Heterochronous multiple primary prostate cancer and lymphoma:A case report

BACKGROUND Multiple primary malignant tumors(MPMTs)are rare type of cancer,especially when solid tumors are the first and lymphoma is the second primary malignancy.We report a patient with heterochronous MPMTs consisting of prostate cancer and rectal diffuse large B-cell lymphoma(DLBCL).CASE SUMMARY We report a 77-year-old male patient diagnosed with prostate cancer who was treated with radiation therapy and one year of endocrine therapy with bicalutamide(50 mg per day)and an extended-release implant of goserelin(1/28 d).Seven years later,rectal DLBCL with lung metastases was found.CONCLUSION Although rare,the possibility of prostate cancer combined with a double primary cancer of DLBCL can provide a deeper understanding.

Prostate-specific antigen reduction after capecitabine plus oxaliplatin chemotherapy:A case report

BACKGROUND Prostate cancer(PC)is currently the most common malignant tumor of the genitourinary system in men.Radical prostatectomy(RP)is recommended for the treatment of patients with localized PC.Adjuvant hormonal therapy(AHT)can be administered postoperatively in patients with high-risk or locally advanced PC.Chemotherapy is a vital remedy for castration-resistant prostate cancer(CRPC),and may also benefit patients with PC who have not progressed to CRPC.CASE SUMMARY A 68-year-old male was admitted to our hospital because of urinary irritation and dysuria with increased prostate-specific antigen(PSA)levels.After detailed examination,he was diagnosed with PC and treated with laparoscopic RP on August 3,2020.AHT using androgen deprivation therapy(ADT)was performed postoperatively because of the positive surgical margin,extracapsular extension,and neural invasion but lasted only 6 mo.Unfortunately,he was diagnosed with rectal cancer about half a year after self-cessation of AHT,and was then treated with laparoscopic radical rectal resection and adjuvant chemotherapy using the capecitabine plus oxaliplatin(CapeOx)regimen.During the entire treatment process,the patient's PSA level first declined significantly after treatment of PC with laparoscopic RP and ADT,then rebounded because of self-cessation of ADT,and finally decreased again after CapeOx chemotherapy.CONCLUSION CapeOx chemotherapy can reduce PSA levels in patients with high-risk locally advanced PC,indicating that CapeOx may be an alternative chemotherapy regimen for PC.

Intermittent androgen deprivation therapy in patients with prostate cancer: Connecting the dots

Intermittent androgen deprivation therapy(IADT)is now being increasingly opted by the treating physicians and patients with prostate cancer.The most common reason driving this is the availability of an off-treatment period to the patients that provides some relief from treatment-related side-effects,and reduced treatment costs.IADT may also delay the progression to castration-resistant prostate cancer.However,the use of IADT in the setting of prostate cancer has not been strongly substantiated by data from clinical trials.Multiple factors seem to contribute towards this inadequacy of supportive data for the use of IADT in patients with prostate cancer,e.g.,population characteristics(both demographic and clinical),study design,treatment regimen,on-and off-treatment criteria,duration of active treatment,endpoints,and analysis.The present review article focuses on seven clinical trials that evaluated the efficacy of IADT vs.continuous androgen deprivation therapy for the treatment of prostate cancer.The results from these clinical trials have been discussed in light of the factors that may impact the treatment outcomes,especially the disease(tumor)burden.Based on evidence,potential candidate population for IADT has been suggested along with recommendations for the use of IADT in patients with prostate cancer.

