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CC BY-NC-ND 4.0 · Revista Urología Colombiana / Colombian Urology Journal 2020; 29(03): 115-122
DOI: 10.1055/s-0039-1693669
Original Article | Artículo Original
Urologic Oncology/Urología Oncológica

Presentación clínico-patológica del adenocarcinoma prostático en un Hospital de tercer nivel en Colombia

Clinical-pathological Presentation of Prostatic Adenocarcinoma in a Tertiary Hospital in Colombia
Paola Lecompte-Osorio 
1   Grupo de Investigación Histopatología, Facultad de Medicina, Universidad de Cartagena, Cartagena, Bolívar, Colombia
,
Andrés Lázaro 
1   Grupo de Investigación Histopatología, Facultad de Medicina, Universidad de Cartagena, Cartagena, Bolívar, Colombia
,
Inés Benedetti 
1   Grupo de Investigación Histopatología, Facultad de Medicina, Universidad de Cartagena, Cartagena, Bolívar, Colombia
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Resumen

Objetivo Mundialmente, el cáncer de próstata es la segunda neoplasia maligna más frecuente en hombres a nivel mundial y la primera en Colombia. Se determinaron las características clínico-patológicas de los casos de cáncer de próstata diagnosticados en un hospital de la región caribe colombiana.

Métodos Se realizó un estudio retrospectivo en la Facultad de Medicina de la Universidad de Cartagena, Colombia. Se analizaron las características clínicas y patológicas de todos los pacientes diagnosticados con cáncer de próstata en el Hospital Universitario del Caribe durante los años 2007 a 2014.

Resultados Se documentaron 394 casos, con edad promedio de 71,13 años (DE ± 8,25). El puntaje de Gleason fue mayor o igual a 8 en el 31,7%. En biopsias hubo localización bilateral del tumor en un 73,5% y compromiso tumoral mayor al 40% del tejido en el 73,2% de los casos. En un 5,8% de los pacientes, hubo valores de PSA normales. Se dio una asociación estadísticamente significativa entre el PSA y el examen digital rectal (p = 0,0009), puntaje de Gleason (p < 0,0001) y porcentaje de compromiso tumoral en biopsias (p < 0,0012). La combinación PSA más examen digital rectal obtuvo una sensibilidad del 96%.

Conclusiones Gran parte de los casos de cáncer de próstata se diagnostican en estadios avanzados. La mayor sensibilidad para el diagnóstico clínico la tiene el uso del PSA más el examen digital rectal, sin dejar de lado la experiencia clínica que permite diagnosticarlo aún con PSA o examen digital rectal normales. Esos hallazgos deben promover la educación de la población.

Abstract

Objective Worldwide, prostate cancer is the second most common malignant neoplasm diagnosed in men, in Colombia is the most common. The objective was to determine clinical and histopathological characteristics based upon the cases of prostate cancer diagnosed in a hospital of the Colombian Caribbean coast.

Methods A retrospective study was conducted in the Faculty of Medicine at the University of Cartagena, Colombia. Clinical and pathological characteristics were analyzed in all patients diagnosed with prostate cancer at the Hospital Universitario del Caribe between January 2007 and December 2014.

Results A total of 394 cases were documented. Mean presentation age was 71,1 years (SD ± 8,25). A Gleason score greater than 8 was reported in 31.7% of the cases. Biopsies showed bilateral tumor localization in 73.5% and percent tumor involvement greater than 40% in 73.2% of cases. 5.8% of patients presented with normal PSA values. A statistically significant difference was found between PSA and: digital rectal exam (p = 0.0009), Gleason Score (p < 0.0001) and percent tumor involvement in biopsies (p < 0.0012). PSA and digital rectal examination had a sensitivity of 96%.

Conclusions A large proportion of prostate cancer cases are diagnosed in advanced stages. The highest sensitivity for the clinical diagnosis is made by the combined use of PSA and digital rectal examination, without ignoring the clinical experience that allows the diagnosis of cancer even in cases with normal PSA and/or digital rectal examination. These findings may increase awareness for the early diagnosis of the disease in the population.

Palabras clave

próstata - enfermedades de la próstata - neoplasias de la prostata - clasificación del tumor - antígeno prostático específico - tacto rectal

Keywords

prostate - prostatic diseases - prostatic neoplasms - neoplasm grading - prostate- specific antigen - digital rectal examination


Publikationsverlauf

Eingereicht: 22. Januar 2019

Angenommen: 12. Juni 2019

Artikel online veröffentlicht:
05. November 2019

© 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Sociedad Colombiana de Urología. Publicado por Thieme Revinter Publicações Ltda
Rio de Janeiro, Brazil

 

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