Background To explore the role of Trans-rectal Color Doppler Flow Imaging (TR-CDFI) and risk-stratification nomogram in a MRI-directed biopsy pathway and examine its clinical performance, via comparisons between existing four biopsy pathways. Methods A Bi-centered retrospective cohort study on biopsy-naïve male population who received ultrasound-guided prostate biopsy from Jan. 2015 to Feb. 2022 was proposed. All enrolled patients should have undergone serum-PSA test, TR-CDFI and multiparametric MRI before biopsy, and subsequently opted for surgical intervention, enabling more accurate pathological grading. We then utilized univariate and multivariate logistic regression analysis to construct a predictive nomogram for risk-stratification. Outcome measurements were overall prostate cancer (PCA) detection rate, clinically significant PCA (csPCA) detection rate, clinically insignificant PCA (cisPCA) detection rate, biopsy avoidance rate and missed csPCA detection rate. Decision curve analysis was used to compare the performances between diagnostic pathways. Results Under the criteria mentioned above, 752 patients from two centers were included. Reference pathway (biopsy for all) showed that overall PCA detection rate was 46.1%, csPCA and cisPCA detection rates were 32.3% and 13.8% respectively. Risk-based MRI-directed TR-CDFI pathway, which incorporated both TR-CDFI and risk stratification nomogram, exhibited PCA detection rate of 38.7%, csPCA detection rate of 28.7%, cisPCA detection rate of 7.0%, Biopsy avoidance rate of 42.4%, and missed csPCA detection rate of 3.6%. Decision curve analysis revealed that the risk-based pathway held the most net benefit, under the threshold probability level between 0.1 and 0.5. Conclusions The risk-based MRI-directed TR-CDFI pathway out-performed other strategies, balancing csPCA detection and biopsy avoidance. This suggested that incorporation of TR-CDFI and risk-stratification nomogram in the early PCA diagnostic procedures could reduce unnecessary biopsies.

Objective:To evaluate the morphological characteristics of transrectal ultrasound(TRUS) on seminal vesicle of the patients with initial diagnosis of premature ejaculation.Methods:Between July 2017 and Dec 2018, the morphological characteristics of TRUS on the seminal vesicle, such as the size, echo and structure of the seminal vesicle, were evaluated on 60 patiets, including 36 cases with initial diagnosis of premature ejaculation and 24 cases with premarital rountine examination. The mean age of the patients in two groups was 24 years (range 22 to 27 years). The details about the length of masturbation and the frequency of masturbation in the presence or absence of masturbation about all the subjects during their puberty were recorded.Results:The size, echo and structure of the seminal vesicle, the rate of the length of masturbation (>6 months) and the frequency of masturbation (>twice per week) during the puberty on the patients with initial diagnosis of premature ejaculation and the other with premarital rountine examination were (31.0±9.7) mm and (26.6±7.3) mm (P<0.001), obscore and clear,echo enhancement and echo normalment, 80.6%(29/36) and 45.8%(11/24) (P=0.011), 75%(27/36) and 33.3%(8/24) (P=0.003), respectively.Conclusion:The morphological characteristics of TRUS on seminal vesicle of the patients with initial diagnosis of premature ejaculation include reduction, the obscure structure and echo enhancement of the seminal vesicle.

先天性巨结肠(hirschsprung's disease,HSCR)又称肠管无神经节细胞症,是一种婴幼儿常见的消化道梗阻疾病,发病率为1/5000,男女比例为4:1[1].主要病因是在胚胎发育的5～12周,神经嵴细胞在迁移过程中受阻,导致结肠远端神经节细胞缺失,引起持续性痉挛,近端肠管扩张.临床表现为腹胀、呕吐及排便障碍等 [2].本文报告一例HSCR术后逆行射精患者,病因主要考虑为HSCR手术的副损伤.

