Relación entre el psa y estudio histopatologico obtenido a traves de la biopsia prostatica transrectal en el Hospital Manuel Ignacio Monteros IESS-Loja, comprendido entre el periodo de enero 2010 hasta octubre 2011

The value of transrectal ultrasonography in both the study and the patient's prostate biopsy cancer risk with elevated PSA is already proven. The aim of this study is to find agreement or relationship between the results of PSA, digital rectal examination, sonographic features of prostatic nodules and histopathological results of ultrasound-guided prostate biopsy, based on experience in our environment. This study presents an analysis of the results of 50 ultrasound guided prostate biopsies, derived from the urology and internal medicine for biopsy, elevated serum PSA before (high to 4ng/ml) at the Hospital Manuel Ignacio Monteros IESS-Loja, in a period between January 2010 to October 2011. All patients, after signing the informed consent, resulting in abnormal PSA, suspicious DRE or a family history of prostate cancer, underwent assessment with ultrasound and transrectal prostate biopsy. The procedure was performed with high resolution ultrasound and checked by the Pathology Department of the institution. We present average age of the patients, digital rectal examination findings correlated with biopsy results, values of total PSA, free PSA and PSA density correlated with prostate biopsy. Also present the sonographic features such as volume, prostatic echotexture characteristic of prostate nodules, echogenicity, size, location, margins, Doppler flow characteristics, integrity of the capsule of the prostate, seminal vesicle characteristics as well as complications were presented during the biopsy. Presented the percentage of each pathological diagnosis in the total study population: BPH, chronic prostatitis. PIN low and high grade adenocarcinoma, graduated according to the Gleason system and sum score and the same as tumor staging classification based on Whitmore Jewwett and prostate tumors. Of the fifty patients examined via transrectal biopsy, 19 (38%) were positive for prostate adenocarcinoma, of whom most were of intermediate differentiation grade according to Gleason score, for its part, the majority of patients were found in stage B (47%) and C (42%) of staging. Hypoechogenic prostate nodules in the periphery, with central vascularization, are the most frequent (53%) and are related to the presence of prostate cancer. Complications during the biopsy procedure were: hematuria (6%), fever (4%), prostatitis (2%) and cardiac arrest (2%). The findings indicate that with a PSA value above 4ng/ml, there is a probability of 33.3% of patients suffering from prostate cancer and a value above 20ng/ml is a 50% chance of developing this disease. In the Department of Internal Medicine Hospital "Manuel Y. Monteros" IESS - Loja protocol has established itself as performing a transrectal prostate biopsy for all patients with PSA values above 4ng/ml, suspicious digital rectal examination and findings suggestive of malignancy in prostate ultrasound, which has been incidental in the discovery of many early-stage prostate carcinomas, which modifies the morbidity and mortality of this disease. During the study is to assess the most appropriate way to evaluate the prostate gland, in the light of different technical publications. The sextant biopsy seems to be the most appropriate, provided it is accompanied by a careful observation of the peripheral region during the procedure. It was shown that the combination of positive DRE, high PSA and prostate hypoechogenic nodules have a high probability vascular positive outcomes for prostate cancer.

• Egile nagusia: León Montaño, Eddy Patricio (author)
• Formatua: bachelorThesis
• Hizkuntza: spa
• Argitaratua: 2011
• Sarrera elektronikoa: http://dspace.unl.edu.ec/jspui/handle/123456789/8061