Asian journal of andrology最新文献

{"title":"Outcomes following varicocele treatment: a comparative study of microsurgical and angioembolization approaches.","authors":"Ammar Al Homsi, Omar Almidani, Fadi Youness, Rashed Rowaiee, Ali Alabdullah, Omar Aljasmi, Ayman Moussa, Kashif Siddiqi, Alaeddin Barham, Omer Raheem","doi":"10.4103/aja202590","DOIUrl":"10.4103/aja202590","url":null,"abstract":"<p><p>The aim of this study was to compare outcomes of microsurgical varicocelectomy (MV) versus percutaneous angioembolization (AE) in men with varicoceles causing infertility or scrotal pain. Endpoints included postoperative changes in semen parameters, complication rates, pain relief, need for additional interventions, and the influence of body mass index (BMI). We retrospectively reviewed 264 male patients treated for varicocele from July 2015 to July 2024 (MV: 214 patients, and AE: 50 patients). Only patients older than 18 years were included. Indications were infertility or chronic varicocele-related scrotal pain. Pre- and post-treatment semen analyses were compared in infertile men, and pain outcomes were assessed in those treated for pain. Complications and secondary interventions were recorded, and outcomes were stratified by BMI. MV significantly improved sperm concentration, motility, and total motile count within 3-6 months, while AE showed no significant change. Complications occurred only in the MV group (8.9%), including hydrocele, hematoma, and surgical site infection, while no complications were reported in the AE group. Persistent pain was observed in one-third of patients in both groups, and AE was associated with a higher rate of secondary intervention (14.0%) compared to MV (6.6%). BMI was not linked to complications or operative time but was associated with poorer baseline semen quality. Within 3-6 months post-treatment, varicocelectomy yielded greater improvement in semen quality, while AE offered a favorable safety profile but less reproductive benefit and a higher retreatment rate. Both approaches were safe across BMI categories, though longer-term studies are needed to clarify patient selection and delayed outcomes.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"556-560"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological and sexual associations of azoospermia in men: a cross-sectional pre-biopsy study.","authors":"Sule Yildirim Kopuk, Deniz Kulaksiz, Mehmet Yilmaz, Muhsin Balaban, Basar Ayribas, Asgar Garayev, Recep Burak Degirmentepe, Mehmet Ozay Ozgur, Eda Ozcan, Ahmet Guzel, Ismail Baglar, Tuncay Toprak","doi":"10.4103/aja2025116","DOIUrl":"10.4103/aja2025116","url":null,"abstract":"<p><p>Azoospermia can lead to significant psychological distress, low self-esteem, and compromised sexual function. However, the impact of these issues before any invasive diagnostic or treatment procedures is not well studied. We conducted a cross-sectional study involving 134 men diagnosed with azoospermia and 164 age-matched fertile controls. All assessments, including anxiety (Beck Anxiety Inventory [BAI]), depression (Beck Depression Inventory-II [BDI-II]), self-esteem (Rosenberg Self-Esteem Scale [RSES]), and erectile function (International Index of Erectile Function-5 [IIEF-5]), were conducted during the diagnosis visit, prior to any testicular biopsy for infertility treatment. Compared with age-matched fertile controls, men with azoospermia exhibited significantly higher anxiety levels (mean ± standard deviation [s.d.]: 17.3 ± 3.9 vs 9.8 ± 2.8), increased depression scores (mean ± s.d.: 24.1 ± 6.3 vs 12.5 ± 5.1), lower self-esteem (mean ± s.d.: 2.8 ± 0.5 vs 1.8 ± 0.3), and poorer erectile function (mean ± s.d.: 17.2 ± 5.1 vs 21.4 ± 5.2), all with P < 0.001. Importantly, decreased self-esteem was strongly correlated with both depression ( r = 0.851) and anxiety ( r = 0.843). Additionally, erectile dysfunction showed an inverse correlation with both depression ( r = -0.867) and anxiety ( r = -0.813), with P < 0.05 for both correlations. The psychological and sexual effects of infertility are often overlooked in the treatment process. Therefore, we advocate that all men with azoospermia receive psychological and sexual support alongside infertility treatment.