prostate cancer

摘要： Linitis plastica is a rare condition showing circumferentially infiltrating intramural anaplastic carcinoma in a hollow viscus,resulting in a tissue thickening of the involved organ as constricted,inelastic,and rigid.While most secondary rectal linitis plastica(RLP)is caused by metastasis from stomach,breast,gallbladder,or bladder cancer,we report an extremely rare and unique case of secondary RLP due to prostate cancer with computed tomography(CT)and magnetic resonance imaging(MRI)findings,including diffusion weighted imaging(DWI).A 78-year-old man presented with approximately a 2-mo history of constipation and without cancer history.On sigmoidoscopy,there was a luminal narrowing and thickening of rectum with mucosa being grossly normal in its appearance.On contrast-enhanced CT,marked contrast enhancement with wall thickening of rectum was noted.On pelvic MRI,rectal wall thickening showed a target sign on both T2-weighted imaging and DWI.A diffuse infiltrative lesion was suspected in the prostate gland based on low signal intensity on T2-weighted imaging and restricted diffusion.A transanal full-thickness excisional biopsy revealed metastasis from a prostate adenocarcinoma invading the submucosa to the muscularis propria consistent with metastatic RLP.We would like to emphasize the CT and MRI findings of metastatic RLP due to prostate cancer.

摘要： Human papillomavirus (HPV) is classified either as high-risk or low-risk types depending on its probability of leading to tumorigenesis. Many studies have shown that HPV infection, especially the high-risk kind, is always related to prostate cancer, bladder cancer, penile cancer, testicular cancer, and other urinary system tumors. However, previous studies differed in sexual openness and racial genetic susceptibility of the study object, sample size, and experimental methods.Hence, the correlation between high-risk HPV infection and urinary system tumors remains controversial. The early open reading frame of the HPV genome is composed of E1-E7, among which E6 and E7 are the key transfer proteins. The combination of these proteins with oncogene and anti-oncogene may be one of the mechanisms leading to tumorigenesis.

摘要： A 61-year-old man with locally advanced prostate cancer was found to have multiple solid intra-abdominal solid lesions during staging investigations.While some were in the pelvis,they were not located in the common landing sites for prostate cancer metastases,and his prostate specific antigen was not significantly elevated to suggest a high burden of metastatic disease.He reported a history of a blunt abdominal trauma due to a motor vehicle accident more than forty years ago which had been conservatively managed.His staging imaging revealed a lack of a discrete spleen in his left upper abdomen and this raised the suspicion that these solid lesions may represent ectopic splenic tissue.Imaging with nuclear medicine scintigraphy confirmed the lesions in his upper abdomen and pelvis to be splenunculi.He proceeded with a combination of androgen deprivation therapy and external beam radiotherapy for locally advanced,non-metastatic prostate cancer.Although it has been described in patients with low risk prostate cancer,this is the first case report of splenunculi mimicking metastases in a patient with locally advanced prostate cancer.

摘要： There is significant variation in clinical outcome between patients diagnosed with prostate cancer(CaP).Although useful,statistical nomograms and risk stratification tools alone do not always accurately predict an individual’s need for and response to treatment.The factors that determine this variation are not fully elucidated.In particular,cellular response to androgen ablation and subsequent paracrine/autocrine adaptation is poorly understood and despite best therapies,median survival in castrate resistant patients is only approximately 35 mo.We propose that one way of understanding this is to look for correlates in other comparable malignancies,such as breast cancer,where markers of at least 4 distinct gene clusters coding for 4 different phenotypic subtypes have been identified.These subtypes have been shown to demonstrate prognostic significance and successfully guide appropriate treatment regimens.In this paper we assess and review the evidence demonstrating parallels in the biology and treatment approach between breast and CaP,and consider the feasibility of patients with CaP being stratified into different molecular classes that could be used to complement prostate specific antigen and histological grading for clinical decision making.We show that there are significant correlations between the molecular classification of breast and CaP and explain how techniques used successfully to predict response to treatment in breast cancer can be applied to the prostate.Molecular phenotyping is possible in CaP and identification of distinct subtypes may allow personalised risk stratification way beyond that currently available.

摘要： AIM:To assess the role of PCA3 urine test in the management of patients with suspected prostate cancer after repeat negative prostate biopsies.METHODS:Patients with suspected prostate cancer either due to high or rising prostate specific antigen(PSA)levels and with a history of prostate biopsy who were candidates for repeat procedure were prospectively recruited to undergo PCA3 urine test.The recommendations on further management including the decision whether to proceed or not to the biopsy were made based on the PCA3 score.Patients’adherence with the recommendations and influence of the PCA3 test on clinical decision making were assessed.The contribution of the multivariate model was measured with a decision curve analysis.RESULTS:Three hundred and fifty-six patients were recruited to the study and underwent the PCA3 test.Twenty-six percent of 263 patients underwent prostate biopsy despite the low risk designation by PCA3 and 30%of 93 men did not proceed to biopsy despite a high risk result,rendering overall adherence of 73%.The variables that significantly correlated with adherence were positive family history of prostate cancer and PSA more than 10 ng/mL.Pre-test clinical stage,the number and the results of previous biopsies were not associated with the adherence.The decision curve analysis gave identical results for cut-off points of 25 and 35.On multivariate analysis the model that included PCA3 score,serum PSA,family history and result of the previous biopsy best performed with Area Under the Curve of 0.77.CONCLUSION:PCA3 urine test markedly outperforms PSA in a repeat biopsy setting.Urologists and patients demonstrate substantial confidence in this analysis and tend to follow its recommendations.

摘要： Targeting androgens via androgen deprivation therapy (ADT) to suppress androgens/androgen receptor (AR) functions remains the standard treatment for prostate cancer. However，most tumors eventually recur in spite of ADT. Here we demonstrate that the prostate epithelial AR may function as asuppresser for prostate cancer metastasis. Results from orthotopically co-inoculated stromal WPMY1 cellswith human epithelial PC3 prostate cancer cells proved that addition of AR in epithelial PC3 cells orknockdown of AR in stromal WPMY1 cells suppressed prostate cancer metastasis. Knockdown of the ARin human CWR22rv1 cells also resulted in increased cell invasion in vitro. Mice lacking the prostateepithelial AR developed larger and more invasive metastatic tumors in lymph nodes and died earlier thanwild-type littermates. In contrast，mice with knockdown of both prostatic epithelia(and stromal ARdeveloped smaller and less invasive metastatic tumors. These data suggest that the epithelial AR is asuppresser and stromal AR is a more dominant stimulator for prostate cancer metastasis. Mechanisticdissection suggested that androgen/AR might modulate many metastasis-related genes via multiplemechanisms. Collectively，these unexpected findings might revolutionize the way we combat prostatecancer，and might allow us to develop new and better therapies，which target the stromal AR only.