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We determine the adsorption rate of polymer melts by means of measurements of molecular mobility. We show that the complex set of molecular rearrangements involved in the adsorption of polymers on flat surfaces can be modeled as an equilibration kinetics driven by the slow Arrhenius process (SAP), a recently discovered molecular mechanism. Our predictive model is based on the single hypothesis that the number of chains adsorbed per unit surface within the timescale of spontaneous fluctuations associated to the SAP is a temperature-invariant constant, not depending on the chemical structure of the polymer. Going beyond the qualitative arguments setting a correlation between equilibrium and nonequilibrium properties, we demonstrate that the rate at which an adsorbed layer grows does not depend on interfacial interactions. By considering simple physical arguments, we demonstrate that this quantity can be straightforwardly determined using the energy barrier of molecular motion as only input.
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This study introduces a two-stage hydrogen production enhancement mechanism using natural particle additives, with a focus on the effects of thermally modified maifanite (TMM) and pH self-regulation on dark fermentation (DF). Initial single-factor experiments identified preliminary parameters for the addition of TMM, which were further optimized using a Box-Behnken design. The established optimal conditions which include mass of 5.5 g, particle size of 120 mesh, and temperature of 324 °C, resulted in a 28.7 % increase in cumulative hydrogen yield (CHY). During the primary hydrogen production stage, TMM significantly boosted the growth and activity of Clostridium_sensu_stricto_1, enhancing hydrogen output. Additionally, a pH self-regulating phenomenon was observed, capable of initiating secondary hydrogen production and further augmenting CHY. These findings presented a novel and efficient approach for optimizing biohydrogen production, offering significant implications for future research and application in sustainable energy technologies.
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Fermentação , Hidrogênio , Zea mays , Hidrogênio/metabolismo , Zea mays/química , Concentração de Íons de Hidrogênio , Clostridium/metabolismo , TemperaturaRESUMO
This research investigates the formation mechanism of soot and particulate matter during the pyrolysis and gasification of waste derived from Municipal Solid Waste (MSW) in a laboratory scale drop tube furnace. Compared with CO2 gasification atmosphere, more ultrafine particles (PM0.2, aerodynamic diameter less than 0.2 µm) were generated in N2 atmosphere at 1200â, which were mainly composed of polycyclic aromatic hydrocarbons (PAHs), graphitic carbonaceous soot and volatile alkali salts. High reaction temperatures promote the formation of hydrocarbon gaseous products and their conversion to PAHs, which ultimately leads to the formation of soot particles. The soot particles generated by waste derived from MSW pyrolysis and gasification both have high specific surface area and well-developed pore structure. Compared with pyrolysis, the soot generated by gasification of waste derived from MSW had smaller size and higher proportion of inorganic components. The higher pyrolysis temperature led to the collapse of the mesoporous structure of submicron particles, resulting in a decrease in total pore volume and an increase in specific surface area. Innovatively, this research provides an explanation for the effect of reaction temperature/ CO2 on the formation pathways and physicochemical properties of soot and fine particulate matter.
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Temperatura Alta , Material Particulado , Pirólise , Resíduos Sólidos , Fuligem , Material Particulado/análise , Material Particulado/química , Resíduos Sólidos/análise , Fuligem/análise , Fuligem/química , Eliminação de Resíduos/métodos , Incineração/métodos , Dióxido de Carbono/análise , Dióxido de Carbono/química , Hidrocarbonetos Policíclicos Aromáticos/análise , Hidrocarbonetos Policíclicos Aromáticos/química , Tamanho da PartículaRESUMO
Mucosal-associated invariant T (MAIT) cells are essential in defending against infection. Sepsis is a systemic inflammatory response to infection and a leading cause of death. The relationship between the overall competency of the host immune response and disease severity is not fully elucidated. This study identified a higher proportion of circulating MAIT17 with expression of IL-17A and retinoic acid receptor-related orphan receptor γt in patients with sepsis. The proportion of MAIT17 was correlated with the severity of sepsis. Single-cell RNA-sequencing analysis revealed an enhanced expression of lactate dehydrogenase A (LDHA) in MAIT17 in patients with sepsis. Cell-culture experiments demonstrated that phosphoinositide 3-kinase-LDHA signaling was required for retinoic acid receptor-related orphan receptor γt expression in MAIT17. Finally, the elevated levels of plasma IL-18 promoted the differentiation of circulating MAIT17 cells in sepsis. In summary, this study reveals a new role of circulating MAIT17 in promoting sepsis severity and suggests the phosphoinositide 3-kinase-LDHA signaling as a driving force in MAIT17 responses.
