Characterizing Prostate Cancer By ex vivo MRS Signatures

描述(申请人提供)：二十年来，PSA检测一直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的显著成功，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，70%的前列腺癌患者被诊断为无症状、中度分化的腺癌。尽管取得了这一成就，前列腺癌仍然是美国男性癌症死亡的第二大原因。在寻求治疗Gleason评分6分和7分肿瘤的前列腺癌患者中，有70%的患者观察到的结果的多样性表明，前列腺癌的评估存在潜在的弱点，并且在目前的描述中没有足够的特异性。肿瘤侵袭性可能是这些患者经历的不可预测的结果的原因，肿瘤侵袭性是一个关键的信息特征，现在不能在不切除前列腺的情况下进行评估。对于他们中的大多数人来说，必须在缺乏关于肿瘤行为和侵袭性的信息的情况下决定治疗方案，尽管所选的疗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)作为一种灵敏和定量探测前列腺癌潜在生物学和行为的工具的初步研究已经产生了显著的结果。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。这项建议旨在将HRMAS 1HMRS测量的完整前列腺切除组织的代谢情况与前列腺组织的组织病理学特征和个别患者的临床状况相关联，以建立前列腺癌的代谢情况并确定癌症的特征。然后，它的目的是在前列腺切除标本和活检标本中测试经组织病理学证实的这些分别用于预测病理阶段和患者临床状态的标志物的诊断效率。最后，它计划纵向评估肿瘤代谢特征的预后能力，独立于组织病理学，预测特定的肿瘤行为和患者结果。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，以及降低前列腺癌护理的相关成本。

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.