Background: To compare the efficacy and safety of local infiltration anesthesia and mucous surface anesthesia in patients undergoing trans-rectal ultrasound-guided (TRUS guided) prostate biopsy. Methods: Patients with suspected prostate cancer undergoing TRUS guided prostate biopsy were randomly divided into two groups between January 2018 and March 2019. Local infiltration anesthesia was performed in the experimental group with lidocaine; while the control group was treated with mucous surface anesthesia. We collected baseline characteristics. Residual urine volume was measured twice: before biopsy, the first micturition after biopsy. Associated complications, positive rate of biopsy, visual analog pain scale (VAS) and Gleason score were recorded. Results: The study included 78 patients. The pain score of experimental group was significantly lower than the control group. Experimental group had lower rate of urinary retention and catheterization. Both groups had similar positive rate of biopsy, residual urine volume, Gleason score, fever and so on. Conclusion: Comparing with mucous surface anesthesia, local infiltration anesthesia relieved the pain better in patients undergoing TRUS guided prostate biopsy. It was more effective and safer. Trial registration: Chinese Clinical Trial Registry, Trial registration number (TRN): ChiCTR1800016424, Date of registration: 01/06/ 2018.

PURPOSE:To investigate the impact of prostate weight on outcomes of nerve sparing laparoscopic radical prosta-tectomy (LRP) and assess its predictive value on postoperative continence and potency recovery.MATERIALS AND METHODS:We conducted a retrospective study on the clinical data of 165 patients with low risk prostate cancer (PCa) who underwent nerve sparing LRP. All the patients included had normal preoperative uri-nary and sexual function. The association of prostate weight with perioperative data was assessed using Spearman correlation coefficient. Univariate and multivariate Cox regression analyses were employed to identify prognostic predictors for continence and potency recovery.RESULTS:Increased prostate weight was significantly associated with older age, higher prostate-specific antigen (PSA), lower biopsy and pathological T stage and Gleason score, longer operative time, and higher estimated blood loss (P < .05). The continence rates at the 3rd, 6th, and 12th month after surgery were 63.6% (105/165), 87.9% (145/165), and 95.8% (158/165); and the potency rates were 44.8% (74/165), 62.4% (103/165) and 77.6% (128/165), respectively. Furthermore, multivariate Cox analysis showed that patient age (HR = 0.52, 95% CI: 0.35- 0.76) and prostate weight (HR = 0.54, 95% CI: 0.34-0.86) were independent predictors for continence recovery, while only patient age (HR = 0.66, 95% CI: 0.45-0.96) could independently predict potency recovery.CONCLUSION:Larger prostate size was correlated with older age, higher PSA, lower tumor stage and grade, longer operative time, and more intraoperative blood loss in low risk PCa patients. Increased prostate weight may inde-pendently predict poor continence recovery after nerve sparing LRP.

The present study analyzed the predictive value of combined analysis of collapsin response mediator protein 4 (CRMP4) methylation levels and the Cancer of the Prostate Risk Assessment (CAPRA-S) Postsurgical score of patients who required adjuvant hormone therapy (AHT) after radical prostatectomy (RP). We retrospectively analyzed 305 patients with prostate cancer (PCa) who received RP and subsequent androgen deprivation therapy (ADT). Two hundred and thirty patients with clinically high-risk PCa underwent immediate ADT, and 75 patients with intermediate risk PCa underwent deferred ADT. CRMP4 methylation levels in biopsies were determined, and CAPRA-S scores were calculated. In the deferred ADT group, the values of the hazard ratios for tumor progression and cancer-specific mortality (CSM) in patients with ≥15% CRMP4 methylation were 6.81 (95% CI: 2.34-19.80) and 12.83 (95% CI: 2.16-26.10), respectively. Receiver-operating characteristic curve analysis indicated that CRMP4 methylation levels ≥15% served as a significant prognostic marker of tumor progression and CSM. In the immediate ADT group, CAPRA-S scores ≥6 and CRMP4 methylation levels ≥15% were independent predictors of these outcomes (uni- and multi-variable Cox regression analyses). The differences in the 5-year progression-free survival between each combination were statistically significant. Combining CAPRA-S score and CRMP4 methylation levels improved the area under the curve compared with the CRMP4 or CAPRA-S model. Therefore, CRMP4 methylation levels ≥15% were significantly associated with a poor prognosis and their combination with CAPRA-S score accurately predicted tumor progression and metastasis for patients requiring AHT after RP.

