Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 508
Filter
1.
Int. braz. j. urol ; 47(3): 558-565, May-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1154500

ABSTRACT

ABSTRACT Purpose: Incidence and mortality of prostate cancer (PCa) are still increasing in developing countries. Limited access to the health system or more aggressive disease are potential reasons for this. Ethnic and social differences in developed countries seem to make inappropriate to extrapolate data from other centers. We aim to report the epidemiological profile of a PSA-screened population from a cancer center in Brazil. Materials and Methods: We retrospectively selected 9.692 men enrolled in a PCa prevention program, comprising total PSA level and digital rectal examination at the first appointment, associated with complementary tests when necessary. Men aged over 40 years-old were included after shared decision-making process. Prostate biopsy (TRUS) was performed when clinically suspected for PCa. After the diagnosis, patients underwent appropriate treatment. Results: TRUS was performed in 5.5% of men and PCa incidence was 2.6%. Overall ratio between number of patients who needed to be screened in order to diagnose one cancer was 38.9 patients, with 2.1 biopsies performed to diagnose a cancer. Positive predictive value (PPV) of TRUS biopsy in this strategy was 47.2%, varying from 38.5% (<50 years-old) to 60% (>80 years-old). We evidenced 70 patients (27.9%) classified as low risk tumors, 74 (29.5%) as intermediate risk, and 107 (42.6%) as high-risk disease. Conclusions: PSA-screening remains controversial in literature. In front of a huge miscegenated people and considering the big proportion of high-risk PCa, even in young men diagnosed with the disease, it is imperative to inform patients and health providers about these data particularities in Brazil.


Subject(s)
Humans , Male , Adult , Aged , Aged, 80 and over , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/epidemiology , Prostate-Specific Antigen/analysis , Biopsy , Brazil/epidemiology , Public Health , Predictive Value of Tests , Retrospective Studies , Early Detection of Cancer , Middle Aged
2.
Rev. Soc. Bras. Clín. Méd ; 19(1): 51-53, março 2021.
Article in Portuguese | LILACS | ID: biblio-1361751

ABSTRACT

A metastização ganglionar cervical por neoplasia da próstata é rara, sendo ainda menos frequente como manifestação inicial da doença. O presente estudo é um relato de um caso clínico de uma pessoa do sexo masculino, com 72 anos, que apresentava massa cervical esquerda, indolor, com 2 meses de evolução e dores ósseas lombar e torácica. A citologia aspirativa por agulha fina com estudo imuno-histoquímico revelou positividade para o antígeno prostático específico, concluindo se tratar de metástase ganglionar de carcinoma da próstata. Analiticamente, constatou-se que o valor do antígeno prostático específico foi maior que 1.000ng/mL, além da elevação da fosfatase alcalina. A cintilografia óssea de corpo inteiro revelou envolvimento ósseo secundário. Após o diagnóstico, o paciente iniciou hormonoterapia e recusou radioterapia com intuito paliativo. Oito meses após o diagnóstico, constatou-se a recorrência da doença, com elevação do valor do antígeno prostático específico novamente. Dessa forma, relata-se um caso de neoplasia da próstata com metastização óssea e ganglionar cervical esquerda em um indivíduo assintomático do ponto de vista urológico. Salienta-se que, no diagnóstico diferencial de adenopatias cervicais, deve-se considerar a neoplasia da próstata em pessoas do sexo masculino. (AU)


Cervical lymph nodes involvement is rare in prostate cancer and uncommon as an initial manifestation. This study is a clinical case report of a 72-year-old man who presented with a left cervical painless mass of 2-month progression, and bone pain on the lumbar and thoracic regions. Fine-needle aspiration cytology with immunohistochemistry staining was performed and revealed positivity for prostate-specific antigen consistent with prostate adenocarcinoma metastasis. Blood tests revealed a prostate-specific antigen of more than 1,000ng/mL, as well as high alkaline phosphatase. Whole-body bone scan showed secondary bone involvement. Following diagnosis, the patient started hormonal therapy and refused palliative radiotherapy. Eight months after diagnosis, recurrence was observed, with prostate-specific antigen elevation again. Thus, a clinical case of prostate cancer with bone and cervical lymph node metastasis in a patient with no urologic symptoms is reported. It should be noted that prostate cancer shall always be considered in the differential diagnosis of cervical lymphadenopathies in male patients. (AU)


Subject(s)
Humans , Male , Aged , Prostatic Neoplasms/pathology , Bone Neoplasms/secondary , Carcinoma/secondary , Lymphadenopathy/etiology , Lymphatic Metastasis/diagnosis , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/therapy , Recurrence , Chest Pain/etiology , Immunohistochemistry , Carcinoma/diagnosis , Carcinoma/therapy , Tomography , Radionuclide Imaging , Prostate-Specific Antigen/blood , Low Back Pain/etiology , Fatal Outcome , Diagnosis, Differential , Alkaline Phosphatase/blood , Hospitalization
3.
Einstein (Säo Paulo) ; 19: eAO6325, 2021. tab
Article in English | LILACS | ID: biblio-1350695

