Utilidad del antígeno prostático específico total y del índice de antígeno prostático específico libre para detectar cáncer de próstata en el paciente asintomático / Utility of total prostate-specific antigen and free prostate- specific antigen index to detect prostate cancer in the asymptomatic patient

Resumen El antígeno prostático específico (PSA) en circulación se encuentra ligado a la alfa-1-quimiotripsina y una pequeña fracción circula de manera libre (PSAl). Se valoró la utilidad clínica del PSA total (PSAt) y el índice de PSA libre para la detección de cáncer prostático en pacientes asintomáticos. Se cuantificó el PSAt, el PSAl y el índice de PSAl en 364 pacientes estratificados por grupo de edad. La frecuencia de valores anormales de PSAt fue del 8,79% (32/364). El grupo de 50-59 años presentó la mayor incidencia de resultados anormales (19/32). No hubo diferencia estadísticamente significativa entre PSAt y el índice de PSAl (p<0,05). El índice PSAl puede potencializar el valor del PSAt para determinar la presencia o ausencia de cáncer prostático. Un índice superior a 0,24 ng/mL puede ayudar a evitar o posponer la indicación de biopsia, principalmente cuando los valores de PSAt están entre 4 y 10 ng/mL.

Abstract Circulating prostate-specific antigen (PSA) is bound to alpha-1-chymotrypsin and a small fraction is free (PSAl). The clinical utility of the total PSA (PSAt) and the PSAl index for prostate cancer screening in asymptomatic patients was assessed. PSAt, PSAl and the PSAl index were quantified in 364 patients stratified by age group. The frequency of abnormal PSAt values was 8.79% (32/364). The 50-59 year-old group presented the highest incidence of abnormal results (19/32). There was no statistically significant difference between PSAt and the PSAl index (p<0.05). The PSAl index can potentiate the PSAt value to determine the presence or absence of prostate cancer. An index greater than 0.24 ng/mL can help to avoid or postpone the indication for a biopsy, especially when the PSAt values are between 4 and 10 ng/mL.

Resumo O antígeno prostático específico (PSA) em circulação é ligado à alfa-1-quimotripsina e a uma pequena fração circula livremente (PSAl). A utilidade clínica do PSA total (PSAt) e do índice de PSAl livre para o rastreamento do câncer de próstata em pacientes assintomáticos foi avaliada. PSAt, PSAl e o índice de PSAl foram quantificados em 364 pacientes estratificados por faixa etária. A frequência de valores anormais de PSAt foi de 8,79% (32/364). O grupo de 50-59 anos apresentou a maior incidência de resultados anormais (19/32). Não houve diferença estatisticamente significativa entre o PSAt e o índice PSAl (p<0,05). O índice PSAl pode potencializar o valor do PSAt para determinar a presença ou ausência de câncer de próstata. Um índice superior a 0,24 ng/mL pode ajudar a evitar ou adiar a indicação de biópsia, principalmente quando os valores de PSAt estão entre 4 e 10 ng/mL.

Saúde do homem: análise do IPSS, PSA e urofluxometria dos participante na campanha "novembro azul" em 2017 / Man's health: analysis of IPSS, PSA and uroflowmetry the population participat of the campaign "blue november" in 2017

O objetivo da pesquisa foi analisar os dados laboratoriais dos participantes da campanha "Saúde do Homem" em novembro de 2017, em Santarém/PA/Brasil. Estudo do tipo transversal e quantitativo, de análise do escorre internacional de sintomas prostáticos (I-PSS), de questionário e de exames laboratoriais. O total de 36 homens acima de 40 anos, com idade média de 55,8 anos participaram da campanha. Estes passaram pelo exame digital da próstata e por exames laboratoriais, como PSA e urofluxometria. A dosagem sérica de PSA mostrou que 100% dos pacientes obtiveram valores de 0-4 ng/ml. Destes, 25 (69%) exibiram ao exame digital da próstata peso estimado abaixo de 30g. No que tange ao exame da urofluxometria, 64% expressaram volume urinário de 150 a 500 ml. Vinte pacientes mostraram valores inferiores a 15 ml/s ao fluxo máximo e os outros, igual ou superior a 15 ml/s. O padrão de curva de fluxo urinário mais prevalente foi do tipo cauda, representando 75% (n=27) e o tipo sino foi o menos frequente com 5,5% (n=2). No resíduo pós-miccional, 39% (n=14) obtiveram acima de 20 ml. De modo que 4 destes apresentaram acima de 100 ml, sugestivo de obstrução urinária. Os resultados neste trabalho permitiram identificar que as alterações encontradas podem estar associadas a obstrução ou disfunção vesical, no entanto, como exame de triagem do risco de câncer de próstata e dos sintomas de HPB, esses testes são suficientes para selecionar os pacientes que se beneficiam do tratamento adequado ou investigação mais complexa.