Primitive neuroectodermal tumor of the prostate in a 58-year-old man:A case report

BACKGROUND Primitive neuroectodermal tumor(PNET),especially located in the prostate,is a rare tumor that mainly occurs in young men.Bladder or rectum invasion and distant metastasis are strongly associated with a poor prognosis.Combination therapy,including radical surgery,adjuvant chemotherapy,and radiotherapy,is available.We present a case of prostatic PNET and a review of 17 cases identified in the literature.CASE SUMMARY A 58-year-old man was admitted complaining of dysuria for 2 years.Computed tomography and magnetic resonance imaging showed a large cystic-solid mass in the pelvic cavity compressing the surrounding bladder and rectum.The mass was iso-to hyperintense on T1-weighted imaging(WI)and heterogeneously hyperintense on T2WI.Cystic degeneration and necrosis were seen in the tumor,and solid tissues within the mass enhanced on contrast-enhanced scan.The patient underwent robot-assisted laparoscopic pelvic tumor resection.Histologically,the presence of many small round cells that were positive for expression of CD99,vimentin,and synaptophysin established the diagnosis of PNET in the prostate after surgery.The patient underwent adjuvant chemotherapy.During 34 mo of follow-up,the patient had no signs or symptoms of recurrence or residual disease.CONCLUSION We present the case of the oldest prostatic PNET patient,who has a good prognosis.This illustrates how older men with prostatic PNET may also benefit from the combination therapy,like younger adults,and achieve a long-term survival.As always,PNET should be considered in the differential diagnosis of aggressive prostatic tumors in young men.

Development of animal models underlining mechanistic connections between prostate inflammation and cancer

The characterization of animal models has indicated that the genetic,dietary and environmental factors and hormonal imbalance may influence the risk to develop prostate inflammatory lesions and prostate cancer(PC)confirming human epidemiologic data.It is now established that the prostate inflammatory response typically results in major changes in the local microenvironment of epithelial cells of the prostate gland,including an intense stromal remodeling,activation of fibroblasts,infiltration of immune cells such as mast cells,macrophages and B and T lymphocytes and collagen deposition.The immune cells recruited at prostate inflammatory lesions and myofibroblasts may contribute to the release of numerous pro-inflammatory cytokines and chemokines that in turn can promote the oxidative stress,genomic instability and proliferation of epithelial cells.The accumulation of additional genetic and/or epigenetic alterations in prostatic stem/progenitor cells may subsequently culminate to their malignant transformation and PC initiation and progression and more particularly with advancing age.The potential mechanistic relationships between the molecular events associated with the persistent inflammatory response and prostate carcinogenesis have important implications for optimizing the current therapies against different prostatic disorders and PCs.

Management about intravesical histological transformation of prostatic mucinous carcinoma after radical prostatectomy:A case report

BACKGROUND Prostatic mucinous carcinoma(MC)and prostatic signet ring cell carcinoma are two variants of prostate cancer.MC has a higher overall survival time among all variants,while signet ring cell carcinoma is associated with lower survival time relative to other carcinomas.Only a small proportion of prostatic MC may contain signet ring cells.Over the last several decades there were only 12 patients that were documented in two studies.CASE SUMMARY We report on a 64-year-old man who was diagnosed with prostatic MC after he received a robotic-assisted laparoscopic radical prostatectomy in the West China Hospital.After robotic-assisted laparoscopic radical prostatectomy,the patient underwent three successive transurethral resections of bladder tumors.Pathological examination of the first transurethral resection of bladder tumors specimen indicated that the neoplasm was prostatic MC that had metastasized to the urinary bladder.The subsequent two transurethral resections of bladder tumors indicated the presence of prostatic mucinous carcinoma with signet ring cells.CONCLUSION This case report aimed to share the management experience,raise awareness,and highlight the importance of multidisciplinary cooperation of prostatic mucinous carcinoma with signet ring cells.

