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Objective:To evaluate the diagnostic value of the 18F-prostate specific membrane antigen (PSMA)-1007 PET/CT in seminal vesicle invasion (SVI) of prostate cancer. Methods:Clinical and pathological materials of 88 patients (age: 51-84 years) who underwent radical prostatectomy (RP) between May 2019 and December 2021 in the First Affiliated Hospital of Xi′an Jiaotong University were analyzed retrospectively. All patients underwent 18F-PSMA-1007 PET/CT examination for primary staging before surgery. The diagnostic efficiency of 18F-PSMA-1007 PET/CT in SVI was obtained using postoperative pathological results as the " gold standard" and ROC curve was drawn. Furthermore, univariate and multivariate logistic regression analyses were used to screen the influencing factors for 18F-PSMA-1007 PET/CT prediction of SVI. Results:The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of 18F-PSMA-1007 PET/CT in diagnosing SVI were 79.55%(70/88), 72.73%(16/22), 81.82%(54/66), 57.14%(16/28) and 90.00%(54/60), respectively. The ROC AUC was 0.77. Results of univariate logistic regression showed that total prostate specific antigen (tPSA), primary SUV max, Gleason score, International Society of Urological Pathology (ISUP) grade group were associated with 18F-PSMA-1007 PET/CT prediction of SVI. Results of multivariate logistic regression showed that Gleason score (odds ratio ( OR)=2.04, 95% CI: 1.19-3.50, P=0.009) was a predictor of SVI in prostate cancer. Conclusion:18F-PSMA-1007 PET/CT has certain diagnostic value in SVI of prostate cancer, and combining with Gleason score can improve the diagnostic efficiency.
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【Objective】 To investigate the value of prostate cancer prevention trial risk calculator （PCPT-RC） combined with biopsy Gleason score for predicting the risk of metastasis in newly diagnosed prostate cancer patients. 【Methods】 We retrospectively collected the data of 74 patients with newly diagnosed prostate cancer confirmed by biopsy from April 2019 to August 2021， concurrent with 18F-PSMA-1007 PET/CT whole body imaging in the same period. Based on this， a binary logistic regression model was established to obtain the high risk probability of PCPT. We calculated the receiver operating characteristic curve （ROC） was drawn and the area under the curve， Yuden index， sensitivity， specificity， positive predictive value and negative predictive value. We compared the predictive value of the prostate cancer prevention trial risk calculator and Gleason score alone or in combination in predicting the risk of prostate cancer metastasis. 【Results】 Based on the PSMA PET/CT results， 74 patients were divided into non-metastatic group （46/74） and metastatic group （28/74）. PCPT high risk probability ［41.14% （16%-67%）］ vs. ［30.89% （5%-65%）］， Gleason score ［8.5（6-10） score］ vs. ［7.7（6-9） score］， tPSA ［26.24（5.70-42.32） ng/mL］ vs. ［19.58（2.47-49.35） ng/mL］， and fPSA ［3.94（0.82-12.00） ng/mL］ vs. ［2.33（0.35-10.20） ng/mL］ were significantly higher in metastatic group than in non-metastatic group. Binary Logistic regression analysis showed that Gleason score and PCPT low risk probability may be independent predictors of prostate cancer metastasis. PCPT low risk probability alone did not predict the risk of prostate cancer metastasis （P=0.172）. The predictive accuracy of Gleason score and high probability of PCPT in predicting prostate cancer metastasis were 0.715 and 0.679， respectively， and the accuracy of the combined prediction was 0.809. 【Conclusion】 PCPT-RC combined with Gleason score is valuable for predicting the metastasis risk of newly diagnosed prostate cancer patients， which has certain guiding significance for clinical individualized treatment.
