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1.
Medicine (Baltimore) ; 98(40): e17451, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577771

RESUMO

INTRODUCTION: Prostate-specific antigen (PSA) is the main tool for early detection, risk stratification and monitoring of prostate cancer (PCa). However, there are controversies about the use of PSA as a population screening test because of the high potential for overdiagnosis and overtreatment associated. The net benefit of screening is unclear and according to the available recommendations, it should be offered to well-informed men with an adequate health status and a life-expectancy of at least 10 years or to men at elevated risk of having PCa. In addition, the factors that influence test results are unclear, as is impact of false positive or negative results on patient health.Our objective is to assess the clinical and analytical factors associated with the presence of false positive and false negative results and the diagnostic/therapeutic process followed by these patients. METHODS AND ANALYSIS: A prospective observational cohort study will be carried out. We will include a cohort of patients with a positive PSA result (1.081 patients) and a sample of patients with negative results (572 patients); both will be followed for 2 years by reviewing medical records to assess the variables associated with these results, as well as characteristics of patient management after a positive PSA value. We will include those patients with a PSA determination from 2 hospitals in the Valencian Community. Patients who have been previously diagnosed with prostate cancer or who are being followed for previous high PSA values will be excluded. DISCUSSION: The study will estimate the frequency of false positive and false negative PSA results in routine clinical practice, and allow us to quantify the potential harm caused. STUDY REGISTRATION: Clinicaltrials.gov (https://clinicaltrials.gov/): NCT03978299, June 7, 2019.


Assuntos
Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/diagnóstico , Protocolos Clínicos , Estudos de Coortes , Detecção Precoce de Câncer , Reações Falso-Negativas , Reações Falso-Positivas , Humanos , Masculino
2.
Anticancer Res ; 39(10): 5773-5780, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31570481

RESUMO

BACKGROUND/AIM: Serum γ-glutamyltransferase (GGT) is reportedly associated with survival and therapeutic response in various malignancies; however, as far as we are aware its impact on metastatic castration-resistant prostate cancer (mCRPC) has never been assessed. PATIENTS AND METHODS: Fifty consecutive men with mCRPC receiving enzalutamide at a single cancer center were retrospectively evaluated. The primary endpoint was overall survival (OS) and the secondary endpoints were prostate-specific antigen (PSA) response, maximal PSA change, and PSA progression-free survival (PSA-PFS). RESULTS: Multivariable analysis demonstrated that elevation of GGT (≥40 U/l) was significantly and independently associated with shorter OS (hazard ratio(HR)=3.61; p=0.004), as were lower hemoglobin (HR=6.04; p<0.001) and higher PSA (HR=4.38; p=0.009). Elevated GGT was also associated with poorer PSA response, maximal PSA change, and shorter PSA-PFS. CONCLUSION: Elevated GGT was an adverse prognostic indicator in men with mCRPC receiving enzalutamide. External validations would improve the generality of our findings.


Assuntos
Antineoplásicos/uso terapêutico , Biomarcadores Tumorais/sangue , Feniltioidantoína/análogos & derivados , Neoplasias de Próstata Resistentes à Castração/sangue , Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico , gama-Glutamiltransferase/sangue , Idoso , Idoso de 80 Anos ou mais , Progressão da Doença , Intervalo Livre de Doença , Humanos , Masculino , Segunda Neoplasia Primária/sangue , Segunda Neoplasia Primária/tratamento farmacológico , Feniltioidantoína/uso terapêutico , Prognóstico , Antígeno Prostático Específico/sangue , Estudos Retrospectivos , Resultado do Tratamento
3.
Curr Urol Rep ; 20(10): 60, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31478113