ABSTRACT

ABSTRACT Objective: To evaluate awareness of prostate cancer in the population of the city of São Paulo. Methods: A total of 392 adults were randomly interviewed on public spaces in the city of São Paulo, and answered a questionnaire that addressed demographic questions and specific knowledge about the prostate cancer. A score was used to assess awareness of cancer in general, and of prostate cancer, considering satisfactory knowledge a score of 6 points. Results: The mean age was 36.9 years (standard deviation of ±12.6) and 58.2% of participants were male. No previous contact with information related to prostate cancer was reported by 45.5% of participants. For these cases, a greater proportion was observed among men aged over 50 years. As to the score, the mean was 3.7 (standard deviation of ±1.3), with a positive correlation among higher scores, higher income and education level. Less than 5% of participants believed they should only search for prostate cancer screening when symptomatic. Finally, among the less frequent responses to risk factors for prostate cancer, is "ethnic origin" (2.8%). Conclusion: Even though most participants did not have a satisfactory score, the level of awareness demonstrated in this study seems superior to that of other populational series. Hence it suggested the assessed population understood some essential concepts in prostate cancer, such as the importance of screening and the follow-up. The efforts made by the Sociedade Brasileira de Urologia on educational campaigns partially explain this. However, working in some concepts, like identifying risk factors for prostate cancer, might optimize screening outcomes.


RESUMO Objetivo: Avaliar o conhecimento da população da cidade de São Paulo em relação ao câncer de próstata. Métodos: Foram entrevistados randomicamente 392 adultos em espaços públicos da cidade de São Paulo, os quais responderam a um questionário que abordava questões demográficas e de conhecimentos específicos sobre o câncer de próstata. Um escore foi utilizado para avaliar o conhecimento de câncer em geral e do câncer de próstata, considerando um conhecimento satisfatório com escore de 6 pontos. Resultados: A média de idade foi de 36,9 anos (desvio-padrão de ±12,6), e 58,2% dos participantes eram do sexo masculino. Ausência de contato anterior com informações relacionadas ao câncer de próstata foi relatada por 45,5% dos participantes. Nesses casos, maior proporção foi observada entre os homens com mais de 50 anos. Quanto ao escore, a média foi 3,7 (desvio-padrão de ±1,3), com correlação positiva entre maiores escores e maiores renda e escolaridade. Menos de 5% dos participantes acreditavam que só deveriam procurar o rastreamento do câncer de próstata quando sintomáticos. Por fim, entre as respostas menos frequentes aos fatores de risco para câncer de próstata, encontrou-se "etnia" (2,8%). Conclusão: Embora a maioria dos participantes não tenha apresentado escore satisfatório, o nível de conhecimento revelado neste estudo parece superior ao de outros estudos populacionais. Assim, sugere-se que a população avaliada tenha compreendido alguns conceitos essenciais do câncer de próstata, como a importância do rastreamento e do acompanhamento. Os esforços da Sociedade Brasileira de Urologia nas campanhas educacionais explicam parcialmente isso. No entanto, trabalhar em alguns conceitos, como identificar fatores de risco para câncer de próstata, pode otimizar os resultados do rastreamento.


Subject(s)
Humans , Male , Female , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/epidemiology , Early Detection of Cancer , Brazil/epidemiology , Cities , Prostate-Specific Antigen
4.
Braz. j. med. biol. res ; 54(10): e11439, 2021. tab, graf
Article in English | LILACS | ID: biblio-1285649

ABSTRACT

Cathepsin Z (CTSZ) is a cysteine protease responsible for the adhesion and migration of both immune and tumor cells. Due to its dual role, we hypothesized that the site of CTSZ expression could be determinant of the pro- or anti-tumorigenic effects of this enzyme. To test this hypothesis, we analyzed CTSZ expression data in healthy and tumor tissues by bioinformatics and evaluated the expression levels of CTSZ mRNA in the blood cells of prostate cancer (PCa) patients by qRT-PCR compared with healthy subjects, evaluating its diagnostic and prognostic implications for this type of cancer. Immune cells present in the blood of healthy patients overexpress CTSZ. In PCa, we found decreased CTSZ mRNA levels in blood cells, 75% lower than in healthy subjects, that diminished even more during biochemical relapse. CTSZ mRNA in the blood cells had an area under the curve for PCa diagnosis of 0.832, with a 93.3% specificity, and a positive likelihood ratio of 9.4. The site of CTSZ mRNA expression is fundamental to determine its final role as a protective determinant in PCa, such as CTSZ mRNA in the blood cells, or a malignant determinant, such as found for CTSZ expressed in high levels by different types of primary and metastatic tumors. Low CTSZ mRNA expression in the total blood is a possible PCa marker complementary to prostate-specific antigen (PSA) for biopsy decisions, with the potential to eliminate unnecessary biopsies.