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【Objective】 To investigate the diagnostic efficiency of 18F-PSMA-1007 PET/CT in assessing the metastasis of newly diagnosed prostate cancer （PC）， and evaluate its relationship with clinical risk classification. 【Methods】 The clinical data of 257 newly diagnosed PC patients who underwent 18F-PSMA-1007 PET/CT between March 2019 and April 2021 were retrospectively reviewed in this study. All images were interpreted by two senior PET/CT diagnostic specialists. According to the D’Amico risk classification， the patients were divided into low-， intermediate- and high-risk groups. According to Gleason score （GS）， the patients were divided into GS≤6， GS=7， and GS≥8 groups. According to the level of serum total prostate-specific antigen （tPSA）， the patients were divided into <10 ng/mL， 10-20 ng/mL， and >20 ng/mL groups. Finally， in the groups with D’Amico risk classification， the subgroups were divided according to tPSA level and GS， and the differences of 18F-PSMA-1007 PET/CT in the detection of metastasis were compared among the subgroups. 【Results】 A total of 257 patients were enrolled with a median tPSA 16.34 （3.38-783.12） ng/mL and median Gleason score （GS） 8 （range： 6-10）. There were 10 （3.89%）， 36 （15.01%）， and 211（80.10%） PC patients in the low-， intermediate-， and high-risk groups， respectively. The rate of metastasis in high-risk group， GS ≥ 8 group， and tPSA >20 ng/mL group was 45.02%， 46.50%， and 47.02%， respectively. The rate of metastasis in low-risk group， GS ≤6 group and tPSA <10 ng/mL group was 0， 8.82%， and 15.63%， respectively. When tPSA <10 ng/mL， the rate of metastasis in low-risk group （0） was lower than that in high-risk group （33.33%）. When tPSA was 10-20 ng/mL， the rate of metastasis in intermediate-risk group （7.69%） was lower than that in high-risk group （38.71%）. When GS ≤6， the rate of metastasis in low-risk group （0） was lower than that in high-risk group （38.71%）. 【Conclusion】 The detection rate of metastasis in patients with newly diagnosed prostate cancer by 18F-PSMA-1007 PET/CT is positively correlated with GS， preoperative tPSA level， and D’Amico risk grade.
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【Objective】 To investigate the value of prostate-specific antigen （PSA） level， Gleason score， and PSMA PET/CT maximum standardized uptake value （SUVmax） in predicting prostate cancer （PCa） metastasis and the treatment option of oligometastatic PCa. 【Methods】 We retrospectively recruited 170 patients with PCa confirmed by pathology， 97 of whom were untreated， and divided them into nonmetastatic group， oligometastatic group （metastasis≤5）， and polymetastatic group. In addition， 28 patients with oligometastatic PCa underwent radical prostatectomy and 45 patients underwent androgen-deprivation therapy. We compared the differences in SUVmax， PSA， and Gleason scores between the three sub-groups of untreated patients， and also analyzed the correlation between SUVmax of local cancer lesions， Gleason score and PSA level. We further compared the differences in SUVmax and PSA levels between radical prostatectomy and androgen-deprivation therapy of oligometastatic PCa patients. According to Gleason score， patients with oligometastatic PCa were divided into two groups （low-intermediate risk group with Gleason score ≤7 and high-risk group with Gleason score ≥8）， and the levels of SUVmax and PSA between the groups were compared. 【Results】 With the increasing number of metastases， SUVmax， PSA levels and Gleason scores all showed an upward trend， and there were significant differences among the three groups （P=0.029， P=0.001， P=0.046）. The post-hoc test found significant difference in Gleason score between the oligometastatic group and the other two groups （P=0.043， P=0.002） as well as correlation of SUVmax level of the primary tumor with Gleason score and PSA （P=0.002， r=0.315； P<0.001， r=0.430）. There was significant difference in PSA level between the two groups after radical prostatectomy and androgen-deprivation therapy （P=0.017）. The difference in PSA between the two treatments persisted in the low-intermediate risk groups （P=0.021）. 【Conclusion】 PSA level， Gleason score and SUVmax have some value in predicting PCa metastasis. Radical prostatectomy is an effective treatment strategy for patients with oligometastatic PCa， especially those with low-intermediate Gleason score.