RESUMO

PURPOSE OF REVIEW: With the long-standing controversy surrounding the use of prostate-specific antigen (PSA) for the detection, evaluation, and surveillance of prostate cancer, there is a need for a minimally invasive technique to identify and risk-stratify these patients. Additionally, in an effort to reduce the number of unnecessary biopsies and identify clinically significant prostate cancer (csPCa), there has been a shift in practice towards the use of multiparametric magnetic resonance imaging (mpMRI) in conjunction with decision-making regarding prostate cancer diagnosis and management. In the current review, we summarize the data regarding the use of mpMRI in the detection, evaluation, and surveillance of csPCa. RECENT FINDINGS: Recent prospective clinical trials have determined that a pre-biopsy mpMRI may rule out insignificant prostate cancers, thereby reducing the number of patients who require a biopsy. The anatomic information gathered from these pre-biopsy mpMRI performed during MRI fusion biopsy in csPCa increases the accuracy of pathologic staging in terms of Gleason scores. In regard to active surveillance, prospective trials suggest little to no clinical utility for mpMRI and fusion biopsy in the surveillance of prostate cancer despite conflicting findings from retrospective studies. Recent trials suggest that mpMRI can play an important role in the detection and evaluation of csPCa. The ideal role for mpMRI in active surveillance remains limited.


Assuntos
Imagem por Ressonância Magnética/métodos , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia , Biomarcadores Tumorais/sangue , Humanos , Biópsia Guiada por Imagem/métodos , Masculino , Gradação de Tumores , Estadiamento de Neoplasias , Vigilância da População , Prognóstico , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/diagnóstico , Medição de Risco
4.
Arch Esp Urol ; 72(7): 641-646, 2019 Sep.
Artigo em Espanhol | MEDLINE | ID: mdl-31475674

RESUMO

Prostate cancer (PCa) is one of the most frequent neoplasms in the masculine sex, which has multiple etiological factors, inflammation is one of them. OBJECTIVE: To determine the role of different inflammatory markers in the diagnosis of PCa in first prostatic biopsies. METHODS: This is a prospective study evaluating neutrophil/ lymphocyte (NLR), neutrophil/monocyte (NMR) and platelet/lymphocyte (PLR) ratios of 78 patients with suspected PCa due to PSA alteration and/or abnormal digital rectal examination, and its correlation with twelve-cylinder biopsy result. RESULTS: The NLR, NMR and PLR were all higher in the group diagnosed with PCa compared to the group with benign prostatic hyperplasia (p > 0.05). CONCLUSIONS: Inflammatory markers can be predictive factors in the diagnosis of PCa, although more studies are needed for their routine use.


Assuntos
Biomarcadores Tumorais/sangue , Neoplasias da Próstata/sangue , Humanos , Masculino , Estudos Prospectivos , Antígeno Prostático Específico/sangue , Estudos Retrospectivos
6.
Pol J Pathol ; 70(2): 127-133, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31556563

RESUMO

We tested the association between HOXB13 G84E (rs138213197) germline mutation and PC risk in Polish men. DNA from 103 consecutive, newly diagnosed patients hospitalised because of PC and DNA from 103 men: volunteers, healthy at the time of the study. The G84E mutation was genotyped using Sanger sequencing. The HOXB13 G84E germline mutation was detected in 2.9% of PC men (3/103) and not detected in any healthy man. Two mutation carriers originated from two of 25 families fulfilling hereditary prostate cancer criteria (HPC) and one mutation carrier from one family among 78 families without HPC (PC frequency: 8% vs. 1.3%, OR = 6.70, p = 0.13). In two of three mutation carriers, disease was detected above 60 years of age. There was a trend for a lower probability of 5-year survival in patients with G84E than in patients without it (66.7% vs. 94.0%, p = 0.08). The HOXB13 G84E germline mutation is associated with increased prostate cancer risk in Polish men, with hereditary form of the disease, and probably with older age at PC onset (> 60 years of age) and shorter survival. However, it is not associated with PSA level, or PC stage or grade at the time of diagnosis.


