increase PSA specificity
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BACKGROUND: The medication used to treat benign prostate hyperplasia (BPH), a common condition in men over 50 years of age, can alter the levels of biomarkers used in prostate cancer detection. Commonly used medications for BPH include alpha-blockers, 5-alpha reductase inhibitors (5-ARIs), and muscarinic antagonists. We studied the impact of these drugs on total prostate-specific antigen (tPSA), free PSA (fPSA), [-2]proPSA, fPSA/tPSA ratio, and the Prostate Health Index (PHI), as well as novel potential biomarkers in the form of glycan composition of fPSA. PATIENTS AND METHODS: Serum samples were collected from 564 males with BPH, with a mean age of 68.5 years. The samples were used to measure levels of tPSA, fPSA, and [-2]proPSA. The fPSA/tPSA and PHI were then calculated. The glycan composition of fPSA was analyzed using lectin-based glycoprofiling. Pharmacotherapy data was collected from the patients' medical records. RESULTS: Alpha-blocker monotherapy was associated with higher fPSA and fPSA/tPSA ratio, and decreased PHI. Levels of tPSA were not impacted. Alpha-blocker and 5-ARI dual therapy was associated with reduced levels of fPSA, [-2]proPSA, and PHI. Therapy combining alpha-blockers and antimuscarinic agents did not significantly influence biomarker levels apart from an increase in a Maackia amurensis lectin-recognized glycan originating in fPSA. CONCLUSION: BPH pharmacotherapy notably affects prostate cancer biomarkers. Recognizing the impact of pharmacotherapy is crucial for achieving an accurate diagnosis of prostate cancer and for planning treatment.
- MeSH
- alfa blokátory terapeutické užití MeSH
- antagonisté muskarinových receptorů * terapeutické užití MeSH
- glykosylace MeSH
- hyperplazie prostaty * krev farmakoterapie MeSH
- inhibitory 5-alfa-reduktasy terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory prostaty krev farmakoterapie MeSH
- prostata patologie metabolismus MeSH
- prostatický specifický antigen * krev MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
Aim: The study aimed to investigate the level of postpartum anxiety in the research sample of women after childbirth and factors related to increased level of postpartum anxiety. The goal was also to establish the basic psychometric properties of the Postpartum Specific Anxiety Scale (PSAS-SK) in the Slovak language, and explore selected sociodemographic, perinatal, and anamnestic factors related to increased level of postpartum anxiety in a Slovak research sample. Design: Quantitative cross-sectional research study. Methods: The study involved 122 postpartum women (four-eight weeks postpartum, age 29.5; ± 4.8; 19-42). Data were collected using the standardized PSAS-SK questionnaire alongside sociodemographic and anamnestic data. Statistical analyses included nonparametric tests (Kruskal-Wallis test and Mann-Whitney U test) and confirmatory factor analysis (CFA) to assess the results. Results: Clinically significant levels of postpartum anxiety occurred in 25% of research participants. We found a significant relationship between perception of childbirth as traumatic and increased levels of postpartum anxiety. However, no significant relationship was confirmed between level of postpartum anxiety and education parity, type of childbirth, complications during pregnancy, perinatal loss, skin-to-skin contact, or health complications in the child. The PSAS-SK had high internal consistency in a Slovak research sample (Cronbach's alpha 0.96). Results of the CFA focusing on confirmation of the four-factor structure of the PSAS-SK indicated the following results: χ2(df = 405) = 2188.0, p < 0.001, CFI = 0.07, RMSEA = 0.008. Conclusion: The Postpartum Specific Anxiety Scale is a valuable tool for the early detection of postpartum anxiety symptoms and for supporting interventions to manage heightened anxiety during the postpartum period, including recommendation of specialized mental health care when appropriate.
