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1.
Rev Med Suisse ; 16(717): 2330-2333, 2020 Dec 02.
Artigo em Francês | MEDLINE | ID: mdl-33263957

RESUMO

Early detection of prostate cancer remains a controversial subject for the general practitioner. In fact, prostate cancer remains the most frequently diagnosed non skin tumor in men with a proportion of 15 %. However, while prostate specific antigen has massively contributed to its identification at a curable stage for 25 years, it has simultaneously appeared essential not to overtreat a cancer with a significant proportion of indolent tumors. In parallel with this controversial background, the prospective randomized study of the European Randomized Study of Screening for Prostate Cancer, and in particular its Swedish subpopulation, has validated during the last decade the benefit of at least early detection. However, due to the variety of treatment options and the potential side effects of some of them, it is recommended that this detection be performed only in properly informed patients.


Assuntos
Detecção Precoce de Câncer , Neoplasias da Próstata/diagnóstico , Detecção Precoce de Câncer/normas , Humanos , Masculino , Programas de Rastreamento/normas , Estudos Prospectivos , Antígeno Prostático Específico/análise , Fatores de Tempo
2.
Ann Biol Clin (Paris) ; 78(5): 565-573, 2020 10 01.
Artigo em Francês | MEDLINE | ID: mdl-33026351

RESUMO

The interpretation of the variation between the results of two dosages performed on the same patient is generally quite empirical. It is usually based on the experience of the biologist or physician. Through two examples, total PSA and hemoglobin, we hoped to set up an indicator of the significance variation between results: The Reference change value or RCV to provide assistance to the validator biologist and prescriber based on measured statistical arguments. This article describes the methodology used for the RCV calculation, the formatting on analysis reports and the limitations of the system.


Assuntos
Variação Biológica Individual , Serviços de Laboratório Clínico/normas , Testes Diagnósticos de Rotina/normas , Hemoglobinas/análise , Antígeno Prostático Específico/análise , Automação Laboratorial/instrumentação , Automação Laboratorial/normas , Interpretação Estatística de Dados , Testes Diagnósticos de Rotina/instrumentação , Testes Diagnósticos de Rotina/métodos , Feminino , Humanos , Ensaio de Proficiência Laboratorial , Masculino , Metanálise como Assunto , Variações Dependentes do Observador , Neoplasias da Próstata/sangue , Neoplasias da Próstata/diagnóstico , Padrões de Referência , Valores de Referência , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
4.
Medicine (Baltimore) ; 99(36): e20755, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32898989

RESUMO

Ga-PSMA-11 positron emission computed tomography /computed tomography (PET/CT) is more sensitive than magnetic resonance imaging (MRI) in detecting prostate cancer (PCa). We evaluated the value of Ga-PSMA-11 PET/CT with MRI in treatment-naive PCa.This retrospective study was approved by the hospital ethics committee. The MRI and Ga-PSMA-11 PET/CT imaging data of 63 cases of highly suspected PCa were enrolled in this study. The SUVmax and apparent diffusion coefficient (ADC), and their ratio, were assessed as diagnostic markers to distinguish PCa from benign disease.There were 107 prostate lesions detected in 63 cases. Forty cases with 64 malignant primary lesions were confirmed PCa, whereas 23 cases had 43 benign lesions. PSMA-avid lesions correlated with hypointense signal on ADC maps and hyperintense signal on diffusion-weighted imaging. The ADC of PCa was lower than that of benign lesions, and SUVmax and SUVmax/ADC of PCa was higher than that of benign lesions (P < .01). ADC had significant negative correlation with Gleason score (GS) and SUVmax, SUVmax, and SUVmax/ADC positively correlated with GS. From ROC analysis, we established cutoff values of ADC, SUVmax, and SUVmax/ADC at 1.02 × 10mm/s, 11.72, and 12.35, respectively, to differentiate PCa from benign lesions. The sensitivity, specificity, and AUC were 90.6%, 58.1%, and 0.816 for ADC, 67.2%, 97.7%, and 0.905 for SUVmax, and 81.2%, 88.4%, and 0.929 for SUVmax/ADC, respectively.Ga-PSMA-11 PET/CT combined with MRI offers higher diagnostic efficacy in the detection of PCa than either modality alone.


