| Section 1 New biomarkers for prostate cancer and its correlation with pathological features and prognosisObjective1.The differentially expressed genes in prostate cancer and normal prostate tissue were screened by high-throughput sequencing method.The TCGA database data and the immunohistochemical results of tissue samples from patients in our hospital were used for verification.Finally the biomarkers of prostate cancer with diagnostic significance were screened out.2.The differentially expressed genes were matched with the clinical data to find the genes that were related to the pathological characteristics and prognosis of prostate cancer,so as to provide evidence support for the screening of new markers for prostate cancer.Methods1.Prostate cancer specimens obtained after radical prostatectomy in our hospital were used for high-throughput sequencing.Differentially expressed genes in prostate tumor and normal prostate tissues were screened by Log2FC>1.5 as the standard.2.The screened differentially expressed genes were further compared in the TCGA database to verify the universality and stability of the differentially expressed genes.The correlation between the differentially expressed genes and the pathological characteristics and prognosis of the radical prostatectomy specimens was analyzed based on the clinical data in the database.3.36 patients that undergoing radical resection of the prostate was taken into the analysis,with high risk vs.low risk is 2:1.The radical surgical specimens was taken into immunohistochemical analysis to verify the differentially expressed gene expression differences of population in our country,and its correlation with pathological characteristics and prognosis were analyzed.Result1.According to high-throughput sequencing results,9 genes were found to be differentially expressed in prostate tumors and normal prostate tissues.The up-regulated genes in tumor tissues were CYP4F8,TMEFF2,CAMKK2,RLN1 and TFF3.Thc down-regulated genes in tumor tissues were IGKC,IGHG1,LTF and MSMB.2.A total of 543 high-throughput sequencing samples of prostate acinar adenocarcinoma were obtained from the TCGA database,of which 492 were prostate cancer data and 51 were matched normal prostate tissue sample data of prostate cancer patients.The results showed that 6 genes were differentially expressed in the TCGA database,namely CYP4F8,TMEFF2,CAMKK2,TFF3,LTF and MSMB.Combined with clinical data analysis,it was found that CAMKK2,CYP4F8,LTF and MSMB were correlated with pathological Gleason score,CAMKK2 and CYP4F8 were correlated with pathological staging after radical resection,and CAMKK2,CYP4F8 and MSMB were correlated with biochemical recurrence after radical resection.3.Immunohistochemical analysis was performed on tissue samples from 36 patients with prostate cancer who met the requirements,and the results showed that CYP4F8,TMEFF2,CAMKK2,TFF3,LTF and MSMB were significantly expressed in prostate cancer and normal prostate tissue.Combined with clinical data,CAMKK2 and CYP4F8 were significantly correlated with pathological staging and risk grade after radical resection.Conclusions1.CYP4F8,TMEFF2,CAMKK2,TFF3,LTF and MSMB are potential biomarkers for the diagnosis of prostate cancer.2.CAMKK2 and CYP4F8 may be predictive biomarkers related to pathological characteristics and prognosis of prostate cancer.Section 2 Analysis of the pathological features and relative risk factors of prostate cancer patients with 1-2 needle positive biopsyObjectiveThe pathological characteristics and the risk degree of radical resection were analyzed in patients with prostate cancer who had 1-2 needle number of positive prostate biopsy.MethodsA retrospective analysis of prostate cancer patients from 2007 to 2017 in Beijing Hospital who had 1-2 positive biopsy needles after MRI and accepted the radical prostatectomy.To analyze the pathological risk of specimen after radical prostatectomy and evaluate the correlation between PI-RADS score and the pathological results,include high risk pathological factors and upgrade/upstage of the radical surgery specimens.And further analyze were taken of the proportion of patients who were preoperatively assessed as low risk final had the high risk of radical pathology factors and discuss the correlation between pi-rads and the phenomenon.ResultAmong the 99 patients,49(49.5%)were of high-risk pathological types after radical prostatectomy.There were 39(39.4%)patients had pathological staging in T2c and more,11(11.1%)patients with Gleason score over 8 and 17(17.2%)patients with margin positive.PIRADS score is an independent risk factor for the occurrence of high-risk pathological types after radical prostatectomy(P=0-014,OR=3.092,95%CI=1.257?7.606).There were 46 patients with low risk,among whom 16(34.8%)patients had postoperative high-risk pathological types.PIRADS score was an independent risk factor for patients with low risk who had postoperative high-risk pathological types(P=0.014,OR=3.092,95%ci=1.257-7.606).Among the 99 patients,65(65.7%)had upgrade or/and upstage after radical surgery,and pi-rads(P=0.043)score could be used as an independent risk factor.ConclusionsFor the prostate cancer patients with 1-2 needles positive needles biopsy after radical prostatectomy,there is a certain upgrade or upstage in pathology and underestimate of the high risk.Preoperative MRI pi-rads score can be used as an independent risk factor for patients with postoperative high-risk pathological types and increased grade or stage.Section 3 Analysis on the characteristics and independent influencing factors of positive surgical margin after radical prostatectomyObjectiveTo analyses the influence factors of positive surgical margin after radical prostatectomy.MethodsA retrospective analysis was conducted on 320 patients who received radical prostatectomy in our hospital from June 2007 to June 2017.The patients were divided into groups by age,PSA,PI-RADS score,clinical stage,biopsy Gleason score and operation method.ResultAmong the total 320 patients,there were 94(29.45)patients had positive surgical margin after radical prostatectomy.The positive rate of surgical margin was different in different positive areas of MRI,among which the MRI showed cancer located in the tip area of prostate had the highest positive rate(47.6%)of surgical margin after prostatectomy.After grouping the risk factors into groups,univariate analysis showed that PSA,pi-rads score and biopsy pathology Gleason score were correlated with the percentage of positive puncture needles after radical resection,but there was no significant statistical correlation between age,preoperative clinical stage,surgical method and the condition of resection margin.Further multivariate analysis showed that pi-rads score(P=0.023)and percentage of positive needle count(P=0.047)could be used as independent predictors of positive surgical margins after radical resectionConclusionsPI-RADS score and percentage of positive biopsy needles were independent risk factors for positive surgical margin after prostatectomy.There was highest positive rate of surgical margin when MRI showed cancer located in the tip area of prostate. |
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