Zobrazení vlastní tkáně nádoru prostaty je při použití postupů zobrazení obvyklých u jiných nádorů obtížné, nedostatečné je používat metody zobrazení pomocí kontrastního CT vyšetření, z hybridních metod také PET/CT s aplikací 18F-fluorodeoxyglukózy. Magnetickou rezonanci je možné využít v detekci karcinomu prostaty u mužů s elevací prostatického specifického antigenu (PSA) a/nebo zvýšeným indexem zdravé prostaty (PHI). V současnosti je možné využití spojení radiologických metod a nukleární medicíny - výpočetní tomografie a pozitronové emisní tomografie (PET/CT) nebo magnetické rezonance a pozitronové emisní tomografie (PET/MR). Pro pozitronovou emisní tomografii je možné využití 18F-fluorocholinu (18F-FCH), 18F-fluciclovinu, a 18F-natriumfluoridu (18F-NaF) nebo 68Ga-PSMA-11 (ligand prostatického specifického membránového antigenu), a to ve vyhledávání, stagingu a restagingu karcinomu prostaty. PET/MR nebo PET/CT s podáním 68Ga-PSMA-11 představuje současnou optimální metodu při stagingu, restagingu a kontrole účinku terapie karcinomu prostaty.
Imaging of the prostate tumour ́s own tissue is using standard tumour imaging approaches remains difficult, the imaging using contrast enhanced computed tomography and also the hybrid imaging using PET/CT with the application of the 18F-fluorodeoxyglucose is insufficient. Magnetic resonance imaging is useful in detection of prostate cancer in patients with elevated prostatic specific antigen (PSA) and/or with increased prostate health index (PHI). Currently, it is possible to use combination of radiological and nuclear medicine methods - hybrid positron emission tomography combined with computed tomography (PET/CT) or with magnetic resonance imaging (PET/MRI) with the application of 18F-fluorocholine (FCH), 18F-fluciclovine, 18F-natriumfluoride (18F-NaF) or 68Ga-PSMA-11 (ligand of prostatic specific membrane antigen) in detection, staging or restaging of prostate carcinoma. PET/CT or PET/MRI with the application of 68Ga-PSMA-11 represents current optimal method for staging, restaging and evaluation of prostate cancer therapy response.
- MeSH
- diagnostické zobrazování klasifikace metody MeSH
- fluorodeoxyglukosa F18 terapeutické užití MeSH
- lidé MeSH
- magnetická rezonanční tomografie metody MeSH
- multimodální zobrazování * klasifikace metody MeSH
- nádory prostaty * diagnostické zobrazování diagnóza MeSH
- PET/CT metody MeSH
- prostatický specifický antigen analýza MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
Laser-induced breakdown spectroscopy (LIBS) is a promising technique for the readout of immunochemical assays utilizing indirect detection of labels (Tag-LIBS), typically based on nanoparticles. We have previously demonstrated that Tag-LIBS immunoassay employing yttrium-based photon-upconversion nanoparticles (UCNPs) can reach sensitivity similar to commonly used enzyme and fluorescence immunoassays. In this study, we report on further increasing the sensitivity of UCNP-based Tag-LIBS immunoassay by employing magnetic microbeads (MBs) as the solid phase in the determination of cancer biomarker prostate-specific antigen. Due to the possibility of analyte preconcentration, MBs enabled achieving a limit of detection (LOD) of 4.0 pg·mL-1, representing two orders of magnitude improvement compared with equivalent microtiter plate-based assay (LOD of 460 pg·mL-1). In addition, utilizing MBs opens up the possibility of an internal standardization of the LIBS readout by employing iron spectral lines, which improves the assay robustness by compensating for LIBS signal fluctuations and bead-bound immunocomplexes lost throughout the washing steps. Finally, the practical applicability of the technique was confirmed by the successful analysis of clinical samples, showing a strong correlation with the standard electrochemiluminescence immunoassay. Overall, MB-based Tag-LIBS was confirmed as a promising immunoassay approach, combining fast readout, multiplexing possibilities, and high sensitivity approaching upconversion luminescence scanning while avoiding the requirement of luminescence properties of labels.
