Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.995
Filtrar
1.
Int Braz J Urol ; 45(6): 1113-1121, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31808398

RESUMO

PURPOSE: To establish whether the citrate concentration in the seminal fluid ([CITRATE]) measured by means of high-resolution nuclear magnetic resonance spectroscopy (1HNMRS) is superior to the serum prostate-specific antigen (PSA) concentration in detecting of clinically significant prostate cancer (csPCa) in men with persistently elevated PSA. MATERIALS AND METHODS: The group of patients consisted of 31 consecutively seen men with histological diagnosis of clinically localized csPCa. The control group consisted of 28 men under long-term follow-up (mean of 8.7 ± 3.0 years) for benign prostate hyperplasia (BPH), with persistently elevated PSA (above 4 ng/mL) and several prostate biopsies negative for cancer (mean of 2.7 ± 1.3 biopsies per control). Samples of blood and seminal fluid (by masturbation) for measurement of PSA and citrate concentration, respectively, were collected from patients and controls. Citrate concentration in the seminal fluid ([CITRATE]) was determined by means of 1HNMRS. The capacities of PSA and [CITRATE] to predict csPCa were compared by means of univariate analysis and receiver operating characteristic (ROC) curves. RESULTS: Median [CITRATE] was significantly lower among patients with csPCa compared to controls (3.93 mM/l vs. 15.53 mM/l). There was no significant difference in mean PSA between patients and controls (9.42 ng/mL vs. 8.57 ng/mL). The accuracy of [CITRATE] for detecting csPCa was significantly superior compared to PSA (74.8% vs. 54.8%). CONCLUSION: Measurement of [CITRATE] by means of 1HNMRS is superior to PSA for early detection of csPCa in men with elevated PSA.


Assuntos
Ácido Cítrico/análise , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/diagnóstico , Sêmen/química , Idoso , Biomarcadores Tumorais/análise , Biópsia , Humanos , Masculino , Pessoa de Meia-Idade , Hiperplasia Prostática/sangue , Hiperplasia Prostática/diagnóstico , Neoplasias da Próstata/sangue , Neoplasias da Próstata/patologia , Reprodutibilidade dos Testes , Medição de Risco , Sensibilidade e Especificidade , Estatísticas não Paramétricas
2.
Medicine (Baltimore) ; 98(50): e18384, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852153

RESUMO

RATIONAL: Intravascular large B-cell lymphoma (IVLBCL) is a rare condition with a poor prognosis. The clinical presentation of primary lymphoma of the prostate is non-specific and it is difficult to distinguish from other prostatic diseases. The primary prostate IVLBCL is very rare, the diagnosis and treatment of which remains unclear. We reported a rare case to explore the diagnosis and treatment for the primary prostate IVLBCL. PATIENTS CONCERNS: This report described a case of a 71-year-old male diagnosed as primary prostate IVLBCL who presented with prostatic hyperplasia. DIAGNOSIS: The patient first visited an outpatient clinic of urinary surgery because of urinary urgency and frequency and was diagnosed as benign prostatic hyperplasia in about January 2010. Four years later, the symptoms worsened quickly within two months. The diagnosis was still prostatic hyperplasia according to the physical examination and imaging. However, histopathology showed IVLBCL of prostate after transurethral resection of the prostate. INTERVENTIONS: With the clear diagnosis of primary prostate stage I IVLBCL, the patient received immunochemotherapy of R-CHOP (rituximab, cyclophosphamide, adriamycin, vincristine, and prednisolone) for 4 cycles and intensity-modulated radiation therapy (IMRT) including the region of prostate with the dose of 45Gy/25f. OUTCOMES: The response was complete remission after all treatment. The last follow-up time of the patient was June 20th, 2019, and no evidence of disease progression was observed. The progression-free survival of the patient was about 49 months until now. LESSONS: The biopsy of prostate by prostatectomy plays an important role in the diagnosis and removal of the original lesion of primary prostate lymphoma. There is no consensus on therapeutic modalities for the treatment of primary prostate IVLBCL till now. Individual treatments include immunochemotherapy and/or radiotherapy according to the National Comprehensive Cancer Network (NCCN) practice guideline of diffuse large B cell lymphoma (DLBCL) based on the performance status and tumor staging of the patient. Timely and accurate diagnosis as well as the appropriate treatment may improve the clinical outcome.


