1.The value of MR IVIM-DWI parameters in predicting the risk of peripheral and transitional zone prostate cancer
Zhiwen CHE ; Jinman ZHONG ; Ali SHANG ; Zehua WEI ; Quanxin YANG
Journal of Xi'an Jiaotong University(Medical Sciences) 2025;46(2):274-279
Objective To investigate the value of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)in predicting the clinical and pathological features of prostate cancer(PCa).Methods We recruited 47 patients who underwent bpMRI combined with IVIM-DWI in our hospital from July 2022 to October 2023 and pathologically confirmed with PCa.Among these cases,20 were transitional zone PCa(TZ-PCa),and 27 were peripheral zone PCa(PZ-PCa).According to the International Society of Urological Pathology(ISUP)risk grades,the patients were divided into high-risk group(ISUP≥3)and low-risk group(ISUP≤2).Differences in the risk levels between TZ-PCa group and PZ-PCa group were compared.Factors including age,total prostate-specific antigen(tPSA),diffusion coefficient(D)value,pseudo diffusion coefficient(D*)value,perfusion fraction(F)value,and apparent diffusion coefficient(ADC)as independent variables were compared between the two groups.Binary logistic regression analysis was further used to identify the factors associated with high or low risk of PCa.Receiver operation characteristic(ROC)curves were plotted to evaluate the diagnostic efficacy of PSA,D value,anatomical zones,and the combined model of PSA+D value+anatomical zones in predicting the risk level of PCa.Results The risk level was higher in PZ-PCa group than in TZ-PCa group(P=0.015).Binary logistic regression analysis showed that the tPSA level in the high-risk group of PCa was higher than that in the low-risk group(OR=1.026,95%CI:1.004-1.049,P=0.014),but the Dmean value was lower than that in the low-risk group(OR=0.993,95%CI:0.987-0.999,P=0.034).PCa in the high-risk group was more distributed in the peripheral zone(OR=5.250,95%CI:1.468-18.772,P=0.023).The diagnostic efficacy of the combined model(AUC=0.887,95%CI:0.787-0.987)was higher than that of tPSA,Dmean,or anatomical partitioning alone(P=0.001,0.043,and 0.003,respectively).Conclusion PZ-PCa has a higher risk level than TZ-PCa.Combining bpMRI localization of anatomical zones with PSA and D value provides the highest efficacy in predicting the risk level of PCa,which can potentially support the development of precise and personalized clinical diagnosis and treatment strategies for PCa.
2.Diagnostic efficacy of diffusion weighted imaging for prostate cancer in different zonal origins
Jinman ZHONG ; Zhiwen CHE ; Jingzhe LIU ; Quanxin YANG
Journal of Practical Radiology 2025;41(3):434-437,466
Objective To evaluate the diagnostic concordance rates between zonal localization and diffusion weighted imaging(DWI)localization of prostate cancer,and to investigate the diagnostic efficacy of DWI for prostate cancer in the transition zone and peripheral zone.Methods Patients with localized prostate cancer who underwent radical prostatectomy were selected.5-grade Lik-ert-scale was used to determine the suspicion level of prostate cancer in DWI sequnence.Patients were divided into no suspicious lesion group(91 cases)(grade≤2 points)and suspicious lesion group(194 cases)(grade≥3 points).The t test,Mann-Whitney U test and χ2 test were used to compare the clinicopathological features between the two groups.Multiple regression analysis was used to detect the correlation between DWI grading and pathological features in the suspicious lesion group.Patients were also divided into transition zone and peripheral zone groups according to zonal localization of lesions.The diagnostic concordance rates between DWI image localization and zonal localization in the suspicious lesion group were compared by χ2 test.Results The study included 285 prostate cancer patients,the prostate-specific antigen(PSA),Gleason score,clinical/pathological stages,tumor volume and extracapsular extension of the sus-picious lesion group were higher than those of the no suspicious lesion group with significant differences(P<0.05).Multiple regres-sion test results showed significant positive correlations between DWI grading and pathological features,including pathological Glea-son score,pathological stages,tumor volume and extracapsular extension(P<0.05).The diagnostic concordance rates of DWI for prostate cancer in different zonal origins increased with the increase of DWI grading.The diagnostic concordance rates of peripheral zone group were higher than those of transition zone group,with more significant differences showed in DWI grade>3 points(P<0.05).Conclusion Prostate cancer with higher DWI grading may have more aggressive clinicopathological features,and show a better diag-nostic concordance rate than those with lower DWI grading.In addition,the diagnostic concordance rate of peripheral zone prostate cancer is higher than that of transition zone prostate cancer,with significant differences in higher DWI grading.
