1.Accuracy of PI-RADS score in diagnosing prostate cancer at different PSA levels
Hanchang WU ; Fang LIU ; Chao MA ; Jian WANG
Academic Journal of Naval Medical University 2025;46(2):223-228
Objective To investigate the accuracy of prostate imaging and reporting data system(PI-RADS)score in diagnosing prostate cancer(PCa)with different prostate-specific antigen(PSA)levels.Methods Patients who underwent multiparametric magnetic resonance imaging scanning with biopsy of the prostate to obtain pathological confirmation in The First Affiliated Hospital of Naval Medical University(Second Military Medical University)between Jan.2017 and Jun.2023 were enrolled,and serum total PSA(t-PSA),free PSA(f-PSA),the ratio of free PSA to total PSA(f/t PSA)and PI-RADS scores were summarized in all patients.The accuracy of PI-RADS score in diagnosing PCa was analyzed at different PSA levels using pathology of the prostate biopsy as the gold standard.Results A total of 2 526 patients were enrolled and categorized into 7 groups according to the PSA level:0-4 ng/mL,>4-10 ng/mL(f/t PSA≥0.16),>4-10 ng/mL(f/t PSA<0.16),>10-20 ng/mL,>20-50 ng/mL,>50-100 ng/mL,and>100 ng/mL.In all patients,the sensitivity of PI-RADS≥3 in diagnosing PCa was 90.0%,which was superior to PI-RADS≥4(sensitivity:76.3%).Among the patients with PSA≤4 ng/mL,the accuracy of PI-RADS≥4 in diagnosing PCa was higher than that of PI-RADS≥3(87.7%vs 64.0%).With the increase of PSA levels,the diagnostic accuracies of PI-RADS≥4 and PI-RADS≥3 were gradually increased and tended to be the same.When PSA was>50-100 ng/mL,the diagnostic accuracies of PI-RADS≥4 and≥3 were 90.7%and 92.0%,respectively.Conclusion At higher PSA levels,the accuracies of PI-RADS scores in diagnosing PCa are higher,which can reduce unnecessary puncture of patients.
2.Prediction of pathological upgrading after radical prostatectomy for ISUP grade 1 prostate cancer:construction of a nomogram model based on clinical,imaging,and puncture biopsy
Fang LIU ; Hanchang WU ; Yun BIAN ; Chengwei SHAO
Academic Journal of Naval Medical University 2025;46(10):1297-1303
Objective To identify risk factors for pathological upgrading after radical prostatectomy in patients with biopsy-confirmed International Society of Urological Pathology(ISUP)grade 1 prostate cancer and to develop a predictive nomogram.Methods A total of 256 patients with ISUP grade 1 prostate cancer diagnosed by biopsy and undergoing radical prostatectomy in The First Affiliated Hospital of Naval Medical University between Jan.2017 and May 2024 were retrospectively enrolled.Clinical,imaging,and biopsy data were collected.Independent predictors were identified using univariate and multivariate binary logistic regression,and a nomogram model was constructed.Model performance was evaluated using receiver operating characteristic curve,clinical impact curve,and decision curve analysis.The stability of the model was evaluated by Hosmer-Lemeshow test.Results Multivariate binary logistic regression analysis revealed that the number of positive puncture cores(odds ratio[OR]=1.80),prostate imaging and reporting data system(PI-RADS)score(OR=1.88),and prostate specific antigen density(PSAD)stage(OR=1.43)were independent predictors of pathological upgrading(all P<0.01).The area under curve(AUC)value of the nomogram model based on the above 3 predictors was 0.82(95%confidence interval 0.77-0.87).Decision curve analysis demonstrated favourable clinical utility within a threshold probability range of 0.01-0.99.Clinical impact curve analysis showed that at a threshold probability of 0.40,the model could avoid 45 unnecessary interventions(12%reduction in false-positive rate)with a net clinical benefit of 0.46.The Hosmer-Lemeshow test indicated good model fit(P=0.45).Conclusion The constructed nomogram model can accurately predict the risk of pathological upgrading after radical prostatectomy in patients with ISUP grade 1 prostate cancer,providing a quantitative tool to support individualized decision-making for active surveillance.
3.Meta-analysis of regimen SOX versus XELOX in treatment of Chinese patients with advanced gastric carcinoma
Yuanjun LI ; Juan XING ; Hanchang WU ; Xu WEI ; Hongmei ZHANG
Chinese Journal of Biochemical Pharmaceutics 2015;37(5):56-60
Objective To compare clinical outcome and adverse reactions between the regimens SOX and XELOX for chemotherapy of advanced gastric carcinoma in Chinese population.Methods The original articles on randomized controlled trials ( RCTs) comparing the chemotherapy of SOX and XELOX in Chinese patients with advanced gastric carcinoma were recruited from the PUBMED, WANFANG, VIP and CNKI databases.The quality of the selected trials were assessed by JADAD method.Meta-analysis about the efficacy and safety of the two chemotherapy methods was performed by Rev Man 5.2.0 software ( Cochrane-information Management System) .Results Eight RCT studies were recruited in our work, including 293 patients in the SOX treatment group and 310 in the XELOX treatment group.The analysis results showed that there was no significant difference in the effect of the two chemotherapy methods (OR=1.19, 95%CI:0.86-1.64,P=0.29), and referred to the safety evaluation, the stomatitis (OR=2.29, 95%CI:1.74-4.89, P<0.0001) incidence in SOX treatment group was higher than XELOX treatment group, and in total, there was no significant difference in adverse reaction incidence of the two chemotherapy methods(OR =0.88, 95%CI: 0.66-1.19, P =0.41).Conclusion In the chemotherapy of advanced gastric carcinoma in Chinese population, there is no significant difference in clinical response rate between SOX and XELOX, and the stomatitis incidence of SOX is significantly higher than that of XELOX.
4.Design of 16 S rRNA-based Oligonucleotide Array Using Group-specific Non-unique Probes in Large Scale Bacteria Detection
Yibo WU ; Xiaochen BO ; Lirong YAN ; Guangchuang YU ; Hui LIU ; Hanchang SUN ; Hongwei XIE ; Shengqi WANG
Progress in Biochemistry and Biophysics 2009;36(8):1025-1034
With thousands of sequenced 16 S rRNA genes available,and advancements in oligonucleotide microarray technology,the detection of microorganisms in microbial communities consisting of hundreds of species may be possible.The existing algorithms developed for sequence-specific probe design are not suitable for applications in large-scale bacteria detection due to the lack of coverage,flexibility and efficiency.Many other strategies developed for group-specific probe design focus on how to find a unique group-specific probe that can specifically detect all target sequences of a group.Unique group-specific probe for each group can not always be found.Hence,it is necessary to design non-unique probes.Each probe can specifically detect target sequences of a different subgroup.Combination of multiple probes can achieve higher coverage.However,it is a time-consuming task to evaluate all possible combinations.A feasible algorithm using relative entropy and genetic algorithm (GA) to design group-specific non-unique probes was presented.

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