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【Objective】 To explore the value of 18F-PSMA-1007 PET/CT in evaluating the primary tumor and infiltration range of prostate cancer. 【Methods】 We retrospectively collected 18F-PSMA-1007 PET/CT whole body imaging data of the patients who came to the Department of Urology， The First Affiliated Hospital of Xi’an Jiaotong University， from March 2019 to June 2021 due to suspected or diagnosed prostate cancer. No treatment was give before the examination. In addition， 51 patients underwent radical surgery after examination and obtained complete pathological results. We used a semi-automatic method to delineate the region of interest （ROI） of 40% SUVmax of prostate cancer foci， and obtained the metabolic parameters， namely， SUVmax， SUVmean， tumor metabolic volume （MTV） and total lesion metabolic （TLM）. We also observed for infiltration of bilateral seminal vesicle glands and bladder. Correlation analysis was used to analyze the correlation of metabolic parameters with Gleason score and tumor grade grouping； McNemar test was used to analyze the accuracy of PSMA in evaluating the extent of prostate invasion. 【Results】 The PET/CT parameters SUVmax， SUVmean， TLM and Gleason score were not significantly correlated， but SUVmean was positively correlated with tumor grade （r=0.306， P=0.041）. The pathological results showed a moderate correlation between the maximum diameter of the tumor and MTV （r=0.479， P=0.003）. The sensitivity evaluated by PSMA-PET/CT to primary prostate tumor， capsule invasion， seminal vesicle gland invasion， and bladder invasion was 72.00%， 64.71%， 83.33%， and 25.00%， respectively； the specificity was 88.46%， 33.33%， 84.61%， and 95.74%， respectively； the accuracy was 80.39%， 52.94%， 86.27%， and 90.19%， respectively. 【Conclusion】 18F-PSMA-1007 PET/CT imaging has high accuracy in assessing primary tumor and the extent of invasion of prostate cancer， which indicates its value in clinical application.
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【Objective】 To analyze the correlation of whole body tumor burden of 18F-prostate specific membrane antigen positron emission computed tomography （18F-PSMA PET/CT） with prostate specific antigen （PSA） and Gleason score so as to evaluate the value of 18F-PSMA PET/CT whole body tumor burden for predicting serum PSA progression in prostate cancer. 【Methods】 We retrospectively recruited 213 patients with prostate cancer who underwent 18F-PSMA PET/CT scanning from March 2019 to April 2021. The serum PSA and Gleason score were collected. Whole body tumor burden was measured by a semi-automatic method. The correlation of tumor burden with serum PSA and Gleason score was analyzed. After radical prostatectomy， the patients were divided into groups according to negative or positive 18F-PSMA PET/CT. PSA differences between groups were compared， and the receiver operating characteristic curve （ROC） of the subjects was drawn so as to obtain the threshold value of PSA to predict the positive rate of 18F-PSMA PET/CT. The patients were followed up for PSA after radical surgery， divided into groups according to the progress of PSA， and the differences in tumor burden between groups were compared. 【Results】 In Gleason score ≤7， =8， and ≥9 groups， whole body tumor burden was correlated with PSA in each group （P=0.001）， and tumor burden significantly differed between the groups （P<0.001）. In initial diagnosis and treatment group， biochemical recurrence group， and medication group， the correlation between tumor burden and PSA was statistically significant （P=0.001）. The Gleason score of primary prostate lesion was significantly correlated with systemic tumor burden （P<0.001）. The area under ROC curve of PSA predicting the positive rate of 18F-PSMA PET/CT after radical prostatectomy was 0.821； when PSA>0.577 ng/mL， the sensitivity and the specificity were 66.7% and 96.8%， respectively. The mean whole body tumor burden in 18F-PSMA PET/CT positive patients with PSA progression was higher than that in patients without PSA progression. 【Conclusion】 The whole body tumor burden of 18F-PSMA PET/CT is significantly correlated with PSA， which is helpful in predicting the serum PSA progression in prostate cancer. PSA can predict the positive rate of 18F-PSMA PET/CT to a certain extent. At the same time， PSA can also predict positive results of 18F-PSMA PET/CT to a certain extent， and guide clinical rational selection of this examination.
