članak: 1 od 1  
Acta chirurgica iugoslavica
2010, vol. 57, br. 2, str. 31-35
jezik rada: engleski
stručni članak
doi:10.2298/ACI1002031P

Koji su mogući razlozi velikih varijacija PSA posle radikalne prostatektomije
aUniverzitet u Beogradu, Medicinski fakultet, Klinički centar Srbije
bSrpska akademija nauke i umetnosti (SANU), Beograd
cInstitute for Radiology, Clinical Center of Serbia, Belgrade
dInstitute for Medical Biochemistry, Clinical Center of Serbia, Belgrade

Sažetak

Cilj rada: Ispitati koji su mogući uzroci velikih varijacija vrednosti uretralnog prostata specifičnog antigena (urPSA), između različitih bolesnika kod kojih je učinjena radikalna retropubična prostatektomija (RRP). Materijal i metode: Kod 46 bolesnika sa lokalizovanim karcinomom prostate određivani su PSA, urPSA, ukupni testosteron, indeks telesne mase (body-mass index, BMI), kao i stadijum androgene alopecije (AGA). Kod 45 bolesnika je učinjena RRP, a kod jednog bolesnika je učinjena cistoprostatektomija sa konstrukcijom ortotopske bešike, zbog infiltrativnog tumora bešike. Rezultati: Prosečna starost bolesnika pre operacije ( plus/minus standardna devijacija, SD), bila je 65.2+5.8 godina. Prosečna vrednost urPSA je bila 20.9+47.5 ng/ml (opseg 0.05 do 212 ng/ml, mediana 2.24 ng/ml). Kada se za graničnu vrednost urPSA uzme vrednost od 2.0 ng/ml, mogu da se formiraju dve grupe: A, sa urPSA < 2.0 ng/ml i B, sa urPSA = 2.0 ng/ml. Bolesnici u grupi A su imali značajno niži skor AGA, nego bolesnici u grupi B (2.4+ 1.3 prema 4.4+2.2, p=0.0003). Osim toga, bolesnici u grupi A su imali značajno niži postoperativni PSA (0.07 +0.08 ng/ml prema 0.14+0.06 ng/ml, p=0.0014). Zaključak: Posle RRP, bolesnici sa višim urPSA imaju viši stepen AGA i viši postoperativni PSA. Ovaj fenomen je verovatno posledica veće lokalne aktivnosti dihidrotestosterona u koži glave i u uretralnim žlezdama koje proizvode PSA.

Ključne reči

androgena alopecija; prostata specifični antigen; radikalna prostatektomija; uretralne žlezde; uretralni PSA; urinarni PSA

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