Assuntos
Linfoma Difuso de Grandes Células B/patologia , Neoplasias da Próstata/patologia , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica , Ciclofosfamida , Erros de Diagnóstico , Doxorrubicina , Humanos , Linfoma Difuso de Grandes Células B/diagnóstico , Linfoma Difuso de Grandes Células B/terapia , Imagem por Ressonância Magnética , Masculino , Prednisona , Hiperplasia Prostática/diagnóstico , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/terapia , Rituximab , Vincristina
3.
Medicine (Baltimore) ; 98(42): e17635, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31626149

RESUMO

This study aimed to investigate the metabolic syndrome-related risk factors for the development of benign prostatic hyperplasia (BPH) with lower urinary tract symptoms (LUTS) in healthy men.A total of 4880 healthy men who underwent transrectal ultrasonography at our hospital during routine health examinations were included in this study. Those who had undergone a prior biopsy or surgery for prostate disease, were suspected of having urinary tract infection, or were taking BPH/LUTS or metabolic syndrome medications were excluded. BPH/LUTS was defined as an International Prostate Symptom Score (IPSS) of ≥8 and a prostate volume (PV) of ≥30 cm.The subjects had a mean age of 54.1 years, PV of 29.2 cm, prostate-specific antigen (PSA) level of 1.20 ng/mL, and IPSS of 9.2. The annual PV growth rate was 0.48 cm/year. Age, body mass index (BMI), PSA, basal metabolic rate, apolipoprotein A-1, fasting blood glucose, high-density lipoprotein (HDL) cholesterol levels were significant predictive factors for PV. Age, PSA, apolipoprotein B, fasting blood glucose, cholesterol, HDL, and low-density lipoprotein (LDL) levels were predictors of BPH/LUTS at the initial health examination. A decreased fat mass and LDL level were a significant risk factor for the development of BPH/LUTS within 5 years in men without a BPH/LUTS diagnosis at the initial examination.Metabolic syndrome-related variables were strongly associated with BPH/LUTS and by decreasing fat mass and LDL levels, development of BPH/LUTS could be prevented within 5 years in healthy Korean men.


Assuntos
LDL-Colesterol/sangue , Sintomas do Trato Urinário Inferior/etiologia , Síndrome Metabólica/complicações , Hiperplasia Prostática/etiologia , Medição de Risco/métodos , Idoso , Biomarcadores/sangue , Biópsia , Glicemia/metabolismo , Índice de Massa Corporal , Progressão da Doença , Endossonografia , Seguimentos , Humanos , Incidência , Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/epidemiologia , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Prognóstico , Próstata/diagnóstico por imagem , Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/epidemiologia , Reto , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco
4.
Clin Lab ; 65(8)2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31414754

RESUMO

BACKGROUND: Prostate cancer is a common male cancer with poor prognosis, and to find molecular diagnostic markers for the early diagnosis of prostate cancer is urgently needed. The aim of this study is to investigate the diagnostic value of serum expression level of miR-494 for prostate cancer. METHODS: Ninety patients with prostate cancer and 90 patients with benign prostatic hyperplasia were enrolled in this study, and 90 healthy volunteers served as the control group. The serum of the participants was collected, and the expression level of miR-494 was measured by RT-PCR. Then the relationship between the expression of miR-494 and the clinical characteristics of the patients was analyzed. Moreover, the correlation between the expression of miR-494 and the Gleason score as well as serum level of prostate specific antigen (PSA) were analyzed. Finally, the diagnostic value of miR-494 for the early diagnosis of prostate cancer was analyzed by ROC curve. RESULTS: miR-494 was significantly increased in the prostatic hyperplasia group compared with the control group, and the level of miR-494 in the prostate cancer group was significantly higher than that in the prostatic hyperplasia group. The level of miR-494 in patients with prostate cancer was positively correlated with tumor size and tumor stage. Moreover, the level of miR-494 was positively correlated with the Gleason score (r = 0.3371, p = 0.0012) and serum level of PSA (r = 0.3485, p = 0.0008) in patients with prostate cancer. Finally, AUC of miR-494 was 0.8090 (95% confidence interval 0.7343 to 0.8837), suggesting that miR-494 is a sensitive biomarker for the diagnosis of prostate cancer. CONCLUSIONS: miR-494 was upregulated in the serum of the patients with prostate cancer and circulating miR-494 can be used as a biomarker for the early diagnosis of prostate cancer.