Assuntos
Mutação em Linhagem Germinativa , Proteínas de Homeodomínio/genética , Neoplasias da Próstata/genética , Idoso , Estudos de Casos e Controles , Predisposição Genética para Doença , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Polônia , Antígeno Prostático Específico/sangue , Fatores de Risco
7.
Orv Hetil ; 160(35): 1376-1379, 2019 Sep.
Artigo em Húngaro | MEDLINE | ID: mdl-31448641

RESUMO

Introduction: Recent experiments and clinical studies indicate the contribution of thyroid hormones to prostate pathology. Aim: In our retrospective analyzis of university patient population, we evaluated the association between thyroid stimulatory hormone (TSH) and prostate specific antigen (PSA). Method: From the Laboratory Information System we retrieved the data of male patients between 40 and 75 years of age who had been subjected to simultaneous TSH and PSA measurements during the last 12 years (n = 7279). The association between logTSH and logPSA levels was tested with multiple regression analysis and adjusted for age. Results: Significant associations between logPSA and logTSH and age (r = 0.297 and 0.472, respectively) were detected. PSA levels were higher in patients with TSH below (n = 405) than in those with TSH within reference range (TSH 0,35-4,95 mU/ml) (n = 6698) (PSA level: 1.118 [0.639-2.338] vs. 0.920 [0.508-1.826] ng/ml, p<0.016). Based on estimates, a 10% decrease in TSH is associated with a 0.42% increase in PSA levels in our population. This corresponds to a 42% increase in PSA levels in the same patient if he would present with 0.2 mU/ml instead of 2.0 mU/ml TSH. Conclusion: The finding that hyperthyreosis might be associated with higher PSA levels indicates that PSA reference ranges would differ in hyperthyreotic and in euthyreotic patients. Probably the PSA clinical decision limits is also recommended to be modified according to the patient's thyroid status. Orv Hetil. 2019; 160(35): 1376-1379.


Assuntos
Antígeno Prostático Específico/sangue , Doenças da Glândula Tireoide/sangue , Glândula Tireoide/fisiologia , Tireotropina/sangue , Adulto , Fatores Etários , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Estudos Retrospectivos , Doenças da Glândula Tireoide/diagnóstico
8.
Anticancer Res ; 39(8): 4411-4414, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31366538

RESUMO

BACKGROUND/AIM: Cabazitaxel use has usually been limited to up to 10 cycles in most countries according to the protocol in the TROPIC trial. Therefore, clinical data on cabazitaxel use beyond 10 cycles is limited. The aim of this study was to report the therapeutic outcome of cabazitaxel chemotherapy administered for >10 cycles. PATIENTS AND METHODS: This study included 74 Japanese patients with prostate cancer between 2014 and 2017. Patients background, and treatment outcomes including PSA decline, progression-free survival, treatment-failure-free survival, overall survival, and adverse events were investigated, comparing patients treated with ≤10 and >10 cycles. RESULTS: Patients characteristics were favorable as indicated by the higher number of cycles of prior docetaxel chemotherapy, absence of pain, and absence of bony and visceral metastases among men who received >10 cycles of cabazitaxel. PSA response, progression-free survival, treatment-failure-free survival and overall survival were better among patients treated with >10 cycles of cabazitaxel compared to those treated with ≤10 cycles. The incidence of severe adverse events was similar between the two groups. CONCLUSION: Taken together, this study suggested that continuous chemotherapy with cabazitaxel beyond 10 cycles may be beneficial.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Docetaxel/administração & dosagem , Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico , Taxoides/administração & dosagem , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Docetaxel/efeitos adversos , Esquema de Medicação , Humanos , Masculino , Pessoa de Meia-Idade , Intervalo Livre de Progressão , Antígeno Prostático Específico/sangue , Neoplasias de Próstata Resistentes à Castração/sangue , Neoplasias de Próstata Resistentes à Castração/patologia , Taxoides/efeitos adversos , Resultado do Tratamento
9.
Cancer Radiother ; 23(6-7): 565-571, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31447344

RESUMO

Prostate cancer is the most common cancer of men over 50 years old. Localized prostatic cancer treatment may be responsible of a decline of patient's quality of life. The main actors of treatment are now focused on minimizing functional consequences of treatments. The radiation oncologist has a central role in patient monitoring. The follow-up is codified by official recommendations of learned societies to enhance the post-cancer period. The main objective of this article is to review the recommendations for clinical and biological follow-up. An inventory of the functional consequences of the various treatments will be detailed, and particularly those caused by androgen deprivation therapy, with a review of precautions before implementation, adverse effects and their management, as well as monitoring recommendations. The analysis of quality of life after curative treatment and suggestions to improve monitoring will also be discussed.