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"646-650"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rho-kinase inhibition reduces DNA fragmentation in human sperm cryopreservation.","authors":"Pawan Limvorapitux, Isarin Thanaboonyawat, Japarath Prechapanich, Pitak Laokirkkiat, Roungsin Choavaratana, Somsin Petyim","doi":"10.4103/aja2025107","DOIUrl":"10.4103/aja2025107","url":null,"abstract":"<p><p>Human sperm cryopreservation is essential for assisted reproductive technology; however, the freeze-thaw process reduces motility and increases DNA fragmentation. Rho-associated coiled-coil kinase (ROCK) inhibitors improve post-thaw survival in several cell types, yet their application to human sperm remains underexplored. We evaluated whether ROCK inhibition reduces DNA fragmentation during cryopreservation by liquid nitrogen vapor slow freezing or vitrification. Each semen sample was divided into four aliquots: 2 were cryopreserved via liquid nitrogen vapor slow freezing with or without ROCK inhibitor and 2 underwent vitrification with or without ROCK inhibitor. After 1 week of cryostorage, samples were thawed at the room temperature, and DNA fragmentation was quantified using the terminal deoxynucleotidyl transferase dUTP nick end labeling assay. DNA fragmentation decreased with ROCK inhibitor versus control after liquid nitrogen vapor slow freezing (mean ± standard deviation [s.d.]: 10.47% ± 6.77% vs 13.54% ± 7.0%; P = 0.002) and after vitrification (mean ± s.d.: 12.51% ± 5.84% vs 16.5% ± 10.77%; P = 0.006). ROCK inhibition thus reduces post-thaw sperm DNA fragmentation with both cryopreservation methods, particularly with liquid nitrogen vapor slow freezing, supporting its potential to improve sperm storage for assisted reproductive technology.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"667-673"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The causal effect of family history of cardiovascular disease on erectile dysfunction: a randomized clinical study and Mendelian randomization study.","authors":"Dong-Jie Li, Bo-Yu Xiang, Yong Li, Chi-Teng Zhang, Li Liu, Xiu-Cheng Li","doi":"10.4103/aja202584","DOIUrl":"10.4103/aja202584","url":null,"abstract":"<p><p>Erectile dysfunction (ED) is increasingly recognized as an early clinical marker of cardiovascular disease (CVD); however, the causal role of familial predisposition to CVD in ED development remains insufficiently defined. This study investigated whether genetic susceptibility associated with a parental history of CVD exerts a causal influence on ED risk, integrating clinical data with Mendelian randomization (MR) analysis. A cohort of 288 men who attended the Department of Andrology of Xiangya Hospital (Changsha, China) between June 2017 and June 2023 were recruited, comprising 223 patients with clinically confirmed ED and 65 controls. Detailed demographic, cardiovascular, and ED severity data were collected. Genetic variants associated with ED and parental CVD history were obtained from genome-wide association study (GWAS) summary statistics, and two-sample MR analyses were conducted to evaluate causal effects. Clinically, men with ED were significantly older, exhibited higher body mass index (BMI), and demonstrated lower testosterone levels compared with controls. A trend toward an association between family history of CVD and ED was observed. MR analyses provided robust evidence of causality, with paternal CVD history increasing ED risk and maternal CVD history exerting an even stronger effect. Sensitivity analyses confirmed the stability of these findings without evidence of pleiotropic bias. Collectively, these results indicate that familial genetic susceptibility to CVD independently contributes to the risk of ED. These findings underscore the clinical importance of incorporating family history into ED risk stratification and highlight the need for early screening and preventive strategies in men with a family history of CVD. Proactive management of this high-risk population may mitigate the future burden of ED and its cardiovascular sequelae.