Parámetros clínicos y analíticos que indicarían la realización de una segunda biopsia en pacientes con psa elevado y biopsia previa negativa
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"apellidos" => "Valer Algarabel" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "L." "apellidos" => "Agüera Fernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "J.M." "apellidos" => "Adot Zurbano" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "M." "apellidos" => "Virseda Chamorro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "J." 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Policlínica Naval de Madrid" "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Urología. Hospital General Yagüe. Burgos" "etiqueta" => "<span class="elsevierStyleSup">***</span>" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Urología. Hospital Gómez Ulla. Madrid" "etiqueta" => "****" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Servicio de Anatomía Patológica. Hospital Militar de Burgos" "etiqueta" => "*****" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Dr. J. Valer Algarabel Servicio de Urología Hospital Militar de Burgos Pº de los Comendadores, s/n 09001 Burgos" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec86602" "palabras" => array:5 [ 0 => "Neoplasia prostática" 1 => "Antígeno prostático específico" 2 => "Biopsia prostática" 3 => "Segunda biopsia" 4 => "Tacto rectal" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec86601" "palabras" => array:5 [ 0 => "Prostatic neoplasm" 1 => "Prostatic specific antigen" 2 => "Biopsy" 3 => "Second biopsy" 4 => "Digital rectal examination" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Determinar que parámetros clínicos, analíticos y ecográficos resultan más eficaces para predecir el resultado de una segunda biopsia en pacientes con PSA elevado, y una primera biopsia prostática negativa.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se realizó un estudio longitudinal en una serie de 435 casos con biopsia negativa. En 59 de estos casos se practicó una segunda biopsia por mantenerse o aparecer un PSA elevado con o sin tacto rectal sospechoso. De los 31 casos en que esta segunda biopsia fue negativa, en 4 casos se realizó una tercera biopsia. La biopsia se efectuó en todas las ocasiones mediante control ecográfico, se valoraron además las características ecográficas de la próstata, el volumen prostático y la proporción de PSA libre.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se demostraron diferencias estadísticamente significativas entre los pacientes con una segunda biopsia negativa y positiva respecto a: la edad, proporción de PSA libre, tacto rectal anormal y presencia de áreas hipoecogénicas en la próstata. El análisis multivariante demostró que los únicos parámetros significativos fueron la proporción de PSA libre y la existencia de un tacto rectal anormal. Basándose en los datos del análisis multivariante se estableció para los pacientes con tacto rectal normal un punto de corte de 0,23 de proporción de PSA libre como indicación para la realización de una segunda biopsia, y de 0,59 para los pacientes con tacto rectal anormal. Este protocolo aplicado a nuestra serie evitaría la realización de una segunda biopsia en 8 pacientes, y de la tercera biopsia en 1 paciente, diagnosticando todos los casos de cáncer prostático.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El tacto rectal combinado con la proporción de PSA libre constituye un parámetro fiable para indicar la realización de una segunda biopsia prostática en pacientes con PSA elevado y biopsia previa negativa.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objectives</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To determine what clinical, analytic and ultrasound parameters, are more effective to predict the result of a second biopsy in patient with high PSA and a first prostate biopsy negative.</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">It was carried out a longitudinal study in a series of 435 cases with negative prostate biopsy. In 59 of these cases it was practiced a second biopsy due to a permanent or sudden high PSA levels with or without a suspicious digital rectal examination. Of the 31 cases with a negative second biopsy, in 4 cases it was carried out a third biopsy. The biopsy was made in all the occasions by transrectal ultrasound guided sextant biopsy. It were also valued the ultrasound characteristic of the prostate, the prostate volume and the proportion of free PSA.