prostate

摘要： 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.

摘要： Low dose rate brachytherapy(LDR)is an accepted,effective treatment with few local side effects,used as monotherapy in patients with low-risk prostate cancer(PC).The aim of this paper is to analyse 245 patients treated with LDR in the Radiation Oncology Department of the Hospital Gómez Ulla,from 2004 to 2016,evaluating the relationship of dosimetric parameters with biochemical and local recurrence as well as genitourinary and gastrointestinal toxicity derived from the technique.The results obtained show a clear relationship between the dose used and biochemical and local failure.

摘要： Prostate-targeted biopsy is usually the preferred method over systematic biopsy because it can effectively detect prostate cancer using only a few puncture cores with fewer complications.With the development of ultrasound,it has gained multimodal technological upgrades,such as the emergence of contrast-enhanced ultrasound,ultrasound elastography,and three-dimensional ultrasonography.Moreover,multimodal ultrasound has played an increasingly significant role in prostate-targeted biopsies.

摘要： BACKGROUND To summarize the imaging,morphological and biological characteristics of sarcomatoid carcinoma(SC)of the prostate with bladder invasion not long after castration.CASE SUMMARY Our two cases were initially diagnosed with adenocarcinoma of the prostate due to dysuria.However,prostate SC was diagnosed after transurethral resection of the prostate(TURP)and castration after only 5 and 10 mo,respectively.Distinctive liver-like tissues appeared in the second TURP procedure in case 1,while a white,fish flesh-like,narrow pedicled soft globe protruded from the prostate to the bladder in case 2.CONCLUSION The sarcomatoid component of SC may arise from one of the specific groups of cancer cells that are resistant to hormonal therapy.Morphological characteristics of SCs can present as“red hepatization”and“fish flesh”.SCs grow rapidly and have a poor prognosis,and thus,extensive TURP plus radiation may be the treatment of choice.

摘要： Dear editor,With the spread of prostate-specific antigen(PSA)screening,an increasing number of early-stage prostate cancers have been diagnosed recently,although many patients are still diagnosed in the advanced stage[1].Although most prostate cancers with metastatic lesions respond to initial androgen ablation therapy,responders ultimately develop progressive disease due to hormone-refractory cancer.

摘要： In this study,we used a meta-analysis method to evaluate the relationship between hypoxia-inducible factor-1α(HIF1α)1772C/T gene polymorphism(rs 11549465)and renal cell carcinoma(RCC)/prostate cancer risk.We searched for relevant studies(before March 1,2019)on Cochrane Library,Embase,and PubMed.Studies meeting the inclusion criteria were recruited into this meta-analysis.The outcome of dichotomous data was showed in the way of odds ratios(OR),and 95%confidence intervals(CI)were also counted.In this investigation,there was no association between HIF1α1772C/T gene polymorphism and susceptibility to RCC in Caucasians,Asians as well as overall populations.In addition,HIF1α1772C/T gene polymorphism was not found to be relevant to the survival in RCC.Interestingly,the T allele was relevant to prostate cancer risk in all populations,but not in Caucasians and Asians.However,the TT genotype and the CC genotype were not related to prostate cancer susceptibility in Asian,Caucasian,and all populations.In conclusion,the T allele of the HIF1α1772C/T gene polymorphism was related to prostate cancer risk in the overall populations.

