经直肠超声联合前列腺特异抗原密度诊断前列腺癌的临床应用价值研究

为探讨经直肠超声与前列腺特异抗原密度(PSAD)联合检查诊断前列腺癌的临床应用价值,选取本院2013年9月~2018年9月期间内接收的97例血清前列腺特异性抗原(PSA)患者实施研究。所有患者均行经直肠超声与前列腺特异抗原密度(PSAD)联合检查,并与手术病理结果进行对比。观察PSAD检查结果,分析经直肠超声与PSAD联合检查的诊断符合率,并对比病理结果与经直肠超声和PSAD联合检查的准确率、灵敏性、特异性情况,分析前列腺癌患者经直肠超声检查的影像学特征及内部回声情况。与病理结果对比,经直肠超声与PSAD联合检查对前列腺癌、移行细胞癌、黏液腺癌检出率均稍低(P>0.05);经直肠超声与PSAD联合检查的准确率、灵敏性、特异性较病理检查均稍低(P>0.05)。经直肠超声检查后根据图像表现可将疾病分为弥漫性、结节型、无结节型3型,不同类型的影像学特征及内部回声情况表现不同,表明经直肠超声与PSAD联合诊断前列腺癌准确性较高,并且可清晰地对不同疾病类型的内部回声作出反映,临床实用价值较高,值得加以推广。     

磁共振弥散成像与超声弹性成像在前列腺穿刺活检中的应用价值

本研究探讨磁共振弥散成像(DWI)与超声弹性成像(UE)在前列腺穿刺活检中的应用价值.112例疑似前列腺癌(PCa)患者中,经前列腺活检病理穿刺证实为阳性(PCa) 59例、阴性(前列腺良性增生)53例.经研究发现,前列腺穿刺活检穿刺阳性患者超声弹性评分高于阴性患者,表观扩散系数(ADC)值低于阴性患者,二者均为前列腺...     

超声引导下甲状腺细针穿刺活检对PTMC的诊断价值

本研究探讨超声引导下甲状腺细针穿刺活检(US-FNAB)对甲状腺微小乳头状癌(PTMC)的诊断价值。选取经病理学检查确诊的203例甲状腺微小结节患者(203个结节)作为研究对象,所有患者均接受了US-FNAB检查,分析不同细胞学特征的甲状腺微小结节与甲状腺Bethesda分类的关系,并以病理学检查结果作为金标准,分析US-FNAB诊断PTMC的价值。根据甲状腺Bethesda分类标准,其中Ⅰ类结节0个、Ⅱ类结节33个、Ⅲ类结节49个、Ⅳ类结节51个、Ⅴ类结节40个、Ⅵ类结节30个。恶性甲状腺结节中实性结节、低回声结节、结节边界模糊、结节纵横径比≥1的占比均大于良性结节(P<0.05);US-FNAB鉴别诊断PTMC与甲状腺良性结节的灵敏度为85.29%、特异度为91.11%;超声鉴别诊断PTMC与甲状腺良性结节的灵敏度为75.00%、特异度为83.70%。US-FNAB对PTMC的诊断价值高于超声检查,对于制定临床个体化治疗方案具有重要意义。     

超声及超声造影引导下粗针活检在周围型肺部病变中的应用

探讨超声及超声造影引导下粗针活检在周围型肺部病变中的应用价值。选择158例经CT或MRI诊断为周围型肺部病变的患者作为研究对象,将其分为常规超声组及超声造影组。常规超声组在普通超声引导下进行穿刺活检,超声造影组则在普通超声的基础上行超声造影检查,然后在其引导下行经皮穿刺活检。比较超声造影组与常规超声组穿刺成功率、病灶内坏死的显示率、亚型(分类)诊断准确率、表皮生长因子受体(EGFR)阳性率及穿刺术后并发症等情况。根据病理结果,超声造影组的成功率(100%)明显高于常规超声组(90%),P<0.05。超声造影组的坏死显示率(46%)明显高于常规超声组(21%),P<0.05。超声造影组的亚型(分类)诊断准确率(96%)略高于常规超声组(94%),差异无统计学意义(P>0.05)。超声造影组的EGFR阳性率(32%)略低于常规超声组(35%),差异无统计学意义(P>0.05)。超声及超声造影引导下穿刺对于周围型肺部病变的诊断具有重要价值,超声造影对于病灶与周边组织结构的关系及病灶内部的血流情况较常规超声更具优势,可有效提高穿刺成功率。     