Assuntos
Biomarcadores Tumorais/genética , Regulação Neoplásica da Expressão Gênica , MicroRNAs/genética , Hiperplasia Prostática/genética , Neoplasias da Próstata/genética , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/sangue , Humanos , Masculino , MicroRNAs/sangue , Pessoa de Meia-Idade , Antígeno Prostático Específico/sangue , Hiperplasia Prostática/sangue , Hiperplasia Prostática/diagnóstico , Neoplasias da Próstata/sangue , Neoplasias da Próstata/diagnóstico , Curva ROC
5.
Urologe A ; 58(9): 1029-1038, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31451881

RESUMO

The demographic developments of western society and the resulting increase in the number of very old patients in urology represents a challenge for the design of clinical studies and, consequently, recommendations of guidelines. While in internal medicine there is already a subspecialization with a focus on the treatment of elderly and multimorbid patients, in urology there is hardly any subspecialization into the problems of geriatric patients. Thus, using a case study as an example, the treatment decisions for benign prostatic hyperplasia (BPH) in geriatric patients are discussed. In addition the available evidence from the literature and guidelines are presented in order to assiste in daily management of geriatric patients with lower urinary tract symptoms and to critically discuss potential fields of application and limitations of the existing guidelines. In this context, we also examine the challenges when choosing a drug therapy and in deciding which of the many surgical options should be used.


Assuntos
Sintomas do Trato Urinário Inferior/diagnóstico , Sintomas do Trato Urinário Inferior/terapia , Guias de Prática Clínica como Assunto , Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/terapia , Urologia/normas , Idoso , Humanos , Sintomas do Trato Urinário Inferior/etiologia , Masculino , Hiperplasia Prostática/etiologia
6.
Clin Lab ; 65(7)2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31307177

RESUMO

BACKGROUND: Prostate cancer (PC) is considered the fifth most common cancer causing death worldwide. Many studies have pointed to dysregulated microRNA (miRNA) expression in PC and their use in early detection and follow-up of the disease. In addition, the Prostate Health Index (PHI) is the FDA-approved blood test joining total, free, and -2proPSA having greater specificity than free and total PSA for assessment of PC. METHODS: In this study, we evaluated the plasma levels of miR-21and miR-221 expression using quantitative real-time polymerase chain reaction (qRT-PCR) among 100 prostate cancer patients (50 localized and 50 metastatic cases) and 50 benign prostatic hyperplasia patients in comparison to 50 normal control subjects, as well as assess-ed its diagnostic and prognostic value and its correlation with the Prostate Health Index (PHI). RESULTS: To our knowledge, we are the first study to join PHI with miRNAs in assessing PC diagnosis and progno-sis. Our results showed that adding miR-21 to PHI for detecting patients with LPC, increased the sensitivity to 95.5% at a specificity 100% (p < 0.0001). Additionally, combining miR-221 and PHI for differentiating patients with MPC, increased the sensitivity to 96.4% at a specificity 100% (p < 0.0001). CONCLUSIONS: The potentials of circulating miR-21, miR-221, and PHI serum level as biomarkers for PC have been established not only as diagnostic factors but also as prognostic markers.


Assuntos
Biomarcadores Tumorais/sangue , MicroRNAs/sangue , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/diagnóstico , Adulto , Idoso , Biomarcadores Tumorais/genética , Diagnóstico Diferencial , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , MicroRNAs/genética , Pessoa de Meia-Idade , Prognóstico , Hiperplasia Prostática/sangue , Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/genética , Neoplasias da Próstata/sangue , Neoplasias da Próstata/genética , Curva ROC
7.
Clin Lab ; 65(7)2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31307183

RESUMO

BACKGROUND: Prostate cancer is considered the most prevalent cancer among men. Recent studies suggest that sex-ually transmissible infections (STIs) may be related to prostate carcinogenesis. Therefore, the aim of this study was to investigate whether STI pathogens (Atopobium vaginae (ATO), Neisseria gonorrhoeae (NG), Chlamydia tra-chomatis (CT), Treponema pallidum (TP), Ureaplasma urealyticum (UU), Gardnerella vaginalis (GV), Herpes Sim-plex Virus (HSV), Cytomegalovirus (CMV), Human herpesvirus (HHV), Human papillomavirus (HPV), and Tricho-monas vaginalis (TV)) presence in prostate tissues are associated with the risk of prostate cancer. METHODS: Paraffin-embedded prostate tissues obtained from patients with hyperplasia and prostate cancer were extracted. Determination of infectious microorganisms of interest was done by quantitative TaqMan real-time PCR assay. RESULTS: STI DNA was detected in 53/243 (21.8%) of the prostate tissues samples (ATO 3.7%, UU 2.88%, GV 2.46%, HSV-2 2.05%, CT 2.05%, CMV 1.64%, NG 1.64%, TP 1.64%, HHV-8 1.23%, HPV 1.23%, and TV 1.23%.) The statistical analysis revealed significant correlation between prevalence of Gardnerella vaginalis (GV) and Herpes Simplex Virus (HSV-2) between hyperplasia and cancerous groups (p = 0.02), respectively. CONCLUSIONS: No statistically significant difference was observed in the prevalence of most candidate infectious or-ganisms between hyperplasia and cancerous groups except for GV and HSV-2. It appears that inflammation in the prostate gland is more associated with prostate hyperplasia than prostate cancer. According to the role of in-fectious microorganisms in induction of chronic inflammation, we cannot exclude the importance of these patho-gens in progression of cancer. More studies are required to explore the associations of cancer with different infec-tious organisms.