Assuntos
Assistência ao Convalescente/normas , Papel do Médico , Neoplasias da Próstata/terapia , Radio-Oncologistas , Idoso , Antagonistas de Androgênios/uso terapêutico , Braquiterapia , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Guias de Prática Clínica como Assunto , Antígeno Prostático Específico/sangue , Prostatectomia , Neoplasias da Próstata/sangue , Qualidade de Vida , Disfunções Sexuais Fisiológicas/terapia , Resultado do Tratamento
10.
Cancer Causes Control ; 30(9): 1009-1012, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31309377

RESUMO

PURPOSE: Epidemiologic data suggest that high levels of physical activity (PA) may reduce the risk of disease progression in men with prostate cancer (PCa), but it is unknown whether PA can delay the requirement for definitive treatment for those on active surveillance (AS). We investigated the influence of PA post-diagnosis on AS discontinuation in men with low-risk disease. METHODS: The effect of PA on the time to AS discontinuation was assessed in 421 patients, of whom 107 underwent additional PCa treatment over a median of 2.5 years. RESULTS: Using Cox regression models, we found that PA was not significantly associated with time to curative treatment initiation. Prostate-specific antigen (PSA) most proximal to AS initiation (HR, 1.11; 95% CI 1.03 to 1.21) and the number of positive cores (HR, 1.34; 95% CI 1.12 to 1.61) at diagnosis were associated with a significantly increased risk of discontinuing AS. CONCLUSION: Our findings suggest that PA during AS for PCa does not significantly influence time to curative treatment.


Assuntos
Exercício , Neoplasias da Próstata/diagnóstico , Adulto , Idoso , Progressão da Doença , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Risco
11.
Anticancer Res ; 39(7): 3879-3885, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31262916

RESUMO

BACKGROUND/AIM: There are few reports that verify the relationship between the therapeutic effects of flutamide and novel androgen receptor-targeted agents. We aimed to evaluate the benefits of flutamide as an alternative anti-androgen agent and its effects on the efficacy of novel androgen receptor-targeted agents. PATIENTS AND METHODS: Patients with castration-resistant prostate cancer on novel androgen receptor-targeted agents without prior docetaxel therapy were included. Changes in prostate-specific antigen (PSA) level were recorded. RESULTS: Patients who responded well to flutamide (Flutamide effective) following initial maximum androgen blockade (MAB) showed significantly higher changes in serum PSA levels (p=0.039) and PSA-progression-free survival (PFS) rate (p=0.016) following enzalutamide therapy compared to those who did not respond well to flutamide. Multivariate analysis showed that the factor of Flutamide effective was significantly associated with a good PSA-PFS rate following enzalutamide therapy (HR=7.36, 95%CI=1.4-38.71, p=0.018). CONCLUSION: Patients showing good response to flutamide following initial MAB may achieve a satisfactory PSA-PFS rate with subsequent enzalutamide therapy.


Assuntos
Antagonistas de Androgênios/uso terapêutico , Flutamida/uso terapêutico , Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico , Acetato de Abiraterona/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Docetaxel/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Feniltioidantoína/análogos & derivados , Feniltioidantoína/uso terapêutico , Antígeno Prostático Específico/sangue , Neoplasias de Próstata Resistentes à Castração/sangue , Receptores Androgênicos , Resultado do Tratamento
12.
Medicine (Baltimore) ; 98(26): e16289, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261602