针刺配合翁沥通胶囊治疗良性前列腺增生的疗效观察

目的观察针刺配合翁沥通胶囊治疗良性前列腺增生的临床疗效及其对血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、前列腺特异性抗原(prostate specific antigen,PSA)水平的影响。方法将119例良性前列腺增生患者随机分为A组40例、B组38例及C组41例。A组采用针刺治疗,B组采用口服翁沥通胶囊治疗,C组采用针刺配合口服翁沥通胶囊治疗。观察3组治疗前后尿动力学各项指标[排尿后残余尿量(postvoid residual urine,PVR)、最大尿流率(maximum urine flow,Qmax)、最大逼尿肌压力]、国际前列腺症状评分(international prostate symptom score,IPSS)、生活质量(quality of life,QOL)评分、中医证候(排尿困难、夜尿频数、腰膝酸软、小腹胀满)积分及实验室指标[血清TNF-α、PSA、白细胞介素-6(interleukin-6,IL-6)、表皮细胞生长因子(epidermal growth factor,EGF)水平]的变化情况,比较3组临床疗效。结果3组治疗后PVR、最大逼尿肌压力、I-PSS、QOL评分、各项实验室指标及中医证候积分均较同组治疗前显著降低,Qmax均显著升高,差异均具有统计学意义(P<0.05)。C组治疗后PVR、最大逼尿肌压力、I-PSS、QOL评分、各项实验室指标及中医证候积分均明显低于A组和B组,Qmax均明显高于A组和B组,差异均具有统计学意义(P<0.05)。A组治疗后各项指标与B组比较,差异均无统计学意义(P>0.05)。C组总有效率为92.7%,明显高于A组的70.0%和B组的73.7%,差异均具有统计学意义(P<0.05)。结论针刺配合翁沥通胶囊治疗良性前列腺增生疗效确切,能降低患者TNF-α、PSA水平,改善其临床症状。

基于肿瘤微环境探讨免疫检查点治疗在前列腺癌的应用及进展

前列腺癌是男性最常见的癌症之一,前列腺癌患者的肿瘤微环境(TME)通常具有抑制免疫反应的特征,包括T细胞功能受损、免疫抑制性细胞浸润以及免疫检查点的过度表达,因此改善TME对于提高免疫治疗效果至关重要。免疫监测、基因组学分析和TME特征的评估可以确定最适合患者的治疗方案。然而,治疗效果因患者差异较大,个体化治疗策略显得尤为关键。本综述深入探讨了前列腺癌的免疫治疗策略,特别是针对TME的干预和个体化治疗策略,以及多层次的治疗组合,旨在为前列腺癌患者提供新的治疗思路和方法,从而提高其生存率和生活质量,为这一常见癌症的治疗提供有力的理论依据。

Using circulating tumor cells to advance precision medicine in prostate cancer

The field of circulating tumor cell(CTC)enrichment has seen many emerging technologies in recent years,which have resulted in the identification and monitoring of clinically relevant,CTC-based biomarkers that can be analyzed routinely without invasive procedures.Several molecular platforms have been used to investigate the molecular profile of the disease,from high throughput gene expression analyses down to single cell biological dissection.The established presence of CTC heterogeneity nevertheless constitutes a challenge for cell isolation as the several subpopulations can potentially display different molecular characteristics;in this scenario,careful consideration must be given to the isolation approach,whereas methods that discriminate against certain subpopulations may result in the exclusion of CTCs that carry biological relevance.In the context of prostate cancer,CTC molecular interrogation can enable longitudinal monitoring of key biological features during treatment with substantial clinical impact,as several biomarkers could predict tumor response to AR signaling inhibitors(abiraterone,enzalutamide)or standard chemotherapy(taxanes).Thus,CTCs represent a valuable opportunity to personalize medicine in current clinical practice.

前体药物甲氨喋呤-α-肽对前列腺癌动物模型治疗的研究

目的 :研究前列腺癌的导向酶 前体药物疗法 (ADEPT) ,在体内观察前体药物甲氨喋呤 α 肽对前列腺癌的作用。方法 :用前体药物甲氨喋呤 α 苯丙氨酸 (MTX α Phe )和甲氨喋呤 α 精氨酸 (MTX α Arg)对前列腺癌荷瘤裸鼠模型行肿瘤生长抑制及药物动力学的观察。结果 :经抗人精浆蛋白单克隆抗体导向的羧肽酶 A MTX α Phe动物模型体内试验 ,ADEPT治疗组肿瘤生长明显抑制 ,裸鼠生存时间延长 ,生活质量优于单用MTX组。药物动力学显示 ,抗人精浆蛋白单克隆抗体 羧肽酶A注入72h后 ,给于MTX α Phe治疗效果最佳。结论 :MTX α Phe +CP