Assuntos
Hiperplasia Prostática/diagnóstico , Neoplasias da Próstata/diagnóstico , Reação em Cadeia da Polimerase em Tempo Real/métodos , Doenças Sexualmente Transmissíveis/complicações , Idoso , Chlamydia trachomatis/genética , Chlamydia trachomatis/patogenicidade , Interações Hospedeiro-Patógeno , Humanos , Masculino , Pessoa de Meia-Idade , Neisseria gonorrhoeae/genética , Neisseria gonorrhoeae/patogenicidade , Papillomaviridae/genética , Papillomaviridae/patogenicidade , Próstata/microbiologia , Próstata/parasitologia , Próstata/virologia , Hiperplasia Prostática/complicações , Neoplasias da Próstata/complicações , Trichomonas vaginalis/genética , Trichomonas vaginalis/patogenicidade , Virulência/genética
8.
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
10.
Presse Med ; 48(4): 447-453, 2019 Apr.
Artigo em Francês | MEDLINE | ID: mdl-31047745

RESUMO

Benign Prostatic Hyperplasia (BPH) concerns 50% of men older that 60 Years old and can induce symptoms also earlier. Medical treatment are mostly alpha blockers (AB), 5-alpha réductase inhibitors (5ARI) and phospho-diestérase inhibitors. In case of failure or poor tolerance of drug treatment, surgery can be indicated, after evaluation of the Bladder Outlet Obstruction (BOO), based on urodynamic studies. Endoscopic or open surgery is selected according to the size of the prostate, the expertise of the urologist and patient preference. Surgical treatment is very efficient but carries frequent complications, especially retrograde ejaculation which is very frequent and can compromise fertility and sexual pleasure. Prostatic Artery Embolisation, an outpatient intervention performed by Interventional Radiologists and available in France since 2012 is a new alternative to surgery in case of failure or poor tolerance of medical treatment. It consists in super-selective injection of calibrated micro-particles into both prostatic arteries after femoral artery puncture at the groin. It is safe and efficient and provides appropriate symptomatic improvement BOO related to BPH.


Assuntos
Embolização Terapêutica , Hiperplasia Prostática/terapia , Artérias , Humanos , Masculino , Próstata/irrigação sanguínea , Hiperplasia Prostática/diagnóstico
11.
Int Braz J Urol ; 45(4): 775-781, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31136110

RESUMO

PURPOSE: To identify how the most frequently used parameters in daily clinical practice diagnosing bladder outlet obstruction (BOO) due to benign prostate hyperplasia (BPH) correlate to each other. MATERIALS AND METHODS: The study included 452 patients with lower urinary tract symptoms (LUTS) of the UNICAMP urology outpatient clinic of LUTS. INCLUSION CRITERIA: patients with BOO due to BPH who agreed to participate in the study. EXCLUSION CRITERIA: patients with urinary tract infection, neurological diseases that compromised the lower urinary tract, prior prostatic surgery, radiotherapy or urethral stenosis. Patient assessment: history, international prostate symptoms score (IPSS), nocturnal quality of life score (NQoL) questionnaires, physical and digital rectal examination (DRE), PSA, transabdominal ultrasound with intravesical prostate protrusion (IPP), post-mictional residue and free urofl owmetry. RESULTS: There was no strong Spearman correlation among the studied variables. The only moderate correlations occurred between IPSS and NQoL (p<0001; c=0.56) and between IPP and prostate volume (p<0001; c=0.57). Weak correlations between IPP and post-mictional residue (p<0001; c=0.31) and free urofl owmetry (p<0001; c=-0.26); and between IPSS and free urofl owmetry (p<0001, c=-0.21) were observed. CONCLUSION: In this study, we found moderate, weak, very weak and absent correlation among the various parameters used in the diagnosis and management of BOO due to BPH. As the value of these tools is variable, the creation of a logical and objective algorithm was not possible and the treatment is based on the interpretation of clinical symptoms.