Gleason score (GS) plays an important role in determining the biology of prostate cancer but prognostic information is scanty. A total of 966 patients with paired biopsy and radical prostatectomy histology were enrolled from 8 academic hospitals in China from January 2005 to March 2013, with median follow-up of 53 months. Kaplan-Meier curves and multivariate models were generated to compare the GS upgrade to those in whom the Gleason score remains the same on the risk of postoperative biochemical recurrence/progression and death. Overall, 331 patients (34.26%) experienced a GS upgrade post Radical Prostatectomy (RP). We found that patients with upgraded GS experienced a significantly higher rate of biochemical recurrence/clinical progression/death/cancerspecific mortality compared to those with concordant GS (P<0.001). According to the biopsy GS, patients were divided into 3 groups (biopsy GS≤6, GS=7, and GS≥8), patients with upgraded GS suffered a significantly higher biochemical recurrence (P<0.005) than those with concordant GS in the 3 groups. In multivariate models, a change in GS was an independent predictor of biochemical recurrence (2.01 (1.45-2.80), P<0.001), progression (1.77 (1.062.96), P=0.003) and death (1.83 (0.83-4.04), P=0.036) in the preoperative setting only. Patients experiencing an upgrade in their GS between biopsy and post RP exhibited significantly more aggressive pathological features than corresponding concordant tumors, and a higher risk of biochemical recurrence/progression and death post RP.

目的 探讨超声辅助的腹腔镜下肾实质切开取石术的临床应用价值.方法 分析2008年1月至2016年1月我院行腹腔镜下肾实质切开取石术8例患者的临床资料,其中男5例,女3例,中位年龄43岁.既往有肾盂输尿管切开取石术史和经皮肾镜碎石取石术(PCNL)史例,PCNL取石失败史2例,多囊肾合并肾结石3例,右肾上盏结石并肾盏重度扩张2例.患者均在气管内麻下行腹腔镜下肾实质切开取石术,同时处理合并疾病.观察术中和术后出血量、结石清除率、术后并发症等指标来评估手术的安全性及治疗效果.结果 8例手术均顺利完成,无中转开放手术,术中均未行肾动脉阻断.1例同时行近端输尿管瘢痕粘连松解,3例多囊肾者同时行该侧肾囊肿去顶减压术.1例肾上极巨大囊性扩张者同时行肾实质囊壁部分切除.手术时间100～180 min,中位数为116 min;术中出血量50～260 ml,中位数为80 ml;术后平均3d拔除肾周引流管,6～9 d拔除尿管,无尿漏发生.术后随访6～36个月,无结石残留及其他并发症发生.结论 选择合适病例行腹腔镜肾实质切开取石术具有安全、高效,创伤小,可同时处理肾脏多种合并病变的优势,是PCNL术的重要补充.术中超声使用有助于结石准确定位和减少肾实质损伤.

TRPM7 is a potential therapeutic target for treatment of prostate cancer. In this study, we investigated the effects of nonselective TRPM7 inhibitor carvacrol on cell proliferation, migration, and invasion of prostate cancer PC-3 and DU145 cells. Our results showed that carvacrol blocked TRPM7-like currents in PC-3 and DU145 cells and reduced their proliferation, migration, and invasion. Moreover, carvacrol treatment significantly decreased MMP-2, p-Akt, and p-ERK1/2 protein expression and inhibited F-actin reorganization. Furthermore, consistently, TRPM7 knockdown reduced prostate cancer cell proliferation, migration, and invasion as well. Our study suggests that carvacrol may have therapeutic potential for the treatment of prostate cancer through its inhibition of TRPM7 channels and suppression of PI3K/Akt and MAPK signaling pathways.