经直肠三维超声与应变力弹性成像对前列腺癌术后膀胱出口畅通度的评估

本文分析经直肠三维超声与应变力弹性成像对老年患者前列腺癌术后膀胱出口畅通度的诊断价值。选取130例老年前列腺癌患者作为研究对象,根据术后膀胱出口畅通度分为对照组与研究组,各65例。所有患者均进行经直肠三维超声、应变力弹性成像检查及尿动力学检查。结果显示,研究组患者的最大膀胱灌注量、最大尿流率(Qmax)测定值低于对照组患者(P<0.05),研究组患者的残余尿量(PVR)、最大逼尿肌压力(Pdetmax)、超声测量膀胱质量(UEBW)、最大弹性评分、动脉阻力指数、移行带指数、突入指数高于对照组患者(P<0.05)。与经直肠三维超声、应变力弹性成像单项诊断相比,两项联合对老年前列腺癌术后膀胱出口畅通度诊断价值较高,曲线下面积(AUC)为0.868(P<0.05)。经直肠三维超声与应变力弹性成像在老年患者前列腺癌术后膀胱出口畅通度的诊断中具有较高价值。     

核磁共振联合超声融合成像引导下前列腺靶向穿刺对PI-RADS评分≥3分的前列腺癌患者的诊断价值

为了探讨核磁共振(MRI)联合超声融合成像引导下前列腺靶向穿刺(MR-TRUS)对PI-RADS评分≥3分的前列腺癌患者的诊断价值,本研究选取了进行前列腺癌筛查且MRI检查PI-RADS评分≥3分的患者100例,均行MRI与超声融合靶向穿刺和传统穿刺.并对上述100名患者进行前列腺特异性抗原(PSA)检测,按4＜PSA...     

经阴道超声联合经腹部超声在异位妊娠诊断中的应用

本研究探讨经阴道超声联合经腹部超声在异位妊娠诊断中的价值.选取疑似异位妊娠患者130例作为为研究对象,行腹部超声、阴道超声检查,确诊异位妊娠患者103例,非异位妊娠者27例.盆腔积液、心血管搏动、附件包块检出率中,经阴道超声高于经腹部超声(P＜0.05);经阴道超声联合经腹部超声诊断异位妊娠的敏感性、准确性、阴性预测值...     

超声联合计算机在晚期恶性梗阻性黄疸治疗中的应用

本文探讨了常规超声、超声造影联合计算机辅助在内镜下逆行胰胆管造影术(ERCP)、经皮经肝穿刺胆道引流术(PTCD)与超声内镜引导下胆道引流术(EUS-BD)治疗晚期恶性梗阻性黄疸中的应用。选取54例晚期恶性梗阻性黄疸患者为研究对象,将其分为ERCP组、PTCD组、EUS-BD组,分析三组患者住院天数、近期并发症和肝脏功能指标等。结果显示:(1)三组患者手术后在治疗晚期恶性梗阻性黄疸效果显著(P<0.01);(2)与其他两组相比,EUS-BD组并发症和住院天数最少(P<0.05);(3)病理分析结果显示,ERCP组和EUS-BD组对导管伤害较少。总之,EUS-BD组患者采用常规超声联合计算机辅助技术,与ERCP组超声造影及PTCD组常规超声相比,更具备优势。     

经腹联合经阴道彩超在评估凶险型前置胎盘合并胎盘植入中的应用价值

本文对经腹联合经阴道彩超在评估凶险型前置胎盘(PPP)合并胎盘植入中的应用价值进行了探讨。选取我院2017年6月~2019年6月PPP患者172例,所有患者均给予经腹彩超、经阴道彩超检查,以产后病理结果为对照,分析经腹彩超、经阴道彩超,以及二者联合,对PPP合并胎盘植入的评估价值。产后病理结果显示,172例PPP患者中,有合并胎盘植入患者120例(69.77%)、无合并胎盘植入患者52例(30.23%)。对PPP合并胎盘植入的敏感度、特异度、准确度进行评估,结果显示,经腹彩超其值分别为76.67%、73.08%、75.58%,经阴道彩超分别为83.33%、80.77%、82.56%,经腹联合经阴道彩超则分别为96.67%、96.15%、96.51%,二者联合明显高于经腹彩超、经阴道彩超,差异有统计学意义(P<0.05)。证实经腹、经阴道彩超是评估PPP合并胎盘植入的有效检查方法,且二者联合的评估价值更高,值得临床推广。     