Assuntos
Sintomas do Trato Urinário Inferior/diagnóstico , Hiperplasia Prostática/diagnóstico , Obstrução do Colo da Bexiga Urinária/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Exame Retal Digital , Humanos , Sintomas do Trato Urinário Inferior/patologia , Sintomas do Trato Urinário Inferior/fisiopatologia , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Próstata/patologia , Hiperplasia Prostática/patologia , Hiperplasia Prostática/fisiopatologia , Qualidade de Vida , Padrões de Referência , Análise de Regressão , Estatísticas não Paramétricas , Inquéritos e Questionários , Ultrassonografia/métodos , Obstrução do Colo da Bexiga Urinária/patologia , Obstrução do Colo da Bexiga Urinária/fisiopatologia , Micção/fisiologia , Urodinâmica/fisiologia
12.
Vasc Health Risk Manag ; 15: 81-87, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31114214

RESUMO

A 74-year-old patient presented with isolated fecal incontinence 6 weeks following endovascular aneurysm repair. The delayed presentation of spinal cord ischemia was precipitated by commencement of alpha-blockers for benign prostatic hyperplasia. This case stresses that vulnerability to spinal cord perfusion is not limited to the perioperative period. In addition, systemic arterial pressure should be closely monitored in cases of marginal vascular insufficiency of the spinal cord.


Assuntos
Antagonistas de Receptores Adrenérgicos alfa 1/efeitos adversos , Aneurisma da Aorta Abdominal/cirurgia , Pressão Arterial/efeitos dos fármacos , Implante de Prótese Vascular/efeitos adversos , Procedimentos Endovasculares/efeitos adversos , Hiperplasia Prostática/diagnóstico por imagem , Quinazolinas/efeitos adversos , Isquemia do Cordão Espinal/etiologia , Isquemia do Cordão Espinal/terapia , Idoso , Angiografia Digital , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aortografia/métodos , Angiografia por Tomografia Computadorizada , Incontinência Fecal/etiologia , Incontinência Fecal/terapia , Humanos , Imagem por Ressonância Magnética , Masculino , Hiperplasia Prostática/diagnóstico , Isquemia do Cordão Espinal/diagnóstico por imagem , Isquemia do Cordão Espinal/fisiopatologia , Fatores de Tempo , Resultado do Tratamento
13.
Clin Lab ; 65(5)2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-31115239

RESUMO

BACKGROUND: Accumulating evidence has revealed that inflammation might play an important role in the genesis and development of cancer. High levels of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ration (PLR) are parameters of systemic inflammation which have been identified to be associated with poor prognosis in PCa. Bone is one of the most common sites of metastasis from prostate cancer; however, there are few studies concerning the correlation of NLR, PLR, and bone metastases in PCa. The aim of this study was to evaluate the performance of neutrophil to lymphocyte ratio (NLR) or platelet to lymphocyte (PLR) in diagnosis of bone metastasis of prostate cancer (PCa). METHODS: Data of 74 PCa patients without metastases, 51 PCa patients with bone metastases, and 43 patients with benign prostatic hypertrophy (BPH) were retrospectively reviewed. The difference of patients' clinical and laboratory characteristics of the three groups was comparatively studied. ROC analysis was used to evaluate the benefit of adding NLR or PLR to prostate specific antigen (PSA) in prediction of bone metastases. Depending on this cutoff value, patients were divided into high-NLR or low-NLR group, high-PLR or low-PLR group. RESULTS: There were significant differences in NLR and PLR between groups with bone metastases and without bone metastases (p = 0.044; p = 0.030), while there was no significant difference between NLR and PLR of the patients with localized prostate cancer and BPH (p = 0.462; p = 0.102). NLR and PLR were correlated with PSA level in the patients with prostate cancer (p = 0.006, r = 0.247; p = 0.025, r = 0.200). The distribution of PSA showed significant differences between the high-NLR and low-NLR group, as well as between the high-PLR and low-PLR group. By applying the ROC curve method, the AUC values of PSA with NLR or PLR were 0.725 and 0.838 (0.763 - 0.913), respectively. Although PSA + PLR had the largest area, there was no statistical significance between PSA + PLR and PSA (p = 0.6992). CONCLUSIONS: NLR and PLR significantly increase in PCa patients with bone metastases and are valuable in the diagnosis of bone metastases in PCa patients.