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【Objective】 To analyze the correlation between metabolic parameters of 18F-deoxyglucose-labeledpositron emission tomography/computed tomography（18F-FDG PET/CT） scan and the immunohistochemistry （IHC） expression in patients with primary breast cancer so as to explore the predictive value of the metabolic parameters for molecular subtypes. 【Methods】 We retrospectively recruited 97 patients who underwent 18F-FDG PET/CT scan from November 2016 to June 2020 with breast cancer. The clinical stages （Ⅰ,Ⅱ,Ⅲ and Ⅳ） and menstrual status （pre-menopause or menopause） were collected. Metabolic parameters， including the maximum standardized uptake value （SUVmax）， mean standardized uptake value （SUVmean）， metabolic tumor volume （MTV） and total lesion glycolysis （TLG） of the primary tumor， were calculated by physician according to the 40% SUVmax principle. The IHC expressions （positive or negative） of the estrogen receptor （ER）， progesterone receptor （PR）， human epidermal growth factor receptor 2 （HER2）， proliferating cell nuclear antigen （Ki-67） and p53； the ipsilateral axillary lymph node metastasis （with or without）， and the molecular subtypes （Luminal A， Luminal B， HER2 overexpression， and triple negative） were determined by an experienced pathologist. The correlations between the metabolic parameters and IHC expression were analyzed by Pearson test or Spearman test， and were further stratified by different menstrual status and ipsilateral axillary lymph node metastasis. Finally， we analyzed metabolic parameters among different molecular subtypes. 【Results】 For all the patients， SUVmax and SUVmean had significantly negative correlation with ER and PR expressions （P<0.05）； SUVmax， SUVmean， and TLG were significantly positively correlated with Ki-67 expression （P<0.05）. SUVmax， SUVmean， and TLG of premenopausal patients （n=57） were negatively correlated with ER and PR expressions （P<0.05）， but positively correlated with Ki-67 expression （P<0.05）. MTV， TLG and PR expressions in postmenopausal patients （n=40） were positively correlated （P<0.05）. In patients with （n=27） or without （n=57） ipsilateral axillary lymph node metastasis， Ki-67 was negatively correlated with SUVmax and SUVmean （P<0.05）； in patients without ipsilateral axillary lymph node metastasis， SUVmax， SUVmean， and TLG were negatively correlated with PR （P<0.05）. Among different molecular types， SUVmax of HER2 overexpression was significantly higher than that of Luminal A （P<0.05）. 【Conclusion】 The 18F-FDG PET/CT metabolic parameters of breast cancer patients have a good correlation with the expression of immunohistochemistry， and SUVmax has predictive value for the expression of hetergeneous molecular types.