RESUMO

To improve the detection of prostate cancer (PCa) by combining the Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) and prostate-specific antigen-age volume (PSA-AV), especially among those in gray zone with PI-RADS v2 score 3 or serum total prostate-specific antigen (tPSA) 4 to 10 ng/mL.The 357 patients were enrolled in this study. The PI-RADS v2 scoring system was used to represent characteristics on multiparametric magnetic resonance imaging (mpMRI). PI-RADS v2 score 3 or tPSA 4 to 10 ng/mL were defined as the gray zone in detecting PCa. The formula equates to the patient age multiplied by the prostate volume, which is divided by the tPSA level. Univariate and multivariate analyses were done to ascertain significant predictors of prostate cancer.In all, 174 (48.7%) were benign prostatic hyperplasia, 183 (51.3%) had PCa. The results showed that PI-RADS v2, tPSA, and PSA-AV were significant independent predictors of prostate cancer. PI-RADS v2 score ≥4 could detect PCa with rate of 82.1%. Serum tPSA ≥10 ng/mL could detect PCa with rate of 66.2%, PSA density (PSAD) ≥0.15 ng/mL/cc with rate of 62.8%, and PSA-AV ≤250 with rate of 83.5%. Combining with PSA-AV ≤250, patients those with tPSA 4 to 10 ng/mL could improve the detection from 36.0% up to 81%, those with PI-RADS v2 score 3 from 28.6% up to 60.0%.PI-RADS v2 and PSA-AV are faithful variables for detecting PCa. And for patients, those in gray zones of PI-RADS v2 and tPSA, PSA-AV can improve detection rate of PCa.


Assuntos
Imagem por Ressonância Magnética , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/diagnóstico por imagem , Fatores Etários , Idoso , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Próstata/patologia , Neoplasias da Próstata/diagnóstico , Estudos Retrospectivos
13.
J Comput Assist Tomogr ; 43(4): 645-651, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31268875

RESUMO

OBJECTIVE: To develop regression models using Prostate Imaging Reporting and Data System (PI-RADS), histogram analysis, and prostate-specific antigen density (PSAD) to predict prostate cancer (PCa) and clinically significant PCa (CSPCa) in patients with prostate-specific antigen of 4 to 20 ng/mL. METHODS: In total, 195 PCa and 386 noncancer patients with prostate-specific antigen of 4 to 20 ng/mL were divided into development and validation cohorts. Magnetic resonance imaging results of them were assessed by PI-RADS scores and histogram analysis-corrected PI-RADS (PI-RADSh) scores. Diagnostic efficiencies for PCa and CSPCa of these scores plus PSAD were evaluated with logistic regression and receiver operating characteristic curve analysis. RESULTS: Prostate-specific antigen density + PI-RADSh score showed significantly higher area under the receiver operating characteristic curve for PCa (0.956) and CSPCa (0.960), which were higher than PI-RADS (0.909 and 0.926), PI-RADSh (0.921 and 0.940), and PSAD + PI-RADS (0.943 and 0.949) (all P < 0.05). CONCLUSIONS: Incorporation of PSAD and histogram analysis raised the diagnosis efficiencies of PI-RADS for PCa and CSPCa.


Assuntos
Bases de Dados Factuais , Imagem por Ressonância Magnética , Antígeno Prostático Específico/sangue , Próstata/diagnóstico por imagem , Neoplasias da Próstata , Idoso , Humanos , Interpretação de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/sangue , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/epidemiologia , Estudos Retrospectivos , Risco
14.
Medicine (Baltimore) ; 98(27): e16351, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277192

