Characterizing Prostate Cancer By ex vivo MRS Signatures

描述（由申请人提供）：二十年来，PSA检测已被常规应用于临床实践。这种强调早期发现恶性肿瘤的方法取得了显著的成功，这可以通过今天的前列腺癌患者群体与20年前的一个关键区别来判断：今天，大约70%的前列腺癌患者被诊断为无症状、中度分化的腺癌。尽管取得了这些成就，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，在寻求Gleason评分为6分和7分肿瘤治疗的前列腺癌患者中，有70%的患者观察到结果的多样性，这表明前列腺肿瘤的评估存在潜在的弱点，并且表明目前对其描述的特异性不足。很可能肿瘤侵袭性是这些患者经历的不可预测的结果，肿瘤侵袭性是一个重要的信息特征，如果没有前列腺切除术，现在无法评估。对于他们中的大多数来说，必须在缺乏肿瘤行为和侵袭性信息的情况下决定治疗方案，尽管所选择的方案可能被证明是不合适的。高分辨率魔角自旋质子磁共振波谱（HRMAS 1HMRS）作为一种敏感定量探测前列腺肿瘤潜在生物学和行为的工具，其初步研究已经取得了显著的成果。这些结果支持了该技术在前列腺癌诊断和治疗计划方面的潜在价值。本研究旨在将HRMAS 1HMRS测量的完整前列腺切除术组织的代谢谱与前列腺组织病理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。在前列腺切除术标本和活检标本中，通过组织病理学证实，测试这些标志物在预测病理分期和患者临床状态方面的诊断效果。最后，它计划纵向评估独立于组织病理学的肿瘤代谢谱的预后能力，以预测特定的肿瘤行为和患者预后。相关性：该项目的总体目标是提高前列腺癌诊断的准确性，为患者的福祉做出贡献，并降低与前列腺癌护理相关的成本。

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.