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【Objective】 To compare the detection efficiency of 99mTc-MDP SPECT and PSMA PET/CT in detecting bone metastases in patients with prostate cancer. 【Methods】 We retrospectively collected data of 83 patients diagnosed with prostate cancer in The First Affiliated Hospital of Xi’an Jiaotong University from March 2019 to July 2020, concurrent with 99mTc-MDP SPECT and 18F-PSMA PET/CT whole body imaging in the same period. Two nuclear medicine physicians attending a double-blind interpretation compared whether the patients with bone metastases detected by two imaging methods under different PSA levels and different Gleason scores, and further analyzed the location and number of inconsistent bone metastases as well as the ability of PET/CT to detect metastatic lesions other than bone. 【Results】 Compared with 99mTc-MDP SPECT, 18F-PSMA PET/CT could detect more prostate cancer patients with bone metastases (P<0.001). When TPSA<10 ng/mL or >20 ng/mL, the detection rate of PET/CT for bone metastasis was higher than that of whole body bone scan (P<0.05). When Gleason score>8, PET/CT was more effective in detecting bone metastasis. The detection rate was higher than that of whole body bone scan (P<0.05). The lesions with positive PET/CT but not diagnosed by bone scan were mainly located in the chest bone, spine bone, and pelvic bone; the lesions with positive bone scan but missed by PET/CT were also more common in chest bone, with low nuclide uptake. The average SUVmax was 2.62±0.47 (1.60-3.30), and adjacent to the liver, spleen or salivary glands with higher metabolism. There were 21/51 (41.18%) cases of lymph node metastasis found outside of bone, 5/51 (9.80%) cases of lung metastasis, and 1/51 (1.96%) cases of liver metastasis. 【Conclusion】 18F-PSMA PET/CT imaging is significantly superior to 99mTc-MDP whole-body bone imaging in diagnosing bone metastasis of prostate cancer, and it can detect metastases other than bone.
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Objective@#To understand the incidence of school bullying and its influencing factors among adolescents in low-income and middle-income countries, and to explore the association between school bullying and mental health of adolescent students, so as to provide reference for prevention and control of school bullying and mental health intervention.@*Methods@#Data was obtained from the 2009-2015 Global School Student Health Survey from 19 low-income and middle-income countries (n=22 963). Binary Logistic regression was used to analyze the influencing factors of school bullying, and multiple linear regression was used to analyze the relationship between school bullying and mental health.@*Results@#The average score of students mental health was(5.75±2.09), and approximately 35.1% of adolescent students reported suffering from school bullying. The rates of school bullying among students in low-income and middle-income countries were 39.4% amd 34.3%, respectively. Students with lower grades, overweight, poor family economic status, low family learning and psychological support, poor perceived family relationship, more truancy, and poor relationship with classmates were more likely to suffer from school bullying(P<0.05). Exposure to school bullying was positively associated with adverse mental health outcomes for women(B=1.27, P<0.01).@*Conclusion@#Not only were school bullying more common in low-income countries, but also school bullying had a greater negative impact on the mental health of girls. We need to pay more attention to school bullying among adolescent students, especially in low-income countries and girls, with cost-effective interventions to reduce or mitigate the consequences of bullying.
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The capacity for thermal tolerance is critical for industrial enzyme. In the past decade, great efforts have been made to endow wild-type enzymes with higher catalytic activity or thermostability using gene engineering and protein engineering strategies. In this study, a recently developed SpyTag/SpyCatcher system, mediated by isopeptide bond-ligation, was used to modify a rumen microbiota-derived xylanase XYN11-6 as cyclized and stable enzyme C-XYN11-6. After incubation at 60, 70 or 80 ℃ for 10 min, the residual activities of C-XYN11-6 were 81.53%, 73.98% or 64.41%, which were 1.48, 2.92 or 3.98-fold of linear enzyme L-XYN11-6, respectively. After exposure to 60-90°C for 10 min, the C-XYN11-6 remained as soluble in suspension, while L-XYN11-6 showed severely aggregation. Intrinsic and 8-anilino-1-naphthalenesulfonic acid (ANS)-binding fluorescence analysis revealed that C-XYN11-6 was more capable of maintaining its conformation during heat challenge, compared with L-XYN11-6. Interestingly, molecular cyclization also conferred C-XYN11-6 with improved resilience to 0.1-50 mmol/L Ca²⁺ or 0.1 mmol/L Cu²⁺ treatment. In summary, we generated a thermal- and ion-stable cyclized enzyme using SpyTag/SpyCatcher system, which will be of particular interest in engineering of enzymes for industrial application.