RESUMO

RATIONAL: How to manage patients with prostate cancer (PCa) with biochemical recurrence (BCR) following primary curative treatment is a controversial issue. Multiple disciplinary team (MDT) mechanism may propose an appropriate treatment plan for patients and can effectively improve patient prognosis and survival, reduce patient diagnosis and treatment waiting time, and greatly improve patient satisfaction. PATIENT CONCERNS: Here, we presented a case of a 77-year-old man with a persistently elevated serum level of prostate-specific antigen (PSA), who had a history of radical prostatectomy (RP) and of 9 years endocrine therapy. DIAGNOSES: Castration-resistant prostate cancer and locally recurrent prostate cancer. INTERVENTIONS: Androgen-deprivation therapy was first utilized 2 months after RP, due to the consideration of BCR on May 5, 2007. And during the next 9 years, he was treated with different endocrine agents but failed to maintain serum levels of PSA stable. Finally, the MDT suggested patient to perform salvage radiation therapy (SRT). Under MDT mechanism, we avoid secondary surgery, so as to reduce the patients' mental suffering and cost of patient care. OUTCOMES: EPIC26 scale assessment revealed leak-free urine, good urine control, no defecation abnormalities or blood in the stool, no breast tenderness and breast enlargement significantly improved. The patient now has no adjuvant therapy, including endocrine therapy. The patient achieved good prognosis through local RT. LESSONS: Pelvic SRT for patients with locally recurrent PCa may restore the same radical effect as RP. And more importantly, MDT mechanism plays an important role in making the most appropriate decisions for patients.


Assuntos
Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/terapia , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/terapia , Idoso , Terapia Combinada , Humanos , Masculino , Prostatectomia , Terapia de Salvação
15.
Analyst ; 144(13): 4051-4059, 2019 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-31157328

RESUMO

Rapid, simultaneous, and sensitive quantification of multiplex prostate biomarkers plays an important role in early diagnosis, especially for obese men and patients. Herein, a surface-enhanced Raman scattering (SERS)-based vertical flow assay (VFA) is presented for simultaneous detection of multiplex prostate cancer biomarkers, such as prostate-specific antigen (PSA), carcinoembryonic antigen (CEA), and alpha-fetoprotein (AFP) on a single test spot. In practice, Raman dyes (RDs) encoded core-shell SERS nanotags instead of conventional gold colloids used in the colorimetric assay are employed in the sensing membrane of SERS based VFAs for multiplex protein detection. Because of the enhanced Raman signal of the core-shell nanostructure and the high surface area to volume ratio (SVR) of the porous sensing membrane, this proposed biosensor shows a wide linear dynamic range (LDR) with detection limits of 0.37, 0.43, and 0.26 pg mL-1 for PSA, CEA, and AFP, respectively, suggesting that this approach can be a good candidate in point of care testing (POCT) for rapid and sensitive biomarker detection and has a huge potential in multiplex analysis and cancer diagnosis.


Assuntos
Biomarcadores Tumorais/sangue , Técnicas Biossensoriais/métodos , Antígeno Carcinoembrionário/sangue , Calicreínas/sangue , Nanopartículas Metálicas/química , Antígeno Prostático Específico/sangue , alfa-Fetoproteínas/análise , Animais , Anticorpos/imunologia , Biomarcadores Tumorais/imunologia , Antígeno Carcinoembrionário/imunologia , Colódio/química , Corantes/química , Cabras , Ouro/química , Humanos , Imunoensaio/métodos , Calicreínas/imunologia , Limite de Detecção , Masculino , Oxazinas/química , Porosidade , Antígeno Prostático Específico/imunologia , Neoplasias da Próstata/sangue , Prata/química , Análise Espectral Raman/métodos , Compostos de Sulfidrila/química , alfa-Fetoproteínas/imunologia
17.
Urologiia ; (2): 73-81, 2019 Jun.
Artigo em Russo | MEDLINE | ID: mdl-31162906

RESUMO

Prostate cancer (PCa) is the 4th most commonly diagnosed cancer in the male population and incidence of different stages is increasing every year. The efficiency of PCa treatment is strongly dependent on the its stage. Prostate Specific Antigen (PSA) is the most widely used and universal biomarker of PCa worldwide. Considering its limited predictive value, particularly in patients older than 50 with PSA level ranging from 4.5 to 10 ng/ml, there is a need to introduce new serum biomarkers of PCa. Current data on different PCa biomarkers are reviewed in the article as well as a role of angiotensin-converting enzyme (ACE) as a novel PCa biomarker.