- MeSH
- imunoanalýza metody MeSH
- lasery * MeSH
- lidé MeSH
- limita detekce * MeSH
- mikrosféry MeSH
- prostatický specifický antigen * analýza imunologie krev MeSH
- spektrální analýza metody MeSH
- ytrium chemie účinky záření MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
V průběhu posledních desetiletí došlo ke značnému nárůstu pacientů léčených pro nezvratné selhání ledvin s diagnostikovaným karcinomem prostaty před transplantací ledviny, stejně jako k nárůstu pacientů po transplantaci ledviny s diagnostikovaným karcinomem prostaty. Vliv hrají předtransplantační screening, stárnutí populace a prodloužené přežívání po transplantaci. Nové poznatky vedou u této skupiny pacientů k úpravě některých diagnostických i léčebných postupů, jasně dané doporučené postupy však nadále chybí. Nově také u pacientů s nízce rizikovým karcinomem prostaty v aktivním sledování nebo po kurativní terapii není třeba dodržovat žádný interval před zařazením na čekací listinu k transplantaci. Zvláštní pozornost je věnována roli imunosupresivní terapie, která je nezbytná pro funkci transplantované ledviny, ale zároveň může ovlivňovat riziko a průběh onkologického onemocnění. Úprava nebo snížení imunosuprese, jak naznačuje aktuální literatura, může být v některých případech rozumným krokem, avšak vyžaduje pečlivé zvážení v kontextu individuálního pacienta. Pacienti, kteří podstoupili transplantaci ledviny a mají diagnostikovaný karcinom prostaty, dosahují podobných léčebných výsledků jako pacienti bez nezvratného selhání ledvin. V textu shrnujeme aktuální poznatky stran epidemiologie, léčebných možností i výzev, kterým čelí medicína u pacientů s karcinomem prostaty před a po transplantaci ledvin, včetně jejich odlišností od běžné populace.
Over recent decades, there has been a significant increase in patients treated for end-stage renal disease diagnosed with prostate cancer before kidney transplantation, as well as an increase in kidney transplant recipients diagnosed with prostate cancer. Pre-transplant screening, the aging population, and extended survival post-transplant play a role. New insights lead to adjustments in some diagnostic and therapeutic procedures in this patient group, yet clear recommended guidelines remain absent. Also, patients with low-risk prostate cancer in active surveillance or after curative therapy are no longer required to wait before being listed for transplantation. Special attention is given to the role of immunosuppressive therapy, which is essential for the function of the transplanted kidney but may also influence the risk and course of oncological disease. Modifying or reducing immunosuppression, as suggested by current literature, may be a reasonable step in some cases but requires careful consideration in the context of the individual patient. Patients who have undergone kidney transplantation and are diagnosed with prostate cancer achieve similar treatment outcomes as patients with no end-stage renal disease. In the text, we summarize current knowledge regarding epidemiology, treatment options, and challenges faced by medicine in patients with prostate cancer before and after kidney transplantation, including their differences from the general population.
- MeSH
- imunosupresivní léčba klasifikace metody MeSH
- lidé MeSH
- management nemoci MeSH
- nádory prostaty * diagnóza epidemiologie farmakoterapie terapie MeSH
- prostatický specifický antigen analýza MeSH
- radioterapie metody MeSH
- transplantace ledvin * metody MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
- přehledy MeSH
BACKROUND: We wanted to characterize conditional survival in prostate cancer (PC) in Sweden around and after 2005 when the vast increase in incidence due to the opportunistic testing for prostate specific antigen (PSA) culminated. We hypothesize that analyzing survival data during that time period may help interpret survival trends. We focus on stage-specific analysis using conditional survival in order to define the periods when deaths most commonly occurred. METHODS: Data on PC patients were obtained from the Swedish cancer registry for analysis of 1-, 2.5- and 5-year relative survival and conditional relative survival between years 2004 and 2018. Tumor-node-metastatic stage classification at diagnosis was used to specify survival. RESULTS: Small improvements were observed in stage- and age-related relative survival duriring the study period. Applying conditional relative survival showed that survival in stage T3 up to 2.5 years was better than survival between years 2.5 and 5. Survival in stage T4 was approximately equal in the first and the subsequent 2.5-year period. For M1, the first 2.5 year survival period was worse than the subsequent one. The proportion of high risk and M1 disease in old patients (80+ years) remained very high and their survival improved only modestly. CONCLUSIONS: The data indicate that M1 metastases kill more patients in the first 2.5 years than between years 2.5 and 5 after diagnosis; T4 deaths are equal in the two periods, and in T3 mortality in the first 2.5-year period is lower than between years 2.5 and 5 after diagnosis. Conditional survival could be applied to explore critical survival periods even past 5 years after diagnoses and to monitor success in novel diagnostic and treatment practices. Improvement of survival in elderly patients may require clinical input.