“健脾利湿化瘀方”对人前列腺癌PC-3细胞荷瘤小鼠的抑瘤作用研究

目的:探讨"健脾利湿化瘀方"对人前列腺癌PC-3细胞小鼠荷瘤模型的抑瘤作用。方法:取60只雄性裸鼠,右前肢皮下接种人前列腺癌PC-3细胞,建立人前列腺癌PC-3细胞小鼠荷瘤模型。确定造模成功后随机分为荷瘤对照组、健脾利湿化瘀方治疗组(全方组)、扶正治疗组、化瘀治疗组、解毒治疗组、长春瑞滨治疗组(西药组),每组10只小鼠。荷瘤对照组给予0.3 m L生理盐水灌胃,每日灌胃2次;中药各治疗组给予0.3 m L中药汤剂灌胃(浓度2 g/m L),每日灌胃2次;长春瑞滨组每日腹腔注射1次,药物浓度6.7 mg/kg。给药14 d后,观察各组小鼠生存状态、测量其体质量及瘤体大小,处死后称量瘤重,计算抑瘤率。结果:各组间,西药组小鼠的生存状态最差,精神状态萎靡,灌胃期不满1周时就死亡过半,即脱落实验。荷瘤对照组小鼠灌胃期间共死亡3只,全方组灌胃期间死亡1只。体质量比较情况:第7天,各组间小鼠体质量下降比较无统计学差异(P>0.05);第14天,全方组与空白对照组相比,小鼠体质量下降具有统计学差异(P=0.032<0.05)。瘤体积变化情况:第7天、第14天各组间差异均无统计学意义(P>0.05)。瘤重结果显示:各组间小鼠瘤重差异具有统计学意义(P=0.04<0.05)。全方组、扶正治疗组、化瘀治疗组、解毒治疗组抑瘤率分别为53.97%、34.92%、22.22%、19.05%。结论:实验研究得出,"健脾利湿化瘀方"能够抑制人前列腺癌PC-3细胞裸鼠移植瘤的生长,有效改善裸鼠生存状态。

下调基因PTTG1表达对前列腺癌LNCaP-AI细胞增殖、侵袭和凋亡的影响

目的:探讨下调垂体肿瘤转化基因1(PTTG1)表达对雄激素非依赖性前列腺癌LNCa P-AI细胞增殖、侵袭、凋亡,以及对雄激素拮抗剂敏感性的影响。方法:LNCa P-AI细胞转染靶向PTTG1基因的siRNA,MTT法检测细胞增殖,Transwell法检测细胞侵袭,流式细胞术检测细胞凋亡,Western印迹检测PTTG1、p-Akt、p-ERK等蛋白表达水平,琼脂糖凝胶电泳法检测PTTG1 mRNA表达水平。结果:siRNA有效抑制了PTTG1的表达;下调PTTG1表达有效抑制了LNCa P-AI细胞在去雄激素培养液中的增殖,24、48、72 h抑制率分别为(19.47±2.12)%、(24.01±2.13)%、(48.02±2.22)%,组间比较有显著性差异(P<0.05);降低其侵袭力,Transwell试验显示,对照组、转染24、48、72 h后穿过聚碳酸酯膜细胞个数分别为111.11±13.47、74.67±9.85、56.44±8.66、37.33±6.14,组间比较有显著性差异(P<0.01);siRNA-PTTG1转染LNCa P-AI细胞后,空白对照组、转染24、48、72 h后凋亡率分别为(2.17±0.49)%、(18.32±0.94)%、(19.94±1.30)%、(21.73±1.88)%,各组间比较有显著性差异(P<0.05)。siRNA联合氟他胺组对LNCa P-AI增殖的抑制作用和促凋亡作用显著强于siRNA或者氟他胺组,并呈氟他胺浓度相关性;50 nmol/L氟他胺、siRNA联合50 nmol/L氟他胺对LNCa P-AI的抑制率分别为(27.13±3.52)%、(67.51±5.13)%,两组间比较有显著性差异(P<0.05);凋亡率分别为(3.94±0.48)%、(19.93±1.72)%,两组间比较有显著性差异(P<0.05);100 nmol/L氟他胺、siRNA联合100 nmol/L氟他胺的抑制率分别为(43.72±3.90)%、(73.19±4.78)%,两组间比较有显著性差异(P<0.05);凋亡率分别为(5.33±0.66)%、(23.43±1.76)%,两组间比较有显著性差异(P<0.05)。结论:siRNA下调PTTG1表达能够抑制LNCa P-AI的增殖和侵袭,促进凋亡,提高了LNCa P-AI细胞对雄激素拮抗剂氟他胺的敏感性,抑制PTTG1表达可能会强化雄激素剥夺治疗晚期前列腺癌的作用。