Subject(s)
Humans , Male , Prostatic Neoplasms/diagnosis , Cathepsin Z , Prognosis , Blood Cells , RNA, Messenger , Prostate-Specific Antigen
5.
National Journal of Andrology ; (12): 803-808, 2021.
Article in Chinese | WPRIM | ID: wpr-922161

ABSTRACT

Objective@#To evaluate the prostate health index (PHI) as a tool for the diagnosis of PCa with a PSA level of 4-10 μg/L and determine the best cut-off value of PHI.@*METHODS@#Fifty-eight patients with a PSA level of 4-10 μg/L underwent transrectal ultrasound-guided prostatic biopsy in our hospital between April 2017 and June 2019. We constructed receiver operating characteristic (ROC) curves for the relationship of the biopsy results with the level of PSA, the ratio of [-2] proPSA to fPSA and PHI, and calculated the area under the ROC curves (AUC).@*RESULTS@#Prostatic biopsy revealed 18 cases of PCa in the 58 patients (31.0%). Statistically significant differences were observed between the PCa and non-PCa groups in [-2] proPSA, %[-2] proPSA and PHI, but not in tPSA, % fPSA and PSA-density. The AUCs of PSA, % fPSA, PSA-density, [-2] proPSA, %[-2] proPSA and PHI were 0.556, 0.407, 0.533, 0.746, 0.751 and 0.774, respectively. The specificity of PHI was 27.50% (95% CI: 14.6%-43.9%), the highest among the above predictors at 90% sensitivity. By applying PHI to this cohort, 13 cases (22.4%) of unnecessary biopsy could be avoided.@*CONCLUSIONS@#The application of PHI can increase the accuracy of PCa prediction and reduce unnecessary prostatic biopsy.、.


Subject(s)
Asians , Humans , Macau , Male , Prostate , Prostate-Specific Antigen , Prostatic Neoplasms/diagnosis
6.
Journal of Biomedical Engineering ; (6): 1219-1228, 2021.
Article in Chinese | WPRIM | ID: wpr-921864

ABSTRACT

With the rapid development of artificial intelligence technology, researchers have applied it to the diagnosis of various tumors in the urinary system in recent years, and have obtained many valuable research results. The article sorted the research status of artificial intelligence technology in the fields of renal tumors, bladder tumors and prostate tumors from three aspects: the number of papers, image data, and clinical tasks. The purpose is to summarize and analyze the research status and find new valuable research ideas in the future. The results show that the artificial intelligence model based on medical data such as digital imaging and pathological images is effective in completing basic diagnosis of urinary system tumors, image segmentation of tumor infiltration areas or specific organs, gene mutation prediction and prognostic effect prediction, but most of the models for the requirement of clinical application still need to be improved. On the one hand, it is necessary to further improve the detection, classification, segmentation and other performance of the core algorithm. On the other hand, it is necessary to integrate more standardized medical databases to effectively improve the diagnostic accuracy of artificial intelligence models and make it play greater clinical value.


Subject(s)
Algorithms , Artificial Intelligence , Humans , Male , Prognosis , Prostatic Neoplasms/diagnosis , Technology
7.
Chinese Journal of Oncology ; (12): 1016-1026, 2021.
Article in Chinese | WPRIM | ID: wpr-920983

ABSTRACT

The morbidity and mortality of prostate cancer ascend yearly, which seriously threatens the health of the male population. Bone is the main metastasis site of prostate cancer, with bone metastases and skeletal-related events (SREs) occuring in more than 70% of patients with advanced prostate cancer. Bone metastases and the resulting SREs, such as spinal cord compression and pathological fracture, seriously affect the life quality of the patients. Although the active treatments of the primary disease is important, the application of bone-modifying agents to prevent SREs cannot be overlooked. However, there is no standard treatment procedure for the bone metastasis of prostate cancer at present. According to the clinical status, the Genitourinary Oncology Committee of Chinese Anti-cancer Association formulated this consensus, which integrated clinical evidence and real world clinical practices in China and abroad, to help clinicians make more accurate diagnosis and treatment for the bone metastases of prostate cancer with multidisciplinary strategies.