- MeSH
- analýza přežití MeSH
- lidé MeSH
- míra přežití MeSH
- nádory prostaty * MeSH
- prostatický specifický antigen MeSH
- registrace MeSH
- senioři MeSH
- staging nádorů MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Švédsko MeSH
BACKGROUND: Prostate cancer is a common cancer in men. Detection methods include the measurement of biomarkers: prostate-specific antigen (PSA), free PSA, [-2]proPSA, and the calculated indices: fPSA/tPSA ratio and Prostate Health Index (PHI). Proper preanalytical conditions are crucial for precise measurement and failure to adhere to protocols or regulations can influence the diagnostic algorithm. We assessed the stability of the above-mentioned biomarkers, fPSA/tPSA ratio and PHI, under various pre-analytical conditions. METHODS: Serum samples from 45 males were collected and stored under specific conditions before tPSA, fPSA, and [-2]proPSA were measured. Subsequently, the fPSA/tPSA and PHI were calculated. RESULTS: tPSA, fPSA, and [-2]proPSA remained stable during the two freeze-thaw cycles. Storage at 4°C and 22°C resulted in stable tPSA concentrations. However, fPSA levels decreased and [-2]proPSA levels increased over time. The fPSA/tPSA ratio remained stable for 72 h, at which point a decrease was observed in the samples kept at 4°C and 22°C. A gradual increase in PHI was observed in the samples kept at 4°C and 22°C. CONCLUSIONS: All biomarkers remained stable during two freeze-thaw cycles. tPSA was the most stable analyte when stored at 4°C, as well as at RT. A gradual increase of [-2]proPSA and a slight decrease in fPSA were observed during the storage test. This led to a decrease in the fPSA/tPSA ratio and an elevation in the PHI. We therefore recommend measuring prostate biomarkers promptly following blood collection. IMPACT: Understanding the pre-analytical stability of prostate biomarkers helps prevent false positive results and improve the accuracy of diagnostics for prostate cancer.
- MeSH
- lidé MeSH
- nádory prostaty * diagnóza MeSH
- prostata patologie MeSH
- prostatický specifický antigen * krev chemie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Rostoucí incidence karcinomu prostaty je – především s ohledem na snadno vyčerpatelné způsoby terapie při progresi tohoto onemocnění do metastatického kastračně rezistentního stadia – hlavní hnací silou pro rozvoj nových léčebných modalit. Radioligandová terapie je jednou z možností, ke které by bylo možné se uchýlit. Tento způsob léčby využívá ligandy schopné cílit na konkrétní buněčné struktury, a dopravit tak zdroj ionizujícího záření přímo k nádorovým buňkám. Radiofarmakum tak působí radiační poškození přímo nádorovým buňkám při minimálním ozáření zdravé tkáně. Lutecium (177Lu) vipivotid tetraxetan (přípravek Pluvicto) patří mezi radiofarmaka, která je dnes možné použít k radioligandové léčbě, konkrétně k terapii metastatického kastračně rezistentního karcinomu prostaty u pacientů, u kterých jiné léčebné postupy již selhaly. Tento článek si klade za cíl shrnout dosavadní poznatky o výzkumu a možnostech použití tohoto radiofarmaka.
The increasing incidence of prostate cancer, especially with regard to the easily exhausted methods of therapy when once developed to the metastatic castration-resistant stage, is the main driving force for the development of new treatment modalities. Radioligand therapy is one option that one can resort to. This therapy uses ligands capable of targeting specific cell structures, thereby delivering a source of ionizing radiation directly to the tumour cells. The radiopharmaceutical thus causes radiation damage directly to the tumour cells with minimal irradiation of healthy tissue. Lutetium ( 177 Lu) vipivotide tetraxetan (Pluvicto) belongs to the radiopharmaceuticals that can be used today for radioligand therapy, specifically for the treatment of metastatic castration-resistant prostate cancer in cases when other treatments have already failed. This article aims to summarize the current knowledge about research and use of this radiopharmaceutical.
