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Id: lil-769759
Autor: Vasudeva, Pawan; Kumar, Niraj; Kumar, Anup; Singh, Harbinder; Kumar, Gaurav.
Título: Safety of 12 core transrectal ultrasound guided prostate biopsy in patients on aspirin
Fonte: Int. braz. j. urol;41(6):1096-1100, Nov.-Dec. 2015. tab, graf.
Idioma: en.
Resumo: Objective: To prospectively assess safety outcome of TRUS guided prostate biopsy in patients taking low dose aspirin. Materials and methods: Consecutive patients, who were planned for 12 core TRUS guided prostate biopsy and satisfied eligibility criteria, were included in the study and divided into two Groups: Group A: patients on aspirin during biopsy, Group B: patients not on aspirin during biopsy, including patients in whom aspirin was stopped prior to the biopsy. Parameters included for statistical analysis were: age, serum prostate specific antigen (PSA), prostate volume, hemoglobin (Hb %), number of hematuria episodes, number of patient reporting hematuria, hematuria requiring intervention, number of patient reporting hematospermia and number of patient reporting rectal bleeding. Results: Of 681 eligible patients, Group A and B had 191 and 490 patients respectively. The mean age, prostate volume, serum PSA and pre-biopsy hemoglobin were similar in both Groups with no significant differences noted between them. None of the post-biopsy complications, including number of hematuria episodes (p=0.83), number of patients reporting hematuria (p=0.55), number of patients reporting hematospermia (p=0.36) and number of patients reporting rectal bleeding (p=0.65), were significantly different between Groups A and B respectively. None of the hemorrhagic complication in either group required intervention and were self limiting. Conclusion: Continuing low dose aspirin during TRUS guided prostate biopsy neither alters the minor bleeding episodes nor causes major bleeding complication. So, discontinuation of low dose aspirin prior to TRUS guided prostate biopsy is not required.
Responsável: BR1.1 - BIREME


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Id: lil-767049
Autor: Pepe, Pietro; Pennisi, Michele; Fraggetta, Filippo.
Título: Anterior prostate biopsy at initial and repeat evaluation: is it useful to detect significant prostate cancer?
Fonte: Int. braz. j. urol;41(5):844-848, Sept.-Oct. 2015. tab.
Idioma: en.
Resumo: ABSTRACT Purpose: Detection rate for anterior prostate cancer (PCa) in men who underwent initial and repeat biopsy has been prospectively evaluated. Materials and Methods: From January 2013 to March 2014, 400 patients all of Caucasian origin (median age 63.5 years) underwent initial (285 cases) and repeat (115 cases) prostate biopsy; all the men had negative digital rectal examination and the indications to biopsy were: PSA values > 10 ng/mL, PSA between 4.1-10 or 2.6-4 ng/mL with free/total PSA≤25% and ≤20%, respectively. A median of 22 (initial biopsy) and 31 cores (repeat biopsy) were transperineally performed including 4 cores of the anterior zone (AZ) and 4 cores of the AZ plus 2 cores of the transition zone (TZ), respectively. Results: Median PSA was 7.9 ng/mL; overall, a PCa was found in 180 (45%) patients: in 135 (47.4%) and 45 (36%) of the men who underwent initial and repeat biopsy, respectively. An exclusive PCa of the anterior zone was found in the 8.9 (initial biopsy) vs 13.3% (repeat biopsy) of the men: a single microfocus of cancer was found in the 61.2% of the cases; moreover, in 7 out 18 AZ PCa the biopsy histology was predictive of significant cancer in 2 (28.5%) and 5 (71.5%) men who underwent initial and repeat biopsy, respectively. Conclusions: However AZ biopsies increased detection rate for PCa (10% of the cases), the majority of AZ PCa with histological findings predictive of clinically significant cancer were found at repeat biopsy (about 70% of the cases).
Responsável: BR1.1 - BIREME