The role of cell division cycle 20 (CDC20) was investigated in chemoresistance to decetaxel and the underlying mechanisms in metastatic castration-resistant prostate cancer (mCRPC). MTT assays were performed to determine effects of siRNA-mediated CDC20 knockdown on cell proliferation and anticancer activity of docetaxel. Western blot analyses were conducted to detect changes of Akt and Wnt signaling. Furthermore, in vivo growth of PCa was examined in nude mice treated with siCDC20 or docetaxel alone or in combination. CDC20 was overexpressed in mCRPC cells. Knockdown of CDC20 suppressed cell proliferation and enhanced anticancer effect of docetaxel with IC50 reducing from 0.358 to 0.188 µg/ml in PC3 cells and 0.307 to 0.162 µg/ml in DU145 cells (P<0.01). While no change of Akt signaling was observed, inhibition of Wnt/β-catenin signaling was detected upon CDC20 silencing. Xenograft tumor growth was significantly reduced in nude mice by CDC20 inhibition. The additional treatment of siCDC20 achieved better anticancer effects than that of docetaxel alone. Silencing of CDC20 may be a new strategy to improve chemosensitization to docetaxel in mCRPC.

Objectives: To present the surgical technique of transvesical single-site laparoscopic radical prostatectomy (TVSSLRP) and to evaluate its clinical efficacy. Methods: The clinical parameters of 39 patients who underwent transvesical single-site laparoscopic radical prostatectomy in Department of Urology, Third Affiliated Hospital of Sun Yat-Sen University from November 2010 to June 2015 were retrospectively reviewed. The age was (M(QR)) 64 (10) years (range 47 to 70 years). The median preoperative serum total prostate specific antigen (PSA) level was 7.9 (2.9) μg/L (range 4.2 to 9.8 μg/L). The clinical TNM stage comprised 24 cases of cT1c and 15 cases of cT2a. All the transrectal biopsy Gleason score ≤6. The International Index of Erectile Function (IIEF-5) was (21.7±1.6) points (range 18 to 24 points). The surgical procedures were performed through single-site transvesical approach. The postoperative serum PSA was regularly detected. The continence status were recorded at 1st month, 3rd month and 6th month after catheter removal, and the potencies were evaluated at 3rd month, 6th month and 12th month postoperative, respectively. Results: All the operations were successfully performed and there was no intraoperative complication or conversion to standard laparoscopic approach. The operation duration was (105±26) minuetes, the estimated blood loss was (100±56) ml and no blood transfusion was required. The pathological TNM stage comprised 30 cases of pT2a and 9 cases of pT2b, the Gleason score all ≤6 and no patient had positive surgical margins. The duration of urinary catheterization was (11.6±1.4) days and hospital stay was (12.9±4.3) days. The continence rates were 84.6%, 97.4%, 100% at 1st month, 3rd month and 6th month after catheter removal, respectively. The potency rates were 48.7%, 64.1%, 76.9% at 3rd month, 6th month and 12th month postoperative, respectively, with an IIEF-5 score≥18. Two cases demonstrated biochemical recurrence and one case presented vesico-urethral stricture during an average follow-up of 39 months (range 12 to 60 months). Conclusions: TVSSLRP is suitable for low-risk organ-confined prostate cancer. It can provide satisfactory continence and potency recovery, less complications and good oncological results.

Currently, there are no well-established preoperative clinicopathological parameters for predicting extra-prostatic extension (EPE) in patients with clinically localised prostate cancer (PCa). The transmembrane protease serine 2 (TMPRSS2)-ETS-related gene (ERG) fusion gene is a specific biomarker of PCa and is considered a prognostic predictor. The aim of the present study was to assess the value of this marker for predicting EPE in patients with clinically localised PCa. In total, 306 PCa patients with clinically localised disease, including 220 patients (71.9%) with organ-confined disease and 86 EPE cases (28.1%), were included in the study. Receiver operating characteristic curves and logistic regression were employed to establish the optimal cut-off value and to investigate whether ERG rearrangement was an independent predictor for the EPE of clinically localised PCa. A leave-one-out cross-validation (LOOCV) model was implemented to validate the predictive power of ERG rearrangement. An increase in ERG rearrangements was identified to be associate'd with EPE, and the optimal cut-off for predicting EPE was determined to be 2.25%, with a sensitivity of 70.24% [95% confidence interval (CI), 62.6-78.9%], a specificity of 80.43% (95% CI, 75.4-85.1%), and an area under the curve (AUC) of 0.781 (95% CI, 0.730-0.826). In the LOOCV model, ERG rearrangement also demonstrated good performance for predicting EPE (sensitivity, 76.923%; specificity, 71.429%; 95% CI for AUC, 0.724-0.958). In addition, a high Gleason score (≥7) and a cT2c classification upon biopsy were independent factors for EPE.