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"509-515"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147505649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proteomic insights into azoospermia: protein differences in testicular tissue between non-obstructive and obstructive azoospermia patients.","authors":"Zhi Wang, Xiao-Dong Li, Wei-Min Shao, Dong-Xuan Zheng, Xiao-Qiang Xiang, Heng-Qing An, Jian-Hua Yang","doi":"10.4103/aja2025114","DOIUrl":"10.4103/aja2025114","url":null,"abstract":"<p><p>Non-obstructive azoospermia (NOA) and obstructive azoospermia (OA) are the main classifications of severe male infertility, but the molecular mechanism of NOA remains poorly understood. This study aimed to identify potential biomarkers and pathological mechanisms by comparing the proteomic differences in testicular tissues of NOA and OA patients. Through proteomic analysis based on liquid chromatography-tandem mass spectrometry (LC-MS/MS) of testicular samples from 5 NOA patients and 5 OA patients, we identified 5264 proteins, among which 717 differentially expressed proteins (DEPs) were found between the two groups (242 upregulated and 475 downregulated in NOA). Bioinformatics analysis indicated that these DEPs were significantly associated with reproductive development, gametogenesis, and cell structural stability. On the basis of this, six candidate proteins, including dysferlin (DYSF), myoferlin (MYOF), mitsugumin 53 (MG53), cluster of differentiation 63 (CD63), caveolin-3 (CAV3), and calpain-3 (CAPN3), were selected from the DEPs and verified in an expanded sample set (37 NOA cases and 28 OA cases) through quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot, confirming their dysregulation in NOA. These findings provide new proteomic insights into NOA, highlighting the disruption of membrane repair and structural pathways, and offer potential biomarkers for understanding its pathogenesis.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"603-612"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148058794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world effectiveness and safety of radium-223 therapy in castration-resistant prostate cancer with bone metastases.","authors":"Hong-Kai Wang, Zhen Hang, Chang Liu, Bo Dai, Yao Zhu, Xiao-Jian Qin, Guo-Wen Lin, Yan-Bo Deng, He-Xun Jiang, Ya Wang, Shao-Li Song, Ding-Wei Ye","doi":"10.4103/aja202598","DOIUrl":"10.4103/aja202598","url":null,"abstract":"<p><p>The effectiveness and safety of radium-223 (Ra-223) in patients with metastatic castration-resistant prostate cancer (mCRPC) and bone metastasis in real-world clinical practice in China remain to be fully examined. This single-center, retrospective, real-world study included Chinese patients with mCRPC treated with Ra-223 between January 2021 and August 2023 in Fudan University Shanghai Cancer Center (Shanghai, China). This study examined the patient characteristics, overall survival (OS), 5-point Visual Analog Scale for pain and safety, as well as factors potentially influencing treatment effectiveness. Ninety-three patients were included. Among them, 25 (26.9%) patients were administered all six injections of Ra-223, and 41 (44.1%) patients received more than 3 injections. After a median follow-up of 19.8 months, median OS was 14.1 (95% confidence interval [CI]: 12.0-16.2) months. Multivariable analysis showed a total number of Ra-223 injections >3 was an independent protective factor of OS (hazard ratio [HR] = 0.443, 95% CI: 0.234-0.837; P = 0.012) after adjusting for age, combination therapy, and previous chemotherapy. For those administered all six injections of Ra-223, no patients had a pain score of 4 and only 4.2% of patients showed a pain score of 3. In total, 62.5% of patients had almost no pain (0 point). Median alkaline phosphatase showed a downward trend during the six-injection treatment period. The most common adverse event was anemia (30.1%), followed by thrombocytopenia (15.1%), nausea (9.7%), weakness (8.6%), and decreased white blood cells (7.5%). This real-world study strongly suggests that Ra-223 has good effectiveness and tolerability in Chinese patients with mCRPC and bone metastases.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"561-567"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147346075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between body mass index and semen quality in infertile men: a cross-sectional study of 28 167 patients.","authors":"Xu Cao, Lu Gao, Xiao-Jie Fu, Jie Chen, Xia-Yang Li, Yi-Shuai Huang, Juan-Zi Shi, Peng-Fei Qu","doi":"10.4103/aja202596","DOIUrl":"10.4103/aja202596","url":null,"abstract":"<p><p>Although the detrimental impact of abnormal body mass index (BMI) on semen quality is well established in the general population, studies exploring this relationship in infertile men remain limited. This study aimed to investigate the association between BMI and semen quality parameters and to identify