demonstrated a high net benefit when NLR,LMR,and PLR were added.Conclusion:Diagnostic cystoscopic biopsy may not accurately represent the true grade of primary bladder cancer,especially for outpatients with low-grade bladder cancer.Moreover,older age,tumour multifocality,high NLR,PLR,and low LMR are risk factors of upgrading,and systemic inflammatory markers improve the predictive ability.

Immunoexpression and prognostic role of p53 in different subtypes of epithelial ovarian carcinoma

We sought to investigate the significance of p53 expression for epithelial ovarian carcinoma.In this study,we used immunohistochemical method to investigate the expression patterns of p53 in different subtypes of epithelial ovarian carcinoma.We found that the expressions of p53 protein in epithelial ovarian cancer（pituita,serosity and intima） were 88.9%,75% and 100%,respectively,while the recurrence rates among three cancer subtypes were significantly different（33.3%,12.5% and 0%,respectively;P 〈 0.05）.Compared with patients without lymph node metastasis,the expression of p53 in patients with lymph node metastasis was significantly strong（68.75% and 100%,respectively;P 〈 0.05）.However,the recurrence rate in the patients with lymph node metastasis（40%） was higher than that without lymph node metastasis（6.25%,P 〈 0.05）.The expressions of p53 protein in ovarian cancer betweenⅠ-Ⅱ（25%） stage and Ⅱ-Ⅳ stage（100%） were significantly different（P 〈 0.05）,and the recurrence rates between the two groups were significantly different（0% and 31.25%,respectively,P 〈 0.05）.Therefore,p53 protein has an intimate relationship with the malignant degree and the prognosis of ovarian cancer.

Prostate cancer in Asia:A collaborative report

The incidence of prostate cancer(PCa)within Asian population used to be much lower than in the Western population;however,in recent years the incidence and mortality rate of PCa in some Asian countries have grown rapidly.This collaborative report summarized the latest epidemiology information,risk factors,and racial differences in PCa diagnosis,current status and new trends in surgery management and novel agents for castration-resistant prostate cancer.We believe such information would be helpful in clinical decision making for urologists and oncologists,health-care ministries and medical researchers.

Over-expression of hypoxia-inducible factor 1 alpha increases an-giogenesis of LNCaP cells

Objective：To evaluate the effect of HIF-1 ct over-expression on angiogenesis in human prostate cancer cells. Methods： LNCaP cells（a human prostate cancer cell line） were transfected with the recombinant plasmid pcDNA3,1 （-）-HIF-1α with Lipofectamine 2000 system, The positive clones were selected by G418 being further confirmed by Western blot and immunofluorescence. The expression levels of VEGF, iNOS and Ang-Ⅱ were determined. Results：The expression of HIF-α in the LNCaP/ HIFlct cells was significantly increased in transfected cells, which induced the up-regulation of VEGF, iNOS, whereas Ang-Ⅱ expression remained un- changed. Conclusion：Over-expression of HIF-α can induce angiogenesis proteins and may improve the angiogenesis potency of prostate cancer.

全基因组关联研究发现中国人群前列腺癌两个新易感位点9q31.2和19q13.4

0前言在全球范围内，前列腺癌的发病率和病死率存在着巨大差异。该病在西方发达国家发病率最高，在非裔美国人群病死率最高，而在亚洲人群中发病率及病死率均为全球最低，提示不同人种在前列腺癌的遗传方面存在异质性。在欧美和日本人群中，全基因组关联研究（GWAS）技术已经被用于检测前列腺癌的遗传易感性位点，但至今尚无关于GWAS检测中国人群前列腺癌易感位点的报道。

Expression and Significance of Coxsackie and Adenovirus Receptor in Renal-Cell Carcinoma