Assuntos
Espectroscopia de Ressonância Magnética/métodos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Antígeno Prostático Específico/análise , Neoplasias da Próstata/patologia , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/diagnóstico por imagem , Estudos Retrospectivos
5.
Am J Surg Pathol ; 44(12): 1635-1642, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32991340

RESUMO

Each Gleason score category of prostatic adenocarcinoma (or Grade Group) may encompass a diverse group of architectural patterns such as well-formed glands, poorly formed glands, cribriform structures, single cells, and/or solid sheets. We have noted heterogeneity within the single-cell subtype of Gleason pattern 5 prostatic adenocarcinoma that has not been fully addressed. Therefore, we retrospectively reviewed a series of radical prostatectomies with high-grade prostatic adenocarcinoma (Grade Group 4 or 5), identifying tumors with a component of single-cell infiltration. Additional cases identified prospectively were also included. TNM status, association with other histologic patterns, and clinical follow-up status were determined. Immunohistochemistry for NKX3.1, E-cadherin, p120 catenin, and prostate-specific antigen (PSA) were performed in each case. Eighteen cases with a component of well-developed Gleason pattern 5 characterized by single infiltrative cells that comprised ≥5% of the tumor were identified (15/202 retrospective radical prostatectomies with the high-grade disease [7.5%]). The single-cell pattern ranged from 5% to 50% of the tumor volume, with 5 cases containing ≥40%, and variable secondary architecture included diffuse infiltrating single cells with targetoid growth pattern around benign glands, solid expansive nests of noncohesive cells, and corded/single file growth pattern. Further morphologic analysis demonstrated 2 distinct histologic subtypes: (1) (subtype 1; n=9) monomorphic "plasmacytoid" tumor cells with eccentrically placed nuclei and variable intracytoplasmic vacuoles with bland cytology and discohesion and (2) (subtype 2; n=9) more cohesive tumor cells with greater cytologic atypia characterized by prominent nucleoli, greater variability in nuclear size/shape, occasional mitotic figures, and more irregular infiltration. By immunohistochemistry, NKX3.1 nuclear expression and PSA cytoplasmic expression was retained in all cases. Concomitant membranous E-cadherin loss and strong cytoplasmic p120 catenin expression were present in 5 of the 18 (28%) cases, all in subtype 1 (5/9, 56%). Overall, 56% (10/18) of patients had advanced-stage disease (≥pT3b), and 70% (7/10) of these patients had associated lymphovascular invasion. All patients had concomitant cribriform patterns of carcinoma. The outcome was available for 14 patients: 4 died of unknown cause; 6 had biochemical recurrence with distant bone metastasis in 5 of the 6; and 4 patients with <3 years of follow-up currently have undetectable serum PSA levels (2 patients received salvage radiotherapy with androgen deprivation and 2 remain on routine follow-up). In summary, the single-cell pattern of Gleason pattern 5 prostatic adenocarcinoma is uniformly associated with other high-risk histologic patterns (eg, cribriform growth), and high-stage disease with distant metastasis is not uncommon. Our data suggest that the "single-cell" Gleason pattern 5 prostatic adenocarcinoma contains 2 distinct subtypes. Somatic CDH1 alterations may play a role in the development of the "plasmacytoid" pattern characterized by monomorphic cytology with concomitant E-cadherin loss and aberrant p120 catenin expression.


Assuntos
Adenocarcinoma/patologia , Neoplasias da Próstata/patologia , Adenocarcinoma/química , Adenocarcinoma/cirurgia , Idoso , Antígenos CD/análise , Biomarcadores Tumorais/análise , Caderinas/análise , Cateninas/análise , Proteínas de Homeodomínio/análise , Humanos , Calicreínas/análise , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Estudos Prospectivos , Antígeno Prostático Específico/análise , Prostatectomia , Neoplasias da Próstata/química , Neoplasias da Próstata/cirurgia , Estudos Retrospectivos , Fatores de Transcrição/análise , Resultado do Tratamento
6.
Curr Opin Urol ; 30(5): 672-678, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32701718