超声造影早期预测前列腺癌经内分泌治疗后进展为去势抵抗性前列腺癌的价值

目的:探讨超声造影(CEUS)联合常见影响因素早期预测前列腺癌(PCa)患者经内分泌治疗后2年内进展为去势抵抗性前列腺癌(CRPC)的价值。方法:选择接受内分泌治疗的92例中晚期PCa患者作为研究对象,治疗前均接受前列腺特异抗原(PSA)水平测定、CEUS检查以及病理分级。内分泌治疗后进行2年随访,随访期间进展为CRPC的PCa患者纳入预后不良组,其余患者纳入预后良好组。比较两组患者的临床指标及CEUS参数,并利用多因素COX回归进行筛选,获得PCa患者进展为CRPC的影响因素。利用受试者工作特征(ROC)曲线评估潜在影响因素早期预测CRPC的价值,并分析各影响因素的联合模型早期预测CRPC的准确性。结果:2年随访期内CRPC的发生率为63.04%(58/92)。多因素COX回归分析结果显示,T分期(P=0.021)、M分期(P=0.024)、Gleason评分(P=0.018)、治疗前PSA(P=0.004)、AUC TIC(P=0.003)是影响PCa进展为CRPC的独立影响因素。ROC曲线分析结果显示各指标预测CRPC的准确性均不高(AUC均<0.9),其中AUC TIC的准确性最高(AUC=0.818)。T分期、M分期、Gleason评分、治疗前PSA的联合可以提高早期预测CRPC的准确性,但准确性仍然不够高(AUC=0.834<0.9)。结合AUC TIC的联合预测模型能够在早期准确预测PCa患者进展为CRPC的概率(AUC=0.910),拟合方程为Logit(P)=-1.259+0.667×M分期+0.420×T分期+0.164×Gleason评分+0.021×治疗前PSA+0.007×AUC TIC。结论:Gleason评分、T分期、M期、治疗前PSA以及AUC TIC是早期预测老年PCa患者进展为CRPC的独立影响因素,利用超声造影指标AUC TIC结合常规临床指标建立的预测模型可以早期准确预测PCa患者进展为CRPC的概率。