三维超声定量参数在宫腔粘连诊断中的应用价值

探讨三维超声在宫腔粘连早期诊断的价值.选取疑似宫腔粘连患者110例,给予阴道三维超声及宫腔镜检查.最终确诊宫腔粘连患者72例.宫腔粘连患者妊娠次数≥2次、人流次数≥2次和清宫次数≥2次的比例明显高于宫腔正常者(P＜0.05);阴道三维超声诊断宫腔粘连的灵敏性、特异性、准确率、阳性预测值和阴性预测值均高于80.00％;三...     

前列腺癌相关肿瘤标志物分析方法的研究进展

肿瘤标志物是在恶性肿瘤细胞中过表达的一类蛋白质,能反映肿瘤的发生、发展,并能监测肿瘤治疗的效果.因此,癌症患者血清中的肿瘤标志物的分析对于癌症状态的监测具有重要意义.常见的前列腺肿瘤标志物包括前列腺特异性抗原(PSA)、前列腺特异性膜抗原(PSMA)、α-甲酰基辅酶A消旋酶(AMACR, P504S)、前列腺酸性磷酸酶(PAP)和钙磷脂结合蛋白3(ANXA3)等.基于对前列腺肿瘤标志物的相关研究,本综述简要介绍了前列腺癌肿瘤标志物的组成、生物功能和生理意义,重点归纳了前列腺癌特异性抗原和前列腺酸性磷酸酶的检测技术,总结了当前前列腺癌肿瘤标志物检测技术的不足,并展望了前列腺癌肿瘤标志物检测在临床应用中的前景.     

High Throughput Isolation and Data Independent Acquisition Mass Spectrometry (DIA-MS) of Urinary Extracellular Vesicles to Improve Prostate Cancer Diagnosis

Proteomic profiling of extracellular vesicles (EVs) represents a promising approach for early detection and therapeutic monitoring of diseases such as cancer. The focus of this study was to apply robust EV isolation and subsequent data-independent acquisition mass spectrometry (DIA-MS) for urinary EV proteomics of prostate cancer and prostate inflammation patients. Urinary EVs were isolated by functionalized magnetic beads through chemical affinity on an automatic station, and EV proteins were analyzed by integrating three library-base analyses (Direct-DIA, GPF-DIA, and Fractionated DDA-base DIA) to improve the coverage and quantitation. We assessed the levels of urinary EV-associated proteins based on 40 samples consisting of 20 cases and 20 controls, where 18 EV proteins were identified to be differentiated in prostate cancer outcome, of which three (i.e., SERPINA3, LRG1, and SCGB3A1) were shown to be consistently upregulated. We also observed 6 out of the 18 (33%) EV proteins that had been developed as drug targets, while some of them showed protein-protein interactions. Moreover, the potential mechanistic pathways of 18 significantly different EV proteins were enriched in metabolic, immune, and inflammatory activities. These results showed consistency in an independent cohort with 20 participants. Using a random forest algorithm for classification assessment, including the identified EV proteins, we found that SERPINA3, LRG1, or SCGB3A1 add predictable value in addition to age, prostate size, body mass index (BMI), and prostate-specific antigen (PSA). In summary, the current study demonstrates a translational workflow to identify EV proteins as molecular markers to improve the clinical diagnosis of prostate cancer.     

Recent Advances in Nanomedicine for the Diagnosis and Treatment of Prostate Cancer Bone Metastasis

Patients with advanced prostate cancer can develop painful and debilitating bone metastases. Currently available interventions for prostate cancer bone metastases, including chemotherapy, bisphosphonates, and radiopharmaceuticals, are only palliative. They can relieve pain, reduce complications (e.g., bone fractures), and improve quality of life, but they do not significantly improve survival times. Therefore, additional strategies to enhance the diagnosis and treatment of prostate cancer bone metastases are needed. Nanotechnology is a versatile platform that has been used to increase the specificity and therapeutic efficacy of various treatments for prostate cancer bone metastases. In this review, we summarize preclinical research that utilizes nanotechnology to develop novel diagnostic imaging tools, translational models, and therapies to combat prostate cancer bone metastases.     

