Článek prezentuje modelový případ staršího pacienta s malým nádorem na ledvině a rozebírá jednotlivé léčebné možnosti. Navazuje na sdělení prezentovaná v rámci 6. ročníku konference Komplexní novinky v onkourologii (KNOU21) specialisty z různých klinických oborů. Konkrétní nález, možná biologická povaha ložiska, přirozený průběh onemocnění, smysl, benefit a rizika aktivní či odložené léčby a specifika geriatrické populace vyžadují kritický pohled na platná obecná doporučení a individualizaci léčebné strategie. Zcela klíčová je multioborová spolupráce s následná diskuze všech zvažovaných léčebných možností s pacientem.
The article presents a model case of an elderly patient with a small renal tumor and discusses possible treatment options. It follows the communication presented by specialists from various medical disciplines at the 6th year of "Komplexní novinky v onkourologii (KNOU21)" conference. The specific finding, the possible biological nature of the lesion, the natural course of the disease, the meaning, benefit and risks of active or delayed treatment and the specifics of the geriatric population require a critical look at current general recommendations and individualization of treatment strategy. Multidisciplinary approach with the subsequent discussion of all considered treatment options with the patient is absolutely crucial.
- Klíčová slova
- malé nádory ledvin,
- MeSH
- ablace metody MeSH
- ledviny chirurgie patologie MeSH
- lidé MeSH
- nádory ledvin * chirurgie diagnóza MeSH
- nefrektomie metody MeSH
- pozorné vyčkávání MeSH
- senioři nad 80 let MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- Publikační typ
- kazuistiky MeSH
Splenogonadální fúze (SGF) je unikátní vývojová malformace, jejímž důsledkem je ektopický výskyt tkáně sleziny v gonádě. Od její první zmínky uplynulo již 135 let, nicméně etiologie i nadále zůstává nejasná. Dle zachování komunikace se slezinou prostřednictvím vazivového pruhu se rozlišují dva typy SGF (kontinuální a diskontinuitní). Některé z případů jsou spojeny s výskytem kryptorchizmu. Pro tuto lézi není popsán typický klinický obraz, nicméně SGF může imitovat nádor varlete. Předoperační identifikace SGF je nesnadná a ke stanovení diagnózy dochází až při histopatologickém vyšetření. V následujícím textu je prezentován případ splenogonadální fúze u 25letého muže, který byl urologicky řešen pro suspektní tumor varlete.
Splenogonadal fusion (SGF) is a unique developmental malformation that results in the ectopic occurrence of spleen tissue in the gonad. 135 years have passed since its first mention, nonetheless the etiology remains unclear. By maintaining communication with the spleen via a ligament, we can differentiate between two types of SGF (continuous and discontinuous). Some of the cases are associated with the occurrence of cryptorchism. There is no typical clinical picture of this lesion and it can mimic a tumor of the testicle. Preoperative identification of SGF is difficult and does not occur until a histopathological examination. The following is man who was urologically examined and treated for a suspected tumor of the testis.
- MeSH
- dospělí MeSH
- kryptorchismus * chirurgie diagnostické zobrazování MeSH
- lidé MeSH
- orchiektomie MeSH
- slezina abnormality MeSH
- spina bifida MeSH
- urogenitální abnormality chirurgie diagnostické zobrazování MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
To date, there has been no evidence regarding the association between urinary sarcosine content and prostate cancer survival. Our main objective was to investigate whether levels of post-treatment urinary sarcosine are associated with relapse. The inclusion criteria were (in accordance with EAU 2017) as follows: histopathologically verified adenocarcinoma in prostate biopsy cores or specimens from transurethral resection of the prostate (TURP) or prostatectomy for benign prostatic enlargement (BPE) with retained ability to urinate. The median follow-up was 53 months. In the study, we retrospectively evaluated a cohort of 511 patients with prostate cancer with various risk factors and treatment strategies. Post-treatment sarcosine levels were elevated in 266 (52%) patients and highly elevated (≥200 nmol/L) in 71 (13%) patients. Urinary sarcosine content was significantly associated with number of relapses that patients experienced, P = 0.002 for sarcosine ≥200 vs ≤30 nmol/L. Multivariate analysis revealed that sarcosine was an independent predictor of recurrent relapses (≥2 relapses with an intermediate period of remission), HR = 3.89 (95% CI 1.29-11.7) for sarcosine >200 vs <30 nmol/L. This trend was even more pronounced in a subgroup of patients who underwent radical prostatectomy, HR = 3.29 (95% CI 1.06-10.18), where (single) relapse-free survival could also be predicted by sarcosine levels, HR = 1.96 (1.05-3.66). Urinary sarcosine may become a possible predictor for patients' outcomes, because patients with elevated post-treatment sarcosine could be predicted to have recurrent relapses of the disease.