Subject(s)
Bone Neoplasms , Bone and Bones , Consensus , Humans , Male , Prostatic Neoplasms/diagnosis , Spinal Cord Compression/etiology
8.
Säo Paulo med. j ; 138(6): 483-489, Nov.-Dec. 2020. tab
Article in English | LILACS, SES-SP | ID: biblio-1145135

ABSTRACT

ABSTRACT BACKGROUND: Population-wide screening for prostate cancer remains a controversial topic, given the need for an individualized approach to patients regarding the risks and benefits of prostate-specific antigen testing and digital rectal examination. OBJECTIVE: The aim of this study was to investigate the prevalence of, and factors associated with, prostate examination among men aged 45 or older. DESIGN AND SETTING: Cross-sectional population-based study developed in the city of Rio Grande (RS), Brazil. METHODS: The outcome of interest was a history of prostate examination (prostate-specific antigen testing or digital rectal examination). The following independent variables were analyzed: age group, skin color, marital status, schooling, economic level, leisure-time physical activity, smoking habits, excessive alcohol consumption, overweight, health insurance, visits to the doctor during the preceding year, hypertension and diabetes. After a two-stage sampling process, the final sample consisted of 281 male individuals. RESULTS: The prevalence of a history of prostate-specific antigen testing or digital rectal examination was 68.3% (95% confidence interval (CI): 62.2 to 74.5). The highest prevalence rates were observed among men aged 70 years or older (88%) and the lowest among smokers (36%). The following characteristics were found to be associated with the outcome: advanced age; marital status other than single; more schooling and higher economic status; practicing physical activity; non-smoking habits; overweight; having health insurance; and having visited a doctor during the preceding year. CONCLUSION: Approximately two thirds of the study population had been screened for prostate examination, mostly older individuals, with higher socioeconomic status and a healthier lifestyle.


Subject(s)
Humans , Male , Middle Aged , Aged , Prostate-Specific Antigen/blood , Digital Rectal Examination/statistics & numerical data , Early Detection of Cancer/statistics & numerical data , Prostatic Neoplasms/diagnosis , Socioeconomic Factors , Brazil , Cross-Sectional Studies , Cities
9.
Int. braz. j. urol ; 46(5): 691-704, Sept.-Oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1134242

ABSTRACT

ABSTRACT Background: The diagnostic value and suitability of prostate cancer antigen 3 (PCA3) for the detection of prostate cancer (PCa) have been inconsistent in previous studies. Thus, the aim of the present meta-analysis was performed to systematically evaluate the diagnostic value of PCA3 for PCa. Materials and Methods: A meta-analysis was performed to search relevant studies using online databases EMBASE, PubMed and Web of Science published until February 1st, 2019. Ultimately, 65 studies met the inclusion criteria for this meta-analysis with 8.139 cases and 14.116 controls. The sensitivity, specificity, positive likelihood ratios (LR+), negative likelihood ratios (LR−), and other measures of PCA3 were pooled and determined to evaluate the diagnostic rate of PCa by the random-effect model. Results: With PCA3, the pooled overall diagnostic sensitivity, specificity, LR+, LR−, and 95% confidence intervals (CIs) for predicting significant PCa were 0.68 (0.64-0.72), 0.72 (0.68-0.75), 2.41 (2.16-2.69), 0.44 (0.40-0.49), respectively. Besides, the summary diagnostic odds ratio (DOR) and 95% CIs for PCA3 was 5.44 (4.53-6.53). In addition, the area under summary receiver operating characteristic (sROC) curves and 95% CIs was 0.76 (0.72-0.79). The major design deficiencies of included studies were differential verification bias, and a lack of clear inclusion and exclusion criteria. Conclusions: The results of this meta-analysis suggested that PCA3 was a non-invasive method with the acceptable sensitivity and specificity in the diagnosis of PCa, to distinguish between patients and healthy individuals. To validate the potential applicability of PCA3 in the diagnosis of PCa, more rigorous studies were needed to confirm these conclusions.


Subject(s)
Humans , Male , Prostatic Neoplasms/diagnosis , Biomarkers, Tumor , Odds Ratio , ROC Curve , Sensitivity and Specificity , Antigens, Neoplasm
10.
Int. j. morphol ; 38(4): 882-887, Aug. 2020. tab, graf
Article in English | LILACS | ID: biblio-1124870

ABSTRACT

The different pathologies of the prostate, involve the presence of a new microenvironment where inflammatory cells are actively recruited. This research explores the presence of mast cells and eosinophils associated with age and the evaluation of prostate cancer progress (Gleason Index). Forty two biopsies of anonymized patients, with confirmed prostate cancer, were used for histological analysis for eosinophils and mast cells and subsequent determination of Gleason index according to age. The results of the histological analyzes show the presence of eosinophils and mast cells in prostate biopsies with confirmed cancer. In the multiple correlation studies, a high correlation was observed between the presence of lymphocytes and the age of the patient diagnosed with prostate cancer, same correlation was observed between the patient's age and higher Gleason Index (Pearson and Spearman p< 0.05). It is concluded that in prostate biopsies from Chilean patients with confirmed cancer, eosinophilia and tissue mastocytosis were observed. Correlation analyzes show a direct correlation between older patients, higher Gleason index and presence of mast cell. Regarding eosinophilia, only a correlation between age and Gleason index was observed Further studies are suggested to determine that the presence of eosinophils and mast cells can be used as early bioindicators of prostate cancer.