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Diferenciação Celular , Células T Invariantes Associadas à Mucosa , Sepse , Humanos , Sepse/imunologia , Sepse/patologia , Sepse/sangue , Células T Invariantes Associadas à Mucosa/imunologia , Células T Invariantes Associadas à Mucosa/metabolismo , Masculino , Feminino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Idoso , Interleucina-17/metabolismo , Interleucina-17/sangue , Transdução de Sinais , Fosfatidilinositol 3-Quinases/metabolismoRESUMO
A novel polymeric microcapsule was designed and synthesized using perfluoropolyether silane (PFPE-silane) as a superhydrophobic core material and ethyl cellulose (EC) as a shell material. The effects of the stirring rate and the core-to-shell ratio on the synthesized microcapsules were investigated. The physicochemical properties of the polymeric microcapsules were evaluated using scanning electron microscopy, fourier transform infrared spectroscopy, thermogravimetric analysis, laser particle size analysis, and wettability analysis. The results showed that when the stirring rate was 650 rpm and the core-to-shell ratio was 1:1, well-distributed and uniformly dispersed microcapsules could be obtained. The results also indicated that the prepared polymeric microcapsules were spherical particles with micropores on the surface, and they had an average particle size of 165.71 µm. The EC shells could effectively prevent the thermal decomposition of PFPE-silane during cement hydration, and the PFPE-silane also exhibited excellent hydrophobicity. The specially designed structure of this polymeric microcapsule suggests its potential for enhancing the corrosion resistance of reinforced concrete structures.
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BACKGROUND: The early detection of high-grade prostate cancer (HGPCa) is of great importance. However, the current detection strategies result in a high rate of negative biopsies and high medical costs. In this study, the authors aimed to establish an Asian Prostate Cancer Artificial intelligence (APCA) score with no extra cost other than routine health check-ups to predict the risk of HGPCa. PATIENTS AND METHODS: A total of 7476 patients with routine health check-up data who underwent prostate biopsies from January 2008 to December 2021 in eight referral centres in Asia were screened. After data pre-processing and cleaning, 5037 patients and 117 features were analyzed. Seven AI-based algorithms were tested for feature selection and seven AI-based algorithms were tested for classification, with the best combination applied for model construction. The APAC score was established in the CH cohort and validated in a multi-centre cohort and in each validation cohort to evaluate its generalizability in different Asian regions. The performance of the models was evaluated using area under the receiver operating characteristic curve (ROC), calibration plot, and decision curve analyses. RESULTS: Eighteen features were involved in the APCA score predicting HGPCa, with some of these markers not previously used in prostate cancer diagnosis. The area under the curve (AUC) was 0.76 (95% CI:0.74-0.78) in the multi-centre validation cohort and the increment of AUC (APCA vs. PSA) was 0.16 (95% CI:0.13-0.20). The calibration plots yielded a high degree of coherence and the decision curve analysis yielded a higher net clinical benefit. Applying the APCA score could reduce unnecessary biopsies by 20.2% and 38.4%, at the risk of missing 5.0% and 10.0% of HGPCa cases in the multi-centre validation cohort, respectively. CONCLUSIONS: The APCA score based on routine health check-ups could reduce unnecessary prostate biopsies without additional examinations in Asian populations. Further prospective population-based studies are warranted to confirm these results.