Assuntos
Neoplasias Ósseas/sangue , Contagem de Leucócitos , Contagem de Plaquetas , Neoplasias da Próstata/sangue , Idoso , Plaquetas , Neoplasias Ósseas/patologia , Humanos , Linfócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos , Prognóstico , Antígeno Prostático Específico/sangue , Hiperplasia Prostática/sangue , Hiperplasia Prostática/diagnóstico , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/secundário , Estudos Retrospectivos , Sensibilidade e Especificidade
14.
Indian J Pathol Microbiol ; 62(2): 251-260, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30971549

RESUMO

Context: Prostate adenocarcinoma (PC) is one of the common cancers in India and world over. Numerous prostatic, nonprostatic lesions, and normal structures can be very similar to adenocarcinoma. A pathologist's awareness of the benign mimics is important for the diagnosis of PC. Aim: The aim of this study was to determine the prevalence, clinical, and histopathological features of PC, and its common mimics, and to study the criteria for their distinction from PC. Materials and Methods: A prospective study of histopathological features of radical prostatectomy and transurethral resection of the prostate specimens, sent to the department of pathology in a medical college, for a period of 2 years was done. A brief clinical history followed by a clinical examination, including per-rectal findings and serum prostate-specific antigen (PSA) levels, was noted. Results: After excluding all the cases of benign hyperplasia of prostate without any associated findings, 50 cases of operated surgical specimens of prostate were studied. PC was the most frequent diagnosis in 28 patients of 50 cases (56.0%). Basal cell hyperplasia formed the predominant mimic (26.0%), followed by prostatic intraepithelial neoplasia (8%), prostate atrophy (4%), clear-cell cribriform hyperplasia(4%),, and one case of atypical adenomatous hyperplasia (2%). Serum PSA was >4 ng/mL in all the cases of PC. In three of the mimics, PSA was >4 ng/mL and in the rest it was <4 ng/mL. Immunohistochemistry (IHC) was not applied in our study. Conclusion: Biopsy still remains a gold standard for diagnosis of PC and its mimics. All the lesions in the above study were diagnosed on routine hematoxylin and eosin staining. IHC is useful especially for lesions in the grey zone but not in routine histopathological study and should not be used as a screening test but should be applied in specific selected cases only.


Assuntos
Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/patologia , Adenocarcinoma/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais , Biópsia , Diagnóstico Diferencial , Humanos , Imuno-Histoquímica , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Próstata/patologia , Antígeno Prostático Específico/sangue , Prostatectomia , Hiperplasia Prostática/diagnóstico , Neoplasia Prostática Intraepitelial/diagnóstico , Neoplasia Prostática Intraepitelial/patologia , Neoplasias da Próstata/epidemiologia , Coloração e Rotulagem
15.
Prog Urol ; 29(5): 263-269, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30948187

RESUMO

INTRODUCTION: Prostatic arterial embolization (PAE) is an experimental therapy for benign prostatic hyperplasia. Its feasibility is based on the knowledge of the pelvic arterial anatomy, and more specifically the prostate. The aim of this study was to describe the prostatic arterial supply: origins, distribution and variability. MATERIAL AND METHODS: We reviewed retrospectively, with two radiologists, 40 arteriographies of patients who underwent PAE in our center. With these observations of 80 hemipelvics, we described the number of prostatic arteries, their origins, their distributions and eventually their anastomoses with other pelvic arteries. RESULTS: There was one prostatic artery in 70% of the cases. It came from a common trunk for the prostate and the bladder in 55% of the cases, from the obturator artery in 17.5% of the cases, from the pudendal artery in 25% of the cases, from the intern iliac artery in 1% of the cases, and from the superior gluteal artery in 1% of the cases. The prostatic artery splitted in two branches (medial and lateral), with no anastomoses in 37% of the cases. Anastomoses with penile and rectal arteries were observed in 29% of the cases. CONCLUSIONS: For our 40 patients, we observed many variations of arterial prostatic anatomy. We proposed a classification in order to increase security and efficacy of PAE, and it should be validated with more patients. LEVEL OF EVIDENCE: 2.


Assuntos
Artérias/anatomia & histologia , Artérias/patologia , Embolização Terapêutica/métodos , Próstata/anatomia & histologia , Próstata/irrigação sanguínea , Hiperplasia Prostática/terapia , Idoso , Idoso de 80 Anos ou mais , Angiografia/métodos , Artérias/diagnóstico por imagem , Artérias/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Próstata/diagnóstico por imagem , Próstata/patologia , Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/patologia , Estudos Retrospectivos
16.
Prim Care ; 46(2): 223-232, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31030823

RESUMO

Benign prostatic hyperplasia (BPH) is a common condition in aging men that is frequently associated with troublesome lower urinary tract symptoms (LUTS). The American Urologic Association Symptom Index is a validated, self-administered tool that is used to diagnose LUTS, guide initial treatment, and assess treatment response. Watchful waiting is an option for men with mild symptoms. Pharmacologic treatment includes alpha-adrenergic blockers and 5-alpha reductase inhibitors. There is no evidence to support the use of herbal supplements in the treatment of LUTS. Surgical therapy is effective and indicated for men with complications from BPH or who fail medical therapy.