Assuntos
Biomarcadores Tumorais/sangue , Peptidil Dipeptidase A/sangue , Hiperplasia Prostática/sangue , Neoplasias da Próstata/sangue , Humanos , Masculino , Próstata/metabolismo , Antígeno Prostático Específico/sangue , Hiperplasia Prostática/diagnóstico , Neoplasias da Próstata/diagnóstico
19.
Anticancer Res ; 39(6): 3089-3094, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31177153

RESUMO

BACKGROUND/AIM: Limited information is available to help physicians decide when to introduce cabazitaxel for metastatic castration-resistant prostate cancer (mCRPC) patients. The objective of this study was to assess the optimal timing of cabazitaxel introduction. PATIENTS AND METHODS: The clinical outcomes of 66 mCRPC patients receiving cabazitaxel following failure of docetaxel were retrospectively analyzed. RESULTS: Among the parameters possibly affecting the timing of cabazitaxel introduction, only an increased prostate-specific antigen (PSA) value from the diagnosis of CRPC had a significant impact on overall survival (OS) after the introduction of cabazitaxel. Furthermore, there was a significant correlation between the increased PSA value from the diagnosis of CRPC and the baseline PSA value at cabazitaxel introduction. Multivariate analysis showed that only the baseline PSA value at cabazitaxel introduction is an independent predictor of OS. CONCLUSION: A comparatively low PSA value could be an alternative index suggesting the optimal timing for cabazitaxel introduction.


Assuntos
Adenocarcinoma/tratamento farmacológico , Antineoplásicos/administração & dosagem , Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico , Taxoides/administração & dosagem , Adenocarcinoma/sangue , Adenocarcinoma/mortalidade , Adenocarcinoma/secundário , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/efeitos adversos , Esquema de Medicação , Humanos , Japão , Calicreínas/sangue , Masculino , Pessoa de Meia-Idade , Antígeno Prostático Específico/sangue , Neoplasias de Próstata Resistentes à Castração/sangue , Neoplasias de Próstata Resistentes à Castração/mortalidade , Neoplasias de Próstata Resistentes à Castração/patologia , Estudos Retrospectivos , Taxoides/efeitos adversos , Fatores de Tempo , Resultado do Tratamento
20.
Int Braz J Urol ; 45(3): 478-485, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31038862

RESUMO

PURPOSE: To evaluate the trend of use of Prostate Specifi c Antigen (PSA) for screening of prostate cancer (PC) among Brazilian doctors, from the beginning of its regular availability in clinical laboratories. MATERIAL AND METHODS: A serial cross-sectional study was performed using data obtained from a large database between 1997 and 2016. The general PSA screening trend during this period, adjusted for the total number of exams performed in men, was analyzed. Time-series analysis was performed through observation of the general regression curve using the generalized least squares method, and the impact of the recommendations was assessed with autoregressive integrated moving average (ARIMA) models. RESULTS: During the period studied 2,521,383 PSA determinations were done. The age of the participants ranged from 21 to 111 years, with an average of 56.7 ± 22.7 years. The relative number of PSA tests/100.000 exams in males showed a constant reduction since 2001, and this trend was more evident in the group aged 55-69 years. Although statistically signifi cant, the impact of reduced PSA screening after the 2012 USPSTF publication was clinically irrelevant. CONCLUSIONS: Our results indicated a continuous reduction in the use of PSA screening over time, regardless of the publication of recommendations or clinical guidelines. The fact that this trend was more pronounced among those with a greater benefi t potential (55-69 years), relative to groups with a greater damage potential due to overdiagnosis and overtreatment (aged >74 years and < 40 years), is a matter of concern. Follow-up studies of these trends are advisable.


Assuntos
Detecção Precoce de Câncer/estatística & dados numéricos , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/diagnóstico , Adulto , Distribuição por Idade , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Brasil , Estudos Transversais , Detecção Precoce de Câncer/métodos , Humanos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Neoplasias da Próstata/sangue , Fatores de Tempo , Adulto Jovem
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