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Antígeno Prostático Específico , Neoplasias da Próstata , Masculino , Humanos , Inteligência Artificial , Gradação de Tumores , Medição de Risco/métodos , Neoplasias da Próstata/diagnóstico , Biópsia , Curva ROCRESUMO
The utilization of a novel monolithic superhydrophobic cement material effectively prevents water infiltration and enhances the longevity of the material. A method for improving superhydrophobic concrete was investigated with the aim of increasing its strength and reducing its cost by compounding superhydrophobic substances with water repellents. The experimental tests encompassed the assessment of the compressive strength, contact angle, and water absorption of the superhydrophobic cementitious materials. The findings demonstrate that an increase in the dosage of isobutyltriethoxysilane (IBTES) progressively enhances the contact angle of the specimen, but significantly diminishes its compressive strength. The contact angle of SIKS mirrors that of SIS3, with a superior compressive strength that is 68% higher. Moreover, superhydrophobicity directly influences the water absorption of cementitious materials, with a more pronounced superhydrophobic effect leading to a lower water absorption rate. The water absorption of cementitious materials is influenced by the combined effect of porosity and superhydrophobicity. Furthermore, FT-IR tests unveil functional mappings, such as -CH3 which can reduce the surface energy of materials, signifying successful modification with hydrophobic substances.
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Modulating vanadia-based metal oxides is one of the effective methods for designing difunctional catalysts for simultaneous control of NOx and chlorobenzene (CB) from the emissions of industrial sources. Excessive NH3 adsorption and polychlorinated species accumulation on the surface are the primary issues poisoning catalysts and reducing their lifetime. Herein, Sb is selected as an NH3 adsorption alleviator and polychlorinated species preventor dopant on V2O5-WO3/TiO2. The catalyst exhibits an excellent performance for total NOx and 90% CB conversions at 300-400 °C under a gas hourly space velocity (GHSV) of 60,000 mL g-1 h-1. The HCl and N2 selectivities are maintained at 90 and 98%, respectively. The anti-poisoning ability could be attributed to the generated V-O-Sb chains on the surface: the band gap of vanadium is narrowed and the electron capability is strengthened. The above variation weakens the Lewis acid sites and blocks the electrophilic chlorination reactions of the catalyst surface (formation of polychlorinated species). In addition, oxygen vacancies on Sb-O-Ti also increase: the ring opening of benzoates is accelerated and NH3 adsorption energy is weakened. The above variation lowers the energy barriers of C-Cl cleavage even under NH3 pre-adsorption models and enhances NOx reduction thermodynamically and kinetically.
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Poluentes Ambientais , Titânio , Amônia , Óxidos , CatáliseRESUMO
This study investigated the influence of thermally modified tourmaline (Tur) on hydrogen production during the dark fermentation of corn stover. Single-factor experimental results revealed influencing factors of particle size, mass, and temperature. Optimization of the experimental process was achieved using the Box-Behnken design, reaching optimum at conditions of 407 °C, 910-mesh, and 6.2 g. The principle analysis experiment showed that the Tur-enhanced group (Tur_En) amplified cumulative hydrogen production by elevating hydrogen production during the sugar-production stage. The Tur_En group's cumulative hydrogen production was measured at 396.2 ± 40.3 (mL/g VS), marking a 34.2% increase compared to the control group. Analysis of microbial diversity indicated that Firmicutes and Bacteroidota emerged as dominant colonies in both stages. Tur facilitated hydrogen production by stimulating the activity of Firmicutes. This study suggests a highly effective Tur-enhanced technology for hydrogen production from corn stover and elucidates the principles underpinning this method from two stages.