potential BMI thresholds linked to altered semen quality. In this cross-sectional study, clinical records from 28 167 men evaluated for infertility prior to assisted reproductive treatment (ART) at Northwest Women's and Children's Hospital (Xi'an, China) between January 2019 and December 2023 were analyzed. Participants were categorized by BMI as underweight (<18.5 kg m -2 ), normal (18.5-24.9 kg m -2 ), overweight (25.0-29.9 kg m -2 ), and obese (≥30.0 kg m -2 ). Conventional semen analysis was performed according to World Health Organization (WHO) guidelines, and a composite measure of \"good\" semen quality was defined using established reference criteria. Multivariable regression, smoothed curve fitting, and threshold effect analyses were used to examine associations between BMI and semen parameters. Underweight men had lower sperm counts, whereas overweight men showed slightly higher progressive motility. Obese men demonstrated significant reductions in semen volume, sperm concentration, sperm count, motile sperm counts, and the likelihood of achieving good semen quality compared with men of normal weight. Smoothed curve fitting and threshold effect analyses revealed an inverted U-shaped relationship between BMI and overall semen quality, with improvement up to a BMI of 26.0 kg m -2 , followed by a decline beyond this point. These findings suggest that maintaining a BMI between 18.5 kg m -2 and 26.0 kg m -2 may optimally support semen quality and reproductive potential in infertile men.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"578-585"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A homozygous splicing mutation in CCDC39 caused multiple morphological abnormalities of the flagella in an infertile man with primary ciliary dyskinesia.","authors":"Wen Tao, Ming Li, Islam Uddin, Di Yan, Xiao-Hua Jiang, Shun Bai","doi":"10.4103/aja2025117","DOIUrl":"10.4103/aja2025117","url":null,"abstract":"<p><p>Primary ciliary dyskinesia (PCD) is a severe sperm defect, leading to male infertility. PCD affects both respiratory function and sperm motility, as motile cilia and sperm flagella rely on axonemal architecture. Multiple morphological abnormalities of the sperm flagella (MMAF) is a distinct form of asthenoteratozoospermia, characterized by a heterogeneous spectrum of flagellar defects. In recent years, coiled-coil domain-containing ( CCDC ) genes have been shown to play crucial roles in both MMAF and PCD. In this study, a homozygous mutation in CCDC39 , c.1528-2A>G, was identified in a patient of a consanguineous Chinese family presenting a typical PCD phenotype. Quantitative real-time polymerase chain reaction (qPCR) and immunofluorescence demonstrated a significant reduction in CCDC39 mRNA levels and loss of the expression of CCDC39 and other axoneme dynein proteins, respectively. Diff-Quik staining and semen analysis from the patient revealed severely reduced sperm motility, in addition to a pronounced MMAF phenotype. Severe axonemal disorganization and ultrastructural defects were consistent with the PCD phenotype in the patient, further suggesting that CCDC39 deficiency is linked to both infertility and systemic ciliary dysfunction. After intracytoplasmic sperm injection (ICSI) treatment, the CCDC39-deficient patient achieved a successful pregnancy. Overall, our findings clearly indicate that the c.1528-2A>G mutation in CCDC39 is associated with the pathogenesis of both MMAF and PCD, thereby advancing genetic diagnosis, treatment, and prognosis related to in vitro fertilization (IVF) outcomes associated with the MMAF phenotype in PCD patients.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"613-619"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148058751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testicular sperm aspiration enhances fertilization rates in MMAF patients undergoing ICSI: a retrospective cohort study.","authors":"Lei-Xi Peng, Long-Long Fu, Jin-Hong Li, Lang Qin, Xiao-Yong Qiao, Yu Bai, Wen-Hong Lu, Yi-Hong Yang","doi":"10.4103/aja2025113","DOIUrl":"10.4103/aja2025113","url":null,"abstract":"<p><p>Multiple morphological abnormalities of the sperm flagella (MMAF) compromise intracytoplasmic sperm injection (ICSI) outcomes. Testicular sperm aspiration (TESA) may be beneficial, but its impact on early embryonic development and pregnancy in MMAF remains uncertain. This study evaluated the effect of TESA on fertilization, cleavage, on-time