Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios alone or combined with prostate-specific antigen for the diagnosis of prostate cancer and clinically significant prostate cancer

Objective:We evaluated whether the blood parameters before prostate biopsy can diagnose prostate cancer(PCa)and clinically significant PCa(Gleason score[GS]7)in our hospital.Methods:This study included patients with increased prostate-specific antigen(PSA)up to 20 ng/mL.The associations of neutrophil-to-lymphocyte ratio(NLR)and platelet-tolymphocyte ratio(PLR)alone or with PSA with PCa and clinically significant PCa were analyzed.Results:We included 365 patients,of whom 52.9%(193)had PCa including 66.8%(129)with GS of≥7.PSA density(PSAD)and PSA had better the area under the curve(AUC)of 0.722 and 0.585,respectively with pZ0.001 for detecting PCa compared with other blood parameters.PSA combined with PLR(PsPLR)and PSA with NLR(PsNLR)had better AUC of 0.608 and 0.610,respectively with p<0.05,for diagnosing GS≥7 population,compared with PSA,free/total PSA,NLR,PLR,and PsNPLR(PSA combined with NLR and PLR).NLR and PLR did not predict PCa on multivariate analysis.For GS≥7 cancer detection,in the multivariate analysis,separate models with PSA and NLR(Model 1:PsNLRþbaseline parameters)or PSA and PLR(Moder 2:PsPLRþbaseline parameters)were made.Baseline parameters comprised age,digital rectal exam-positive lesions,PSA density,free/total PSA,and magnetic resonance imaging.Model 2 containing PsPLR was statistically significant(odds ratio:2.862,95% confidence interval:1.174-6.975,p=0.021)in finding aggressive PCa.The predictive accuracy of Model 2 was increased(AUC:0.734,p<0.001)than that when only baseline parameters were used(AUC:0.693,p<0.001).Conclusion:NLR or PLR,either alone or combined with PSA,did not detect PCa.However,the combined use of PSA with PLR could find the differences between clinically significant and insignificant PCa in our retrospective study limited by the small number of samples.

Highly accurate colorectal cancer prediction model based on Raman spectroscopy using patient serum

BACKGROUND Colorectal cancer(CRC) is an important disease worldwide, accounting for the second highest number of cancer-related deaths and the third highest number of new cancer cases. The blood test is a simple and minimally invasive diagnostic test. However, there is currently no blood test that can accurately diagnose CRC.AIM To develop a comprehensive, spontaneous, minimally invasive, label-free, bloodbased CRC screening technique based on Raman spectroscopy.METHODS We used Raman spectra recorded using 184 serum samples obtained from patients undergoing colonoscopies. Patients with malignant tumor histories as well as those with cancers in organs other than the large intestine were excluded. Consequently, the specific diseases of 184 patients were CRC(12), rectal neuroendocrine tumor(2), colorectal adenoma(68), colorectal hyperplastic polyp(18), and others(84). We used the 1064-nm wavelength laser for excitation. The power of the laser was set to 200 mW.RESULTS Use of the recorded Raman spectra as training data allowed the construction of a boosted tree CRC prediction model based on machine learning. Therefore, the generalized R^2 values for CRC, adenomas, hyperplastic polyps, and neuroendocrine tumors were 0.9982, 0.9630, 0.9962, and 0.9986, respectively.CONCLUSION For machine learning using Raman spectral data, a highly accurate CRC prediction model with a high R^2 value was constructed. We are currently planning studies to demonstrate the accuracy of this model with a large amount of additional data.

荷尔蒙疗法治疗前列腺癌的疗效及副作用：来自日本的经验和观点

目前，随着对前列腺癌去势抵抗机制的诠释，各种新型抗雄激素及雄激素生物合成抑制剂相继被开发出来了。相信这些新药物会改善激素疗法。另一方面，越来越多的人却对激素疗法提出质疑，如可能诱发心血管疾病等不良反应等。鉴于激素疗法对白种人和亚洲人的疗效及不良反应存在种族差异，本文综述了日本激素疗法治疗前列腺癌的经验。首先，本研究发现基础的激素疗法能长期控制某些局部前列腺癌患者的病情，还发现接受激素疗法的患者生活质量比之前预想的要好。激素疗法作为一种新辅助治疗和辅助治疗方法，对患有高危前列腺癌、局部晚期前列腺癌并接受前列腺根治术及放疗的患者十分有效。激素疗法作为辅助疗法的疗效还有待进一步临床试验证实。本研究还发现，日本心血管疾病死亡人数中，接受过激素疗法的患者并不比普通人群多。不过，即便是在日本，由于患者生活方式的改变可能会增加对激素疗法不良反应的易感性，因此还应努力减少副作用，这对糖尿病等内分泌和代谢性疾病的管理必不可少。预计未来将开发靶向治疗列腺癌的新型激素药物，如选择性激素受体调节剂。