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Hidrogênio , Zea mays , Fermentação , Hidrólise , Concentração de Íons de HidrogênioRESUMO
BACKGROUND: Urinary bladder cancer (UBC) is a common malignancy of the urinary tract; however, the mechanism underlying its high recurrence and responses to immunotherapy remains unclear, making clinical outcome predictions difficult. Epigenetic alterations, especially DNA methylation, play important roles in bladder cancer development and are increasingly being investigated as biomarkers for diagnostic or prognostic predictions. However, little is known about hydroxymethylation since previous studies based on bisulfite-sequencing approaches could not differentiate between 5mC and 5hmC signals, resulting in entangled methylation results. METHODS: Tissue samples of bladder cancer patients who underwent laparoscopic radical cystectomy (LRC), partial cystectomy (PC), or transurethral resection of bladder tumor (TURBT) were collected. We utilized a multi-omics approach to analyze both primary and recurrent bladder cancer samples. By integrating various techniques including RNA sequencing, oxidative reduced-representation bisulfite sequencing (oxRRBS), reduced-representation bisulfite sequencing (RRBS), and whole exome sequencing, a comprehensive analysis of the genome, transcriptome, methylome, and hydroxymethylome landscape of these cancers was possible. RESULTS: By whole exome sequencing, we identified driver mutations involved in the development of UBC, including those in FGFR3, KDMTA, and KDMT2C. However, few of these driver mutations were associated with the down-regulation of programmed death-ligand 1 (PD-L1) or recurrence in UBC. By integrating RRBS and oxRRBS data, we identified fatty acid oxidation-related genes significantly enriched in 5hmC-associated transcription alterations in recurrent bladder cancers. We also observed a series of 5mC hypo differentially methylated regions (DMRs) in the gene body of NFATC1, which is highly involved in T-cell immune responses in bladder cancer samples with high expression of PD-L1. Since 5mC and 5hmC alternations are globally anti-correlated, RRBS-seq-based markers that combine the 5mC and 5hmC signals, attenuate cancer-related signals, and therefore, are not optimal as clinical biomarkers. CONCLUSIONS: By multi-omics profiling of UBC samples, we showed that epigenetic alternations are more involved compared to genetic mutations in the PD-L1 regulation and recurrence of UBC. As proof of principle, we demonstrated that the combined measurement of 5mC and 5hmC levels by the bisulfite-based method compromises the prediction accuracy of epigenetic biomarkers.
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Post-neurosurgical bacterial meningitis (PNBM) is one of the severe complications in patients receiving neurosurgical procedures. Recent studies have found microbe-related glycans play important roles in adhesion, invasion, and toxicity toward innate immunological reactions. In this study, we aimed to investigate the glycomic profile and its potential diagnostic efficacy in post-neurosurgical bacterial meningitis (PNBM) patients with hemorrhagic stroke. A total of 136 cerebrospinal fluid (CSF) samples were recruited and divided into a PNBM group and a non-PNBM group based on the clinical diagnostic criteria. A lectin biochip-based method was established for the detection of glycans in CSF. The clinicopathological data and biochemical parameters in CSF from all patients were analyzed. Two models for multivariate analysis investigating glycan changes in the CSF were conducted, aiming at determining the specific expression and diagnostic efficacy of lectin-probing glycans (LPGs) for PNBM. In univariate analysis, we found that 8 out of 11 LPGs were significantly correlated with PNBM. Model 1 multivariate analysis revealed that PNA (p = 0.034), Jacalin (p = 0.034) and LTL (p = 0.001) were differentially expressed in the CSF of PNBM patients compared with those of non-PNBM patients. Model 2 multivariate analysis further disclosed that LTL (p = 0.021) and CSF glucose (p < 0.001) had independent diagnostic efficacies in PNBM, with areas under the curve (AUC) of 0.703 and 0.922, respectively. In summary, this study provided a new insight into the subject of CSF glycomics concerning bacterial infection in patients with hemorrhagic stroke.
