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Estudo da incidência do cancro da próstata na RAM e avaliação da sua deteção precoce, através da associação do marcador [-2] proPSA ao PSA e PSA livre
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Abstract(s)
O cancro da próstata (CP) é uma das patologias mais frequentes no homem em todo o mundo, sendo considerado um grave problema de saúde pública. Esta patologia apresenta uma elevada heterogeneidade, pelo que nos dias de hoje, torna-se cada vez mais, importante a realização de estudos a nível dos possíveis fatores de risco, diagnóstico, progressão e tratamento da doença. A introdução do antigénio específico da próstata (PSA) como marcador serológico possibilitou grandes avanços na deteção precoce do cancro da próstata. Atualmente é o marcador serológico mais utilizado a nível de rastreio, embora ainda existam algumas dúvidas, relativamente à sensibilidade e à especificidade do teste. Assim sendo, torna-se fundamental a descoberta de novos marcadores que auxiliem quer o diagnóstico quer o prognóstico da patologia, de modo a evitar ou a retardar a progressão da doença, conduzindo a novas terapias menos invasivas para o doente. Com o presente trabalho realizou-se um estudo retrospetivo que incluiu soros de 15.369 indivíduos masculinos, com o intuito de avaliar a incidência de cancro da próstata na Região Autónoma da Madeira (RAM), os quais foram submetidos a análise para detetar as quantidades de PSA, PSA livre e [-2] proPSA, utilizando a técnica de imunoensaio quimiluminescente. A 82 desses indivíduos foram realizadas biópsias, das quais 27 apresentaram resultados positivos e 55 apresentaram resultados negativos. De acordo com os valores de cut-offs do PSA, intervalo [2,0-10,0 ng/mL], 33% das biópsias eram positivas e 67% das biópsias eram negativas. A doença atingiu maioritariamente os indivíduos com idade superior a 70 anos (63,63%), tendo 2 pacientes apresentado um score de Gleason superior a 7 (tumor agressivo) e 3 pacientes, um score menor que 7 (tumor moderadamente diferenciado). O teste ROC em que foram comparados os valores de PSA, PSA livre e [-2] proPSA permite aferir que o [-2] proPSA foi a isoforma do PSA que apresentou maior valor de predicção na deteção precoce do CP. Este trabalho procurou contribuir para um melhor conhecimento do perfil dos indivíduos, com maior probabilidade de contraírem o cancro da próstata na população da RAM.
Prostate cancer is the most frequent pathology in man worldwide and is considered a serious public health problem. This disease shows to be highly variable in its clínical features, so nowadays it is increasingly important to conduct studies about the risk factors, diagnostic, progression and treatment of disease. The introduction of prostate specific antigen (PSA) as a serological marker enables great advances in early diagnostic of prostate cancer. The PSA is currently the most widely used serum marker in the screening of prostate cancer, although still some doubts about the sensitivity and specificity of this test. Therefore, it becomes essential to discover novel markers that can assist both in terms of diagnosis and prognosis of disease, and to prevent the progression of the disease, leading to new less invasive therapies. In this work we performed a retrospective study with a total of 15.369 individuals, in order to assess the incidence of prostate cancer in Autonomous Region of Madeira (RAM), which serum samples were submitted to chemiluminescent immunoassay to detect the amounts of PSA, free PSA and [-2] proPSA. Among these individuals, 82 biopsies has been realized from which 27 were positive and 55 negative. For PSA values in the interval range of 2,0-10,0 ng/ml, 33% biopsies were positive and 67 % negative. The disease shows higher prevalence in men older than 70 years (63,63 %). Two patients had Gleason score greater than 7 (aggressive tumor), and 3 patients, a lower score than 7 (moderately differentiated tumor). According to ROC test, which compares PSA, free PSA and [-2] proPSA values, the last one is himself as the best predictor for early detection of prostate cancer. This study sought to contribute to a better understanding of prostate cancer in the population profile of RAM.
Prostate cancer is the most frequent pathology in man worldwide and is considered a serious public health problem. This disease shows to be highly variable in its clínical features, so nowadays it is increasingly important to conduct studies about the risk factors, diagnostic, progression and treatment of disease. The introduction of prostate specific antigen (PSA) as a serological marker enables great advances in early diagnostic of prostate cancer. The PSA is currently the most widely used serum marker in the screening of prostate cancer, although still some doubts about the sensitivity and specificity of this test. Therefore, it becomes essential to discover novel markers that can assist both in terms of diagnosis and prognosis of disease, and to prevent the progression of the disease, leading to new less invasive therapies. In this work we performed a retrospective study with a total of 15.369 individuals, in order to assess the incidence of prostate cancer in Autonomous Region of Madeira (RAM), which serum samples were submitted to chemiluminescent immunoassay to detect the amounts of PSA, free PSA and [-2] proPSA. Among these individuals, 82 biopsies has been realized from which 27 were positive and 55 negative. For PSA values in the interval range of 2,0-10,0 ng/ml, 33% biopsies were positive and 67 % negative. The disease shows higher prevalence in men older than 70 years (63,63 %). Two patients had Gleason score greater than 7 (aggressive tumor), and 3 patients, a lower score than 7 (moderately differentiated tumor). According to ROC test, which compares PSA, free PSA and [-2] proPSA values, the last one is himself as the best predictor for early detection of prostate cancer. This study sought to contribute to a better understanding of prostate cancer in the population profile of RAM.
Description
Keywords
Cancro da próstata Antigénio específico da próstata PSA livre [-2] proPSA Incidência Prevalência Prostate cancer Prostate specific antigen Free PSA [-2] proPSA Incidence Prevalence Bioquímica Aplicada . Faculdade de Ciências da Vida