The objective of this research was to analyze the laboratory data of the population end of campaign "Man's Health" in November 2017, at Santarém/PA. Study of transverse type and quantitative analysis of the flows of international prostate symptoms (IPSS), a questionnaire and laboratory tests. The total of 36 men over 40 years, with an average age of 55.8 years participated in the campaign. These passed through the prostate digital exam and lab tests, such as PSA and uroflowmetry. The dosage of serum PSA showed that 100% of patients obtained values of 04 ng/ml. Of these, 25 (69%) exhibit digital prostate exam estimated weight below 30 g. With regard to the examination of uroflowmetry, 64% expressed urinary volume of 150 to 500 ml. Twenty patients demonstrate less than 15 ml/s maximum flow and the other, not less greater than 15 ml/s pattern of urinary flow curve more prevalent was the tail type, representing 75% (n = 27) and the Bell type was less frequent with 5.5% (n = 2). In the pós - miccional residue, 39% (n = 14) achieved over 20 ml. So that 4 of these being presented over 100 ml, suggestive of urinary obstruction. The results in this paper identified the changes found may be associated with obstruction or bladder dysfunction, however, as screening examination of the risk of prostate cancer and BPH symptoms, these tests are sufficient to Select the patients who benefit from appropriate treatment or investigation.

Testosterona y antígeno prostático específico en pacientes portadores de carcinoma prostático, provincia Holguín, 2013-2015 / Testosterone and Prostate Specific Antigen in Patients with Prostatic Carcinoma. Holguín Province. 2013-2015

Introducción: el incremento de las enfermedades oncológicas cobra cada vez más vidas en el mundo y en Cuba, sin distinción de raza y edad. En la actualidad esta enfermedad ocupa un lugar cada vez más preponderante a nivel mundial y constituyen la primera causa de muerte. El cáncer de próstata constituye la segunda causa de muerte en el hombre a nivel mundial y ocupa el quinto lugar dentro de los tumores malignos, con un estimado de 30 000 casos nuevos por años en el mundo. Objetivo: caracterizar el comportamiento sérico de la testosterona y el antígeno prostático específico en los pacientes portadores de carcinoma prostático, en los años 2013 a 2015 en la provincia de Holguín. Métodos: se realizó una investigación de tipo descriptiva transversal. El universo estuvo constituido por 104 pacientes diagnosticados con cáncer de próstata, en el Centro Oncológico del Hospital Vladimir Ilich Lenin. Se utilizaron indicadores descriptivos del tipo de las frecuencias absolutas, porcentaje, media, desviación estándar y coeficiente de variación. Se distribuyeron las cifras de testosterona y antígeno prostático específico en grupos de edades y se asociaron a sus valores séricos. Resultados: las cifras de testosterona se mantuvieron normales en el 97,12% de los casos, mientras que los niveles del antígeno prostático específico se elevaron considerablemente en el 85,57%. El grupo de edades con mayor frecuencia absoluta, en ambos casos, fue el de 61 a 71 años. Conclusiones: el carcinoma prostático afecta principalmente al adulto mayor y que eleva el antígeno prostático específico. Es necesario aplicar el programa establecido para un diagnóstico precoz de dicha enfermedad con lo que se eleva la posibilidad de un tratamiento oportuno y efectivo que facilite las probabilidades de curación y control de la misma.

Introduction: the increase of oncological diseases is taking on more and more lives in the world and in Cuba without distinction of race and age. At present this disease occupies an increasingly preponderant place in the world and is already the leading cause of death. Prostate cancer is the second leading cause of death in men worldwide and ranks fifth in the cause of this condition, with an estimated 30.000 new cases per year in the world. Objective: to characterize the serum behavior of testosterone and specific prostatic antigen in patients with prostatic carcinoma, from 2013 to 2015 in the province of Holguín. Methods: a retrospective cross-sectional descriptive study was carried out. The universe consisted of 104 patients diagnosed with prostate cancer at the Cancer Center of Vladimir I. Lenin Hospital. Descriptive indicators of the type of asolute, percentage, mean, standard deviation and coefficient of variation were used. The testosterone and specific prostatic antigen numbers were distributed in age groups and their serum values ​​were associated. Results: testosterone levels remained normal in 97.12% of cases, while levels of prostate specific antigen increased significantly in 85.57%. The age group with the most patients presented in both cases was 61 to 71 years. Conclusions: this research confirmed that this neoplasia mainly affects the elderly and raises the specific prostatic antigen. The program established for an early diagnosis of this disease is necessary to be applied, which raises the possibility of a timely and effective treatment that facilitates the chances of cure and control of this illness.

Relationship of Prostate Specific Antigen & Prostate Specific Antigen Density and Prostatic Intraepithelial Neoplasia in Patient with Benign Prostatic Hyperplasia and Prostatic Cancer / 대한비뇨기과학회지

Prostate intraepithelial neoplasia (PIN) is a putative premalignant change in the human prostate, which is an intraluminal proliferation of the secretory cells of the prostatic duct-acinar system that is enveloped by a basal cell layer and displays a spectrum of dysplastic cytologic features ranging from minimal atypia (low grade PIN) to those which are ultimately indistinguishable from carcinoma cells (high grade PIN). To evaluate the clinical significance of the PIN in prostatic tumor and BPH, we reviewed the serum prostate specific antigen (PSA), prostate specific antigen density (PSAD), and pathologic findings in the specimen of 21 BPH and 11 Prostate cancers, which were pathologically confirmed. The distributions of PIN are 7/21 (33%) in BPH and 8/ 11 (73%) in prostatic ca (P0.05). There was no significant difference in the distribution of PIN according to histologic types of BPH. And high grade PIN was observed only in prostatic cancer. Therefore, if high grade PIN is observed in pathologic specimens, undetected prostatic cancer should be found.