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Proximity to a nonrepulsive wall is commonly considered to cause slower dynamics, which should lead to greater relaxation times for capped thin polymer films than for bulk melts. To the contrary, here we demonstrate that Al-capped films of poly(2-chlorostyrene) exhibit enhanced dynamics with respect to the bulk, similar to analogous freestanding films. To quantitatively resolve the impact of interfaces on whole film dynamics, we analyzed the experimental data via the Cooperative Free Volume rate model. We found that the interfacial region adjacent to a cap contains an excess of free volume (relative to the bulk) about half of that proximate to a free surface. Employing a useful analogy between confinement and pressure effects, we estimated that the effect of capping an 18 nm freestanding film would be equivalent to applying a pressure increase of 19 MPa.
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Polímeros , PressãoRESUMO
The rate at which a nonequilibrium system decreases its free energy is commonly ascribed to molecular relaxation processes, arising from spontaneous rearrangements at the microscopic scale. While equilibration of liquids usually requires density fluctuations at time scales quickly diverging upon cooling, growing experimental evidence indicates the presence of a different, alternative pathway of weaker temperature dependence. Such equilibration processes exhibit a temperature-invariant activation energy, on the order of 100 kJ mol-1. Here, we identify the underlying molecular process responsible for this class of Arrhenius equilibration mechanisms with a slow mode (SAP), universally observed in the liquid dynamics of thin films. The SAP, which we show is intimately connected to high-temperature flow, can efficiently drive melts and glasses toward more stable, less energetic states. Our results show that measurements of liquid dynamics can be used to predict the equilibration rate in the glassy state.
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We compared the influences of Al2O3 and SiO2 on a traditional V2O5-MoO3/TiO2 for the simultaneous removal of NOx and chlorobenzene (CB). The Al2O3 doping catalyst considerably broadens the active temperature window with higher NOx reduction and CB oxidation efficiencies than the SiO2 doping one and the V2O5-MoO3/TiO2. Furthermore, its resistance to SO2 was preserved and the quantities of polychlorinated byproducts also decreased. The increase in activity at low temperatures could be due to the promotion of vanadia reducibility via interactions between V2O5 and Al2O3. Moreover, the high temperature activity could be due to the additional surface acidities provided by Al2O3, in which the Lewis acid sites played the predominant role in both NH3 adsorptions and CB de-chlorination compared to the Brønsted acid sites. Finally, we proposed that Al2O3 is an effective addition for vanadia-based catalyst in NOx and CB simultaneous removal from stationary sources.
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Poluentes Ambientais , Dióxido de Silício , Catálise , Clorobenzenos , TitânioRESUMO
(R, S)-2-Chloromandelic acid, which can crystallize in racemic crystals (forms α and ß) or a conglomerate (form γ), has been studied for its glass-forming behavior. Below the glass transition temperature, samples of the title compound crack into pieces. Correlation plots of DSC results have been used to investigate what determines the cracking and its occurrence temperature. We found that the latter is influenced by the polymorph from which the melt state has been obtained, showing that a certain memory of the previous crystalline phase persists in the undercooled melt. Moreover, this residual structure could be eliminated by elongating the annealing period or increasing the annealing temperature. Investigation using broadband dielectric spectroscopy confirmed such a memory effect. Finally, we studied the role of cracking in the control of the crystallization. In contrast with previous literature on other glass-forming molecular systems, we verified that the crystallization upon reheating is not impacted by the occurrence of cracks in the glassy state. This observation challenges the current views on polymorphic crystallization from organic glasses.