Las diferentes patologías de próstata, involucran la presencia de un nuevo microambiente donde las células inflamatorias son activamente reclutadas. La presente investigación explora la presencia de mastocitos y eosinófilos asociadas a la edad y la evaluación del progreso del cáncer de próstata según índice de Gleason. Cuarenta y dos biopsias de pacientes anonimizados, con cáncer prostático confirmados, fueron utilizadas para su análisis histológico para eosinófilos y mastocitos y posterior determinación del índice de Gleason según edad. Los resultados de los análisis histológicos, muestran la presencia de eosinófilos y mastocitos en biopsias de próstata con cáncer confirmado. En los estudios de correlación múltiple, se observó una alta correlación entre la presencia de linfocitos, mastocitos y la edad del paciente diagnosticado con cáncer prostático, igual correlación se observó entre la edad del paciente y mayor índice de Gleason (Pearson y Spearman p<0,05). Se concluyó que en las biopsias de próstata de pacientes chilenos con cáncer confirmado, se observó eosinofilia y mastocitosis tisular. Los análisis de correlación muestran una correlación directa entre pacientes de mayor edad, índice de Gleason más alto y la presencia de mastocitos. Con respecto a la eosinofilia, solo se observó una correlación entre la edad y el índice de Gleason. Se sugieren estudios adicionales para determinar que la presencia de eosinófilos y mastocitos puede usarse como bioindicadores tempranos del cáncer de próstata.


Subject(s)
Humans , Male , Prostatic Neoplasms/pathology , Prostate/pathology , Prostatic Neoplasms/diagnosis , Biopsy , Mastocytosis/pathology , Biomarkers, Tumor/analysis , Chile , Age Factors , Eosinophilia/pathology , Early Detection of Cancer , Neoplasm Grading
12.
Enferm. actual Costa Rica (Online) ; (38): 32-44, Jan.-Jun. 2020.
Article in Portuguese | LILACS, BDENF | ID: biblio-1090085

ABSTRACT

Resumo O objetivo desta investigação foi compreender a atuação de Equipes de Saúde da Família sobre a detecção precoce do câncer de próstata. É uma investigação pesquisa de abordagem qualitativa realizada com 10 profissionais de saúde, entre eles médicos, enfermeiros, técnicos de enfermagem e agentes comunitários de saúde, de duas Unidades de Saúde da Família de Jaguaquara, Bahia, Brasil. Para a coleta de dados foi aplicado a entrevista semiestruturada norteada por um roteiro contendo cinco questões inerentes a temática. As informações produzidas foram submetidas à técnica de análise do conteúdo de Bardin, que originaram três categorías temáticas. Ressalta-se que o projeto foi aprovado pelo Comitê de Ética em Pesquisa, sob parecer nº. 1.644.785. Entre os resultados foram obtidos: Ações para promoção da detecção precoce do câncer de próstata; Importância do Diagnóstico Precoce; Fatores que dificultam a detecção precoce do Câncer de próstata. Conclui-se que diante da problemática existente acerca da procura dos serviços de saúde pelo público masculino, é preciso que os profissionais estejam preparados e capacitados de forma que os programas de saúde possam cumprir seus objetivos de promoção e prevenção eficaz.


Abstract The aim of this research was to understand the performance of Family Health Teams on early detection of prostate cancer. It is a qualitative research conducted with 10 health professionals, including doctors, nurses, nursing technicians and community health agents, from two Family Health Units of Jaguaquara, Bahia, Brazil. For data collection we apply a semi-structured interview guided by a script containing five questions inherent to the theme. The information produced was submitted to Bardin's content analysis technique, which originated three thematic categories. It is noteworthy that the project was approved by the Research Ethics Committee, under opinion no. 1,644,785. Between the results we obtained: actions to promote early detection of prostate cancer; importance of early diagnosis; factors that hinder early detection of prostate cancer. It is concluded that given the existing problem regarding the demand for health services by the male public, professionals need to be prepared and trained so that health programs can meet their objectives of effective promotion and prevention.


