Analiza koncentracij za prostato specifičnega antigena (PSA) v serumu glede na starost in sezonska nihanja

Šegula, Larisa (author), Osredkar, Joško (mentor), Smrkolj, Tomaž (co-mentor)

Rak prostate velja za enega izmed najpogostejših vrst rakov v razvitem svetu. Zaradi počasnega razvoja lahko mine več let, preden se dokončno klinično izrazi, zato je pomembno, da ga odkrijemo še v zgodnjih stadijih. Pri tem nam je v veliko pomoč določanje za prostato specifičnega antigena (PSA), saj se povišanje njegove koncentracije v serumu lahko pojavi že mnogo pred izraženostjo rakave bolezni. S starostjo se povečuje koncentracija PSA, s tem pa tudi možnost za bolezni prostate. Namen magistrske naloge je analizirati koncentracije PSA pri moških in preveriti, ali med posameznimi starostnimi skupinami obstajajo statistično značilne razlike. Obenem smo želeli ugotoviti, ali obstaja sezonsko nihanje koncentracij PSA. V raziskavi smo analizirali vrednosti PSA pri bolnikih, ki so bili od leta 2015 do leta 2020 obravnavani v UKC Ljubljana. V prvem delu naloge smo v statistično analizo vključili bolnike, ki niso imeli s prostato povezanih diagnoz. Razdelili smo jih v podskupine po dekadah in ugotavljali, ali med posameznimi dekadami obstajajo statistično značilne razlike v koncentraciji PSA ter katere starostne skupine se med seboj razlikujejo. Primerjava prve (0–40 let) in druge (40–50 let) dekade ni pokazala statistično značilnih razlik v koncentraciji PSA (p = 0,898), medtem ko smo uspeli dokazati, da statistično značilne razlike v koncentracijah PSA med preostalimi dekadami obstajajo (p < 0,000). Rezultati so pokazali, da imajo mlajši moški nižje koncentracije PSA, in potrdili, da se koncentracija PSA z leti zvišuje. V drugem delu naloge smo ugotavljali, ali obstajajo statistično značilne sezonske razlike v koncentraciji PSA. Preiskovance, ki so bili večkrat obravnavani v UKC Ljubljana, smo razdelili v štiri podskupine po trimesečjih odvzema vzorca. Ugotavljali smo, ali se vrednosti celokupnega in prostega PSA med skupinami razlikujejo. S statistično analizo nismo uspeli dokazati statistično značilnih razlik v koncentracijah celokupnega PSA (p = 0,555) in prostega PSA (p = 0,383) med trimesečji. Prav tako smo z opisno statistiko ugotovili, da so razlike v srednji vrednosti PSA med posameznimi sezonami minimalne. Čeprav nam statistično značilnih sezonskih razlik ni uspelo dokazati, smo pri nekaterih posameznikih opazili razlike v koncentraciji PSA med poletnim in zimskim obdobjem. V zadnjem delu naloge smo prikazali še potek bolezni in zdravljenja pri pacientu z malignim obolenjem prostate.

• Language: Slovenian
• Keywords: PSA, fPSA, rak prostate, dekade, sezonsko nihanje
• Work type: Master's thesis/paper
• Organization: FFA - Faculty of Pharmacy
• Year: 2022
• PID: 20.500.12556/RUL-135543
• Publication date in RUL: 18.03.2022

Secondary language

• Language: English
• Title: Analysis of serum prostate specific antigen (PSA) levels in relation to age and seasonal variations

Abstract

Prostate cancer is considered to be one of the most common types of cancer in the developed world. As it can take several years to present clinically due to its slow progress, it is important to detect it during its early stages. Determining the prostate-specific antigen (PSA) is a helpful diagnostic tool because an increase in its serum concentration can occur long before the onset of cancer. The concentration of PSA increases with age along with the probability for prostate cancer. In this thesis, we aim to analyze PSA concentrations in men and ascertain whether there are statistically significant differences between individual age groups. We also want to determine any seasonal fluctuations in PSA concentrations. In this study, we analyzed PSA values in patients treated in the University Medical Centre Ljubljana between 2015 and 2020. Initially, we included the patients without any prostate-related diagnoses. They were divided into subgroups by decades to determine whether statistically significant differences in PSA concentration exist between decades. A comparison of the first (0–40 years) and second (40–50 years) decade did not show statistically significant differences in PSA concentration (p = 0.898). However, we were able to prove statistically significant differences in PSA concentrations between the remaining decades (p < 0.000). The results showed that younger men have lower PSA concentrations, confirming that PSA concentrations increase with age. Second, we determined whether there are statistically significant seasonal differences in PSA concentration. The patients who were treated in the University Medical Centre Ljubljana multiples times were divided into four subgroups depending on the quarter when the sample was taken. We studied whether the values of total and free PSA differed between the groups. We failed to demonstrate statistically significant differences in the concentrations of total PSA (p = 0.555) and free PSA (p = 0.383). Using descriptive statistics, we found that the differences in the mean PSA value between the seasons are minimal. Despite not being able to prove statistically significant seasonal differences, we observed the differences in PSA concentration between summer and winter in some individuals. Lastly, we presented a case of prostate cancer and its treatment for one patient.

• Keywords: PSA, fPSA, prostate cancer, decades, seasonal variations