OBJECTIVESThis study was aimed to explore Cdc20 expression and its correlation with clinicopathological characteristics and biochemical recurrence (BCR) after laparoscopic radical prostatectomy (LRP) in clinically localized prostate cancer (PCa).METHODSCdc20 expression was examined by immunohistochemistry in 166 cases, including 60 cases of benign hyperplasia of prostate (BPH) patients treated by transurethral resection and 106 cases of consecutive PCa patients treated by LRP without neoadjuvant therapy in a single Chinese institution. The correlation with clinicopathological features and the predictive value for BCR were statistically analyzed.RESULTSCdc20 expression was detected in 52 (86.7%) BPH and 97 (91.5%) PCa samples, which was statistically insignificant (P= 0.675). The rate of patients with high expression of Cdc20 was 21.7% in BPH and 37.7% in PCa (P= 0.033). A correlation was revealed between Cdc20 expression and postoperative Gleason scores (P= 0.046), positive surgical margin (P< 0.001). BCR-free survival was significantly lower in patients with high Cdc20 expression than those with low Cdc20 expression (P= 0.018). Univariate analysis indicated pTstage, post operative Gleason score, seminal vesicle invasion, lymph node invasion, surgical margin and Cdc20 expression significantly influenced BCR. Multivariate analysis revealed that postoperative Gleason score, seminal vesicle invasion, lymph node invasion, surgical margin and Cdc20 expression were independent predictors for BCR. After stratified by Gleason score and surgical margin status, Cdc20 expression and lymph node invasion remained significant in Cox regression analysis.CONCLUSIONSOverexpression of Cdc20 may serve as an independent predictor for BCR in patients of clinically localized PCa undergoing LRP without neoadjuvant therapy.

目的 探讨精囊镜技术治疗射精管梗阻性无精子症的可行性和疗效.方法 回顾性分析2009年12月至2015年11月中山大学附属第三医院采用精囊镜射精管扩张技术治疗36例射精管梗阻性无精子症患者临床资料.患者年龄23～39岁,平均28岁.术前常规行精液分析、精浆果糖测定和经直肠超声检查等检查明确诊断为射精管梗阻性无精子症.36例无精症患者,精液量0.1～1.8 ml,pH值6.0～7.2,精液常规和离心均未检出精子.结果 单纯精囊镜扩张射精管治疗射精管梗阻23例,精囊镜技术联合射精管口切开治疗13例.手术时间12～60 min,平均25 min.33例获得随访,随访时间2～48个月,平均12个月,25例患者在术后1～3个月复查精液常规或离心可找到精子,其中17例精子密度和活力接近正常,7例获得妊娠.8例患者术后复查精液仍未见精子.结论 精囊镜射精管扩张治疗射精管梗阻性无精子症技术可行,对于精囊镜技术经验丰富的术者,该方法是治疗射精管梗阻性无精子症安全有效的手段.