Assuntos
Inibidores de 5-alfa Redutase/uso terapêutico , Antagonistas Adrenérgicos alfa/uso terapêutico , Hiperplasia Prostática/diagnóstico , Humanos , Sintomas do Trato Urinário Inferior/etiologia , Masculino , Hiperplasia Prostática/complicações , Hiperplasia Prostática/tratamento farmacológico , Hiperplasia Prostática/terapia
17.
Prog Urol ; 29(5): 288-292, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30962142

RESUMO

AIM: To assess the feasibility of voiding urethrocystoscopy (VUC) in males and describe the characteristics of dynamic movements of the prostatic lobes during micturition. MATERIAL AND METHODS: Patients scheduled for benign prostatic obstruction relief in a tertiary reference center were included in this prospective evaluation. During urethrocystoscopy with a small diameter flexible endoscope, the bladder was filled until desire to void. The patient was asked to void with endoscope in place facing the veru montanum. Movements of the prostatic lobes during micturition were characterized, video-recorded, and categorized based on the dynamics of the lateral lobes, the posterior lobe and the bladder neck. RESULTS: In all, 192 evaluations were conducted. In 161 cases (84%), the patient was able to void. Among these patients, 126 cases were stated as "closed" (coalescent), without opening of the initial part of the urethra and the bladder neck. In 38 cases, there was no opening of the lateral lobes (type 1A), and in 47 cases a partial opening of the distal parts of the lateral lobes was seen (type 1B). In 31 cases, a fixed posterior bladder neck was seen (type 2A) and in 10 cases a mobile median lobe, with a rolling ball effect, was seen (type 2B). In 25 cases, the lumen was completely open and equivocal in 10 cases. CONCLUSIONS: This study demonstrates the feasibility of VUC and describes for the first time the dynamics of prostatic lobes during micturition. This evaluation may lead to a new approach for understanding the mechanical aspects of benign prostatic obstruction. LEVEL OF EVIDENCE: 3.


Assuntos
Cistoscopia/métodos , Hiperplasia Prostática/diagnóstico , Obstrução Uretral/diagnóstico , Obstrução do Colo da Bexiga Urinária/diagnóstico , Micção/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Estudos de Viabilidade , Humanos , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão/fisiologia , Próstata/diagnóstico por imagem , Próstata/patologia , Hiperplasia Prostática/complicações , Obstrução Uretral/etiologia , Obstrução do Colo da Bexiga Urinária/etiologia , Urodinâmica/fisiologia
18.
PLoS One ; 14(4): e0215003, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30970027

RESUMO

Urine of prostate cancer (PCa) carries miRNAs originated from prostate cancer cells as a part of both nucleoprotein complexes and cell-secreted extracellular vesicles. The analysis of such miRNA-markers in urine can be a convenient option for PCa screening. The aims of this study were to reveal miRNA-markers of PCa in urine and design a robust and precise diagnostic test, based on miRNA expression analysis. The expression analysis of the 84 miRNAs in paired urine extracellular vesicles (EVs) and cell free urine supernatant samples from healthy donors, patients with benign and malignant prostate tumours was done using miRCURY LNA miRNA qPCR Panels (Exiqon, Denmark). Sets of miRNAs differentially expressed between the donor groups were found in urine EVs and urine supernatant. Diagnostically significant miRNAs were selected and algorithm of data analysis, based on expression data on 24-miRNA in urine and obtained using 17 analytical systems, was designed. The developed algorithm of data analysis describes a series of steps necessary to define cut-off values and sequentially analyze miRNA expression data according to the cut-offs to facilitate classification of subjects in case/control groups and allows to detect PCa patients with 97.5% accuracy.