RESUMO

PURPOSE OF REVIEW: Technical improvements in imaging equipment and availability of radiotracers, such as PSMA-ligands have increased the synergy between Urology and Nuclear Medicine. Meanwhile artificial intelligence is introduced in Nuclear Imaging. This review will give an overview of recent technical and clinical developments and an outlook on application of these in the near future. RECENT FINDINGS: Digital PET/CT has shown gradual improvement in lesion detection and demarcation over conventional PET/CT, but total-body PET/CT holds promise for a magnitude of improvement in scan duration and quality, quantification, and dose optimization. PET-guided decision-making with the application of PSMA-ligands has been shown useful in demonstrating and biopting primary prostate cancer (PCa) lesions, guiding radiotherapy, guiding surgical resection of recurrent PCa, and assessing therapy response in PCa. Artificial intelligence made its way into Nuclear Imaging just recently, but encouraging progress promises clinical application with unprecedented possibilities. SUMMARY: Evidence is growing on clinical usefulness of PET-guided decision-making with the still relatively new PSMA ligands as a prime example. Rapid evolution of PET instrumentation and clinical introduction of artificial intelligence will be the gamechangers of nuclear imaging in the near future, though its powers should still be mastered and incorporated in clinical practice.


Assuntos
Antígenos de Superfície/metabolismo , Glutamato Carboxipeptidase II/metabolismo , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/tendências , Tomografia por Emissão de Pósitrons/tendências , Antígeno Prostático Específico/análise , Neoplasias da Próstata/diagnóstico por imagem , Inteligência Artificial , Humanos , Masculino , Membranas , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Tomografia por Emissão de Pósitrons/métodos , Neoplasias da Próstata/metabolismo , Neoplasias da Próstata/patologia
7.
Clin Exp Metastasis ; 37(4): 551-560, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32519046

RESUMO

Prospective evidence for the clinical role and efficacy of prostate specific membrane antigen (PSMA) positron emission tomography (PET)/magnetic resonance imaging (MRI) combining MRI characterization and localization of lesions with PET avidity in comparison to conventional imaging is limited. In a prospective clinical trial, we aimed to evaluate the diagnostic yield and therapeutic impact of PSMA PET/MRI in men with biochemical recurrence (BCR) following curative therapy. A single-centre, prospective clinical trial at the Princess Alexandra Hospital recruited 30 patients with BCR. Patients underwent PSMA PET/MRI and concurrent conventional CT chest, abdomen, pelvis and whole-body bone scan. Biopsy was performed when safety possible for histological correlation of identified lesions. Clinical efficacy and impact of PSMA PET findings were evaluated. 30 patients with BCR were recruited (median PSA 0.69 ng/ml). PSMA avid lesions were present in 21 patients (70%). 23 patients were previously treated with definitive surgery, 6 patients received external beam radiotherapy and 1 patient had low dose rate brachytherapy. A total of 8 of 9 lesions biopsied were positive (88.9% histological correlation). PSMA PET/MRI detected local recurrence (p = 0.005) and pelvic lesions (p = 0.06) more accurately than conventional imaging. PSMA PET/MRI may be useful in staging men with biochemical recurrence, especially when PSA is low. Our data demonstrates a high detection rate, especially for locally recurrent disease, and highlights the role of this modality when PSA is low. This modality has the potential to significantly improve prostate cancer detection and may have implications for earlier salvage treatment, avoidance of futile local therapy and change patient management to lead to improved outcomes.


Assuntos
Imagem por Ressonância Magnética/métodos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Idoso , Humanos , Masculino , Recidiva Local de Neoplasia/diagnóstico , Estudos Prospectivos , Próstata/patologia , Antígeno Prostático Específico/análise , Neoplasias da Próstata/terapia
8.
Pan Afr Med J ; 35: 61, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32537065

RESUMO

Introduction: guidelines issued by different organizations worldwide differ on the use of prostate specific antigen (PSA) in prostate cancer. However, no local data is available describing how PSA testing is offered by our healthcare facilities in the country. The objectives of this study were to describe PSA testing and subsequent prostate biopsy uptake in a South African urban population. Methods: this was a descriptive retrospective study. Data of all PSA tests and prostate biopsies performed at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) laboratory for 2013 calendar year was extracted from the laboratory information system. Results: a total of 20 365 PSA tests were performed on 17 481 men during the study period. The majority of men were Black African (79%). The mean age for Black Africans (55.5 years, SD 13.3) was significantly lower than other racial groups (62.9 years, SD 12.6, p < 0.0005). PSA level was lower in Black Africans compared to others. Prostate biopsy uptake across all age groups was lower in Black African men compared to others (2% versus 4%, p = 0.01). Of the 423 men who had a prostate biopsy, 50% had prostate cancer. More Black African men were diagnosed with prostate cancer on biopsy compared to men of other racial groups (54% versus 43%, p = 0.03). Conclusion: our study confirms that PSA testing is prevalent in healthcare facilities in South Africa. Black African men are tested for PSA levels but have low biopsy uptake and are more likely to be diagnosed with prostate cancer.