Resumen El objetivo de esta investigación fue comprender el desempeño de los equipos de salud familiar en la detección temprana del cáncer de próstata. Es una investigación cualitativa realizada con 10 profesionales de la salud, incluidos médicos, enfermeras, técnicos de enfermería y agentes de salud comunitaria, de dos Unidades de Salud Familiar de Jaguaquara, Bahía, Brasil. Para la recopilación de datos, utilizamos una entrevista semiestructurada con una guía que contiene cinco preguntas inherentes al tema. Se aplicó la técnica de análisis de contenido de Bardin, que originó tres categorías temáticas. Es de destacar que el proyecto fue aprobado por el Comité de Ética de Investigación, en virtud del dictamen no. 1,644,785. Entre los resultados se obtuvo: las acciones para promover la detección temprana del cáncer de próstata; importancia del diagnóstico precoz; factores que dificultan la detección temprana del cáncer de próstata. Se concluye que debido al problema existente con respecto a la demanda de servicios de salud por parte del público masculino, los profesionales deben estar preparados y capacitados para que los programas de salud puedan cumplir sus objetivos de promoción y prevención efectivas.


Subject(s)
Humans , Male , Primary Health Care , Prostatic Neoplasms , Prostatic Neoplasms/diagnosis , Brazil , Men's Health , Family Practice , Health Promotion
13.
Int. braz. j. urol ; 46(2): 244-252, Mar.-Apr. 2020. tab, graf
Article in English | LILACS | ID: biblio-1090589

ABSTRACT

ABSTRACT Purpose To evaluate the usefulness of natural killer cell activity (NKA) in diagnosing prostate cancer (PC). Materials and Methods The medical records of patients who underwent transrectal prostate biopsy (TRBx) at Korea University Ansan Hospital between May 2017 and December 2017 were retrospectively reviewed. NKA levels were measured using NK Vue® Tubes (ATgen, Sungnam, Korea). All blood samples were obtained at 8 AM on the day of biopsy. Patients with other malignancies, chronic inflammatory conditions, high prostate-specific antigen (PSA) level (>20ng/mL), or history of taking 5-alpha-reductase inhibitor or testosterone replacement therapy were excluded. Results A total of 102 patients who underwent TRBx for PC diagnosis were enrolled. Among them, 50 were diagnosed with PC. Significant differences in age and NKA level were observed between the PC and no-PC groups. Receiver operating characteristic (ROC) curve analysis showed that the optimal cut-off of NKA level for the prediction of PC was 500pg/dL, with a sensitivity of 68.0% and a specificity of 73.1%. In addition, NKA level (0.630) had the greatest area under the ROC curve compared to those for the ratio of total PSA to free PSA (0.597) and PSA density (0.578). Conclusions The results of this pilot study revealed that low NKA and high PSA levels were likely to be associated with a positive TRBx outcome. NKA detection was easy and improved the diagnostic accuracy of PC.


Subject(s)
Humans , Male , Aged , Prostatic Neoplasms/diagnosis , Killer Cells, Natural/metabolism , Prostate-Specific Antigen/blood , Prostatic Neoplasms , Prostatic Neoplasms/blood , Killer Cells, Natural/physiology , Biomarkers/metabolism , Biomarkers/blood , Pilot Projects , Retrospective Studies , ROC Curve , Sensitivity and Specificity , Image-Guided Biopsy , Middle Aged
14.
Int. braz. j. urol ; 46(1): 34-41, Jan.-Feb. 2020. tab
Article in English | LILACS | ID: biblio-1056354

ABSTRACT

ABSTRACT Purpose: Prostate cancer screening in the elderly is controversial. The Brazilian government and the National Cancer Institute (INCA) do not recommend systematic screening. Our purpose was to assess prevalence and aggressiveness of prostate cancer in men aged 70 years and above, on the first Latin American database to date. Materials and Methods: Cross-sectional study (n=17,571) from 231 municipalities, visited by Mobile Cancer Prevention Units of a prostate-specific antigen (PSA) based opportunistic screening program, between 2004 and 2007. The criteria for biopsy were: PSA>4.0ng/ml, or PSA 2.5-4.0ng/ml with free/total PSA ratio ≤15%, or suspicious digital rectal examination findings. The screened men were stratified in two age groups (45-69 years, and ≥70 years). These groups were compared regarding prostate cancer prevalence and aggressiveness criteria (PSA, Gleason score from biopsy and TNM staging). Results: The prevalence of prostate cancer found was 3.7%. When compared to men aged 45-69 years, individuals aged 70 years and above presented cancer prevalence about three times higher (prevalence ratio 2.9, p<0.01), and greater likelihood to present PSA level above 10.0ng/ml at diagnosis (odds ratio 2.63, p<0.01). The group of elderly men also presented prevalence of histologically aggressive disease (Gleason 8-10) 3.6 times higher (p<0.01), and 5-fold greater prevalence of metastases (PR 4.95, p<0.05). Conclusions: Prostate cancer screening in men aged over 70 may be relevant in Brazil, considering the absence of systematic screening, higher prevalence and higher probability of high-risk disease found in this age range of the population studied.