消瘀散结抑癌灌肠剂治疗晚期前列腺癌的临床研究

【目的】观察中药消瘀散结抑癌灌肠剂治疗晚期前列腺癌的临床疗效。【方法】根据自愿原则,将22例患者分为治疗组(15例)和对照组(7例)。对照组仅给予最大限度雄激素阻断治疗(MAB),治疗组在MAB治疗基础上给予消瘀散结抑癌灌肠剂(由山慈菇、夏枯草、莪术、虎杖、吴茱萸等组成)灌肠,隔天1次,2组疗程均为2个月。观察2组治疗前后前列腺体积、前列腺特异性抗原(PSA)、最大尿流率(MFR)等指标的变化。【结果】(1)在依从性方面,治疗组中有2例因不能耐受灌肠而退出研究,其他20例均获得随访2个月。(2)治疗后2组患者血清PSA水平均明显降低(与治疗前比较,P<0.01),但治疗组的降低作用明显优于对照组(P<0.05)。(3)治疗后2组患者前列腺的体积均有所缩小(与治疗前比较,P<0.05),分别缩小达到26.1%和26.2%。2组治疗后比较,差异无显著性意义(P>0.05),表明2组在缩小前列腺体积方面作用相似。(4)治疗后2组患者的MFR均明显改善(与治疗前比较,P<0.01)。2组治疗后比较,差异有显著性意义(P<0.05),表明治疗组在改善患者最大尿流率方面优于对照组。【结论】中药协同MAB治疗晚期前列腺癌作用优于单用MAB;灌肠给药是个很好的给药途径,可直达病所且副作用少、起效快。

雄激素受体三螺旋形成寡核苷酸抗前列腺癌细胞增殖的研究

目的 探讨反基因策略对雄激素受体(AR)表达和前列腺癌细胞增殖的影响。方法 针对AR基因2 4 4 7～2 4 6 1核苷酸序列设计并合成三螺旋形成寡核苷酸(TFO) ,经脂质体介导转染LN CaP前列腺癌细胞株,于转染后2 4、4 8、72h分别采用3H 胸腺嘧啶核苷(TdR)参入实验测定癌细胞增殖活性,用逆转录聚合酶链反应(RT PCR)方法检测ARmRNA表达,用放射配基结合分析法(RBA)单点法检测AR蛋白质表达,并与反义寡核苷酸(ASON)相比较。结果 2 4、4 8、72hTFO组LNCaP细胞的AR表达水平明显低于ASON组(P <0 0 5 ) ,TFO对LNCaP细胞增殖的抑制率显著高于ASON(P <0 0 5 )。结论 该TFO能有效抑制AR表达和前列腺癌细胞增殖。

前列腺分叶状肿瘤一例诊治分析

目的探讨前列腺分叶状肿瘤(phyllodes tumor,PT)的临床表现、诊断及治疗方法。方法报告1例前列腺分叶状肿瘤,结合文献分析其临床表现、病理特征和免疫组化表达、诊断及治疗。结果前列腺PT的临床症状类似良性前列腺增生(BPH),影像学检查有囊性改变。临床治疗多行根治性前列腺切除,病理检查显示肿瘤由上皮和间质成分组成,上皮细胞增生,无异型性,间质细胞增生伴不同程度异型,并可挤压突入腔隙形成裂隙状或分叶状外观。免疫组化染色显示上皮细胞表达细胞角蛋白(CK)、上皮膜抗原(EMA),间质细胞表达波形蛋白(V imentin),部分表达平滑肌肌动蛋白(SMA),术后可给予放化疗。结论前列腺PT少见,确诊依靠病理检查。根治性前列腺切除术是目前主要的治疗方法,放疗与化疗有一定的临床价值。

垂体肿瘤转化基因1在雄激素非依赖性前列腺癌发生过程中的表达变化

目的:探讨垂体肿瘤转化基因1(PTTG1)在前列腺癌由激素依赖性转化为激素非依赖性过程中的表达变化。方法:通过在去雄激素培养条件下长期培养雄激素依赖性前列腺癌细胞株LNCa P,建立并验证雄激素非依赖性亚系LNCa P-AI细胞模型,用Western印迹、RT-PCR方法每2周检测在去雄激素培养过程中PTTG1的表达改变。结果:经过3个月培养,成功建立雄激素非依赖性亚系LNCa P-AI细胞模型;在LNCa P细胞中,随着去雄激素培养时间延长,PTTG1的表达水平逐渐升高,基质金属蛋白酶-2(MMP-2)和MMP-9表达有同步升高趋势。结论:PTTG1表达在雄激素非依赖性前列腺癌发生过程中逐渐增强,可能是晚期前列腺癌基因治疗的靶标之一。