3.Diagnostic efficacy of diffusion weighted imaging for prostate cancer in different zonal origins
Jinman ZHONG ; Zhiwen CHE ; Jingzhe LIU ; Quanxin YANG
Journal of Practical Radiology 2025;41(3):434-437,466
Objective To evaluate the diagnostic concordance rates between zonal localization and diffusion weighted imaging(DWI)localization of prostate cancer,and to investigate the diagnostic efficacy of DWI for prostate cancer in the transition zone and peripheral zone.Methods Patients with localized prostate cancer who underwent radical prostatectomy were selected.5-grade Lik-ert-scale was used to determine the suspicion level of prostate cancer in DWI sequnence.Patients were divided into no suspicious lesion group(91 cases)(grade≤2 points)and suspicious lesion group(194 cases)(grade≥3 points).The t test,Mann-Whitney U test and χ2 test were used to compare the clinicopathological features between the two groups.Multiple regression analysis was used to detect the correlation between DWI grading and pathological features in the suspicious lesion group.Patients were also divided into transition zone and peripheral zone groups according to zonal localization of lesions.The diagnostic concordance rates between DWI image localization and zonal localization in the suspicious lesion group were compared by χ2 test.Results The study included 285 prostate cancer patients,the prostate-specific antigen(PSA),Gleason score,clinical/pathological stages,tumor volume and extracapsular extension of the sus-picious lesion group were higher than those of the no suspicious lesion group with significant differences(P<0.05).Multiple regres-sion test results showed significant positive correlations between DWI grading and pathological features,including pathological Glea-son score,pathological stages,tumor volume and extracapsular extension(P<0.05).The diagnostic concordance rates of DWI for prostate cancer in different zonal origins increased with the increase of DWI grading.The diagnostic concordance rates of peripheral zone group were higher than those of transition zone group,with more significant differences showed in DWI grade>3 points(P<0.05).Conclusion Prostate cancer with higher DWI grading may have more aggressive clinicopathological features,and show a better diag-nostic concordance rate than those with lower DWI grading.In addition,the diagnostic concordance rate of peripheral zone prostate cancer is higher than that of transition zone prostate cancer,with significant differences in higher DWI grading.
4.The value of MR IVIM-DWI parameters in predicting the risk of peripheral and transitional zone prostate cancer
Zhiwen CHE ; Jinman ZHONG ; Ali SHANG ; Zehua WEI ; Quanxin YANG
Journal of Xi'an Jiaotong University(Medical Sciences) 2025;46(2):274-279
Objective To investigate the value of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)in predicting the clinical and pathological features of prostate cancer(PCa).Methods We recruited 47 patients who underwent bpMRI combined with IVIM-DWI in our hospital from July 2022 to October 2023 and pathologically confirmed with PCa.Among these cases,20 were transitional zone PCa(TZ-PCa),and 27 were peripheral zone PCa(PZ-PCa).According to the International Society of Urological Pathology(ISUP)risk grades,the patients were divided into high-risk group(ISUP≥3)and low-risk group(ISUP≤2).Differences in the risk levels between TZ-PCa group and PZ-PCa group were compared.Factors including age,total prostate-specific antigen(tPSA),diffusion coefficient(D)value,pseudo diffusion coefficient(D*)value,perfusion fraction(F)value,and apparent diffusion coefficient(ADC)as independent variables were compared between the two groups.Binary logistic regression analysis was further used to identify the factors associated with high or low risk of PCa.Receiver operation characteristic(ROC)curves were plotted to evaluate the diagnostic efficacy of PSA,D value,anatomical zones,and the combined model of PSA+D value+anatomical zones in predicting the risk level of PCa.Results The risk level was higher in PZ-PCa group than in TZ-PCa group(P=0.015).Binary logistic regression analysis showed that the tPSA level in the high-risk group of PCa was higher than that in the low-risk group(OR=1.026,95%CI:1.004-1.049,P=0.014),but the Dmean value was lower than that in the low-risk group(OR=0.993,95%CI:0.987-0.999,P=0.034).PCa in the high-risk group was more distributed in the peripheral zone(OR=5.250,95%CI:1.468-18.772,P=0.023).The diagnostic efficacy of the combined model(AUC=0.887,95%CI:0.787-0.987)was higher than that of tPSA,Dmean,or anatomical partitioning alone(P=0.001,0.043,and 0.003,respectively).Conclusion PZ-PCa has a higher risk level than TZ-PCa.Combining bpMRI localization of anatomical zones with PSA and D value provides the highest efficacy in predicting the risk level of PCa,which can potentially support the development of precise and personalized clinical diagnosis and treatment strategies for PCa.
