Weksler Meir, Simon Avi, Lenkinski Robert E, Landsman Hagar, Matzkin Haim, Mabjeesh Nicola, Leibovitch Ilan
R&D Department, Prosight Ltd., Bay-Yam 5697439, Israel.
Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
Diagnostics (Basel). 2023 Jan 24;13(3):424. doi: 10.3390/diagnostics13030424.
A key step in providing management/treatment options to men with suspected prostate cancer (PCa) is categorizing the risk in terms of the presence of benign, low-risk, intermediate-risk, or high-risk disease. Our novel modality brings new evidence, based on the long-known hallmark characteristic of PCa-decreased zinc (Zn), which is the most direct metabolic sign of malignancy and its aggressiveness. To date, this approach has not been adopted for clinical use for a number of reasons that are described in this article, and which have been addressed by our approach. Zn has to be measured on fresh samples, prior to fixating in formalin; therefore, samples have to be scanned during the biopsy session. As Zn depletion occurs in the glands where the tumors develop, estimation of the glands' levels in the scanned tissue, along with their compactness, are essential for accurate diagnosis. Combined with the Zn depletion, this facilitates a reliable assessment of disease aggressiveness. Data gathered in the clinical study described here indicate that, in addition to improving the biopsy quality by real-time interactive guidance, a malignancy score can now be established for the entire prostate, allowing higher granularity personalized risk stratification and more decisive treatment decisions for all PCa patients.
为疑似前列腺癌（PCa）男性提供管理/治疗方案的关键步骤是根据良性、低风险、中风险或高风险疾病的存在对风险进行分类。我们的新方法基于PCa长期已知的标志性特征——锌（Zn）含量降低，带来了新的证据，锌含量降低是恶性肿瘤及其侵袭性最直接的代谢标志。迄今为止，由于本文所述的一些原因，这种方法尚未用于临床，而我们的方法解决了这些问题。锌必须在固定于福尔马林之前在新鲜样本上进行测量；因此，样本必须在活检过程中进行扫描。由于肿瘤发生部位的腺体中会出现锌耗竭，因此估计扫描组织中腺体的水平及其紧密程度对于准确诊断至关重要。结合锌耗竭情况，这有助于对疾病侵袭性进行可靠评估。此处描述的临床研究收集的数据表明，除了通过实时交互式引导提高活检质量外，现在还可以为整个前列腺建立恶性肿瘤评分，从而为所有前列腺癌患者实现更高粒度的个性化风险分层和更具决定性的治疗决策。
