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- 저자 : Giovanni Lughezzani (검색결과 2 건)
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Alberto Abrate,Giovanni Lughezzani,Giulio Maria Gadda,Giuliana Lista,Ella Kinzikeeva,Nicola Fossati,Alessandro Larcher,Paolo Dell’Oglio,Francesco Mistretta,Nicolòmaria Buffi,Giorgio Guazzoni,Massimo L 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.7
Prostate-specific antigen (PSA) is recognized as an organ-specific marker with low specificityand sensitivity in discriminating prostate cancer (PCa) from other benign conditions,such as prostatic hyperplasia or chronic prostatitis. Thus, in the case of clinicalsuspicion, a PCa diagnosis cannot be made without a prostate biopsy. [-2]proPSA(p2PSA), a precursor of PSA, has been investigated as a new marker to accurately detectPCa. The aim of this systematic review was to discuss the available literature regardingthe clinical validity and utility of p2PSA and its derivatives, p2PSA/fPSA (%p2PSA)and the Prostate Health Index (PHI). A systematic search of the PubMed and Scopuselectronic databases was performed in accordance with the PRISMA statement(http://www.prisma-statement.org), considering the time period from January 1990 toJanuary 2014 and using the following search terms: proprostate specific antigen, proenzymePSA, proPSA, [-2]proPSA, p2PSA, Prostate Health Index, and PHI. To date,115 studies have been published, but only 35 were considered for the qualitativeanalysis. These studies suggested that p2PSA is the most cancer-specific form of PSA,being preferentially expressed in PCa tissue and being significantly elevated in the serumof men with PCa. It is now evident that p2PSA, %p2PSA, and PHI measurementsimprove the specificity of the available tests (PSA and derivatives) in detecting PCa. Moreover, increasing PHI values seem to correlate with more aggressive disease. Somestudies have compared p2PSA and its derivatives with other new biomarkers and foundp2PSA to be significantly more accurate. Indeed, the implementation of these tests inclinical practice has the potential to significantly increase the physician’s ability to detectPCa and avoid unnecessary biopsies, while also having an effective impact on costs. Further studies in large, multicenter, prospective trials are required to confirm theseencouraging results on the clinical utility of these new biomarkers.
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Fabio Grizzi,Gianluigi Taverna,Piergiuseppe Colombo,Mauro Seveso,Guido Giusti,Silvia Proietti,Girolamo Fiorini,Giovanni Lughezzani,Paolo Casale,Nicolò Buffi,Massimo Lazzari,Giorgio Guazzoni 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.6
Purpose: Prostate cancer is the most frequent cancer in men in Europe. A major focus in urology is the identification of new biomarkerswith improved accuracy in patients with low-risk prostate cancer. Here, we evaluated two-dimensional neovascular complexityin prostate tumor and nontumor biopsy cores by use of a computer-aided image analysis system and assessed the correlationsbetween the results and selected clinical and pathological parameters of prostate carcinoma. Materials and Methods: A total of 280 prostate biopsy sections from a homogeneous series of 70 patients with low-risk prostatecancer (Gleason score 3+3, prostate-specific antigen [PSA]<10 ng/mL, and clinical stage T1c) who underwent systematic biopsysampling and subsequent radical prostatectomy were analyzed. For each biopsy, 2-μm sections were treated with CD34 antibodiesand were digitized by using an image analysis system that automatically estimates the surface fractal dimension. Results: Our results showed that biopsy sections without cancer were significantly more vascularized than were tumors. No correlationswere found between the vascular surface fractal dimension and patient's age, PSA and free-to-total PSA ratios, pathologicalstage, Gleason score, tumor volume, vascular invasion, capsular penetration, surgical margins, and biochemical recurrence. Conclusions: The value of angiogenesis in prostate cancer is still controversial. Our findings suggest that low-risk prostate cancertissues are less vascularized than are nontumor tissues. Further studies are necessary to understand whether angiogenesis is a hallmarkof intermediate- and high-risk prostate cancer.
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