摘要： BACKGROUND Trans-urethral resection of prostate(TURP)is one of the most commonly performed operations in urology to treat bladder outflow obstruction(BOO)in men.TURP surgery is also a key for endo-urological training in the British National Health Service(NHS)for training junior urologists.The working hypothesis is that prostate resection speed(PRS)in the context of bipolar TURP surgery,is not a key factor in major complication rates or broad patient outcomes at 3 mo after surgery,and therefore supervising consultants should not focus primarily on resection speed when teaching TURP.AIM To investigate objective differences in consultants vs trainees PRS and whether PRS affected complication rates/outcomes after TURP.METHODS Retrospective descriptive study analyzing patient case-notes,operative and electronic records,study undertaken at Burton Queen’s Hospital NHS Foundation Trust,United Kingdom,a secondary care centre in the public sector of the NHS.Participants included:all Bipolar TURPs undertaken between 13/04/2016 and 27/06/2017.Exclusions:patients undergoing concomitant operations or where intra-operative equipment problems occurred.Resected prostate(g),operative time,post-operative complications and outcomes at 3-mo were obtained from electronic records.Clavien-Dindo Grade II complications or above considered significant.Binary successful yeso outcome at 3-mo after surgery included both patients who reported moderate to significant symptom improvement,or being catheter-free for those catheterized before TURP.RESULTS 157 patients were identified.After exclusion a total of 125 patients were included from analysis.The mean PRS for trainees(0.34 g/min)was found to be lower than the mean PRS for consultants(0.41 g/min).The operating urologist’s PRS was not observed to be related to the number of TURPs that they performed during the period of the study.The trainee vs consultant means post-operative success rates(86.5%vs 90.5%)were comparable.The Trainees’patients did not suffer any significant complications as defined by the study.There was no clear relationship observed between PRS and the rate of significant post-operative complications or patients’3-mo binary successful outcome.PRS was noted to increase with increasing intra-operative experience for both Trainees 1 and 2 when comparing the first half of their TURPs to their latter half.CONCLUSION Consultants have a higher PRS in comparison to trainees.There is no trend between PRS and significant post-operative complication rates or 3-mo outcomes.

摘要： Objective:To investigate the effect of prostate volume on robot-assisted radical prostatectomy.Methods:Clinical data of 75 patients underwent RARP in the Affiliated Hospital of Qingdao University were retrospectively analyzed.The patients were divided into 3 groups according to size of prostate.A total of 35 cases with prostate volume less than 30ml were recorded as group 1,27 cases with volume of 30 to 50 ml were recorded as group 2,and 13 cases with volume greater than 50ml were recorded as group 3.Age,BMI,preoperative PSA,operation time,intraoperative bleeding volume,postoperative drainage volume,indwelling time of catheter,indwelling time of drainage tube,total hospitalization time,pathological stage,surgical margin,urine control and biochemical recurrence were observed.Results:All operations were performed under Da Vinci robot assistance,and no patient was transferred to open surgery.There was no significant difference in age,preoperative PSA,BMI,operation time,intraoperative bleeding volume,postoperative drainage volume,indwelling time of catheter,total hospitalization time,pathological stage,rate of positive surgical margin and recovery of urinary continence between the groups.Indwelling time of drainage tube was longer in group with larger prostate,6.4(±4.5)days in group 1,6.3(±2.9)days in group 2 and 7.1(±2.5)days in group 3.Gleason score was lower in group with larger prostate,with statistical difference.Conclusion:Prostate volume had no significant effect on urinary control,rate of positive surgical margin and recurrence after RARP.Gleason score of pathological tissue was lower and indwelling time of drainage tube was longer in patients with larger prostate after RARP.Operation time and intraoperative bleeding volume of large prostate patients underwent RARP need to be further studied.RARP has certain advantages for patients with large prostate.

摘要： Emerging data indicate that the nervous system plays an important role in carcinogenesis. However, more studies are required to help further elucidate the mechanisms involved in the neural regulation of carcinogenesis. Some recent findings describing the neural regulatory mechanisms of action in prostate cancer, pancreatic cancer and hepatocellular carcinoma are discussed, with a focus on the sympathetic, parasympathetic, and sensory neuronal elements of the nervous system. Norepinephrine, which is released by the sympathetic nervous system and binds to the beta-adrenergic receptor, regulates cellular responses in both normal and tumor cells. It has also been shown that the destruction of sensory neurons can prevent or at least slow pancreatic cancer. Cortisol, the main stress hormone, is also discussed and how it could potentially be involved in hepatocellular carcinoma development. The importance of studying other signaling molecules in the nervous system, such as oxytocin and its receptor, the oxytocin receptor, and how they might be involved in carcinogenesis when aberrantly expressed is highlighted. This is an area of study which clearly needs further investigation. A clearer understanding of the detailed mechanisms of how the nervous system is involved in carcinogenesis could potentially aid in the identification of novel biomarkers and development of novel preventative and therapeutic strategies in various cancers.