Assuntos
Biópsia/estatística & dados numéricos , Disparidades em Assistência à Saúde/estatística & dados numéricos , Antígeno Prostático Específico/análise , Neoplasias da Próstata/diagnóstico , Adulto , Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Idoso , Grupos de Populações Continentais/estatística & dados numéricos , Mineração de Dados , Humanos , Laboratórios , Masculino , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/etnologia , Estudos Retrospectivos , África do Sul
9.
Cancer Causes Control ; 31(9): 861-867, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32556947

RESUMO

PURPOSE: This study describes longitudinal trends in the use of prostate-specific antigen (PSA)-based testing in two geographically distinct healthcare systems following the 2011 US Preventive Services Task Force (USPSTF) recommendations against routine PSA screening. METHODS: We analyzed population-based health claims data from 253,139 men aged 40-80 who were enrolled at two US healthcare systems. We assessed trends in the percentage of eligible men receiving ≥ 1 PSA test per year by time period (2000-2008, 2009-2011, 2012-2014), age (40-54, 55-69, 70-80), and race (white, black, other, unknown), and conducted a joinpoint regression analysis. RESULTS: Men aged 55-69 and 70-80 years of all races had similar use of PSA testing between 2000 and 2011, ranging between 47 and 56% of eligible men by year, while only 22-26% of men aged 40-54 had a PSA test per year during this period. Overall, the percentage of men receiving at least one PSA test per year decreased by 26% between 2009-2011 and 2012-2014, with similar trends across race and age groups. PSA testing declined significantly after 2011 (annual percent change = - 11.28). CONCLUSIONS: Following the 2011 USPSTF recommendations against routine PSA screening, declines in PSA testing were observed among men of all races and across all age groups in two large US healthcare systems.


Assuntos
Calicreínas/análise , Antígeno Prostático Específico/análise , Neoplasias da Próstata/diagnóstico , Adulto , Comitês Consultivos , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Detecção Precoce de Câncer/estatística & dados numéricos , Registros Eletrônicos de Saúde/estatística & dados numéricos , Fidelidade a Diretrizes , Humanos , Estudos Longitudinais , Masculino , Massachusetts/epidemiologia , Michigan/epidemiologia , Pessoa de Meia-Idade , Serviços Preventivos de Saúde/estatística & dados numéricos , Neoplasias da Próstata/epidemiologia , Análise de Regressão , Estados Unidos/epidemiologia
11.
Anal Chim Acta ; 1109: 98-106, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32252911

RESUMO

An ultrasensitive sandwich-type electrochemiluminescence (ECL) immunosensor was developed for detection of prostate specific antigen (PSA) using an amplification strategy based on ZnO nanorods-l-cysteine-luminol nanocomposites and the biotin-streptavidin system. The biotin-streptavidin system served as a capture probe to increase the number of antibodies. ZnO nanorods not only acted as a nanocarrier that increased the number of luminol molecules and secondary antibodies, but also enhanced the ECL signal of luminol-H2O2 system by promoting H2O2 decomposition, which can further increase ECL intensity. Under optimized conditions, the proposed immunosensor demonstrated excellent analytical performance with a wide linear detection range of 0.03 pg mL-1 to 30 ng mL-1 and a detection limit of 0.01 pg mL-1 (the detection limit in real samples was 0.021 pg mL-1). This method exhibited excellent stability, reproducibility, and selectivity. In addition, the results of PSA determinations in human serum samples obtained using the proposed immunosensor were consistent with data collected using the commercial chemiluminescence immunoassay analyzer.


Assuntos
Técnicas Biossensoriais , Técnicas Eletroquímicas , Medições Luminescentes , Antígeno Prostático Específico/análise , Cisteína/química , Humanos , Luminol/química , Masculino , Nanocompostos/química , Nanotubos/química , Óxido de Zinco/química
12.
Chem Commun (Camb) ; 56(36): 4942-4945, 2020 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-32239063