Subject(s)
Humans , Male , Aged , Aged, 80 and over , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/epidemiology , Mass Screening/methods , Prostatic Neoplasms/pathology , Biopsy , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Risk Factors , Age Factors , Prostate-Specific Antigen/blood , Risk Assessment , Digital Rectal Examination , Early Detection of Cancer , Neoplasm Grading , Middle Aged , Neoplasm Staging
15.
Ibom Medical Journal ; 13(3): 156-163, 2020.
Article in English | AIM | ID: biblio-1262928

ABSTRACT

Background: Digital rectal examination (DRE) is an indispensable tool for provisional diagnosis of prostate diseases. When abnormal prostate examination findings are elicited, a diagnosis of prostate cancer (Pca) is usually entertained and further tests to confirm or rule out the presence of Pca demands histological examination of biopsied tissue. A combination of DRE findings and serum PSA increases the predictive value for Pca diagnosis. In this study, we evaluated the degree of accuracy of DRE to diagnose Pca confirmed by histology reports of biopsy specimens.Materials and Methods: Two hundred and six (206) patients were studied over a period of three years. Information retrieved from their case notes were entered into a well-structured protocol for management of prostatic diseases. Analysis of variables collated was performed with the statistical package for the social sciences (SPSS) version 20.0. Frequency table was used to analyze categorical variables while descriptive statistics was used for continuous variables. Level of significance was set at P<.05.Results: 206 patients were studied with mean age of 68.23±8.71 years ranging from 48 to 91 years. Men in the Pca group were older than those in the BPH group. Abnormal DRE was associated with high grade tumours, and high level of aggressive tumour characteristics by WHO grade group standard.Conclusion: DRE has a high level of accuracy in predicting a diagnosis of Pca which was confirmed by histology reports especially in prostates with abnormal findings


Subject(s)
Biopsy , Digital Rectal Examination , Lower Urinary Tract Symptoms , Nigeria , Prostatic Neoplasms/diagnosis
17.
Int. braz. j. urol ; 45(6): 1113-1121, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1056346

ABSTRACT

ABSTRACT 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.


Subject(s)
Humans , Male , Aged , Prostatic Neoplasms/diagnosis , Semen/chemistry , Prostate-Specific Antigen/blood , Citric Acid/analysis , Prostatic Hyperplasia/diagnosis , Prostatic Hyperplasia/blood , Prostatic Neoplasms/pathology , Prostatic Neoplasms/blood , Biopsy , Biomarkers, Tumor/analysis , Reproducibility of Results , Sensitivity and Specificity , Statistics, Nonparametric , Risk Assessment , Middle Aged
18.
Ciênc. Saúde Colet ; 24(9): 3265-3274, set. 2019. tab
Article in Portuguese | LILACS | ID: biblio-1019671

ABSTRACT

Resumo Disparidades na atenção ao câncer de próstata têm sido reveladas e associadas a fatores sociodemográficos e clínicos, os quais determinam os tempos para diagnóstico e início do tratamento. O objetivo deste artigo é avaliar a associação de variáveis sociodemográficas e clínicas com os tempos para o início do tratamento do câncer de próstata. Estudo de coorte longitudinal prospectivo utilizando dados secundários, cuja população é de homens com câncer de próstata atendidos nos períodos de 2010-2011 e 2013-2014 no Hospital Santa Rita de Cássia, Vitória, Espírito Santo, Brasil. A população do estudo foi de 1.388 homens, do total, os com idade inferior a 70 anos (OR = 1,85; IC = 1,49-2,31), não brancos (OR = 1,30; IC = 1,00-1,70), com menos de oito anos de estudo (OR = 1,52; IC = 1,06-2,17) e encaminhados pelos serviços do Sistema Único de Saúde (OR = 2,52; IC = 1,84-3,46) apresentaram maior risco de atraso no tratamento. Da mesma forma, quanto menor o escore de Gleason (OR = 1,78; IC = 1,37-2,32) e os níveis de Antígeno Prostático Específico (OR = 2,71; IC = 2,07-3,54) maior a probabilidade de atraso para iniciar o tratamento. Portanto, as características sociodemográficas e clínicas exerceram uma forte influência no acesso ao tratamento do câncer de próstata.


Abstract Introduction: Disparities in prostate cancer care have been evidenced and associated with sociodemographic and clinical factors, which establish the time for diagnosis and initiation of treatment. Objective: To evaluate the association of sociodemographic and clinical variables with the onset of prostate cancer treatment. Methods: This is a prospective longitudinal cohort study with secondary data with a population of men with prostate cancer attended in the periods 2010-2011 and 2013-2014 at the Santa Rita de Cássia Hospital in Vitória, Espírito Santo, Brazil. Results: The study population consisted of 1,388 men. Of the total, those younger than 70 years (OR = 1.85; CI = 1.49-2.31), nonwhite (OR = 1.30; CI = 1.00-1.70), less than 8 years of schooling (OR = 1.52; CI = 1.06-2.17) and referred by the Unified Health System services (OR = 2.52; CI = 1.84-3.46) were more likely to have a delayed treatment. Similarly, the lower the Gleason score (OR = 1.78; CI = 1.37-2.32) and Prostate-Specific Antigens levels (OR = 2.71; CI = 2.07-3.54), the greater the likelihood of delay for the onset of treatment. Conclusion: Therefore, sociodemographic and clinical characteristics exerted a strong influence on the access to prostate cancer treatment.


