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Gao X, Li LY, Rassler J, Pang J, Chen MK, Liu WP, Chen Z, Ren SC, Zhou FJ, Xie KJ, Zhou X, Qian HJ, Bai XZ, Liu JM, Yang JG, He D, Shao CK, Su ZL, Wang J, Qiu JG, Ling L. Prospective Study of CRMP4 Promoter Methylation in Prostate Biopsies as a Predictor For Lymph Node Metastases. J Natl Cancer Inst 2017; 109:2957325. [PMID: 28122909 DOI: 10.1093/jnci/djw282] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/31/2016] [Accepted: 10/26/2016] [Indexed: 12/16/2022] Open
Abstract
Background For patients with prostate cancer (PCa), the presence of pelvic lymph node metastasis (LNM) is a strong predictor of poor outcome. However, the approaches with promising sensitivity and specificity to detect LNM are still lacking. We investigated the value of collapsin response mediator protein 4 (CRMP4) promoter methylation in biopsies as a predictor for LNM. Methods CRMP4 promoter methylation at two previously identified CpG sites was determined in 80 case-matched biopsy samples (the training set) using bisulfite pyrosequencing. The predictive cutoff value was independently validated using cohort I of 339 PCa patients (Southern China) and cohort II of 328 case patients (Germany, across China). Mann-Whitney U test, the receiver operating characteristic curve, McNemar's test, and logistic regression were used to assess data. All statistical tests were two-sided. Results In the training set, CRMP4 promoter methylation (≥15.0% methylated) was statistically significantly associated with LNM (P < 001). Successful validations were achieved in both cohorts I and II (sensitivity = 92.3%, 95% confidence interval [CI] = 79.3 to 97.9, and sensitivity = 92.2%, 95% CI = 81.1 to 97.8, respectively; specificity = 92.7%, 95% CI = 80.2 to 99.1, and specificity = 91.3%, 95% CI = 87.4 to 94.4, respectively). The sensitivity of CRMP4 promoter methylation is superior to conventional MRI (cohort I: 92.3% vs 26.2%, P < 001; cohort II: 92.2% vs 33.3%, P < 001). CRMP4 promoter methylation is an independent predictor of LNM (cohort I: hazard ratio [HR] = 8.35, 95% CI = 5.64 to 12.35, P < 001; cohort II: HR = 12.46, 95% CI = 5.82 to 26.70, P < 001) in a multivariable analysis model. Conclusion CRMP4 promoter methylation in diagnostic biopsies could be a robust biomarker for LNM in PCa.
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Affiliation(s)
- Xin Gao
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
| | - Liao-Yuan Li
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
| | - Jörg Rassler
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
| | - Jun Pang
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
| | - Ming-Kun Chen
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
| | - Wei-Peng Liu
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
| | - Zheng Chen
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
| | - Shan-Cheng Ren
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
| | - Fang-Jian Zhou
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
| | - Ke-Ji Xie
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
| | - Xing Zhou
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
| | - Hui-Jun Qian
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
| | - Xian-Zhong Bai
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
| | - Jiu-Min Liu
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
| | - Jiang-Gen Yang
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
| | - Dan He
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
| | - Chun-Kui Shao
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
| | - Zu-Lan Su
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
| | - Jing Wang
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
| | - Jian-Guang Qiu
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
| | - Li Ling
- Affiliations of authors: Department of Urology (XG, LYL, JP, MKC, ZC, JGQ), Department of Pathology (DH, CKS, ZLS), and Department of Radiology (JW), The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Urology, St. Elisabeth Hospital, University of Leipzig, Leipzig, Germany (JR); Department of Urology, The First Affiliated Hospital, Nanchang University, Nanchang, China (WPL); Department of Urology, Changhai Hospital, The Second Military Medical University, Shanghai, China (SCR); Department of Urology, Cancer Center, Sun Yat-sen University, Guangzhou, China (FJZ); Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical University, Guangzhou, China (KJX); Department of Urology, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China (XZ); Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China (HJQ); Department of Urology, Cancer Hospital, Guangxi Medical University, Nanning, China (XZB); Department of Urology, Guangdong General Hospital, Guangzhou, China (JML); Department of Urology, Shenzhen People's Hospital, Shenzhen, China (JGY); Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China (LL)
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