gf Objective To analyze the relationship between serum alanine aminotransferase (ALT) and hype‐ruricemia occurrence .Methods Sixty‐nine patients with hyperuricemia were selected as the observation group and 60 healthy people were chosen as the control group;serum levels of ALT and serum uric acid (SUA) were detected in the two groups ,and the levels of serum inflammatory factors (TNF‐α,CRP ,IL‐6) and fat factors(FFA ,APN) were detected in the observation group .The occurrence rate of ALT increase in the two groups were performed statistics . The levels of serum inflammatory factors and the fat factors in the observation group were compared among different ALT increased levels .Results The occurrence rate of ALT increase and the ALT level in the observation group were higher than those in the control group (P<0 .05) .In the SUA level aiming at the patients of the observation group , the ALT severe elevated group>moderately elevated group>mildly elevated group>non‐elevated group (P<0 .05);in the serum TNF‐α,IL‐6 ,CRP and FFA levels ,ALT severe elevated group>moderately elevated group>mildly el‐evated group>non‐elevated group (P<0 .05);in the serum APN level ,severely elevated group<moderately elevated group<mild elevated group<non‐elevated group (P<0 .05) .Conclusion The elevation of serum ALT is closely re‐lated to the occurrence of hyperuricemia ,and the serum ALT level has the same varying trend with level of SUA and has interaction .The mechanism may be related to the changes of serum inflammatory factors and fat factors .

Odontogenic ameloblast associated protein (ODAM) is a protein contributed to cell adhesion and has been shown to express in normal prostate tissue, but the expression and significance of ODAM in prostate cancer remain unknown. In this study, we detected the protein expressions of ODAM in 88 prostate cancer tissues with immunohistochemical staining, and found that 53 cases (60.2%) was high expression of ODAM, which was shown in the cytoplasm and paranuclear regions. Furthermore, low expression of ODAM was significantly correlated with lymph node metastasis, preoperative PSA and Gleason score, but not with mean age, follow-up duration, PSM rate and distribution of pathological T stage. Additionally, our results of multivariate analysis showed that low ODAM expression was an independent predictor of biomedical recurrence, while the positive lymph node metastasis, Gleason score, and preoperative PSA were not the independent risks for biomedical recurrence. Overexpression of ODAM did not inhibit the growth of prostate cancer cells PC3, but significant suppressed their invasion and migration with decrease of the protein levels of MMP-2. These results suggest that ODAM is a predictor for biomedical recurrence and inhibits the migration and invasion of prostate cancer.

目的 探讨DOPEY2在TMPRSS2-ERG基因融合阴性前列腺癌中的表达及其临床意义.方法 本研究通过RT-PCR和Western Blot技术检测前列腺癌细胞株VCaP和PC-3中ERG和DOPEY2的表达情况,同时,采用免疫组化技术检测46例前列腺癌根治术后的石蜡标本中ERG和DOPEY2的表达情况,分析两者的表达以及与临床病理特征之间的关系.结果 DOPEY2在TMPRSS2-ERG基因融合阳性前列腺癌细胞株VCaP中的mRNA和蛋白表达水平,均比TMPRSS2-ERG基因融合阴性前列腺癌细胞株PC-3低,且差异均有统计学意义(P＜0.05).免疫组化结果显示,DOPEY2在TMPRSS2-ERG基因融合阴性组织中的阳性表达率高于基因融合阳性组(76.5％和33.3％,P＜0.05),且DOPEY2阳性的患者具有较高的Gleason分级和T分期(P＜0.05).ERG蛋白的阳性率为26.1％(12/46),且与低Gleason评分组相关,而与患者的年龄、血浆PSA值,病理T分期和远处转移等参数均无相关性.结论 DOPEY2在TMPRSS2-ERG基因融合阴性前列腺癌中的表达高于TMPRSS2-ERG基因融合阳性前列腺癌,DOPEY2可能作为一个有潜力的分子标记物指导前列腺癌分期及判断预后.

