ALBERTO AZOUBEL ANTUNES
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Cirurgia, Faculdade de Medicina - Docente
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina - Líder
40 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 40
- Prostate biopsy in patients with long-term use of indwelling bladder catheter: What is the rationale?(2012) ANTUNES, Alberto A.; BARBOSA, Joao Arthur B. A.; REIS, Sabrina T.; GUARIERO, Mary S.; FUKUSHIMA, Julia T.; DALL'OGLIO, Marcos F.; FREIRE, Geraldo de C.; LUCON, Antonio M.; LEITE, Katia R.; SROUGI, MiguelObjective: Acute urinary retention (AUR) is expected to occur in 2% to 39% men with benign prostatic hyperplasia. To date, no study has elucidated the effect of long-term use of indwelling bladder catheter on serum prostate specific antigen (PSA) levels and on the incidence of prostate cancer (CaP). The aim of the present study is to analyze the incidence of CaP in patients with long-term use of indwelling bladder catheter and determine some practice patterns on this issue. Materials and methods: The study comprised a retrospective analysis of data from 1,651 patients who had undergone transrectal ultrasound (TRUS)-guided prostate biopsy from July 2004 to June 2009. Among these patients, 198 (12%) were using an indwelling bladder catheter during the biopsy for at least 1 month. The incidence of CaP was recorded according to total PSA levels. Other variables such patient age, free/total PSA rate, PSA density, prostate volume, and duration of catheter use was also analyzed. Men with a digital rectal examination suspicious for cancer were not considered for analysis. Results: Median patient age was 71 years (37 to 89 years). Overall, 25% of patients presented a CaP diagnosis. CaP incidence according to the PSA levels was 0%, 18.9%, 24.5%, and 40.6% for patients with PSA <= 4.0, 4.1-10.0, 10.1-20.0, and >20.0 ng/ml, respectively. When prostate volume was analyzed together, we demonstrated that only 1 (2.4%) patient with PSA below 10.0 ng/ml and prostate volume >60 g had CaP. Median total PSA, PSA density, and prostate volume were statistically different between patients with and without CaP. Conclusions: Prostate biopsy should not be indicated for all patients with diagnosis of BPH and AUR who present an elevated PSA level. Patients with PSA below 10.0 ng/ml, and prostate volume >60 g should only undergo biopsy in selected cases. Patients with PSA >20.0 ng/ml and a prostate volume <= 60 g are at higher risk of CaP diagnosis.
article 13 Citação(ões) na Scopus Socioeconomic status is an independent predictor of biochemical recurrence among patients with prostate cancer who undergo radical prostatectomy(2011) SROUGI, Victor; ANTUNES, Alberto A.; REIS, Sabrina T.; DALL'OGLIO, Marcos F.; NESRALLAH, Adriano J.; LEITE, Ktia R. M.; SROUGI, MiguelPurpose: Socioeconomic status (SES) may influence cancer characteristics and behavior in several aspects. We analyzed PCa characteristics and behavior among low income uninsured men, and compare them to high income patients with health insurance in a developing country. Materials and Methods: A retrospective case-control study was performed on 934 patients with clinically localized PCa who underwent radical prostatectomy between March, 1999 and July, 2009. Patients were divided in two groups, according to their SES. In group 1 (n=380), all had low income, low educational levels and couldn't afford medical insurance. In group 2 (n=554), all had higher income, higher education and had medical insurance. Results: Patients from group 1 were older, had higher Gleason scores, higher rates of seminal vesicle and bladder neck involvement. The Kaplan Meier disease-free survival curve demonstrated that after a follow-up of four years, about 50% of uninsured patients had biochemical recurrence, versus 21% of insured patients (Log rank test: p < 0.001). A multivariate Cox regression analysis for the risk of disease recurrence demonstrated that only PSA levels, Gleason score, seminal vesicle involvement and SES were statistically significant variables. Patients with a low SES presented 1.8 times the risk of recurrence as compared to patients with a high SES. Conclusions: Patients with low SES were older, presented more aggressive PCa characteristics and a high rate of disease recurrence. A low SES constituted an independent predictor for disease recurrence.- Biochemical recurrence rates are similar for pT2-positive surgical margins and pT3a(2014) LEITE, Katia R. M.; HARTMANN, Carolina; REIS, Sabrina T.; VIANA, Nayara; DALL'OGLIO, Marcos F.; ST'ANNA, Alexandre C.; NESRALLAH, Adriano; NESRALLAH, Luciano; ANTUNES, Alberto A.; CAMARA-LOPES, Luiz H.; SROUGI, MiguelObjective: Histological details of positive surgical margins in radical prostatectomy specimens have been related to outcome after surgery in rare studies recently published. Our objective is to assess whether the status of surgical margins, the extent and the Gleason score of positive margins, and the extent of the extraprostatic extension are predictive of biochemical recurrence post-radical prostatectomy. Materials and Methods: Three hundred sixty-five radical prostatectomy specimens were analyzed. The length of the positive surgical margin and extraprostatic extension and the Gleason score of the margin were recorded. Statistical analyses examined the predictive value of these variables for biochemical recurrence. Results: 236 patients were stage pT2R0, 58 pT2R1, 25 pT3R0 and 46 pT3R1. Biochemical recurrence occurred in 11%, 31%, 20% and 45.7% of pT2R0, pT2R1, pT3R0 and pT3R1, respectively. The extent of the positive surgical margins and the Gleason score of the positive surgical margins were not associated with biochemical recurrence in univariate analysis in a mean follow up period of 35.9 months. In multivariate analyses, only the status of the surgical margins and the global Gleason score were associated with biochemical recurrence, with a risk of recurrence of 3.1 for positive surgical margins and of 3.8 for a Gleason score > 7. Conclusion: Positive surgical margin and the global Gleason score are significant risk factors for biochemical recurrence post-radical prostatectomy, regardless of the extent of the surgical margin, the extent of the extraprostatic extension, or the local Gleason score of the positive surgical margin or extraprostatic tissue. pT2R1 disease behaves as pT3R0 and should be treated similarly.
- The use of statins is related to a lower PSA level after endoscopic enucleation of the prostate with holmium laser (HoLEP) for the treatment of BPH(2023) SUARTZ, Caio Vinicius; BRAZ, Natalia Doratioto Serrano Faria; ANJOS, Gabriel Carvalho dos; REIS, Sabrina Thalita dos; NAHAS, William Carlos; ANTUNES, Alberto AzoubelObjectiveTo determine the factors that may be associated with a 2-month high baseline level of Total Prostatic Specific Antigen (PSA) after endoscopic enucleation of the prostate with Holmium Laser (HoLEP).Materials and methodsRetrospective study of a prospectively collected database of adult males undergoing HoLEP at a single tertiary institution from September 2015 to February 2021. Pre-operative epidemiological, clinical characteristics and post-operative factors were analyzed and a multivariate analysis was performed to determine factors independently related to PSA decline.ResultsA total of 175 men aged 49-92 years with a prostate size ranging from 25 to 450 cc underwent HoLEP, and after excluding data from patients due to loss of follow-up or incomplete data, 126 patients were included in the final analysis. The patients were divided into group A (n = 84), which included patients with postoperative PSA nadir lower than 1 ng/ml, and group B(n = 42), with postoperative PSA levels greater than 1 ng/ml. In the univariate analysis there was a correlation between the variation of the PSA value and the percentage of resected tissue (p = 0.028), for each 1 g of resected prostate there was a reduction of 0.104 ng/mL, furthermore there was a difference between the means of age of group A (71.56 years) and group B (68.17 years) (p = 0.042). In the multivariate analysis, the use of statins and lower postoperative PSA levels (p = 0.024; HR = 3.71) were correlated.ConclusionsOur results indicate that PSA after HoLEP is correlated with patient's age, the presence of incidental prostate cancer, and the use of statins.
- GREB1 tissue expression is associated with organ-confined prostate cancer(2012) ANTUNES, Alberto A.; LEITE, Katia R.; REIS, Sabrina T.; SOUSA-CANAVEZ, Juliana M.; CAMARA-LOPES, Luiz H.; DALL'OGLIO, Marcos F.; SROUGI, MiguelObjective: By reason of its heterogeneous behavior, it is difficult to determine the prognosis of many prostate cancer cases. Patients with the same clinicopathologic conditions may present varying clinical findings and rates of progression. We determined the role of new genes as potential molecular markers for prostate cancer prognosis. Materials and methods: We performed a microarray analysis of two pools of patients with prostate cancer divided according to their clinicopathologic characteristics. After that, we validated these results by testing the genes with most different expressions between the two pools using the quantitative real time polymerase chain reaction method. We analyzed gene expression in 33 patients with localized prostate cancer according to prostate specific antigen (PSA), pathologic stage, Gleason score, and biochemical recurrence. For statistical analysis we used the Mann-Whitney Test. Results: The microarray analysis revealed that 4,147 genes presented a different expression between the two pools. Among them, 3 genes, TMEFF2, GREB1, and THIL,, were at least 13-times overexpressed, and 1 gene, IGH3, which was at least 5times under-expressed in pool 1 (good prognosis) compared with pool 2 (bad prognosis), were selected for analysis. After the validation tests, GREB1 was significantly more overexpressed among patients with stage T2 compared with T3 (P = 0.020). The expressions of other 3 genes did not present significant differences according to the clinicopatholoOcal variables. Conclusions: Tissue expression of GREB1 is associated with organ-confined prostate cancer and may constitute a gene associated with a favorable prognosis.
