Characterizing Prostate Cancer By ex vivo MRS Signatures

描述（由申请人提供）：二十年来，PSA检测已在临床实践中常规使用。这种方法的突出成功，其重点是恶性肿瘤的早期检测，可以通过今天的前列腺癌患者群体与20年前的前列腺癌患者群体之间的一个关键区别来判断：今天，>70%的前列腺癌患者被诊断为无症状的中度分化腺癌。尽管取得了这一成就，前列腺癌仍然是美国男性癌症死亡的第二大原因。根据肿瘤形态学确定，对于寻求治疗Gleason评分为6和7的肿瘤的>70%的PCa患者观察到的结局多样性指出了前列腺肿瘤评估中的潜在弱点，并表明其当前描述的特异性不足。很可能是肿瘤的侵袭性，一个至关重要的信息特征，现在不能评估没有子宫切除术，解释了这些患者经历的不可预测的结果。对于他们中的大多数人来说，治疗决定必须在缺乏有关肿瘤行为和侵袭性的信息的情况下确定，尽管所选择的过程可能被证明是不合适的。高分辨率魔角旋转质子磁共振波谱（HRMAS 1HMRS）作为一种工具，灵敏和定量探测前列腺肿瘤的潜在生物学和行为的初步研究已经产生了显着的结果。这些结果支持了该技术在前列腺癌诊断和治疗计划中的潜在价值。该提案旨在将通过HRMAS 1HMRS测量的完整前列腺切除组织的代谢谱与前列腺组织病理学特征和个体患者的临床状态相关联，以建立前列腺癌代谢谱并定义癌症特征。然后，其目的是测试通过组织病理学证实的这些各自的标记物用于预测子宫内膜切除术标本和活检样品中的病理分期和患者临床状态的诊断功效。最后，它计划纵向评估肿瘤代谢谱的预后能力，独立于组织病理学，以预测特定的肿瘤行为和患者结局。相关性：该项目的总体目标是提高前列腺癌诊断的准确性，为患者的健康做出贡献，并降低与前列腺癌相关的护理费用。

DESCRIPTION (provided by applicant): For two decades, PSA testing has been employed routinely in clinical practice. The outstanding success of this approach, with its emphasis on early detection of malignancy, can be judged by one key distinction between today's prostate cancer patient population and that of 20 years ago: today, >70% of prostate cancer patients are diagnosed with asymptomatic, moderately differentiating adenocarcinomas. Despite this accomplishment, prostate cancer remains the second leading cause of cancer death among American men. The diversity of outcomes observed for this >70% of PCa patients who seek treatment for Gleason score 6 and 7 tumors, as determined by tumor morphology, points to an underlying weakness in the evaluation of prostate tumors, and indicates insufficient specificity in their current description. It is likely that tumor aggressiveness, a crucially informative feature that cannot now be assessed without prostatectomy, accounts for the unpredictable outcomes experienced by these patients. For most of them, decisions on treatment must be determined in the absence of information about tumor behavior and aggressiveness, and in spite of the fact that the selected course may prove to be inappropriate. Preliminary studies of high resolution magic-angle-spinning proton magnetic resonance spectroscopy (HRMAS 1HMRS) as a tool for sensitively and quantitatively probing the underlying biology and behavior of prostate tumors have produced significant results. These results support the technique's potential value for prostate cancer diagnosis and treatment planning. This proposal seeks to correlate metabolic profiles of intact prostatectomy tissue, measured by HRMAS 1HMRS, with both prostate tissue histopathological features and the clinical status of individual patients, in order to establish prostate cancer metabolic profiles and to define cancer signatures. It then aims to test the diagnostic efficacy, confirmed by histopathology, of these respective markers for predicting pathological stage and patient clinical status in both prostatectomy specimens and biopsy samples. Finally, it plans to assess longitudinally the prognostic capability of tumor metabolic profiles, independent of histopathology, to predict specific tumor behavior and patient outcome. Relevance: the overall goal of the project is to improve the accuracy of prostate cancer diagnosis, to contribute to the patient well-being, as well as to reduce costs related prostate cancer cares.