ABSTRACT
Objective:To evaluate the prognostic value of preoperative red cell distribution width to platelet ratio on prostate cancer patients treated with endocrine therapy after radical prostatectomy.Methods:The clinical data of 349 prostate cancer patients treated with endocrine therapy after radical prostatectomy in our hospital from October 2007 to October 2018 were retrospectively analyzed.Among all the patients, the average age was 67 years old(ranged 42 to 84 years). The preoperative newly diagnosed PSA level was 4.2-499.2 ng/ml(average 30.6 ng/ml). 158 cases had a Gleason score of more than 8. 191 cases had a Gleason score of below than 8. According to tumorous staging, 151 patients were staged less than or equal to stage T 2b, 110 patients were staged as stage T 2c, 88 patients were staged equal or greater than stage T 3a. 295 patients were staged less than 1.15 ng/(ml·cm 3)of prostate specific antigen density, 54 patients were staged equal or greater than 1.15 ng/(ml·cm 3). There were 86 cases of seminal vesicle invasion and 263 cases of non-seminal vesicle invasion. There were 121 patients with low risk of prostate cancer, 83 patients with medium risk, and 145 patients with high risk. All patients received endocrine therapy after radical prostatectomy with androgen deprivation therapy (ADT). End point of observation was biochemical recurrence-free survival (RFS) with PCa patients treated with endocrine therapy after radical prostatectomy. Patients were categorized in two groups with high RPR and low RPR values using a cut-off point as calculated by the receiver-operating curve analysis.Correlations between RPR and clinical characteristics were analyzed.The prognostic analysis of preoperative RPR on prostate cancer patients treated with endocrine therapy after radical prostatectomy was estimated using Kaplan-Meier analysis and Cox proportional hazards models. Kaplan-Meier method was used to draw the survival curve. Meanwhile, univariate and multivariate Cox regression were used to explore factors influencing the prognosis of PCa patients. Results:of the 349 cases, ranging 4-132 months. Biochemical recurrence with PCa patients occurred in 93 cases, and 256 patients were not biochemical recurrence.The ideal cutoff value of preoperative RPR was 0.27(95% CI 0.502-0.653, P<0.05)determined by the ROC curve, by which the 349 patients was divided into the high RPR group of 66 patients(18.9 %) and the low RPR group of 283 patients(81.1 %). Preoperative RPR was significantly associated with Gleason score ( P=0.005), newly diagnosed tPSA value ( P=0.000), tumor T stage ( P=0.031), PCa risk scale ( P=0.037), positive margin ( P=0.030). The RFS in the high RPR group(26.0 months)was shorter than that in the low RPR group(35.0 months)( P<0.001). In univariate analysis, Gleason score ( HR=1.579, 95% CI 1.049-2.376, P=0.028), serum newly diagnosed tPSA ( HR=2.979, 95% CI 1.655-5.362, P=0.000), tumor T stage( HR=1.292, 95% CI 1.009-1.653, P=0.042), preoperative RPR value ( HR=3.555, 95% CI 2.339-5.401, P=0.000) were prognostic factors ( P<0.05). Cox multivariate analysis showed that higher newly diagnosed tPSA value( HR=1.917, 95% CI 1.033-3.558, P=0.039)and higher RPR value( HR=3.086, 95% CI 1.994-4.775, P=0.000) were independent predictors for endocrine therapy after radical prostatectomy of PCa( P<0.05). Conclusions:Preoperative RPR was an independent predictor for poor prognosis in PCa patients treated with endocrine therapy after radical prostatectomy.
ABSTRACT
Objective:To investigate the correlation of preoperative peripheral lymphocyte-to-monocyte ratio(LMR)with the biochemical relapse and prognosis in prostate cancer(PCa)patients treated with endocrine therapy after radical prostatectomy(RP).Methods:Clinical data of 306 prostate cancer patients treated with endocrine therapy after radical prostatectomy were retrospectively analyzed in our hospital from June 2008 to June 2019.The end point of observation was biochemical relapse-free survival(RFS)in all patients receiving RP.The best cutoff value of preoperative LMR was calculated by receiver operating characteristic(ROC)curve.All patients were divided into the high LMR group(LMR≥2.8, n=93, 30.4%)and the low LMR group(LMR<2.8, n=213, 69.6%). The differences in clinical indicators of PCa were compared between high and low LMR groups.CoX regression model on the risk ratio of single and multiple factors were used to analyze the survival effect of preoperative LMR on the prognosis of PCa patients undergoing endocrine therapy after operation.Results:The median follow-up time was ranged from 4 to 132 months.The area under the ROC curve of LMR was 0.582(95% CI: 0.511-0.652, P<0.05), and the cutoff value of the preoperative LMR was 2.8, which was significantly associated with clinical T stage( P=0.023)and lymphatic metastasis( P=0.031). Kaplan-Meier analysis demonstrated that the low LMR group had a short RFS and a poor prognosis(31.0 months vs.38.5 months)than those in the high LMR group( P<0.05). Lymphatic metastasis and preoperative LMR were independent predictors for RFS in PCa patients treated with endocrine therapy after radical prostatectomy. Conclusions:Preoperative peripheral LMR can be used as an auxiliary indicator of the prognosis in PCa patients treated with endocrine therapy after radical prostatectomy.
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AIM:To study the senescence of human umbilical vein endothelial cells(HUVECs) and Bcl-2,Bax gene expression associated with apoptosis induced by angiotensinⅡ(AngⅡ).METHODS:HUVECs were cultured in vitro and the cell viability was observed by methyl thiazolyl tetrazolium(MTT).HUVECs were intervened by AngⅡ and valsartan(AngⅡ type 1 receptor blocking) and divided into 3 groups:the control group,AngⅡ group(stimulated with AngⅡ10-6mol/L for 48 h),valsartan group(valsartan was added to cells 1 h before 10-6mol/L AngⅡ treatment).?-gal staining aod cell cycle analysis were used to identify the cell aging status.Morphologic changes and percentage of apoptosis were assayed with Hoechst33258 under fluorescent microscope.The expressions of Bcl-2 and Bax,and the apoptosis-associated genes were detected by immunocytochemical staining,RT-PCR and Western blotting.RESULTS:The cell viability by AngⅡ-induced cells was(81.9%?4.1)%,the positive cell number of ?-gal staining was significantly higher in AngⅡ-induced cells(80.10%?6.81)% than that in the control cells.The cell cycle was at G0-G1(91.36%?6.45)%,the apoptotic cells significantly increased(31.84?2.86)% under fluorescent microscope.In valsartan group,Bcl-2 mRNA and protein expression increased markedly(P