RESUMO

The detection of prostate specific antigen (PSA) is extremely important for the early diagnosis of prostate cancer. Herein, we report a dual-round signal amplification strategy for colorimetric/fluorescence/photoacoustic triple read-out detection of PSA using a silica coated Au@Ag core-shell nanorod (denoted Au@Ag@SiO2) based enzyme-linked immunosorbent assay (ELISA) system. In the presence of PSA, monoclonal primary antihuman PSA antibody (Ab1) captured PSA and was subsequently recognized by the secondary antihuman PSA detection antibody (Ab2) which was conjugated with glucose oxidase (GOx) functionalized magnetic beads (MBs) for signal amplification, then GOx catalyses the addition of glucose to generate hydrogen peroxide that etches the silver layer in Au@Ag@SiO2, thus producing abundant Ag+ to realize the second signal amplification. With the degradation of the silver layer, an obvious color change (green-to-pink) of the Au@Ag@SiO2 solution could be observed by the naked eye and its surface plasmon resonance (SPR) absorption had a red-shift, enhancing photoacoustic signal read-out at 780 nm. Additionally, the released Ag+ was caught by a Ag+-fluorescent probe (Ag+-FP) for enhanced fluorescence signal read-out. These results suggested that this ELISA system achieves a triple read-out detection of PSA. This work provides a promising strategy for multiple read-out detection of biomarkers, which has great potential in clinical diagnosis.


Assuntos
Colorimetria , Fluorescência , Técnicas Fotoacústicas , Antígeno Prostático Específico/análise , Técnicas Biossensoriais , Ensaio de Imunoadsorção Enzimática , Ouro/química , Humanos , Nanopartículas/química , Dióxido de Silício/química , Prata/química , Ressonância de Plasmônio de Superfície
13.
Anticancer Res ; 40(4): 2291-2296, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32234928

RESUMO

BACKGROUND/AIM: The best sequential treatment for castration-resistant prostate cancer (CRPC) remains unclear. This study evaluated the therapeutic effects of ethinylestradiol (EE) on CRPC. PATIENTS AND METHODS: A total of 80 patients with CRPC, treated with 0.5-1.5 mg/day of EE, were retrospectively assessed. RESULTS: The median duration from the initial treatment to the beginning of EE was 48.3 months. A decline in the prostate-specific antigen (PSA) from the baseline was noted in 60 patients (75%) and a >50% PSA decline in 27 patients (34%). The median time of PSA progression, overall survival, and cancer-specific survival after EE were 5.60 months, 24.00 months, and 27.93 months, respectively. CONCLUSION: EE administration for CRPC showed a relatively high PSA response regardless of timing of sequential treatment. The frequency of cardiovascular adverse events was not significantly high. EE administration is a potential treatment option for CRPC.


Assuntos
Etinilestradiol/uso terapêutico , Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Antígeno Prostático Específico/análise , Estudos Retrospectivos , Resultado do Tratamento
14.
Biosensors (Basel) ; 10(3)2020 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-32188036

RESUMO

A novel recyclable surface-enhanced Raman scattering (SERS)-based immunoassay was demonstrated and exhibited extremely high sensitivity toward prostate specific antigen (PSA). The immunoassay, which possessed a sandwich structure, was constructed of multifunctional Fe3O4@TiO2@Au nanocomposites as immune probe and Ag-coated sandpaper as immune substrate. First, by adjusting the density of outside Au seeds on Fe3O4@TiO2 core-shell nanoparticles (NPs), the structure-dependent SERS and photocatalytic performance of the samples was explored by monitoring and degradating 4-mercaptobenzonic acid (4MBA). Afterwards, the SERS enhancement capability of Ag-coated sandpaper with different meshes was investigated, and a limit of detection (LOD), as low as 0.014 mM, was achieved by utilizing the substrate. Subsequently, the recyclable feasibility of PSA detection was approved by zeta potential measurement, absorption spectra, and SEM images and, particularly, more than 80% of SERS intensity still existed after even six cycles of immunoassay. The ultralow LOD of the recyclable immunoassay was finally calculated to be 1.871 pg/mL. Therefore, the recyclable SERS-based immunoassay exhibits good application prospects for diagnosis of cancer in clinical measurements.