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Id: lil-731121
Autor: Aglamis, Erdogan; Kocaarslan, Ramazan; Yucetas, Ugur; Toktas, Gokhan; Ceylan, Cavit; Doluoglu, Omer Gokhan; Unluer, Erdinc.
Título: How many cores should be taken in a repeat biopsy on patients in whom atypical small acinar proliferation has been identified in an initial transrectal prostate biopsy?
Fonte: Int. braz. j. urol;40(5):605-612, 12/2014. tab.
Idioma: en.
Resumo: Objective To compare cancer detection rates according to the number of biopsy cores in patients on whom a repeat prostate biopsy was performed for atypical small acinar proliferation (ASAP). Materials and Methods The data of 4950 consecutive patients on whom prostate biopsies were performed were assessed retrospectively. A total of 107 patients were identified as having ASAP following an initial prostate biopsy, and they were included in the study. A six-core prostate biopsy (PBx) was performed on 15 of the 107 patients, 12 PBx on 32 patients, and 20 PBx on 60 patients. Cancer detection rates were compared according to the number of biopsy cores. The localization of the cancer foci was also evaluated. Results The cancer detection rates in patients on whom 6 PBx, 12 PBx, and 20 PBx were performed were 20% (3/15), 31% (10/32), and 58% (35/60), respectively, and a statistically significant difference was found (p = 0.005). When cancer detection rates in patients with total prostate specific antigen (PSA) < 10ng/mL, PSA density ≥ 0.15, normal digital rectal examination, and prostate volume ≥ 55mL were compared according to the number of biopsy cores, a significant difference was identified (p = 0.02, 0.03, 0.006, and 0.04, respectively). Seventy-five percent of the foci where cancer was detected were at the same and/or adjacent sites as the ASAP foci in the initial biopsy, and 54% were identified in contralateral biopsies in which ASAP foci were present. Conclusion As the biopsy core number increases, the cancer detection rate increases significantly in patients on whom a repeat biopsy is performed due to ASAP. The highest cancer rate is found in 20-core repeat biopsies performed equally from all foci. .
Responsável: BR1.1 - BIREME


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Id: lil-655988
Autor: Oh, Jin Kyu; Kim, Khae Hawn; Jung, Han; Yoon, Sang Jin; Kim, Tae Beom.
Título: Second to fourth digit ratio: its relationship with core cancer volume and Gleason score in prostate biopsy
Fonte: Int. braz. j. urol;38(5):611-619, Sept.-Oct. 2012. tab.
Idioma: en.
Resumo: OBJECTIVE: To investigate the relationships between 2nd to 4th digit ratio (digit ratio) and prostate cancer detection rate and biopsy findings, including Gleason score. MATERIALS AND METHODS: In 770 consecutive men aged 40 years or older that presented with lower urinary tract symptoms (LUTS), right hand 2nd and 4th digit lengths were measured prior to PSA determinations, DRE and transrectal ultrasonography (TRUS). Among these, 166 men with a prostate specific antigen (PSA) level ≥ 3 ng/mL or abnormal digit rectal examination (DRE) prospectively underwent prostate biopsies. The relationship between digit ratio and prostate cancer detection rate and biopsy findings was investigated. RESULTS: The study subjects were allocated to two groups by digit ratio (group A: digit ratio < 0.95; n = 420; group B: digit ratio ≥ 0.95; n = 350). Despite similar biopsy rates (22.4% vs. 20.6%, p = 0.544), group A had higher cancer detection rate (46.8% (44/94) vs. 23.6% (17/72), p = 0.002; OR = 2.847, 95% CI = 1.445-5.610). When we analyzed 408 positive biopsy cores (group A: digit ratio < 0.95, n = 282; group B: digit ratio ≥ 0.95, n = 126), group A had higher percentage of core cancer volume (46.7% vs. 37.1%, p = 0.005) and more biopsy cores with high Gleason score (sum of Gleason score ≥ 9: 18/282 (6.4%) vs. 1/126 (0.8%), p = 0.010; primary Gleason score = 5: 12/282 (4.3%) vs. 0/126 (0.0%), p = 0.021). CONCLUSIONS: A lower digit ratio is related to an increased detection rate of prostate cancer, a high percentage of core cancer volume and a high Gleason score.
Responsável: BR1.1 - BIREME