OBJECTIVE To investigate the expression of Coxsackie and Adenovirus receptor （CAR） in renal-cell carcinoma and the relationship of the CAR to the biological behavior of the carcinomas. METHODS The immunohistochemical SP method was used to detect the expression of Coxsackie and Adenovirus receptor in 48 cases of renal- cell carcinoma and in 12 cases of normal renal tissue 2 cm away from the tumor tissue. RESULTS The positive rates of CAR were 100% in 12 cases of para-tumor normal renal tissue and 35.4% in 48 cases of renal-cell carcinoma respectively. The difference of CAR expression between them was significant （P〈0.05）. The grades of the tumor were as follows： 22 in Grade Ⅰ, 17 in Grade Ⅱ and 9 in Grade Ⅲ with the CAR positive rate being 54.5%, 23.5% and 11.1%, respectively. There was a negative correlation between CAR expression and tumor grading （P〈0.05）. In addition, the number of the cases in stages I to IV were 19, 13, 11 and 5 respectively, with the respective positive rates being 57.9%, 30.8%, 18.2% and 0.0%, i.e. there also was a negative relationship between CAR expression and the stage （P〈0.05）. CONCLUSION CAR expression is down-regulated in renal-cell carcinoma compared with normal tissue. The level of CAR may be a sensitive predictor of differentiation, invasion and metastasis. Loss of CAR expression correlates with the invasive phenotype in our analysis of renal-cell carcinoma.

Development of a high-power blue diode laser for precision vaporization of prostate tissue for the surgical management of benign prostatic hyperplasia

This paper explores the advancement and application of high-power blue diode lasers in treating benign prostatic hyperplasia(BPH).Addressing the challenges posed by existing techniques,the study focuses on optimizing tissue removal methods.Energy platform for BPH should balance a range of factors,such as operative time,patient conditions,urinary functions,complications,durability,accessibility,and cost,all while prioritizing patient care.Blueray Medical's innovation of high-power blue diode laser systems for BPH surgery is explored,with emphasis on achieving a balance among these considerations.By illustrating the biomedical effects of lasers and their interaction with soft tissues,particularly emphasizing the role of photon absorption by biomolecules and proteins in tissue behavior,this study outlines the advantages of the highpower blue diode laser system.The initial laboratory experiments and clinical results consistently align with our theoretical predictions,especially in terms of tissue vaporization efficiency,tissue coagulation,and bleeding control.In conclusion,blue diode lasers hold potential to enhance surgical outcomes for BPH.Their unique properties offer benefits like improved tissue removal rate and reduced thermal damages.Integrating blue laser technology into BPH protocols could lead to shorter hospital stays,cost savings,and expanded patient eligibility,although rigorous clinical studies are needed to fully understand their benefits and limitations.

Efficacy and safety of LY01005 versus goserelin implant in Chinese patients with prostate cancer: A multicenter, randomized, open-label, phase III, non-inferiority trial

Background:LY01005(Goserelin acetate sustained-release microsphere injection)is a modified gonadotropin-releasing hormone(GnRH)agonist injected monthly.This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer.Methods:We conducted a randomized controlled,open-label,non-inferiority trial across 49 sites in China.This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections.The primary efficacy endpoints were the percentage of patients with testosterone suppression≤50 ng/dL at day 29 and the cumulative probability of testosterone≤50 ng/dL from day 29 to 85.Non-inferiority was prespecified at a margin of-10%.Secondary endpoints included significant castration(≤20 ng/dL),testosterone surge within 72 h following repeated dosing,and changes in luteinizing hormone,follicle-stimulating hormone,and prostate specific antigen levels.Results:On day 29,in the LY01005 and goserelin implant groups,testosterone concentrations fell below medical-castration levels in 99.3%(142/143)and 100%(140/140)of patients,respectively,with a difference of-0.7%(95%confidence interval[CI],-3.9%to 2.0%)between the two groups.The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3%and 97.8%,respectively,with a between-group difference of 1.5%(95%CI,-1.3%to 4.4%).Both results met the criterion for non-inferiority.Secondary endpoints were similar between groups.Both treatments were well-tolerated.LY01005 was associated with fewer injection-site reactions than the goserelin implant(0%vs.1.4%[2/145]).Conclusion:LY01005 is as effective as goserelin implants in reducing testosterone to castration levels,with a similar safety profile.Trial registration:ClinicalTrials.gov,NCT04563936.