Objective To compare the stone-free rate and security of stone extractor and lithotomy forceps applied in the ureteroscopic lithotripsy.Methods Totally 45 cases with ureteral stone underwent ureteroscopic lithotripsy in the Third Affiliated Hospital of Sun Yat-Sen University were enrolled in this study from July 2015 to October 2015,in which the stone extractor applied in 22 cases who were enrolled in the study group,and the traditional lithotomy forceps applied in 23 cases performed by the same surgeon as the control.The data were statistical analysis.The stone-free rate,complains and operation time of both group were analyzed.Results The operations were performed successfully in all cases,without any severe complications.In the extractor group and forceps group,the stone-free rate was 95.4％ and 86.9％ respectively (P＜0.05),the mean operation time was (30±10) min and (58±18) min,and the mean fetching stone time was (15.3±2.7) s and (35.3±10.2)s (P＜0.05),the mean size of fetched stones was (6.2±1.3) mm and (4.3±2.2) mm (P＜0.05).Ureter and urethral mucosa injury occurred in 2 cases in the extractor group and 7 cases in the forceps group arisen from fetching stone.There was no stone slipped from stone extractor,and 13 stones slipped from lithotomy forceps.Conclusions The stone extractor has obvious advantage and was safe in the ureteroscopic lithotripsy.

Objective To compare the oncologic and functional outcomes of retropubic radical prostatectomy (RRP) and laparoscopic radical prostatectomy (LRP) for the treatment of localized and locally advanced prostate cancer (PCa).Methods From October 2000 to December 2013,729 PCa cases who underwent radical prostatectomy were retrospectively analyzed.Of the 729 patients,164 cases underwent RRP while 565 cases conducted LRP.The median age in RRP and LRP groups was 69 (38-84) years and 69 (39-88) years,median follow-up time was 58 (18-153) months and 66 (19-174) months,respectively.All the cases were stratified into localized (RRP 78 cases,LRP 370 cases) and locally advanced (RRP 86,LRP 195) PCa according to pathological TNM stage.Positive surgical margins (PSM),1-and 2-year urinary continence,potency,5-year biochemical recurrence-free survival and 5-year cancer-specific survival were recorded and analyzed between RRP and LRP groups.Results In localized and locally advanced cases between the 2 groups (RRP versus LRP),PSM rates were 11.5％ versus 13.8％,31.4％ versus 32.8％,5-year biochemical recurrence free rates were 79.7％ versus 85.6％,46.8％ versus 50.6％,and 5-year cancer-specific survival rates were 97.8％ versus 98.8％,85.3％ versus 91.2％.There was no significant difference between RRP and LRP groups (P ＞0.05).The 1-and 2-year urinary continence rates (RRP versus LRP) in localized PCa were 87.2％ versus 92.7％,97.4％ versus 96.5％,respectively (P ＞ 0.05).The 1-and 2-year urinary continence rates (RRP versus LRP) in locally advanced PCa were 76.7％ versus 85.1％,88.4％ versus 90.8％,respectively (P ＞ 0.05).The difference was significantly observed regarding potency between RRP and LRP groups (42.6％ versus 59.0％,P ＜ 0.05) in patients with localized PCa.Conclusions The oncological and functional outcomes between RRP and LRP are comparable both in localized and locally advanced PCa.LRP had advantage on erectile functional recovery over RRP.

目的 本研究通过分析多聚腺苷二磷酸核糖聚合酶(PARP-1)在前列腺癌及前列腺增生组织中的表达差异,探讨其与其他临床指标的相关性,并分析与前列腺癌预后的相关性.方法 检测126例前列腺癌组织及83例前列腺增生组织中PARP-1的表达情况,比较分析实验组与对照组之间PARP-1表达的差异,以及实验组PARP-1表达水平与其他临床指标的相关性,并分析PARP-1与前列腺癌预后的相关性.结果 前列腺癌组PARP-1的阳性表达率(38.9％)显著高于前列腺增生组(10.8％)(P＜0.05).PARP-1表达水平与其他临床病理指标的相关性分析结果显示,PARP-1表达水平与临床分期密切相关(P＜0.05);但与年龄及Gleason评分无明显相关性(P＞0.05).生存分析显示,PARP-1蛋白表达水平高的前列腺癌患者预后较低表达水平的患者差(P＜0.05).结论 PARP-1在前列腺癌组织中的表达较前列腺增生组织中明显增高,且随着临床分期的增高而表达增强,其高表达的患者预后较差,表明其可能在前列腺癌的发生发展中发挥重要作用.