ABSTRACT
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.
Subject(s)
Male , Adult , Middle Aged , Aged , Prostatic Hyperplasia , Prostatic Neoplasms , Prostate-Specific Antigen , Serine Peptidase Inhibitor Kazal-Type 5 , Patients , Biopsy , Chymotrypsin , Mass Screening , Incidence , Morbidity , Diagnosis , Absenteeism , AlkB Homolog 3, Alpha-Ketoglutarate-Dependent Dioxygenase , Age GroupsABSTRACT
Generation of the HLA-B*15 group of alleles has been analyzed using exon 1, intron 1, exon 2, intron 2, and exon 3 sequences from human and nonhuman primates. Results indicated that the 230 alleles analyzed could be grouped into 5 different lineages of evolution coming from nonhuman primate MHC-B* alleles sharing characteristic nucleotide sequences. The major evolutionary mechanism of evolution in this group of alleles is the gene conversion event with the exchange of genomic sequences present in other HLA-B*alleles. This evolutionary event reflects the importance of the exchanges between different genomic regions of distinct HLA-A*, -B*, or -C* alleles and only 1 group of HLA-B* alleles (B*15 in the present paper). These data also correlated with the geographic distribution of the lineages postulated and with the corresponding serologic specificities (B62, -63, -71, -72, -75, -76, and -77). In conclusion, the high degree of polymorphism of 1 group of alleles has a specific and simple pathway of evolution, which could result in new insight into the study of immune system functionality, disease association studies, and anthropological studies.
Subject(s)
Gene Conversion , HLA-B Antigens/genetics , HLA-B Antigens/immunology , Isoantibodies/metabolism , Animals , Base Sequence , Epitopes , Evolution, Molecular , Gene Conversion/genetics , Gene Conversion/immunology , Gene Frequency , Geography , HLA-B Antigens/classification , Humans , Isoantibodies/genetics , Isoantibodies/immunology , Molecular Sequence Data , Polymorphism, Genetic , Primates , Sequence HomologyABSTRACT
Human leukocyte antigen (HLA)-G alleles follow a different pattern of polymorphism generation from those of the HLA classical I alleles. These polymorphisms have been defined as a result of random permitted point mutations in exons. However, this polymorphism maintenance could have an evolutionary specific pathways based on noncoding regions as introns, 14-bp deletion/insertion (exon 8), or promoter regions. Therefore a systematic sequencing study of HLA-G alleles was done obtaining the complete genomic sequence of 16 different HLA-G alleles: nine alleles were intron and exon confirmatory sequences, four were exon confirmatory and new intron described sequences, and three were new alleles. A 14-bp deletion/insertion polymorphism was also sequenced in these alleles. These sequences, together with those previously published, were compared, and phylogenetic and molecular evolutionary analyses were performed. Results showed the presence of three major specific evolutionary patterns, tentatively named lineages, and the other four as minor lineages (only one allele). The relative age of the major lineages could also be established based on the number of lineage-specific positions and the number of alleles of each lineage. Two main mechanisms are clearly defined in the generation of the lineages (introns), gene conversion, and/or convergent evolution following specific patterns.