Assuntos
Compostos Férricos/química , Ouro/química , Calicreínas/análise , Antígeno Prostático Específico/análise , Prata/química , Titânio/química , Humanos , Imunoensaio , Limite de Detecção , Nanopartículas Metálicas/química , Nanocompostos , Reciclagem , Análise Espectral Raman , Propriedades de Superfície
15.
Anal Chim Acta ; 1106: 183-190, 2020 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-32145847

RESUMO

Photoactive materials with high photo-electron transfer efficiency and stable signal output hold a key role in constructing the photoelectrochemical (PEC) biosensing systems. In this study, the ternary CdS@Au-g-C3N4 heterojunction was first prepared and characterized, and its application in PEC bioanalysis was explored. The gold nanoparticles sandwiched between CdS and g-C3N4, acting as both plasmonic photosensitizer and electron relay, significantly boosted the light absorption and accelerated the charge transfer from g-C3N4 to CdS, both of which contributed to the enhancement of photoelectric conversion efficiency. Signal quenching with graphene oxide-CuS efficiently weakened the photocurrent from CdS@Au-g-C3N4. The combination of the excellent PEC properties of CdS@Au-g-C3N4 and the remarkable quenching effects of graphene oxide-CuS enabled construction of a sandwich-type PEC immunosensor for prostate specific antigen (PSA) detection. This immunosensor achieved sensitive PSA analysis by multiple signal amplification mechanisms, with a detection limit of 0.6 pg mL-1 and a wide linear range from 1.0 pg mL-1 to 10 ng mL-1. This work not only demonstrates the great potential of noble metal sandwiched ternary heterojunctions in the PEC field, but also lays a foundation for developing the general PEC immunoassays.


Assuntos
Técnicas Biossensoriais , Técnicas Eletroquímicas , Imunoensaio , Antígeno Prostático Específico/análise , Compostos de Cádmio/química , Cobre/química , Ouro/química , Grafite/química , Humanos , Compostos de Nitrogênio/química , Tamanho da Partícula , Processos Fotoquímicos , Sulfetos/química , Propriedades de Superfície
16.
In Vivo ; 34(2): 757-765, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32111781

RESUMO

BACKGROUND/AIM: To report the outcomes of patients with prostate cancer treated with dose-escalated radiotherapy over a 15-year period at our Institution. PATIENTS AND METHODS: Patients with biopsy-proven cT1-4N0M0 disease who received radical external beam radiotherapy (EBRT) were reviewed. The endpoints were 5-year overall survival (OS), freedom from biochemical failure (FFBF) and late treatment toxicities. RESULTS: A total of 236 patients were eligible. Median follow-up was 70 months. Low-, intermediate- and high-risk disease was found in 9%; 29% and 62% of patients, respectively. The median radiation dose was 73.8 Gy. Overall 42% of patients had dose escalation to >74 Gy. Five-year OS and FFBF were 95.2%/81.6%/75.4% and 95.0%/98.0%/82.0% for low-/intermediate-/high-risk patients, respectively. Dose escalation to >74 Gy did not improve FFBF (hazard ratio=0.97, 95% confidence intervaI=0.43-2.19, p=0.93) and was associated with a 4.3-fold increase in the odds of grade 3 or more rectal bleeding (p<0.01). CONCLUSION: Dose escalation to >74 Gy did not improve OS or FFBF but was associated with a higher rate of grade 3 or more rectal haemorrhage.


Assuntos
Neoplasias da Próstata/radioterapia , Idoso , Idoso de 80 Anos ou mais , Antagonistas de Androgênios/uso terapêutico , Relação Dose-Resposta à Radiação , Hemorragia/etiologia , Humanos , Estimativa de Kaplan-Meier , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Avaliação de Resultados em Cuidados de Saúde/métodos , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Antígeno Prostático Específico/análise , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/tratamento farmacológico , Radioterapia/efeitos adversos , Radioterapia/métodos , Reto/patologia , Reto/efeitos da radiação
17.
Sci Rep ; 10(1): 5157, 2020 03 20.
Artigo em Inglês | MEDLINE | ID: mdl-32198373

