RESUMEN
BACKGROUND: The PCA3 urinary assay has shown promise in predicting the presence of prostate cancer. We evaluated the value of this test in patients undergoing initial and repeat prostate biopsy. METHODS: PCA3 and PSA levels were obtained from 456 men with no known personal history of prostate cancer prior to prostate biopsy. Two hundred eighty-nine men underwent an initial prostate biopsy and 167 underwent a repeat prostate biopsy. PCA3 and PSA levels were compared to the prostate biopsy results. RESULTS: PCA3 score was shown to be independent of prostate volume (P = 0.162) and PSA level (P = 0.959). PCA3 scores were significantly higher in patients with cancer on prostate biopsy compared to patients with negative biopsy results (P < 0.0001). In logistic regression, PCA3 showed a significantly higher AUC than PSA (0.726 vs. 0.512, P = 0.0001). This difference persisted when examining the initial biopsy subgroup, with PCA3 out-performing PSA (AUC 0.772 vs. AUC = 0.552, P < 0.0001), but not in the repeat biopsy subgroup (AUC = 0.605 vs. AUC = 0.500, P = 0.2488). CONCLUSIONS: PCA3 was found to be a better predictor of prostate cancer than PSA in the total population as well as the initial biopsy population, but was not superior to PSA in the repeat biopsy population. Prostate 73: 48-53, 2013. © 2012 Wiley Periodicals, Inc.
Asunto(s)
Antígenos de Neoplasias/sangre , Antígeno Prostático Específico/sangre , Próstata/patología , Neoplasia Intraepitelial Prostática/diagnóstico , Neoplasias de la Próstata/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Área Bajo la Curva , Biomarcadores de Tumor/metabolismo , Biopsia , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Valor Predictivo de las Pruebas , Próstata/metabolismo , Neoplasia Intraepitelial Prostática/sangre , Neoplasias de la Próstata/sangre , Reproducibilidad de los Resultados , Estudios Retrospectivos , Índice de Severidad de la EnfermedadRESUMEN
Situs inversus totalis (SIT) is a rare condition with left-right mirror imaging of both abdominal and thoracic organs. While this configuration is rarely of medical importance, an understanding of this unique anatomy is essential in the setting of surgical intervention. Here we review a case of renal cell carcinoma (RCC) in the setting of SIT. The patient underwent a hand-assisted laparoscopic radical nephrectomy. Pathology revealed pT3aNxMx Fuhrman Grade 2 clear cell RCC.