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Alzheimer's disease (AD) is a neurodegenerative disease that contributes to 60-70% dementia around the world. One of the hallmarks of AD undoubtedly lies on accumulation of amyloid-ß (Aß) in the brain. Aß is produced from the proteolytic cleavage of the beta-amyloid precursor protein (APP) by ß-secretase and γ-secretase. In pathological circumstances, the increased ß-cleavage of APP leads to overproduction of Aß, which aggregates into Aß plaques. Since Aß plaques are a characteristic of AD pathology, detecting the amount of Aß is very important in AD research. In this protocol, we introduce the immunofluorescent staining method to visualize Aß deposition. The mouse model used in our experiments is 5×FAD, which carries five mutations found in human familial AD. The neuropathological and behavioral deficits of 5xFAD mice are well-documented, which makes it a good animal model to study Aß pathology. We will introduce the procedure including transcardial perfusion, cryosectioning, immunofluorescent staining and quantification to detect Aß accumulation in 5×FAD mice. With this protocol, researchers can investigate Aß pathology in an AD mouse model.
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Doença de Alzheimer/metabolismo , Peptídeos beta-Amiloides/metabolismo , Modelos Animais de Doenças , Animais , Camundongos Transgênicos , Placa Amiloide/metabolismo , Coloração e RotulagemRESUMO
In this study, power parameters (power, frequency, and voltage), initial Hg0 concentration, and residence time are investigated for the removal of the increased Hg0 concentration via surface dielectric barrier discharge (SDBD). The synergistic effect of a Mn/Ce/Ti catalyst with SDBD is verified with a mixture of flue gas (Hg0, NO, and SO2). Results show that Hg0 oxidation efficiency has an optimal frequency, which declines as the input voltage increases. The amplification of the Hg0 removal efficiency decreases as voltage increases. The effect of the initial Hg0 concentration gradually decreases as the peak voltage increases. The residence time slightly affects the Hg0 removal efficiency at a high peak voltage. The cooling water temperature behaves differently on Hg0 oxidation under high and low voltages. X-ray photoelectron spectroscopy (XPS) reveals the relative atomic concentrations of Mn2+ and Mn3+ in the Mn-TiO2 and Mn-Ce-TiO2 catalysts are 66.84% and 65.80%, respectively, which indicate that Ce addition will not affect surface Mn. Mn has a limited catalytic action on the removal of flue gas with and without SDBD. Nevertheless, SDBD can stimulate the oxygen storage capacity of Mn to increase the NO2 conversion rate. Mn-Ce-TiO2 greatly improves the removal efficiencies of NO and SO2 because of the existence of the redox pairs of Mn4+/Mn3+, Ce4+/Ce3+, and Ti4+/Ti3+. However, the three catalysts slightly differ on Hg0 removal when combined with SDBD, indicating that the effect of the catalyst was weakened after SDBD was added.
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Mercúrio , Titânio , Catálise , Oxirredução , TemperaturaRESUMO
PURPOSE: To externally validate the clinical utility of Chinese Prostate Cancer Consortium Risk Calculator (CPCC-RC) and Asian adapted Rotterdam European Randomized Study of Screening for Prostate Cancer Risk Calculator 3 (A-ERSPC-RC3) for prediction prostate cancer (PCa) and high-grade prostate cancer (HGPCa, Gleason Score ≥ 3 + 4) in both Chinese and European populations. MATERIALS AND METHODS: The Chinese clinical cohort, the European population-based screening cohort, and the European clinical cohort included 2,508, 3,616 and 617 prostate biopsy-naive men, respectively. The area under the receiver operating characteristic curve (AUC), calibration plot and decision curve analyses were applied in the analysis. RESULTS: The CPCC-RC's predictive ability for any PCa (AUC 0.77, 95% CI 0.75-0.79) was lower than the A-ERSPC-RC3 (AUC 0.79, 95% CI 0.77-0.81) in the European screening cohort (p < 0.001), but similar for HGPCa (p = 0.24). The CPCC-RC showed lower predictive accuracy for any PCa (AUC 0.65, 95% CI 0.61-0.70), but acceptable predictive accuracy for HGPCa (AUC 0.73, 95% CI 0.69-0.77) in the European clinical cohort. The A-ERSPC-RC3 showed an AUC of 0.74 (95% CI 0.72-0.76) in predicting any PCa, and a similar AUC of 0.74 (95% CI 0.72-0.76) in predicting HGPCa in Chinese cohort. In the Chinese population, decision curve analysis revealed a higher net benefit for CPCC-RC than A-ERSPC-RC3, while in the European screening and clinical cohorts, the net benefit was higher for A-ERSPC-RC3. CONCLUSIONS: The A-ERSPC-RC3 accurately predict the prostate biopsy in a contemporary Chinese multi-center clinical cohort. The CPCC-RC can predict accurately in a population-based screening cohort, but not in the European clinical cohort.