单纯内分泌与内分泌加内照射治疗晚期前列腺癌的疗效对比分析

目的 :研究核素内照射改善前列腺癌骨转移引起的疼痛及对骨转移治疗的疗效 ,并与内分泌治疗进行比较。方法 :对 5 2例前列腺癌骨转移患者均采用双侧睾丸切除加氟他胺 (2 5 0mg ,3次 /d)治疗。所有患者均于术前不同时间出现明显的疼痛症状 ,其中 15例接受89锶内照射治疗 (14 8MBq静脉注射 ) ,8例接受153 Sm EDTMP内照射治疗 (37MBq/kg静脉注射 ,1次 /月 ) ;2 9例未接受内照射治疗者作为对照组。 结果 :89锶治疗组有 14例患者疼痛明显缓解 ,占 93.3% (14 / 15 ) ;153 Sm EDTMP治疗组有 6例疼痛明显缓解 ,占 75 .0 % (6 / 8) ;单纯内分泌治疗组经调整药物剂量或结构后 ,疼痛明显缓解者仅 9例 ,占 31.0 % (9/ 2 9)。99Tcm MDP全身骨显像示骨转移病灶出现不同程度的好转 ,其中89锶治疗组有 11例 ,占 73.3% (11/ 15 ) ;153 Sm EDTMP治疗组有 5例 ,占6 2 .5 % (5 / 8) ,而单纯内分泌组有 7例 ,占 2 4 .1% (7/ 2 9)。89锶治疗组 3例、153 Sm EDTMP治疗组有 2例出现血白细胞和血小板明显下降 ,经对症治疗后恢复。结论 :核素内照射治疗能改善前列腺癌骨转移引起的疼痛 ,并可不同程度地抑制肿瘤骨转移灶的生长 ,但必须密切观察血红蛋白。

去势抵抗性前列腺癌的临床精准治疗进展

近年来,我国前列腺癌的发病率呈逐年上升趋势,且大多数患者就诊时癌细胞已经发生转移,内分泌治疗可使多数患者的病情得到控制和改善,但经过一段时间缓解后多数患者极易发展为去势抵抗性前列腺癌(CRPC)。此类患者预后极差,治疗颇为棘手,迫切需要新的治疗策略。精准医学是根据每个患者的个体差异,制定最为合适的个性化治疗方案。基因组、蛋白质组、代谢组等海量生物学数据及大数据分析方法是精准医学模式的精髓。精准医学为人类攻克肿瘤带来了希望。本文就CRPC精准医学的内涵、二代测序及基因组测序在CRPC中的应用及CRPC临床分子靶向治疗的进展进行综述,以总结和探讨CRPC临床精准医学研究的进展。

多功能纳米载体输送疏水性化疗药物抗前列腺癌细胞作用的研究

目的:使用新型纳米载体:叶酸靶向PEG-PAsp(DIP-co-BzA)输送紫杉醇(PTX)特异性促PC-3细胞(人前列腺癌细胞)凋亡,初步探讨其进入PC-3细胞的效率及对体外细胞毒性作用。方法:构建纳米聚合物叶酸靶向PEG-PAsp(DIP-co-BzA)后,测定载体的药物包裹率、pH响应性和不同浓度的毒性;通过MTT实验、流式细胞术等试验对叶酸靶向PEG-PAsp(DIP-co-BzA)传输化疗药PTX至PC-3细胞的靶向性进行研究。结果:由于叶酸配体对叶酸受体的亲和力,体外培养的PC-3细胞对叶酸靶向组PEG-PAsp(DIP-co-BzA)/PTX的摄取量明显高于非靶向组,这些靶向型PEG-PAsp(DIP-co-BzA)/PTX在pH≈7.4的生理条件下具有良好的化学和胶体稳定性,包埋在胶束中的PTX在pH≈5.0环境中能完全释放。换言之,这种聚合物胶束具有pH响应的核心,增强了药物在酸性环境中的释放。结论:在前列腺癌治疗中叶酸靶向pH响应聚合物胶束为疏水性PTX的转运提供了一种有效的途径。