Subject(s)
Humans , Male , Aged , Aged, 80 and over , Prostatic Neoplasms/therapy , Prostate-Specific Antigen/blood , Healthcare Disparities , Health Services Accessibility , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/pathology , Socioeconomic Factors , Brazil , Prospective Studies , Cohort Studies , Longitudinal Studies , Age Factors , Neoplasm Grading , Time-to-Treatment/statistics & numerical data , Middle Aged
19.
Rev. méd. Maule ; 34(1): 9-15, ago. 2019. tab
Article in English | LILACS | ID: biblio-1371496

ABSTRACT

INTRODUCTION: Prostate cancer has become an important public health problem affecting millions of men worldwide every year. Like other malignant tumors, prostate cancer shows evidence of a strong inflammatory component that is dependent on the release of pro-inflammatory cytokines, which might play a major role in the development and progression of the tumor, helping in its early stage, progression and aggressiveness. AIMS: The goal of this study was to determine the relationships between the serum levels of pro-inflammatory cytokines and the different stages of prostate cancer. To this end, sera from patients enrolled by The Laboratory of Metabolic Diseases and Cancer of the Faculty of Pharmacy and Biochemistry at the University Juan Agustín Maza in Argentina, were analyzed through ELISA and their pro-inflammatory cytokines (IL-6, TNF-α and MCP-1) quantified. Patients were first classified into three groups (Control, at Risk, and Cancer subjects) and anthropometric, biochemical and histological parameters of prostate were then determined for all groups. RESULTS AND CONCLUSIONS: Despite displaying elevated serum concentrations of IL-6 and TNF-α in the Cancer and the Risk groups compared to the Control group, the differences did not reach significance. However, there was a positive correlation between these cytokines only in the Risk and Cancer groups, showing a general inflammatory behavior in these patients. The results obtained provide general data about the behavior of pro-inflammatory cytokines in prostate cancer. However, they do not demonstrate a direct correlation between serum levels and neoplastic progression. Nevertheless, these findings do not rule out a possible relationship between prostate cancer and serum levels of pro-inflammatory cytokines.


Subject(s)
Humans , Male , Prostatic Neoplasms/diagnosis , Cytokines/blood , Inflammation Mediators/blood , Prostatic Neoplasms/blood , Body Mass Index , Case-Control Studies , Prostate-Specific Antigen
20.
Salud pública Méx ; 61(4): 542-544, Jul.-Aug. 2019.
Article in English | LILACS | ID: biblio-1099331

ABSTRACT

Abstract: Prostate-specific antigen (PSA)-based early detection for prostate cancer is the subject of intense debate. Implementation of organized prostate cancer screening has been challenging, in part because the PSA test is so amenable to opportunistic screening. To the extent that access to cancer screening tests increases in low- and middle-income countries (LMICs), there is an urgent need to thoughtfully evaluate existing and future cancer screening strategies to ensure benefit and control costs. We used Mexico's prostate cancer screening efforts to illustrate the challenges LMICs face. We provide five considerations for policymakers for a smarter approach and implementation of PSA-based screening.


Resumen : El uso del Antígeno Prostático Específico (APE) para tamizaje para cáncer de próstata sigue siendo tema de amplio debate. La implementación de estrategias de tamiz organizado de cáncer de próstata ha sido un reto en parte porque la prueba de APE se presta para detección oportunista. A medida que aumenta el acceso a las pruebas de detección de cáncer en los países de ingresos bajos y medianos (PIBM), existe la necesidad urgente de evaluar cuidadosamente las estrategias actuales y futuras de detección oportuna de cáncer para garantizar su beneficio y controlar sus costos. Utilizamos los esfuerzos de tamizaje de cáncer de próstata de México para ilustrar los retos para PIBM. Ofrecemos cinco consideracio nes dirigidas a tomadores de decisión que permitan contar con estrategias racionales de implementación de tamizaje para cáncer de próstata basado en el uso de APE.


Subject(s)
Humans , Male , Middle Aged , Aged , Prostatic Neoplasms/diagnosis , Prostate-Specific Antigen/blood , Developing Countries , Early Detection of Cancer/methods , Policy Making , Prostatic Neoplasms/blood , Health Education , Age Factors , Outcome Assessment, Health Care , Cost-Benefit Analysis , Mexico
SELECTION OF CITATIONS
SEARCH DETAIL