Assuntos
MicroRNAs/genética , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/genética , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/urina , Estudos de Casos e Controles , Interpretação Estatística de Dados , Vesículas Extracelulares/genética , Redes Reguladoras de Genes , Humanos , Masculino , MicroRNAs/urina , Pessoa de Meia-Idade , Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/genética , Hiperplasia Prostática/urina , Neoplasias da Próstata/urina
19.
Urology ; 127: 86-90, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30817961

RESUMO

OBJECTIVE: To study the feasibility of transvesical prostate resection and its effect on urethral stricture. MATERIALS AND METHODS: We included 99 patients with symptomatic bladder outlet obstruction who underwent transvesical resection of prostate (TVRP; n = 48) and transurethral (TURP; n = 51) prostatectomy. We examined all the patients by means of digital rectal examination, transrectal ultrasound, and evaluated them by international prostate symptom score, quality of life score, uroflowmetric assessment and PSA level, and established definitive diagnosis. We followed up the patients in first month, third month, and the first year of the operation and monitored once a year in the following years. RESULTS: In this study, totally 99 symptomatic bladder outlet obstruction patients were included (TVRP = 48 and TURP = 51). Mean age of the patients were 66.5 ± 8.2vs 68 ± 9.8years for our patients with TVRP and TURP, respectively. Two groups displayed similar values in terms of improvements in the Qmax and PVR, and there were no statistically significant differences in between. We obtained similar values for resection time and weight of resected prostate tissue in both groups. Urethral stricture was not observed in TVRP group. In TURP group however, stricture was observed in 4 (7.8%) patients in bulbar urethra in sixth month at average. And there was also a concomitant urethral meatal stricture in one of these patients. When the 2 groups were compared, the rate of urethral stricture was statistically significantly higher in the TURP group (P = .001). CONCLUSION: Resection of prostate without using urethra significantly reduces the incidence of urethral stricture due to mucosal damage.


Assuntos
Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/cirurgia , Ressecção Transuretral da Próstata/métodos , Obstrução do Colo da Bexiga Urinária/diagnóstico , Obstrução do Colo da Bexiga Urinária/cirurgia , Idoso , Estudos de Casos e Controles , Estudos de Coortes , Estudos de Viabilidade , Seguimentos , Hematúria/diagnóstico , Hematúria/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/fisiopatologia , Prostatectomia/efeitos adversos , Prostatectomia/métodos , Medição de Risco , Índice de Gravidade de Doença , Ressecção Transuretral da Próstata/efeitos adversos , Resultado do Tratamento , Ultrassom Focalizado Transretal de Alta Intensidade/métodos , Estreitamento Uretral/diagnóstico por imagem , Estreitamento Uretral/cirurgia , Retenção Urinária/diagnóstico , Retenção Urinária/epidemiologia , Infecções Urinárias/diagnóstico , Infecções Urinárias/epidemiologia
20.
Tumour Biol ; 41(3): 1010428319827223, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30907281

RESUMO

Prostate cancer represents a major cause of cancer death in men worldwide. Novel non-invasive methods are still required for differentiation of non-aggressive from aggressive tumors. Recently, changes in prostate-specific antigen glycosylation pattern, such as core-fucosylation, have been described in prostate cancer. The objective of this study was to evaluate whether the core-fucosylation determinant of serum prostate-specific antigen may serve as refined marker for differentiation between benign prostate hyperplasia and prostate cancer or identification of aggressive prostate cancer. A previously developed liquid chromatography-mass spectrometry/mass spectrometry-based strategy was used for multiplex analysis of core-fucosylated prostate-specific antigen (fuc-PSA) and total prostate-specific antigen levels in sera from 50 benign prostate hyperplasia and 100 prostate cancer patients of different aggressiveness (Gleason scores, 5-10) covering the critical gray area (2-10 ng/mL). For identification of aggressive prostate cancer, the ratio of fuc-PSA to total prostate-specific antigen (%-fuc-PSA) yielded a 5%-8% increase in the area under the curve (0.60) compared to the currently used total prostate-specific antigen (area under the curve = 0.52) and %-free prostate-specific antigen (area under the curve = 0.55) tests. However, our data showed that aggressive prostate cancer (Gleason score > 6) and non-aggressive prostate cancer (Gleason score ≤ 6) could not significantly (p-value = 0.08) be differentiated by usage of %-fuc-PSA. In addition, both non-standardized fuc-PSA and standardized %-fuc-PSA had no diagnostic value for differentiation of benign prostate hyperplasia from prostate cancer. The %-fuc-PSA serum levels could not improve the differentiation of non-aggressive and aggressive prostate cancer compared to conventional diagnostic prostate cancer markers. Still, it is unclear whether these limitations come from the biomarker, the used patient cohort, or the imprecision of the applied method itself. Therefore, %-fuc-PSA should be further investigated, especially by more precise methods whether it could be clinically used in prostate cancer diagnosis.


Assuntos
Biomarcadores Tumorais/química , Antígeno Prostático Específico/química , Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/patologia , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/patologia , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/sangue , Cromatografia Líquida , Diagnóstico Diferencial , Glicosilação , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Próstata/patologia , Antígeno Prostático Específico/sangue , Espectrometria de Massas em Tandem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA