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Concordancia del puntaje de Gleason en biopsia transrectal de próstata y prostatectomía radical en pacientes del Hospital Militar Central.
dc.contributor.advisor | Estrada Guerrero, Andrea | spa |
dc.contributor.advisor | Quiroga Matamoros, William | spa |
dc.contributor.author | Castaño Charry, Diana Patricia | |
dc.contributor.author | Suarez Pinilla, Juan Camilo | |
dc.coverage.spatial | Medicina | spa |
dc.date.accessioned | 2019-04-24T14:23:42Z | |
dc.date.accessioned | 2019-12-30T19:08:55Z | |
dc.date.available | 2019-04-24T14:23:42Z | |
dc.date.available | 2019-12-30T19:08:55Z | |
dc.date.issued | 2019-03-25 | |
dc.identifier.uri | http://hdl.handle.net/10654/21126 | |
dc.description.abstract | El puntaje de Gleason como herramienta de estadificación histológica en pacientes con cáncer de próstata juega un papel de suma importancia en la determinación de pronóstico y comportamiento de la enfermedad por lo que es factor que debe ser tenido en cuenta al momento de la toma de decisiones en cuanto al tratamiento a realizar. Sin embargo, a pesar de la confiabilidad del puntaje de Gleason con respecto al mismo espécimen, la correlación entre el resultado de la biopsia de próstata y de la pieza quirúrgica obtenida de la prostatectomía radical es variable. Lo que podría impactar en la toma de decisiones terapéuticas y finalmente en la sobrevida del paciente Objetivo: Determinar la concordancia entre el puntaje de Gleason de la biopsia transrectal de próstata con el Gleason de la prostatectomía radical. Materiales y Métodos: Se realizó un estudio de concordancia de pruebas diagnósticas de 90 registros de patología de prostatectomía radical realizadas entre 2014-2018. Todos los pacientes debían tener biopsia de próstata previa a la prostatectomía radical, y ambos procedimientos realizados en el Hospital Militar Central. El índice correlación de Kappa de Cohen se usó para determinar la concordancia entre las variables. Resultados: El índice de concordancia de Kappa de Cohen para el gleason en grupo de riesgo fue de 0.154 y Kappa ponderado fue de 0.379, implicando una concordancia pobre y débil respectivamente entre el resultado anatomopatológico de la biopsia transrectal de próstata con el de la prostatectomía radical.. Conclusiones: En general, la confiabilidad de la puntuación de Gleason de las biopsias con aguja para predecir la patología final fue débil. Sin embargo, no se determinó que esta concordancia sea significativa al momento de tomar decisiones en el manejo del paciente, ya que el grado de sub estadificación y sobre estadificación son comparables con centros de referencia mundial y la decisión terapéutica toma en cuenta esta diferencia y otros factores clínicos que permiten una adecuada elección. | spa |
dc.description.tableofcontents | 1. Resumen 5 2. Marco Teórico 6 3. Planteamiento Del Problema Y Justificación 11 3.1. Pregunta De Investigación 12 4. Objetivos 13 4.1. Objetivo General 13 4.2. Objetivos Específicos 13 5. Metodología 14 5.1. Tipo De Estudio 14 5.2. Población Blanco 14 5.3. Población Objeto 14 5.4. Centro De Estudio Ejecutor 14 5.5. Criterios De Inclusión 14 5.6. Criterios De Exclusión 15 5.7. Tamaño De La Muestra 15 5.8. Definición De Las Variables 15 5.9. Procedimientos Para La Recolección De Información, Instrumentos A Utilizar Y Métodos Para El Control De Calidad De Los Datos 16 6. Plan De Análisis 17 7. Cronograma 18 8. Presupuesto 19 9. Aspectos Éticos 20 10. Resultados 21 11. Discusión 25 12. Conclusiones 28 13. Trayectoria De Los Investigadores 29 14. Referencias Bibliográficas 32 | spa |
dc.format | spa | |
dc.format.mimetype | application/pdf | spa |
dc.language.iso | spa | spa |
dc.language.iso | spa | spa |
dc.publisher | Universidad Militar Nueva Granada | spa |
dc.rights | Derechos Reservados - Universidad Militar Nueva Granada, 2019 | spa |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/2.5/co/ | spa |
dc.title | Concordancia del puntaje de Gleason en biopsia transrectal de próstata y prostatectomía radical en pacientes del Hospital Militar Central. | spa |
dc.type | info:eu-repo/semantics/bachelorThesis | spa |
dc.rights.accessrights | info:eu-repo/semantics/openAccess | spa |
dc.publisher.department | Facultad de Medicina | spa |
dc.type.local | Trabajo de grado | spa |
dc.description.abstractenglish | The Gleason score as a histological staging tool in patients with prostate cancer plays an important role on prognosis determination and the disease behavior, which is a factor that must be taken into account at the moment of the taking of decisions regarding the treatment to be performed. However, despite the reliability of Gleason score with respect to the same specimen, the correlation between the result of the prostate biopsy and the surgical specimen of the radical prostatectomy is variable. Objective: Determine the concordance between the Gleason score of the transrectal prostate biopsy and the Gleason score of the radical prostatectomy. Materials and methods: Concordance study. 90 records of radical prostatectomy pathology between 2014-2018 was carried out. All patients had to have a prostate biopsy prior to radical prostatectomy, and both procedures performed at Hospital MIlitar Central. Cohen's Kappa correlation was used to determine the agreement between the variables. Results: Cohen's Kappa concordance index for the gleason score in the risk group was 0.154 and weighted Kappa was 0.379, implying a poor and weak concordance as a result of the anatomopathological result of the transrectal prostate biopsy with radical prostatectomy. Conclusions: In general, the reliability of the cycle score of needle biopsies to predict the final pathology was weak. However, it was not determined that this concordance is significant at the time of making decisions in the management of the patient. upgrading and overgrading degree are comparable with world reference centers and the therapeutic decision takes into account this difference and other clinical factors that allow for an adequate treatment choice. | eng |
dc.title.translated | Gleason score concordance in transrectal prostate biopsy and radical prostatectomy in Hospital Militar Central patients | spa |
dc.subject.keywords | Gleason | spa |
dc.subject.keywords | Prostatectomy | spa |
dc.subject.keywords | Biopsy | spa |
dc.publisher.program | Urología | spa |
dc.creator.degreename | Especialista en Urología | spa |
dc.subject.decs | UROLOGIA | |
dc.subject.decs | ENFERMEDADES DE LA PROSTATA | |
dc.subject.decs | BIOPSIA | |
dc.description.degreelevel | Especialización | spa |
dc.publisher.faculty | Medicina y Ciencias de la Salud - Urología | spa |
dc.type.dcmi-type-vocabulary | Text | spa |
dc.type.version | info:eu-repo/semantics/acceptedVersion | spa |
dc.rights.creativecommons | Atribución-NoComercial-SinDerivadas | spa |
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dc.relation.references | 13. Andriole, M.D GL, Catalona, M.D WJ. Prostate Carcinoma. Annu Rev Med. 1994;45(1):351-359 | spa |
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dc.relation.references | 26. Epstein JI, Feng Z, Trock BJ, Pierorazio PM. Upgrading and Downgrading of Prostate Cancer from Biopsy to Radical Prostatectomy: Incidence and Predictive Factors Using the Modified Gleason Grading System and Factoring in Tertiary Grades. Eur Urol. 2012;61(5):1019-1024. doi:10.1016/j.eururo.2012.01.050. | spa |
dc.relation.references | 27. Kuroiwa K, Shiraishi T, