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.
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.
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。
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.
Radionuclides can be labeled on biomolecules with specific binding ability. By binding with specific targets of tumors, particles such as α or β emitted by the radionuclides will specifically irradiate tumors and produce ionizing radiation effects, resulting in cell senescence and death within the irradiation range, achieving tumor treatment results, and this way has little impact on surrounding normal tissues. Lutetium-177 (177Lu) can emit γ rays for CT imaging, and can also emit β rays for tumor treatment, so 177Lu is now one of the radionuclides that can be used for integrated diagnosis and treatment. This review summarizes the clinical application of 177Lu in several solid tumors, in conjunction with currently published research.
ObjectiveTo explore the feasibility of targeted cryoablation for localized prostate cancer in day surgery.MethodThe clinical data of patients with localized prostate cancer who underwent cryoablation from April 2017 to May 2019 were retrospective analyzed. The patients’ satisfaction, postoperative complications, chronic pain and indwelling catheter term were recorded on the 1st (the next day after operation) and 7th day after the operation of follow-up.ResultsA total of 98 patients were included. All patients underwent the surgeries successfully. The average age of the patients was (73.43±7.86) years old. The average length of postoperative hospital stay was (1.55±0.43) days, including 34 cases (34.69%) discharged within 24 hours after the surgery. The satisfaction rate of patients was 100% on the 1st and 7th day after the operation. Twelve cases (12.24%) removed the catheter at the discharge, 83 cases (84.69%) removed the catheter on the 7th day after the operation. Because of the urinary retention, 3 cases (3.06%) removed the catheter 2 weeks after the operation. All patients were satisfied with urine control after the removal of the catheter. Ten cases (10.20%) had postoperative complications, including 3 of urinary tract infection, 3 of urinary retention, and 4 of perineal edema; the patients recovered after symptomatic treatment. On the day of surgery, 8 cases (8.16%) had slight postoperative pain in perineal (the Visual Analogue Scale scores were all 2). After oral analgesic treatment, the patients’ symptoms were alleviated.ConclusionTargeted cryoablation is a safe and effective method for the treatment of localized prostate cancer with a low incidence of postoperative complications, and it has certain feasibility in day surgery mode.
目的 应用判别分析探讨不同指标对前列腺癌预测诊断中的应用价值。 方法 收集2008年1月－2011年9月经直肠超声检查并行经直肠超声引导下经会阴前列腺穿刺活检术，具有前列腺特异性抗原（PSA）、超声图像特征的941例患者以及其中含有血流阻力指数（RI）指标的200例患者的临床资料，采用最近距离及极大似然判别分析两种方法分别拟合患者年龄、血清PSA、经直肠前列腺超声声像图特征以及RI指标预测前列腺癌。 结果 最近距离判别分析显示RI对前列腺癌的判别无临床意义。联合患者年龄、超声检查和血清PSA值，判别结果提示超声、超声+年龄、年龄+超声+PSA三种判别的灵敏度逐渐增加。年龄+超声+PSA联合指标的灵敏度为88.89%，其错判率在20.00%以内。 结论 年龄+超声+PSA联合指标的极大似然判别分析可提高前列腺癌的诊断预测水平，避免前列腺穿刺给患者带来的痛苦，并给临床医生的临床诊断提供参考，有较好的应用价值。