- MeSH
- adenokarcinom chirurgie moč MeSH
- biologické markery moč MeSH
- hyperplazie prostaty chirurgie moč MeSH
- lidé MeSH
- lokální recidiva nádoru moč MeSH
- nádory prostaty chirurgie moč MeSH
- pooperační období MeSH
- prostatektomie MeSH
- recidiva MeSH
- retrospektivní studie MeSH
- sarkosin moč MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
The hypothesis that dogs can detect malignant tumours through the identification of specific molecules is nearly 30 years old. To date, several reports have described the successful detection of distinct types of cancer. However, is still a lack of data regarding the specific molecules that can be recognized by a dog's olfactory apparatus. Hence, we performed a study with artificially prepared, well-characterized urinary specimens that were enriched with sarcosine, a widely reported urinary biomarker for prostate cancer (PCa). For the purposes of the study, a German shepherd dog was utilized for analyses of 60 positive and 120 negative samples. Our study provides the first evidence that a sniffer dog specially trained for the olfactory detection of PCa can recognize sarcosine in artificial urine with a performance [sensitivity of 90%, specificity of 95%, and precision of 90% for the highest amount of sarcosine (10 µmol/L)] that is comparable to the identification of PCa-diagnosed subjects (sensitivity of 93.5% and specificity of 91.6%). This study casts light on the unrevealed phenomenon of PCa olfactory detection and opens the door for further studies with canine olfactory detection and cancer diagnostics.
- MeSH
- analýza moči metody MeSH
- čich fyziologie MeSH
- lidé MeSH
- nádory prostaty diagnóza moč MeSH
- psi fyziologie MeSH
- sarkosin chemie moč MeSH
- senzitivita a specificita MeSH
- studie proveditelnosti MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- psi fyziologie MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
The effects of sarcosine on the processes driving prostate cancer (PCa) development remain still unclear. Herein, we show that a supplementation of metastatic PCa cells (androgen independent PC-3 and androgen dependent LNCaP) with sarcosine stimulates cells proliferation in vitro. Similar stimulatory effects were observed also in PCa murine xenografts, in which sarcosine treatment induced a tumor growth and significantly reduced weight of treated mice (p < 0.05). Determination of sarcosine metabolism-related amino acids and enzymes within tumor mass revealed significantly increased glycine, serine and sarcosine concentrations after treatment accompanied with the increased amount of sarcosine dehydrogenase. In both tumor types, dimethylglycine and glycine-N-methyltransferase were affected slightly, only. To identify the effects of sarcosine treatment on the expression of genes involved in any aspect of cancer development, we further investigated expression profiles of excised tumors using cDNA electrochemical microarray followed by validation using the semi-quantitative PCR. We found 25 differentially expressed genes in PC-3, 32 in LNCaP tumors and 18 overlapping genes. Bioinformatical processing revealed strong sarcosine-related induction of genes involved particularly in a cell cycle progression. Our exploratory study demonstrates that sarcosine stimulates PCa metastatic cells irrespectively of androgen dependence. Overall, the obtained data provides valuable information towards understanding the role of sarcosine in PCa progression and adds another piece of puzzle into a picture of sarcosine oncometabolic potential.
- MeSH
- buněčný cyklus účinky léků fyziologie MeSH
- geny nádorové fyziologie MeSH
- glycin-N-methyltransferasa metabolismus MeSH
- lidé MeSH
- myši inbrední BALB C MeSH
- myši nahé MeSH
- myši MeSH
- nádorové buněčné linie MeSH
- nádory prostaty metabolismus patofyziologie MeSH
- polymerázová řetězová reakce MeSH
- regulace genové exprese u nádorů účinky léků fyziologie MeSH
- sarkosin metabolismus farmakologie MeSH
- sarkosindehydrogenasa metabolismus MeSH
- transkriptom MeSH
- transplantace nádorů MeSH
- upregulace MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- myši MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