- MeSH
- klinická studie jako téma MeSH
- lidé MeSH
- lutecium * farmakokinetika farmakologie terapeutické užití účinky záření MeSH
- nádory prostaty rezistentní na kastraci MeSH
- nádory prostaty * terapie MeSH
- prostatický specifický antigen MeSH
- protokoly protinádorové léčby MeSH
- radiofarmaka aplikace a dávkování farmakologie terapeutické užití MeSH
- radioligandová zkouška metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
V práci stručne opisujeme možnosti využitia metód tzv. tekutej biopsie, teda detekcie vysoko nádorovo-špecifických markerov z telových tekutín, na diagnostiku karcinómu prostaty (CaP). V tomto prípade je dôležité hodnotiť biomarkery, ktoré sú orgánovo-špecifické, ako napríklad kalikreíny (rôzne formy PSA), avšak tie nie sú rakovinovo-špecifické. Na zvýšenie spoľahlivosti diagnostiky CaP je preto nutné použiť biomarkery, ktoré sú orgánovo-špecifické a zároveň rakovinovo-špecifické, k takým biomarkerom patrí glykoprofilácia fPSA (free PSA, free prostate-specific antigen/voľný prostatický špecifický antigén) vo forme Giasay (glycopsy immunoassay) testu. Giasay test poskytuje vysokú hodnotu AUC = 0,82 (AUC, area under curve/plocha pod ROC krivkou; ROC, receiver operating curve/operačná charakteristika prijímača), oveľa vyššiu v porovnaní s kalikreínovými testami (vrátane PHI, prostate health index/index zdravia prostaty), a vopred odhalí aj kastračne rezistentnú formu či veľmi skoré štádiá ochorenia. Zároveň Giasay test preukáže podľa výsledkov validácií 63-70 % negatívnych prípadov biopsií v populácii. Tieto hodnoty prevyšujú na Slovensku a v Čechách dostupné laboratórne metódy využívané na skríning a diagnostiku CaP.
In this work, we briefly describe the possibilities of using the so-called liquid biopsy i.e. the detection of highly tumor-specific markers from body fluids, for the diagnosis of prostate cancer (CaP). For this purpose, it is important to use biomarkers that are organ-specific, such as kallikreins (different forms of PSA). Unfortunately, such biomarkers are not cancer-specific. To increase the reliability of CaP diagnosis, it is therefore necessary to use biomarkers that are organ-specific and at the same time cancer-specific, and such biomarkers include glycoprofiling of fPSA (free form of prostate specific antigen) in the form of Giasay (glycopsy immunoassay) test. The Giasay test provides a high value of AUC = 0.82 (AUC - area under curve i.e. the area under receiver operating curve), much higher compared to kallikrein tests (including PHI, prostate health index), and it also reveals the castration-resistant form or very early stages of the disease in advance. At the same time, the Giasay test reveals, according to the validation results, 63-70% of negative cases of biopsies in the population. These values exceed the laboratory methods available in Slovakia and the Czech Republic for the screening and diagnosis of CaP.
- Klíčová slova
- glykoprofilace,
- MeSH
- glykomika * MeSH
- lidé MeSH
- nádorové biomarkery analýza MeSH
- nádory prostaty * diagnóza MeSH
- tekutá biopsie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- přehledy MeSH
Karcinom prostaty patří celosvětově k nejčastějším typům nádorů u mužů. Incidence karcinomu prostaty se nadále zvyšuje (zlepšení diagnostických metod), zatímco mortalita je přibližně stacionární. V diagnostice karcinomu prostaty má své výsadní postavení prostatický specifický antigen (PSA) jako hlavní sérový marker. Jedná se o marker orgánově specifický, ale nikoliv nádorově specifický. Od PSA bylo odvozeno několik dalších parametrů, které mají zvýšit jeho senzitivitu a specificitu. S využitím PSA se počítá i do budoucna, v rámci plánovaného screeningového programu.
Prostate cancer is one of the most common types of cancer in men worldwide. The incidence of prostate cancer continuously increases (improvement in diagnostic methods) while the mortality rate remains stationary. In the diagnosis of prostate cancer, prostate specific antigen (PSA) has a privileged position as the main serum marker. It is an organ-specific but not tumor-specific marker. Several other parameters have been derived from PSA to increase its sensitivity and specificity. PSA is expected to be used in the future as part of the planned screening programme.