5.The value of exponential apparent diffusion coefficient value in predicting progression-free survival in patients with FIGO stage Ⅰ/Ⅱ cervical cancer
Wanxu REN ; Lei DENG ; Ali SHANG ; Zhiwen CHE ; Jinman ZHONG ; Quanxin YANG
Journal of Practical Radiology 2024;40(3):402-405,421
Objective To explore the correlation between exponential apparent diffusion coefficient(eADC)value before radical hysterectomy and postoperative clinical results in patients with International Federation of Gynecology and Obstetrics(FIGO)stageⅠ/Ⅱ cervical cancer,and to find MR quantitative indicators for predicting the prognosis of patients with early stage cervical cancer.Methods Patients with FIGO stage Ⅰ/Ⅱ cervical cancer who underwent surgical treatment were retrospectively collected.All patients underwent MRI plain scan and diffusion weighted imaging(DWI)scan before surgery.Baseline parameters included age,menopause,stage,tumor size,pathological differentiation and type,lymph node involvement,and postoperative adjuvant therapy.MR parameters included mean apparent diffusion coefficient(ADCmean),normalized apparent diffusion coefficient(nADC),eADC,SIDWI,and SIT2.Baseline and MRI parameters associated with recurrence were determined by Cox regression analysis.Results The progression-free survival(PFS)in the low eADC group was longer than that in the high eADC group(P=0.010).Univariate analysis showed that ADC,nADC and eADC were associated with recurrence(P<0.05).In multivariate analysis,only eADC[hazard ratio(HR)3.610;95%confidence interval(CI)1.467-8.886;P=0.005]was associated with recurrence.Conclusion Preoperative eADC is associated with PFS in patients with surgically treated FIGO stage Ⅰ/Ⅱ cervical cancer and is helpful in evaluating the prognosis of patients with cervical cancer.
6.Comparison of clinicopathological characteristics and prognostic evaluation of prostate cancers between peripheral zone and transition zone
Jinman ZHONG ; Jianke DING ; Zhiwen CHE ; Quanxin YANG
Journal of Xi'an Jiaotong University(Medical Sciences) 2024;45(6):988-992
[Objective] To compare the clinicopathological characteristics of localized prostate cancers between peripheral zone and transition zone and to evaluate biochemical recurrence-free survival rates between the two groups following radical prostatectomy. [Methods] Between February 2016 and August 2021, prostate cancer candidates meeting the eligibility criteria of the study were retrospectively enrolled and divided into transition zone group and peripheral zone group based on the zonal origin. The patients were followed regularly after radical prostatectomy. Unpaired t-test, χ2-test and Mann-Whitney U-test were used to compare age, serum prostate specific antigen (PSA), tumor volume, Gleason score, laterality of positive biopsy core, mean percentage of positive biopsy cores, clinical/pathological stage, seminal vesicle invasion, lymph node metastasis, and positive surgical margin between the two groups. The biochemical recurrence-free survival rates of the two groups were evaluated by Kaplan-Meier and the differences were determined by log-rank test. [Results] A total of 273 cases were included in the study, among which 176 were peripheral zone cancers and 97 were transition zone cancers. The mean tumor volume of the transition zone group was greater than that of peripheral zone group (P=0.002). The serum PSA of transition zone group was higher than that of the latter (P=0.047); however, both mean percentage of positive biopsy cores and the percentage of seminal vesicle invasion were higher in transition zone group than in peripheral zone group (P=0.028, 0.047). Furthermore, there was no significant difference in biochemical recurrence-free survival rate between the two groups (P=0.783). [Conclusion] Despite the greater tumor volume and higher PSA compared with those in peripheral zone cancers, transition zone cancers have similar biochemical recurrence-free survival rates following radical prostatectomy, suggesting that transition zone cancers may have a lower degree of aggressiveness than the latter.