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Baracat, Edmund Chada
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Id: lil-653763
Autor: Ricci, Marcos Desidério; Calvano Filho, Carlos Marino Cabral; Oliveira Filho, Helio Rubens de; Filassi, José Roberto; Pinotti, José Aristodemo; Baracat, Edmund Chada.
Título: Analysis of the concordance rates between core needle biopsy and surgical excision in patients with breast cancer / Análise das taxas de concordância entre a biópsia com agulha grossa e a excisão cirúrgica em pacientes com câncer de mama
Fonte: Rev. Assoc. Med. Bras. (1992);58(5):532-536, set.-out. 2012. tab.
Idioma: en.
Resumo: OBJECTIVE: To evaluate whether immunohistochemical marker studies performed on core needle biopsy (CNB) specimens accurately reflect the marker status of the tumor obtained from final surgical specimen. METHODS: This was a retrospective study that used the database of the Division of Mastology of the Hospital das Clínicas, São Paulo, Brazil. Sixty-nine patients submitted to ultrasound-guided CNB diagnosed with breast cancer were retrospectively analyzed. Immunohistochemistry (IHC) on core biopsy specimens was compared to that of excisional biopsy regarding estrogen receptor (ER), progesterone receptor (PR), human epidermal gowth factor receptor 2 gene (HER2), p53, and Ki67. The analysis of the concordance between CNB and surgical biopsy was performed using the kappa (k) coefficient (95% CI). RESULTS: A perfect concordance between the labeling in the surgical specimens and the preoperative biopsies in p53 (k = 1.0; 95% CI: 0.76-1.0) was identified. There was an almost perfect concordance for ER (k = 0.89; 95% CI: 0.65-1.0) and a substantial concordance for PR (k = 0.70; 95% CI: 0.46-0.93). HER2 (k = 0.61; 95% CI: 0.38-0.84) and Ki-67 (k = 0.74; 95% CI: 0.58-0.98) obtained a substantial concordance this analysis. CONCLUSION: The results of this study indicate that the immunohistochemical analysis of ER, PR, Ki-67, and p53 from core biopsy specimens provided results that accurately reflect the marker status of the tumor. The concordance rate of HER2 was less consistent; although it produced substantial concordance, values were very close to moderate concordance.

OBJETIVO: Avaliar se a análise dos marcadores imunoistoquímicos obtidos por meio de espécimes de core biopsy (CB) refletem com precisão o perfil dos marcadores tumorais obtidos por biópsia cirúrgica excisional (BCE). MÉTODOS: Estudo retrospectivo usando dados da Divisão de Mastologia do Hospital das Clínicas de São Paulo. Sessenta e nove pacientes submetidas à CB guiada por ultrassom com diagnóstico de câncer de mama foram analisadas retrospectivamente. O exame imunoistoquímico dos espécimes de CB foram comparados com aquele obtido a partir da BCE em relação ao receptor de estrogênio (RE), receptor de progesterona (RP), human epidermal gowth factor receptor 2 gene (HER2), p53 e Ki-67. A análise de concordância entre a CB e a BCE foram realizados usando o coeficiente de kappa (k) (IC 95%). RESULTADOS: A concordância perfeita entre a BCE e a CB do p53 (k = 1,0; IC 95%: 0,76-1,0) foi identificada. A concordância foi quase perfeita para o RE (k = 0,89; IC 95%: 0,65-1,0) e concordância substancial foi identificada para o RP (= 0,70; IC 95%: 0,46-0,93). O HER2 (k = 0,61; IC 95%: 0,38-0,84) e Ki-67 (k = 0,74; IC 95%: 0,58-0,98) obtiveram uma concordância substancial nesta análise. CONCLUSÃO: os resultados deste estudo indicam que a análise imunoistoquímica do RE, RP, Ki-67 e p53 a partir dos espécimes de CB fornecem resultados que refletem com precisão o perfil dos marcadores do tumor. O HER2 foi menos consistente, porque apesar de ter produzido uma concordância substancial, os valores foram muito próximos da concordância moderada.
Responsável: BR1.1 - BIREME



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