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Prostate specific antigen in the staging of localized prostate cancer: influence of tumor differentiation, tumor volume and benign hyperplasia.前列腺特异性抗原在局限性前列腺癌分期中的作用:肿瘤分化、肿瘤体积及良性增生的影响
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The development of human benign prostatic hyperplasia with age.人类良性前列腺增生随年龄的发展。
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本文引用的文献

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Selection and Validation of Predictive Models of Radiation Effects on Tumor Growth Based on Noninvasive Imaging Data.基于无创成像数据的肿瘤生长辐射效应预测模型的选择与验证
Comput Methods Appl Mech Eng. 2017 Dec 1;327:277-305. doi: 10.1016/j.cma.2017.08.009. Epub 2017 Aug 18.
2
The Characteristics of the Transitional Zone in Prostate Growth With Age.前列腺随年龄增长的移行带特征
Urology. 2017 Jul;105:136-140. doi: 10.1016/j.urology.2017.03.010. Epub 2017 Apr 4.
3
Computational imaging reveals shape differences between normal and malignant prostates on MRI.计算成像揭示了 MRI 上正常前列腺和恶性前列腺之间的形状差异。
Sci Rep. 2017 Feb 1;7:41261. doi: 10.1038/srep41261.
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Three-dimensional Image-based Mechanical Modeling for Predicting the Response of Breast Cancer to Neoadjuvant Therapy.基于三维图像的力学建模用于预测乳腺癌对新辅助治疗的反应
Comput Methods Appl Mech Eng. 2017 Feb 1;314:494-512. doi: 10.1016/j.cma.2016.08.024. Epub 2016 Sep 1.
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Tissue-scale, personalized modeling and simulation of prostate cancer growth.前列腺癌生长的组织尺度、个性化建模与模拟
Proc Natl Acad Sci U S A. 2016 Nov 29;113(48):E7663-E7671. doi: 10.1073/pnas.1615791113. Epub 2016 Nov 16.
6
Stiffness of benign and malignant prostate tissue measured by shear-wave elastography: a preliminary study.通过剪切波弹性成像测量良性和恶性前列腺组织的硬度:一项初步研究。
Eur Radiol. 2017 May;27(5):1858-1866. doi: 10.1007/s00330-016-4534-9. Epub 2016 Aug 23.
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Multiparametric magnetic resonance imaging characteristics of normal, benign and malignant conditions in the prostate.前列腺正常、良性及恶性病变的多参数磁共振成像特征
Eur Radiol. 2017 May;27(5):2095-2109. doi: 10.1007/s00330-016-4479-z. Epub 2016 Aug 4.
8
Patient-specific Deformation Modelling via Elastography: Application to Image-guided Prostate Interventions.通过弹性成像进行患者特异性变形建模:在图像引导前列腺介入中的应用。
Sci Rep. 2016 Jun 7;6:27386. doi: 10.1038/srep27386.
9
Predicting the Response of Breast Cancer to Neoadjuvant Therapy Using a Mechanically Coupled Reaction-Diffusion Model.使用机械耦合反应扩散模型预测乳腺癌对新辅助治疗的反应
Cancer Res. 2015 Nov 15;75(22):4697-707. doi: 10.1158/0008-5472.CAN-14-2945. Epub 2015 Sep 2.
10
Accuracy of Magnetic Resonance Imaging/Ultrasound Fusion Targeted Biopsies to Diagnose Clinically Significant Prostate Cancer in Enlarged Compared to Smaller Prostates.磁共振成像/超声融合靶向活检诊断大体积前列腺与小体积前列腺临床显著前列腺癌的准确性。
J Urol. 2015 Sep;194(3):669-73. doi: 10.1016/j.juro.2015.03.025. Epub 2015 Mar 14.

计算机模拟表明,良性前列腺增生引起的前列腺肿大在机械上阻碍了前列腺癌的生长。

Computer simulations suggest that prostate enlargement due to benign prostatic hyperplasia mechanically impedes prostate cancer growth.

机构信息

Departamento de Matemáticas, Universidade da Coruña, 15071 A Coruña, Spain;

Department of Civil Engineering and Architecture, University of Pavia, 27100 Pavia, Italy.

出版信息

Proc Natl Acad Sci U S A. 2019 Jan 22;116(4):1152-1161. doi: 10.1073/pnas.1815735116. Epub 2019 Jan 7.

DOI:10.1073/pnas.1815735116
PMID:30617074
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6347698/
Abstract

Prostate cancer and benign prostatic hyperplasia are common genitourinary diseases in aging men. Both pathologies may coexist and share numerous similarities, which have suggested several connections or some interplay between them. However, solid evidence confirming their existence is lacking. Recent studies on extensive series of prostatectomy specimens have shown that tumors originating in larger prostates present favorable pathological features. Hence, large prostates may exert a protective effect against prostate cancer. In this work, we propose a mechanical explanation for this phenomenon. The mechanical stress fields that originate as tumors enlarge have been shown to slow down their dynamics. Benign prostatic hyperplasia contributes to these mechanical stress fields, hence further restraining prostate cancer growth. We derived a tissue-scale, patient-specific mechanically coupled mathematical model to qualitatively investigate the mechanical interaction of prostate cancer and benign prostatic hyperplasia. This model was calibrated by studying the deformation caused by each disease independently. Our simulations show that a history of benign prostatic hyperplasia creates mechanical stress fields in the prostate that impede prostatic tumor growth and limit its invasiveness. The technology presented herein may assist physicians in the clinical management of benign prostate hyperplasia and prostate cancer by predicting pathological outcomes on a tissue-scale, patient-specific basis.

摘要

前列腺癌和良性前列腺增生是老年男性常见的泌尿生殖系统疾病。这两种病理可能同时存在,并具有许多相似之处,这表明它们之间存在一些联系或相互作用。然而,缺乏证实它们存在的确凿证据。最近对大量前列腺切除术标本的研究表明,起源于较大前列腺的肿瘤具有较好的病理特征。因此,较大的前列腺可能对前列腺癌具有保护作用。在这项工作中,我们提出了一种对此现象的力学解释。研究表明,随着肿瘤的增大而产生的力学应力场会减缓其动力学过程。良性前列腺增生会导致这些力学应力场的产生,从而进一步抑制前列腺癌的生长。我们推导了一个组织尺度、患者特异性的力学耦合数学模型,定性地研究了前列腺癌和良性前列腺增生的力学相互作用。该模型通过分别研究每种疾病引起的变形来进行校准。我们的模拟表明,良性前列腺增生的病史会在前列腺中产生力学应力场,从而阻碍前列腺肿瘤的生长并限制其侵袭性。本文所介绍的技术可以通过预测组织水平、患者特异性的病理结果,帮助医生对良性前列腺增生和前列腺癌进行临床管理。