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Neoplasias da Próstata/patologia , Idoso , Biópsia , China , Estudos de Coortes , Detecção Precoce de Câncer , Europa (Continente) , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de RiscoRESUMO
BACKGROUND: To identify novel miRNAs implicated in prostate cancer metastasis. METHODS: Sixty-five prostate cancer tissues and paired pan-cancer tissues were sequenced. Novel miRNAs were re-analyzed by MIREAP program. Biological functions of miR-N5 were transwell experiment and colony formation. Target genes of miR-N5 were analyzed by bioinformatic analysis. Downstream of target gene was analyzed by The Cancer Genome Atlas (TCGA) and Memorial Sloan Kettering Cancer Center (MSKCC) databases and confirmed by CHIP experiment. RESULTS: We identified a novel miRNA-miR-N5, which was downregulated in PCa cells, PCa tissue, and in the serum of patients with PCa. Knockout of miR-N5 enhanced migration and invasiveness in vitro. miR-N5 specified targeted CREBBP 3'-UTR and inhibited CREBBP expression, which mediated H3K56 acetylation at the promoter of EGFR, ß-catenin and CDH1. CONCLUSION: This study may shed the light on miR-N5 which influences metastasis via histone acetylation.
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Proteína de Ligação a CREB/fisiologia , Histonas/metabolismo , MicroRNAs/fisiologia , Neoplasias da Próstata/patologia , Acetilação , Idoso , Idoso de 80 Anos ou mais , Proteína de Ligação a CREB/genética , Linhagem Celular Tumoral , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica/prevenção & controle , Regiões Promotoras Genéticas , Neoplasias da Próstata/genéticaRESUMO
We performed this study to investigate the diagnostic performance of prostate-specific antigen density (PSAD) in a multicenter cohort of the Chinese Prostate Cancer Consortium. Outpatients with prostate-specific antigen (PSA) levels ≥4.0 ng ml-1 regardless of digital rectal examination (DRE) results or PSA levels <4.0 ng ml-1 and abnormal DRE results were included from 18 large referral hospitals in China. The diagnostic performance of PSAD and the sensitivity and specificity for the diagnosis of prostate cancer (PCa) and high-grade prostate cancer (HGPCa) at different cutoff values were evaluated. A total of 5220 patients were included in the study, and 2014 (38.6%) of them were diagnosed with PCa. In patients with PSA levels ranging from 4.0 to 10.0 ng ml-1, PSAD was associated with PCa and HGPCa in both univariate (odds ratio [OR] = 45.15, P < 0.0001 and OR = 25.38, P < 0.0001, respectively) and multivariate analyses (OR = 52.55, P < 0.0001 and OR = 26.05, P < 0.0001, respectively). The areas under the receiver operating characteristic curves (AUCs) of PSAD in predicting PCa and HGPCa were 0.627 and 0.630, respectively. With the PSAD cutoff of 0.10 ng ml-2, we obtained a sensitivity of 88.7% for PCa, and nearly all (89.9%) HGPCa cases could be detected and biopsies could be avoided in 20.2% of the patients (359/1776 cases). Among these patients who avoided biopsies, only 30 cases had HGPCa. We recommend 0.10 ng ml-2 as the proper cutoff value of PSAD, which will obtain a sensitivity of nearly 90% for both PCa and HGPCa. The results of this study should be validated in prospective, population-based multicenter studies.