RESUMO

The gold standard for prostate cancer (PCa) diagnosis is prostate biopsy. However, it remines controversial as an invasive mean for patients with PSA levels in the gray zone (4-10 ng/mL). This study aimed to develop strategy to reduce the unnecessary prostate biopsy. We retrospectively identified 235 patients with serum total PSA testing in the gray zone before prostate biopsy between 2014 and 2018. Age, PSA derivates, prostate volume and multiparametric magnetic imaging (mpMRI) examination were assessed as predictors for PCa and clinically significant PCa with Gleason score ≥ 7 (CSPCa). Univariate analysis showed that prostate volume, PSAD, and mpMRI examination were significant predictors of PCa and CSPCa (P < 0.05). The differences of diagnostic accuracy between mpMRI examination (AUC = 0.69) and other clinical parameters in diagnostic accuracy for PCa were not statistically significant. However, mpMRI examination (AUC = 0.79) outperformed prostate volume and PSAD in diagnosis of CSPCa. The multivariate models (AUC = 0.79 and 0.84 for PCa and CSPCa) performed significantly better than mpMRI examination for detection of PCa (P = 0.003) and CSPCa (P = 0.036) among patients with PSA level in the gray zone. At the same level of sensitivity as the mpMRI examination to diagnose PCa, applying the multivariate models could reduce the number of biopsies by 5% compared with mpMRI examination. Overall, our results supported the view that the multivariate model could reduce unnecessary biopsies without compromising the ability to diagnose PCa and CSPCa. Further prospective validation is required.


Assuntos
Antígeno Prostático Específico/análise , Neoplasias da Próstata/diagnóstico , Idoso , Biópsia/métodos , China , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Próstata/patologia , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/patologia , Estudos Retrospectivos
19.
Int J Mol Sci ; 21(4)2020 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-32053990

RESUMO

BACKGROUND: Widespread use of prostate specific antigen (PSA) in screening procedures allowed early identification of an increasing number of prostate cancers (PCas), mainly including indolent cancer. Availability of different therapeutic strategies which have a very different impact on the patient's quality of life suggested a strong need for tools able to identify clinically significant cancer at diagnosis. Multi-parametric magnetic resonance showed very good performance in pre-biopsy diagnosis. However, it is an expensive tool and requires an experienced radiologist. In this context, a simple blood-based test is worth investigating. In this context, researchers focused their attention on the development of a laboratory test able to minimize overdiagnosis without losing the identification of aggressive tumors. RESULTS: Recent literature data on PCa biomarkers revealed a clear tendency towards the use of panels of biomarkers or a combination of biomarkers and clinical variables. Phi, the 4Kscore, and Stockholm3 as circulating biomarkers and the Mi-prostate score, Exo DX Prostate, and Select MD-X as urinary biomarker-based tests have been developed. In this scenario, phi is worthy of attention as a noninvasive test significantly associated with aggressive PCa. CONCLUSIONS: Literature data showed that phi had good diagnostic performance to identify clinically significant (cs) PCa, suggesting that it could be a useful tool for personalized treatment decision-making. In this review, phi potentialities, limitations, and comparisons with other blood- and urinary-based tests were explored.


Assuntos
Biomarcadores Tumorais/análise , Calicreínas/análise , Antígeno Prostático Específico/análise , Neoplasias da Próstata/diagnóstico , Animais , Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/urina , Biópsia , Humanos , Calicreínas/sangue , Calicreínas/urina , Imagem por Ressonância Magnética , Masculino , Próstata/patologia , Antígeno Prostático Específico/sangue , Antígeno Prostático Específico/urina , Neoplasias da Próstata/sangue , Neoplasias da Próstata/patologia , Neoplasias da Próstata/urina , Medição de Risco
20.
Medicina (Kaunas) ; 56(2)2020 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-32102477

RESUMO

Prostate cancer is one of the most encountered cancer diseases in men worldwide and in consequence it requires the improvement of therapeutic strategies. For the clinical diagnosis, the standard approach is represented by solid biopsy. From a surgical point of view, this technique represents an invasive procedure that may imply several postoperative complications. To overcome these impediments, many trends are focusing on developing liquid biopsy assays and on implementing them in clinical practice. Liquid samples (blood, urine) are rich in analytes, especially in transcriptomic information provided by genetic markers. Additionally, molecular characterization regarding microRNAs content reveals outstanding prospects in understanding cancer progression mechanisms. Moreover, these analytes have great potential for prostate cancer early detection, more accurate prostate cancer staging and also for decision making respecting therapy schemes. However, there are still questionable topics and more research is needed to standardize liquid biopsy-based techniques.


Assuntos
MicroRNAs/análise , Neoplasias da Próstata/sangue , Biomarcadores Tumorais/análise , Biomarcadores Tumorais/sangue , Detecção Precoce de Câncer/métodos , Detecção Precoce de Câncer/normas , Detecção Precoce de Câncer/estatística & dados numéricos , Humanos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/normas , Programas de Rastreamento/estatística & dados numéricos , MicroRNAs/sangue , Antígeno Prostático Específico/análise , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/fisiopatologia
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