Saratov JOURNAL of Medical and Scientific Research

prostate cancer

Diagnosis and combined treatment of patients with locally advanced prostate cancer

Year: 2015, volume 11 Issue: №3 Pages: 317-322
Heading: Urology Article type: Review
Authors: Popkov V.M., Kim T.D., Ponukalin A.N.
Organization: Saratov State Medical University
Summary:

Prostate cancer is one of the most urgent problems of modern oncology. The article provides an overview of the methods of treatment of locally advanced prostate cancer, comparative characteristics, the advantages of both independent and combined methods. The results of multicenter studies have been stated.

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Identification of risk factors of prostate adenocarcinoma recurrence after HIFU therapy using immunohistochemical markers

Year: 2014, volume 10 Issue: №4 Pages: 654-658
Heading: Urology Article type: Original article
Authors: Popkov V.M., Maslyakova G.N., Voronin E.S., Fomkin R.N.
Organization: Saratov State Medical University
Summary:

The purpose of this study was to identify risk factors for recurrence of prostate adenocarcinoma after HIFU therapy. Material and methods: Material for the study was obtained from patients diagnosed with adenocarcinoma before and after HIFU treatment. Morphological study was conducted using a standard staining, and immunohistochemical markers: PCNA, Amacr, E-cadherin, Bel2, Andr, Estr, VEGF, P53, PCNA. Results: After treatment in 89% of patients with initial prostate volume greater than 50 cc the signs of recurrence of adenocarcinoma were showed. At low risk for D'Amico after treatment the expression of proliferation markers, VEGF, Amacr significantly decreased. With a high degree of risk — increased expression of Bel2. After treatment the expression of the following markers: PCNA, Amacr, VEGF significantly increased in the group of patients with the presence of invasion. Conclusion: Patients with initial prostate volume less than 50 cc, low risk to D'Amico, the lack of perineural and perivascular invasion have a low risk of recurrence after HIFU therapy; patients at high risk for D'Amico, the presence of perineural and perivascular invasion initial and prostate volume greater than 50 cc, low-grade cribriform form of adenocarcinoma have a high risk of recurrence of adenocarcinoma. Recurrence of adenocarcinoma develops independently of the period after HIFU therapy.

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Prognosis of prostate gland morphology study using artificial neural network

Year: 2014, volume 10 Issue: №2 Pages: 328-332
Heading: Proceedings of all-Russia week of science with international participants Article type: Original article
Authors: Popkov V.M., Shatylko T.V., Fomkin R.N.
Organization: Saratov State Medical University
Summary:

The research goal is to optimize the management of patients with serum PSA level falling in the range of 4-10 ng/ ml by designing and educating of an artificial neural network, which may be used to predict prostate gland morphology basing on clinical, laboratory and imaging data. Material and methods. Data of 254 patients, who were admitted to the oncological Department of S. R. Mirotvortsev Clinical hospital for transrectal prostate biopsy, was collected to construct several artificial neural networks with different architecture. External validation was performed on 27 patients, who had prostate biopsy in January-February 2014. Results. One-layer network, consisting of 11 input, 9 hidden and 3 output neurons, was determined to be the most successful: in 92.6% cases it was correct in predicting prostate cancer or its absence. Input factors were evaluated according to their relative importance, from more important to less important: prostate volume, serum PSA, patient's age, prostate consistency, PSA velocity, prostate symmetry, previous negative biopsy, free serum PSA, intake of 5-alpha-reductase inhibitors. Conclusion. Artificial neural networks may be used to predict morphological findings in prostate biopsy. High PSA density and firm prostate consistency should cause suspicion of prostate cancer.

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Prostate cancer diagnostics with biopsy material

Year: 2013, volume 9 Issue: №4 Pages: 632-636
Heading: Macro- and Micromorphology Article type: Original article
Authors: Fedorina Т.A., Poletaeva S.V.
Organization: Samara State Medical University
Summary:

The aim of the article is to study the potential importance of specific location of biopsy of prostate cancer. Material and methods. Histological material from 700 patients has been examinated. 580 specimen of radical prostatectomy were examined. TRUS-guided 12-cores biopsy has been performed in all patients. Histological, computer morphomet-ric, immunohistochemal methods (PIN4-coctail, AR) were used. Results. It has been established that undergrading of carcinoma in needle biopsy occurred in 26% of patients. Overgrading of carcinoma in needle biopsy may also occur, but it was only found in 3% of cases. Undergrading results have been explained by low amount of tumor elements taken from tiny areas of carcinoma, multicentric growth and heterogenous structure of tumor. Conclusions. An important task is to identify the minimal or limited adenocarcinoma in biopsies, as tumor of >1cc volume is often found in prostatectomy specimen.

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Postoperative monitoring of prostate-specific antigen (PSA) after treatment with high-intensive focused ultrasound (HIFU

Year: 2012, volume 8 Issue: №4 Pages: 1001-1007
Heading: Urology Article type: Original article
Authors: Popkov V.M., Fomkin R.N., Blyumberg B.I.
Organization: Saratov State Medical University
Summary:

Research objective: to estimate efficiency of treatment of prostate cancer using high-intensive focused ultrasound on the basis of laboratory analysis of postoperative level prostate-specific antigen (PSA). Objects of research. Objects of research consisted of 110 patients treated in urological clinic of Hospital n.a. S. R. Mirotvortsev (Saratov State Medical University) during the period February, 2009 — March, 2012. Patients took 110 sessions of primary operative treatment of prostate cancer by HIFU therapy method. Technique and research methods. Concentration of PSA in blood changed in all patients every 1,5 month within 6 months after operation, irrespective of its kind (including after repeated HIFU), further — after every 3 month till one year, and later on after 6 months. We were guided by references of the International Consensus, which considers PSA level more than 0,5 ng/ml in blood after 3 months of treatment to be unsatisfactory result. We also headed for PSA level before treatment and oncological risk degree. Results. Median nadir formed 0,5 ng/ml PSA by 3 months after treatment. Patients demonstrated different indicators of PSA dynamics depending on oncological risk, stage and hormonal therapy management. Patients with low oncological risk had initially lower PSA concentration, further PSA concentration reached nadir level faster. At patients with widespread forms of prostate cancer accurate dependence of PSA concentration according to prevalence of process was traced. Time of PSA nadir amount did not differ and was marked as 12-14 weeks on average. At patients received hormonal therapy, lower value of PSA nadir was marked. The conclusion. Monitoring of PSA concentration (PSA nadir by 3 months, dynamics of PSA concentration change) is of great importance in early revealing of relapse after prostate HIFU therapy. High level of PSA nadir and PSA growth according to time period are important prognostic factors.

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