Day-3 embryo development, and clinical pregnancy and explored modification by female age and MMAF genotype. In this retrospective cohort, 196 MMAF patients undergoing ICSI (January 2019-December 2024) without female-factor infertility were analyzed: TESA group ( n = 65) versus non-TESA group ( n = 131). Only fresh embryo transfer cycles were included. Outcomes were fertilization, cleavage, on-time Day-3 embryo development, and pregnancy. Multivariable regression was complemented by inverse probability of treatment weighting, propensity score matching, and stratified analyses by female age and genotype. Robustness was examined using bootstrap resampling and outlier-sensitivity analyses. Notably, TESA was associated with higher fertilization rates (adjusted coefficient: +5.63%, P = 0.022; inverse probability of treatment weighting average treatment effect [IPTW-ATE]: +5.9%, P = 0.022; Cohen's d: 0.371). Cleavage gains were smaller (IPTW-ATE: +3.8%, P = 0.013; Cohen's d: 0.246) and method-sensitive. No significant differences were found for on-time Day-3 development or pregnancy; power was limited for these endpoints. TESA mostly improved fertilization in women aged 30-35 years (IPTW-ATE: +9.5%, P = 0.017) and cleavage in genotype-negative patients (IPTW-ATE: +10.1%, P = 0.012). Propensity models showed good balance (area under the receiver operating characteristic curve: 0.638, and standardized differences <0.1); power was adequate for fertilization (0.825). Overall, TESA is associated with higher fertilization rates in MMAF-ICSI, with modest and method-sensitive evidence for cleavage, supporting selective use. Prospective, multi-center validation is needed. Limited downstream effects suggest a role primarily at early stages.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"634-640"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147949864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting the upgrading of the International Society of Urological Pathology Grade Group in nonclinically significant prostate cancer: a multicenter observational study.","authors":"Ling Zhou, Shi-Yan Li, Zhang-Yun Wang, Yu-Yu Liu, Chao Chen, Hong Yu","doi":"10.4103/aja2025115","DOIUrl":"10.4103/aja2025115","url":null,"abstract":"<p><p>The aim of this study was to explore the predictors of International Society of Urological Pathology (ISUP) Grade Group (GG) upgrading in nonclinically significant prostate cancer (non-csPCa) biopsy specimens guided by transrectal ultrasound (TRUS) following radical prostatectomy (RP). A retrospective analysis was conducted on clinical data from 231 patients who underwent TRUS-guided biopsy and RP between January 2018 and December 2023. Univariate and multivariate logistic regression analyses were employed to identify independent predictors of postoperative ISUP GG upgrading. The diagnostic efficiency of these predictors was evaluated using receiver operating characteristic (ROC) curves. Additionally, ROC analysis was used to compare the predictive performance of different positive target (PT) imaging methods across prostate volume (PV) subgroups. The study included 111 (48.1%) patients in the GG concordance group and 120 (51.9%) patients in the GG upgrading group. Univariate analysis revealed that PV, prostate-specific antigen density, Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1), magnetic resonance imaging (MRI) PT, contrast-enhanced ultrasound (CEUS) PT, and clinical T stage significantly influenced GG upgrading (all P < 0.05). Multivariate logistic regression revealed PV (OR = 0.974; 95% CI: 0.955-0.994; P = 0.010), MRI PT (OR = 3.902; 95% CI: 1.507-10.102; P = 0.005), and CEUS PT (OR = 2.280; 95% CI: 1.073-4.845; P = 0.032) as independent predictors. The prediction model demonstrated the highest diagnostic performance (area under the receiver operating characteristic curve [AUC] = 0.738, P < 0.001). MRI PT showed superior predictive efficacy compared with CEUS PT in patients with a PV <30.13 ml. In conclusion, PV, CEUS PT, and MRI PT were identified as independent predictors of postoperative ISUP GG upgrading. The predictive model exhibited the best overall performance, and compared with CEUS PT, MRI PT demonstrated greater predictive accuracy for smaller prostates.</p>","PeriodicalId":93889,"journal":{"name":"Asian journal of andrology","volume":" ","pages":"660-666"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}