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The diagnostic and prognostic ability of selected serum and urinary markers of prostate cancer
Do Carmo Silva, Joana Isabel ; Veselý, Štěpán (advisor) ; Čapoun, Otakar (referee) ; Fedorko, Michal (referee)
The diagnostic and prognostic ability of selected serum and urinary markers of prostate cancer Abstract Serum prostate specific antigen (PSA) is the only widely approved marker in prostate cancer (PC) diagnosis and follow up after treatment. Its role has remained controversial due to lack of specificity and the risk of overdiagnosis of insignificant PC. The aim of this work was to explore promising markers of PC and to improve current patient stratification to adjuvant treatment. Three main studies were performed using different media (urine and serum). The first study included the evaluation of Engrailed-2 (EN2) - a urinary marker of interest - in 90 patients with localized PC, 30 healthy controls, and 40 patients indicated for prostate biopsy. The second study evaluated 205 men with high-risk PC-features who underwent radical prostatectomy (RP) and were subject to a strict follow-up protocol of ultrasensitive PSA (UPSA) at close time intervals. The ability of particular measurements to predict biochemical recurrence (BCR) and thus the need for adjuvant therapy was assessed using the area under the curve (AUC) and a stratification model was created. The third study involved 128 patients who underwent RP. PSA and its serum isoforms normally used in the diagnostic context were evaluated both preoperatively...
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Detection of circulating tumour cells and their clinical application in patients with bioptically proven prostate cancer.
Čapoun, Otakar ; Soukup, Viktor (advisor) ; Zachoval, Roman (referee) ; Veselý, Štěpán (referee)
1 ABSTRACT Introduction and aim of the study Circulating tumor cells (CTCs) are a promising tool of identifying patients with castration- resistant prostate cancer (CRPC) who will benefit from often demanding cytotoxic therapy. The aim of this work was to evaluate the prognostic significance of CTC in docetaxel-treated CRPC patients. During the project, we also tested the various methods of CTC cultivation and studied their genetic profile as well as the genetic profile of histological specimen at the time of diagnosis. Patients and methods A total of 39 patients who met the CRPC criteria and were indicated for docetaxel chemotherapy were included in the prospective study. Blood collection for CTC analysis was done in all patients before chemotherapy and on the first day of the fourth or fifth cycle of docetaxel. In parallel, CTCs were cultivated. Isolation and detection of CTC was done using the AdnaTest system, which consists of immunomagnetic separation and subsequent detection of mRNA from the CTC lysate. The primary objective of the study was to evaluate the overall survival (OS) of patients. Survival analysis was performed using the Kaplan-Meier method of estimating the survival distribution function. The impact of individual factors was tested using the Log-rank test, the Wilcoxon test and the Cox...
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