Using the Method of “Optical Biopsy” of Prostatic Tissue to Diagnose Prostate Cancer

Simple SummaryAnalytical discrimination models of Raman spectra of prostate cancer tissue were constructed by using the projections onto latent structures data analysis (PLS-DA) method for different wavelengths of exciting radiation—532 and 785 nm. These models allowed us to divide the Raman spectra of prostate cancer and the spectra of hyperplasia sites for validation datasets with the accuracy of 70–80%, depending on the specificity value. Meanwhile, for the calibration datasets, the accuracy values reached 100% for the excitation of a laser with a wavelength of 785 nm. Due to the registration of Raman “fingerprints”, the main features of cellular metabolism occurring in the tissue of a malignant prostate tumor were confirmed, namely the absence of aerobic glycolysis, over-expression of markers, and a strong increase in the concentration of cholesterol and its esters, as well as fatty acids and glutamic acid.AbstractThe possibilities of using optical spectroscopy methods in the differential diagnosis of prostate cancer were investigated. Analytical discrimination models of Raman spectra of prostate tissue were constructed by using the projections onto latent structures data analysis(PLS-DA) method for different wavelengths of exciting radiation—532 and 785 nm. These models allowed us to divide the Raman spectra of prostate cancer and the spectra of hyperplasia sites for validation datasets with the accuracy of 70–80%, depending on the specificity value. Meanwhile, for the calibration datasets, the accuracy values reached 100% for the excitation of a laser with a wavelength of 785 nm. Due to the registration of Raman “fingerprints”, the main features of cellular metabolism occurring in the tissue of a malignant prostate tumor were confirmed, namely the absence of aerobic glycolysis, over-expression of markers (FASN, SREBP1, stearoyl-CoA desaturase, etc.), and a strong increase in the concentration of cholesterol and its esters, as well as fatty acids and glutamic acid. The presence of an ensemble of Raman peaks with increased intensity, inherent in fatty acid, beta-glucose, glutamic acid, and cholesterol, is a fundamental factor for the identification of prostate cancer.     

Assessment of the Efficacy of Olive Leaf (Olea europaea L.) Extracts in the Treatment of Colorectal Cancer and Prostate Cancer Using In Vitro Cell Models

Cancer is one of the most serious public health issues worldwide, ranking second only to cardiovascular diseases as a cause of death. Numerous plant extracts have extraordinary health benefits and have been used for centuries to treat a variety of ailments with few side effects. Olive leaves have a long history of medicinal and therapeutic use. In this study, the anti-cancer properties of an olive leaf extract were investigated in vitro using colorectal and prostate cancer cell lines (HT29 and PC3, respectively). A high-performance liquid chromatography analysis showed that the olive leaf extract contained a high chlorogenic acid content. Accordingly, chlorogenic acid may be related to the observed effects of the aqueous extract on cancer cells, including increased inhibition of cancer cell growth, migration, DNA fragmentation, cell cycle arrest at the S phase, reactive oxygen species (ROS) production, and altered gene expression. The effects of the extracts were greater in HT29 than in PC3 cells. These results suggest that chlorogenic acid, the main constituent in the olive extract, is a promising new anti-cancer agent. Further analyses should focus on its in vivo effects on colorectal tumor models, both alone and in combination with established agents.     

Super Early Scan of PSMA PET/CT in Evaluating Primary and Metastatic Lesions of Prostate Cancer

⁶⁸Ga-prostate specific membrane antigen (PSMA)-11 PET/CT has been widely used in the diagnosis of prostate cancer (PCa); however, the urine lead shielding resulting from the urinary metabolism of tracers may obstruct the detection of surrounding metastasis. In this research, the additive value of super early scanning in diagnosing primary lesions and metastasis in the pelvic cavity was evaluated. Firstly, the differentiation efficiency of ⁶⁸Ga-PSMA-11 PET scanned at 3 min post-injection (min P.I.) was measured in PSMA-positive (22rv1 cells) and PSMA-negative (PC3 cells) model mice. Secondly, 106 patients were scanned at 3 min P.I. for the pelvic cavity and then scanned as a standard protocol at 45 min P.I. In the results, the differential diagnosis of PSMA expression was completely reflected as early as 3 min P.I. for mice models. For patients, when correlated with the Gleason score, the quantitative results of the super early scan displayed a comparable correlation coefficient with the routine scan. The target to bladder ratios increased from 1.44 ± 2.40 at 45 min to 10.10 ± 19.10 at 3 min (p < 0.001) for the primary lesions, and it increased from 0.99 ± 1.88 to 9.27 ± 23.03 for metastasis. Meanwhile, the target to background ratios increased from 2.21 ± 2.44 at 3 min to 19.13 ± 23.93 at 45 min (p < 0.001) for the primary lesions, and it increased from 1.68 ± 2.71 to 12.04 ± 18.73 (p < 0.001) for metastasis. In conclusion, super early scanning of ⁶⁸Ga-PSMA-11 PET/CT added referable information for metastasis detection in order to avoid disturbing tracer activity in the urinary system.     

增强CT联合血清指标诊断结直肠癌的价值

本文探讨癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、胰岛素样生长因子结合蛋白-3(IGFBP-3)及增强CT在结直肠癌中的联合诊断效果。选取100例结直肠癌患作为观察组,同时选取结直肠良性肿瘤患者60例作为对照组,检测血清CEA、CA19-9、IGFBP-3,同时给予增强CT检查。观察组血清CEA和CA19-9高于对照组(P<0.05),而IGFBP-3低于对照组(P<0.05);TNM分期Ⅲ~Ⅳ和Ⅰ~Ⅱ患者血清CEA、CA19-9和IGFBP-3差异比较有统计学意义(P<0.05);增强CT联合血清指标联合诊断灵敏性为89.00%、特异性为90.00%;增强CT诊断结直肠癌T分期、N分期与病理结果Kappa值分别为0.696和0.790(P<0.05)。CEA、CA19-9、IGFBP-3联合增强CT是一种具有较高效能的结直肠癌诊断方法。     

血清CEA、CA19-9检测诊断老年胃癌的价值探讨

目的对应用血清CEA、CA19-9联合检测方式对患有胃癌疾病的老年患者的病情实施诊断的临床价值进行研究。方法选择广丰县中医院收治的患有胃癌疾病和胃部良性疾病的老年患者各60例,再抽取同期接受健康体检的健康老年人资料60例,分别将其定义为研究1组、研究2组、对照组。采用化学发光法对三组研究对象的血清CEA、CA19-9水平进行测定,对比分析检测结果和两项指标的阳性率。结果研究1组的血清CEA、CA19-9水平明显高于对照组和研究2组,组间数据比较差异显著(P0.05);研究2组的血清CEA、CA19-9水平明显高于对照组,组间数据比较差异显著(P0.05)。研究1组的CEA、CA19-9水平检测阳性人数明显多于对照组和研究2组,组间数据比较差异显著(P0.05);研究2组的CEA、CA19-9水平检测阳性人数明显多于对照组,组间数据比较差异显著(P0.05)。结论患有胃癌疾病的老年患者的血清CEA、CA19-9水平会异常升高,临床上可以将其作为老年胃癌疾病诊断的重要依据。     

A Review on the Current State and Future Perspectives of [99mTc]Tc-Housed PSMA-i in Prostate Cancer

Recently, prostate-specific membrane antigen (PSMA) has gained momentum in tumor nuclear molecular imaging as an excellent target for both the diagnosis and therapy of prostate cancer. Since 2008, after years of preclinical research efforts, a plentitude of radiolabeled compounds mainly based on low molecular weight PSMA inhibitors (PSMA-i) have been described for imaging and theranostic applications, and some of them have been transferred to the clinic. Most of these compounds include radiometals (e.g., ⁶⁸Ga, ⁶⁴Cu, ¹⁷⁷Lu) for positron emission tomography (PET) imaging or endoradiotherapy. Nowadays, although the development of new PET tracers has caused a significant drop in single-photon emission tomography (SPECT) research programs and the development of new technetium-99m (^99mTc) tracers is rare, this radionuclide remains the best atom for SPECT imaging owing to its ideal physical decay properties, convenient availability, and rich and versatile coordination chemistry. Indeed, ^99mTc still plays a relevant role in diagnostic nuclear medicine, as the number of clinical examinations based on ^99mTc outscores that of PET agents and ^99mTc-PSMA SPECT/CT may be a cost-effective alternative for ⁶⁸Ga-PSMA PET/CT. This review aims to give an overview of the specific features of the developed [^99mTc]Tc-tagged PSMA agents with particular attention to [^99mTc]Tc-PSMA-i. The chemical and pharmacological properties of the latter will be compared and discussed, highlighting the pros and cons with respect to [⁶⁸Ga]Ga-PSMA11.