7.Effects of biomimetic network membrane prepared by chitosan/gelatin/pectin on proliferation and mineralization of mesenehymal stem cells
Hong SUN ; Zhiwen YAN ; Shuofeng LI ; Yanjie XIONG ; Fan LIANG ; Ao LI ; Fanglian YAO ; Pengcheng CHE
Journal of Jilin University(Medicine Edition) 2019;45(1):17-22,后插1
Objective::To explore the effects of the biomimetic network membrane prepared by chitosan/gelatin/pectin on the proliferation and mineralization of mesenchymal stem cells (MSCs) , and to evaluate its feasibility of constructing tissue engineering bone.Methods:Chitosan, gelatin and pectin were made into a new biomimetic network membrane in a certain ratio by biomimetics.The experiment was divided into control group (MSCs+conventional medium) , material group (MSCs+network membrane+conventional medium) and material+OS group (MSCs+network membrane+OS medium) .The cell morphology was observed by inverted phase contrast microscope;the growth and secretion of extracellular matrix of the MSCs were observed under scanning electron microscope (SEM) .The proliferation of cells was determined by MTT assay (The MSCs were divided into negative control group and material group, and they were cultivated with blank medium and medium including materials) .The expression of calcium in MSCs was detected by Alizarin Red staining.Real-time polymerase chain reaction (RT-PCR) was used to determine the expression levels of osteocalcin (OC) mRNA and osteopontin (OPN) mRNA in the MSCs.Results:The network membrane was semitransparent thin film.The MSCs were short shuttle and clustered under inverted phase contrast microscope.After cultured for 7d, the MSCs were shuttle;after cultured for 14d, the number of MSCs was increased, with pseudo feet on the membrane;after cultured for21d, the MSCs clustered with a lot of neo-formed extracellular matrix.The MTT results showed that there was no significant difference in the proliferation level of MSCs between material group and negative control group (P>0.05) .The Alizarin Red staining results showed that the MSCs in the network membrane were dyed orange red.The RT-PCR results showed that the expression levels of OC mRNA in the MSCs in material group and material+OS group were lower on the 7th and 14th days, but on the 21th day, the expression levels were significantly increased and reached the peak;the expression level of OC mRNA in the MSCs in material group was significantly increased on the 7th day, and the expression level reached the peak on the 14th day, then fell slightly on the 21th day;compared with control group, the expression levels of OC mRNA and OPN mRNA in the cells in material group and material+OS group at different time points were significantly increased (P<0.01) , but there were no significant differences between material group and material+OS group (P>0.05) .Conclusion:Chitosan/gelatin/pectin biomimetic network membrane has good biocompatibility, and MSCs can grow and proliferate well on the membrane.The membrane can induce the MSCs to express mineralization-related genes and proteins without inducers.
8.Significance of transrectal ultrasound combined with carcinoembryonic antigen examination on accurate preoperative staging of rectal carcinoma
Erguo PANG ; Che CHI ; Zhiwen YANG ; Bingzhao ZHANG
Cancer Research and Clinic 2011;23(11):765-767
Objective To study the consistency of preoperative staging by transrectal ultrasonography (TRUS) combined with serum carcinoembryonic antigen (CEA) and the postoperative pathological TNM staging (PTNM).Methods 118 rectal cancer patients pathologically proven were divided into preoperative TRUS combined with CEA group (59 cases) and along TRUS group (59 cases).The consistency of preoperative stag in 2 groups and postoperative pathological stage was analyzed retrospectively.Results In TRUS combined with CEA group,the accuracy of T stage was 79.7 % (47/59),and the accuracy of N stage was 77.8 % (42/59),compared with the postoperative pTNM.While in along TRUS group,the accuracy of T stage was 86.4 % (51/59),and the accuracy of N stage was 57.7 % (30/59).The consistencies of T and N stage in TRUS combined with CEA group and postoperative pTNM were better (κ =0.685,P =0.000; κ =0.544,P =0.000).While the consistency of T stage in along TRUS and postoperative pTNM was better (κ =0.755,P =0.000),but that of N stage was poor (κ =0.154,P =0.229).Conclusion Preoperative evaluation by the TRUS combined with CEA can increase the accuracy of preoperative stage which can provide more reliable basis for decision-making and improve the rate of coincidence of operative procedures in line with forecasts.At the same time,it can provide the basis for the accurate preoperative diagnosis and individualized treatment.

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