Urine spermine and multiparametric magnetic resonance imaging for prediction of prostate cancer in Japanese men.

Objectives: To investigate the role of urine spermine and spermine risk score in predicting prostate cancer (PCa) diagnoses in combination with multiparametric magnetic resonance imaging (mpMRI). Methods: Three hundred forty seven consecutive men with elevated prostate-specific antigen (PSA) with mpMRI examination were prospectively enrolled in this study. In 265 patients with PSA levels between 4 and20 ng/ml, pre-biopsy urine samples were analyzed for spermine levels with ultra-high performance liquid chromatography (UPLC-MS/MS). Transperineal image-guided prostate biopsies with 16-18 cores were performed. Logistic regressions were used to form different models for the prediction of the PCa, and the performances were compared using the area under the curve (AUC). Results: The median serum PSA level and prostate volume were 7.4 ng/mL and 33.9 mL, respectively. PCa and high-grade PCa (ISUP group ≥2, HGPCa) were diagnosed in 66.0% (175/265) and 132/265 (49.8%) cases, respectively. The urine spermine levels were significantly lower in men with PCa (0.87 vs. 2.20, P < 0.001). Multivariate analyses showed that age, PSA, PV, urine spermine level, and Prostate Imaging Reporting and Data System (PI-RADS) findings were independent predictors for PCa. The Spermine Risk Score is a multivariable model including PSA, age, prostate volume, and urine spermine. Adding the Spermine Risk Score to PI-RADS improved the AUC from 0.73 to 0.86 in PCa and from 0.72 to 0.83 in high grade PCa (HGPCa) prediction (both P < 0.001). At 90% sensitivity for HGPCa prediction using Spermine Risk Score, 31.1% of unnecessary biopsies could be avoided. In men with equivocal MRI PI-RADS score 3, the AUC for HGPCa prediction was 0.58, 0.79, and 0.87 for PSA, PSA density, and Spermine Risk Score, respectively. Conclusion: Urine Spermine Risk Score, including mpMRI could accurately identify men at high risk of HGPCa and reduce unnecessary prostate biopsies. Spermine Risk Score could more accurately predict HGPCa than PSA density in men with MRI showing equivocal PI-RADS 3 lesions.

Urine spermine and multivariable Spermine Risk Score predict high-grade prostate cancer.

BACKGROUND: To investigate the role of urine spermine and Spermine Risk Score in prediction of high-grade prostate cancer (HGPCa, ISUP grade group ≥2). METHODS: Nine hundred and five consecutive men with elevated PSA were prospectively recruited from two hospitals. Core analyses focused on consecutive men with PSA 4-20 ng/mL (n = 600). Pre-biopsy urine without prior prostatic massage was analyzed for spermine level with ultra-high performance liquid chromatography with triple quadrupole mass spectrometer (UPLC-MS/MS). The proportions of PCa and HGPCa were compared across different spermine ranges. Logistic regressions were used to form different models, and their performances were compared using area under curve (AUC) and decision curve analysis (DCA). RESULTS: PCa and HGPCa were diagnosed in 30.8% (185/600) and 17.2% (103/600) men, respectively, and were significantly associated with lower urine spermine levels. Between the lowest and highest quartiles of spermine results, a threefold increase in PCa risk (49.3% vs. 16.7%) and 3.5-fold increase in ISUP grade group ≥2 PCa risk (31.3% vs. 8.7%) were observed. Multivariate analysis showed PSA, prostate volume (PV), digital rectal examination (DRE), and spermine, which were independent predictors for PCa and HGPCa, and a Spermine Risk Score with these factors achieved the highest AUC of 0.78 for PCa and 0.82 for HGPCa. At 90% sensitivity for HGPCa, 36.7% biopsies and 24.4% ISUP grade group 1 diagnoses could have been avoided, with a negative predictive value of 95.4%. DCA revealed net clinical benefit of the Spermine Risk Score. Internal validation with bootstrapping showed good discrimination and calibration. CONCLUSION: Urine spermine and Spermine Risk Score identified men at higher risk of HGPCa and reduced unnecessary biopsies.

Photodynamic and photothermal synergistic behavior of triphenylamine-porphyrin nanoparticles for DNA interaction, cellular cytotoxicity and localization.

In this paper, amphiphilic conjugated triphenylamine-porphyrins TPA-Por-TPA and TPA-Por were designed and synthesized. The water-soluble nanostructures TPA-Por-TPA NPs and TPA-Por NPs spontaneously assembled after π-π stacking, which can be changed by improving the internal transfer ability of electrons. The intercalation and external binding modes of these free porphyrins and nanoporphyrins interacting with ct-DNA were confirmed by UV-vis and fluorescence spectroscopy. Reactive oxygen species (ROS) production was studied by 2',7'-dichlorofluorescein diacetate, demonstrating that the rate of production of ROS is TPA-Por-TPA NPs > TPA-Por-TPA > TPA-Por NPs > TPA-Por. In addition, the structure of the NP enhanced the acceptor-donor conjugated structure, resulting in fluorescence quenching and promoting non-radiative heat generation. The photothermal conversion efficiencies of the TPA-Por-TPA NPs and TPA-Por NPs were measured and calculated to be 34.89% and 37.99%, respectively. At the same time, the three nanomaterials showed good photocytotoxicity, and the IC50 of the TPA-Por-TPA NPs and TPA-Por NPs was 32.18 and 36.62 µg ml-1, respectively, at 10 min after laser irradiation. The cellular uptake and subcellular localization of these NPs were further evaluated through a confocal laser scanning microscope. The results showed that the conjugated NPs have good biocompatibility properties in the cancer cells. These properties make it possible for triphenylamine porphyrin NPs to become photosensitizers for the photodynamic and photothermal synergistic treatment of tumors, and have potential prospects for applications in cancer diagnosis and treatment.

Responsive upconversion nanoprobe for monitoring and inhibition of EBV-associated cancers via targeting EBNA1.

Non-responsive emission enhancement is the disadvantage of upconversion nanomaterials (UCNM) when compared with conventional organic based agents for molecular imaging. We herein show a new strategy by conjugating NaGdF4:Yb3+,Er3+@NaGdF4 (UCNP) with peptides to achieve responsive UC emission enhancement upon binding to a targeted protein - EBNA1. EBNA1 is a well-known viral latent protein for the EBV-associated cancer. Peptide-coating of the functionalized core-shell nanoparticle diminishes upconverted emission intensity drastically. However, the peptide-coated UCNP shows selective and responsive UC emission enhancement via aggregation with the targeted protein. This phenomenon paves a new way for UCNM in molecular imaging.

Reversible and Sensitive Hg2+ Detection by a Cell-Permeable Ytterbium Complex.

A cell-permeable ytterbium complex shows reversible binding with Hg2+ in aqueous solution and in vitroby off-on visible and NIR emission. The fast response and 150 nM sensitivity of Hg2+ detection is based upon FRET and the lanthanide antenna effect. The reversible Hg2+ detection can be performed in vitro, and the binding mechanism is suggested by NMR employing the motif structure in a La complex and by DFT calculations.