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">It was demonstrated statistically significant differences among the patients with a second biopsy negative and positive regarding: the age, proportion of free PSA, abnormal digital rectal examination and presence of hipoechogenic areas in the prostate. The multivariate analysis demonstrated that the only significant parameters were the proportion of free PSA and the existence of an abnormal digital rectal examination. Based on the data of multivariate analysis, we settled down for the patients with normal digital rectal examination a cut-off point of 0,23 of proportion of free PSA as indication for the realization of a second biopsy, and of 0,59 for the patients with abnormal digital rectal examination. This protocol applied to our series would avoid the realization of a second biopsy in 8 patients, and a third biopsy in 1 patient, diagnosing all the cases of prostate cancer.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The digital rectal examination associated with the proportion of free PSA constitutes a reliable parameter to indicate the realization of a second prostate biopsy in patient with high PSA and previous negative biopsy.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:20 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radical prostatectomy: Options and issues" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Octubre | 0 | 10 | 10 |
| 2024 Septiembre | 0 | 9 | 9 |
| 2024 Agosto | 0 | 15 | 15 |
| 2024 Julio | 0 | 14 | 14 |
| 2024 Junio | 0 | 24 | 24 |
| 2024 Mayo | 0 | 15 | 15 |
| 2024 Abril | 0 | 17 | 17 |
| 2024 Marzo | 0 | 36 | 36 |
| 2024 Febrero | 0 | 28 | 28 |
| 2024 Enero | 0 | 12 | 12 |
| 2023 Diciembre | 0 | 17 | 17 |
| 2023 Noviembre | 0 | 18 | 18 |
| 2023 Octubre | 0 | 24 | 24 |
| 2023 Septiembre | 0 | 4 | 4 |
| 2023 Agosto | 0 | 4 | 4 |
| 2023 Julio | 1 | 39 | 40 |
| 2023 Junio | 0 | 3 | 3 |
| 2023 Mayo | 0 | 5 | 5 |
| 2023 Abril | 0 | 6 | 6 |
| 2023 Marzo | 0 | 5 | 5 |
| 2023 Febrero | 0 | 10 | 10 |
| 2023 Enero | 0 | 13 | 13 |
| 2022 Diciembre | 0 | 26 | 26 |
| 2022 Noviembre | 0 | 22 | 22 |
| 2022 Octubre | 0 | 8 | 8 |
| 2022 Septiembre | 0 | 11 | 11 |
| 2022 Agosto | 0 | 17 | 17 |
| 2022 Julio | 0 | 5 | 5 |
| 2022 Junio | 0 | 12 | 12 |
| 2022 Mayo | 0 | 5 | 5 |
| 2022 Abril | 0 | 6 | 6 |
| 2022 Marzo | 0 | 1 | 1 |
| 2022 Febrero | 0 | 4 | 4 |
| 2022 Enero | 0 | 3 | 3 |
| 2021 Diciembre | 0 | 3 | 3 |
| 2021 Noviembre | 0 | 4 | 4 |
| 2021 Octubre | 0 | 3 | 3 |
| 2021 Septiembre | 0 | 1 | 1 |
| 2021 Agosto | 0 | 2 | 2 |
| 2021 Junio | 1 | 1 | 2 |
| 2021 Mayo | 0 | 2 | 2 |
| 2021 Marzo | 0 | 3 | 3 |
| 2021 Febrero | 0 | 2 | 2 |
| 2021 Enero | 0 | 5 | 5 |
| 2020 Diciembre | 0 | 1 | 1 |
| 2020 Noviembre | 0 | 2 | 2 |
| 2020 Octubre | 0 | 2 | 2 |
| 2020 Septiembre | 0 | 4 | 4 |
| 2020 Agosto | 0 | 7 | 7 |
| 2020 Julio | 0 | 1 | 1 |
| 2020 Junio | 0 | 1 | 1 |
| 2020 Mayo | 0 | 3 | 3 |
| 2020 Abril | 0 | 2 | 2 |
| 2020 Marzo | 0 | 7 | 7 |
| 2020 Febrero | 0 | 1 | 1 |
| 2020 Enero | 0 | 10 | 10 |
| 2019 Diciembre | 0 | 8 | 8 |
| 2019 Noviembre | 0 | 3 | 3 |
| 2019 Octubre | 0 | 9 | 9 |
| 2019 Septiembre | 0 | 3 | 3 |
| 2019 Agosto | 0 | 1 | 1 |
| 2019 Julio | 0 | 7 | 7 |
| 2019 Junio | 0 | 12 | 12 |
| 2019 Mayo | 0 | 46 | 46 |
| 2019 Abril | 0 | 4 | 4 |
| 2018 Febrero | 2 | 1 | 3 |
| 2018 Enero | 4 | 3 | 7 |
| 2017 Diciembre | 1 | 0 | 1 |
| 2017 Noviembre | 6 | 2 | 8 |
| 2017 Octubre | 5 | 5 | 10 |
| 2017 Septiembre | 5 | 3 | 8 |
| 2017 Agosto | 7 | 0 | 7 |
| 2017 Julio | 16 | 1 | 17 |
| 2017 Junio | 14 | 2 | 16 |
| 2017 Mayo | 23 | 5 | 28 |
| 2017 Abril | 15 | 1 | 16 |
| 2017 Marzo | 19 | 29 | 48 |
| 2017 Febrero | 5 | 5 | 10 |
| 2017 Enero | 4 | 1 | 5 |
| 2016 Diciembre | 17 | 2 | 19 |
| 2016 Noviembre | 20 | 5 | 25 |
| 2016 Octubre | 23 | 4 | 27 |
| 2016 Septiembre | 17 | 7 | 24 |
| 2016 Agosto | 12 | 2 | 14 |
| 2016 Julio | 11 | 1 | 12 |
| 2016 Junio | 13 | 6 | 19 |
| 2016 Mayo | 18 | 12 | 30 |
| 2016 Abril | 13 | 9 | 22 |
| 2016 Marzo | 23 | 7 | 30 |
| 2016 Febrero | 7 | 9 | 16 |
| 2016 Enero | 13 | 12 | 25 |
| 2015 Diciembre | 12 | 10 | 22 |
| 2015 Noviembre | 7 | 1 | 8 |
| 2015 Octubre | 19 | 7 | 26 |
| 2015 Septiembre | 19 | 7 | 26 |
| 2015 Agosto | 9 | 1 | 10 |
| 2015 Julio | 13 | 4 | 17 |
| 2015 Junio | 3 | 0 | 3 |
| 2015 Mayo | 7 | 2 | 9 |
| 2015 Abril | 11 | 4 | 15 |
| 2015 Marzo | 11 | 0 | 11 |
| 2015 Febrero | 2 | 1 | 3 |
| 2015 Enero | 15 | 1 | 16 |
| 2014 Diciembre | 5 | 2 | 7 |
| 2014 Noviembre | 5 | 2 | 7 |
| 2014 Octubre | 15 | 3 | 18 |
| 2014 Septiembre | 18 | 0 | 18 |
| 2014 Agosto | 5 | 2 | 7 |
| 2014 Julio | 7 | 2 | 9 |
| 2014 Junio | 10 | 2 | 12 |
| 2014 Mayo | 2 | 0 | 2 |
| 2014 Abril | 3 | 1 | 4 |
| 2014 Marzo | 2 | 0 | 2 |
| 2014 Febrero | 2 | 2 | 4 |
| 2014 Enero | 2 | 0 | 2 |
| 2013 Diciembre | 5 | 4 | 9 |
| 2013 Noviembre | 10 | 3 | 13 |
| 2013 Octubre | 10 | 11 | 21 |
| 2013 Septiembre | 6 | 5 | 11 |
| 2013 Agosto | 6 | 4 | 10 |
| 2013 Julio | 2 | 0 | 2 |
| 2002 Marzo | 461 | 0 | 461 |
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