conferenceObject EXPRESSION PROFILE OF CD105 IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA (BPH): A NEW ANGIOGENIC MARKER(2013) BIOLO, Karlo; KIRIHARA, Ricardo; REIS, Sabrina T.; VIANA, Nayara I.; SAJOVIC, Paulo; ARAUJO, Luiz Henrique; LEITE, Katia R.; SROUGI, Miguel; ANTUNES, Alberto A.- MicroRNAs 143 and 145 may be involved in benign prostatic hyperplasia pathogenesis through regulation of target genes and proteins(2014) VIANA, Nayara I.; REIS, Sabrina T.; DIP, Nelson G.; MORAIS, Denis R.; MOURA, Caio M.; SILVA, Iran A.; KATZ, Betina; SROUGI, Miguel; LEITE, Katia R. M.; ANTUNES, Alberto A.Objectives: The aim of this study was to analyze the roles of miR-143 and miR-145, as well as the gene and protein expression of their targets (KRAS, ERK5, MAP3K3, and MAP4K4) in the pathogenesis of benign prostatic hyperplasia (BPH). Methods: We analyzed the specimens of 44 patients diagnosed with BPH who underwent surgical treatment. The control group consisted of prostate samples from 2 young patients who were organ donors. miRNAs and their target genes were assessed using real-time polymerase chain reaction (qRT-PCR), and protein levels were assessed by Western blotting. Results: miR-143 and miR-145 were overexpressed in, respectively, 62.5% and 73.8% of the cases. The ERK5 and MAP4K4 genes were underexpressed respectively in 59.4% and 100% of the BPH samples, whereas KRAS and MAP3K3 were overexpressed respectively in 79.4% and 61.5% of the samples. Increased protein expression was found for both KRAS (4,312.2 luminance/area) and MAP3K3 (7,461.7 luminance/area), while the ERK5 protein was more abundant in the samples from patients with prostate larger than 60 grams (p = 0.019). Conclusions: The overexpression of miR-143 and miR-145 in BPH samples suggests an association with the pathogenesis of the disease; additionally, the latter miRNA may act through the inhibition of MAP4K4. KRAS and MAP3K3 overexpression may also be associated with BPH pathogenesis. Further analyses are necessary to confirm these results.
conferenceObject UNDER-EXPRESSION OF MICRORNA-155 MAY INHIBIT PROSTATE GROWTH THROUGH SMAD-2 PATHWAY IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA(2012) ANTUNES, Alberto A.; REIS, Sabrina; NAKANO, Elcio; BIOLO, Karlo; PARANHOS, Mario; CORDEIRO, Paulo; FREIRE, Geraldo Campos; LEITE, Katia; SROUGI, Miguel- Physical activity effects on bladder dysfunction in an obese and insulin-resistant murine model(2021) OLIVEIRA, Andre Matos de; FONSECA, Fernando Mello Froes; REIS, Sabrina Thalita; VIANA, Nayara Izabel; OLIVEIRA, Edilamar Menezes; LEIRIA, Luiz Osorio; LEITE, Katia Ramos Moreira; NAHAS, William Carlos; SROUGI, Miguel; ANTUNES, Alberto AzoubelObjective: To investigate the role of physical activity in functional and molecular bladder alterations in an obese and insulin-resistant murine model. Methods: Wistar rats were randomized into 1. physical activity and standard diet; 2. physical activity and high-fat diet; 3. no physical activity and standard diet; and 4. no physical activity and high-fat diet. Groups 1 and 2 were subjected to a 10-week swimming protocol. Urodynamic study (UDS) was performed, and the expression of genes in the bladder tissue related to the insulin pathway (IRS1/IRS2/PI3K/AKT/eNOS) was assessed using quantitative real-time polymerase chain reaction. Results; Groups 1 and 2 presented lower body weight gains than groups 3 (213.89 +/- 13.77 vs 261.63 +/- 34.20 grams (g), p = 0.04) and 4 (209.84 +/- 27.40 vs 257.57 +/- 32.95 g, p = 0.04), respectively. Group 4 had higher insulin level (6.05 +/- 1.79 vs 4.14 +/- 1.14 ng/ml, p = 0.038) and higher homeostasis model assessment of insulin resistance (HOMA-IR) index (1.95 +/- 0.73 vs 1.09 +/- 0.37, p = 0.006) than group 1. On UDS, group 4 had greater number of micturition (13.6 +/- 4.21 vs 6.0 +/- 1.82, p = 0.04), higher postvoid pressure (8.06 +/- 2.24 vs 5.08 +/- 1.23, p = 0.04), lower capacity (0.29 +/- 0.18 vs 0.91 +/- 0.41 ml, p = 0.008), and lower bladder compliance (0.027 +/- 0.014 vs 0.091 +/- 0.034 ml/mmHg, p = 0.016) versus group 1. High-fat diet was related to an underexpression throughout insulin signaling pathway, and physical activity was related to an overexpression of the pathway. Conclusions: The insulin signaling pathway may be involved in the pathogenesis of bladder dysfunction related to a high-fat diet. Physical activity may help to prevent bladder disfunction induced by a high-fat diet through the insulin pathway.
conferenceObject CAN WE PREDICT WHICH PATIENTS WILL PRESENT RESOLUTION OF DETRUSOROVERACTIVITY (DO) AFTER TRANSURETHRAL RESECTION OF THE PROSTATE (TURP)?(2015) ISCAIFE, Alexandre; REIS, Sabrina T.; ALBERTINI, Aline; NUNES, Marco A.; LUCON, Antonio M.; NAHAS, Willian C.; SROUGI, Miguel; ANTUNES, Alberto A.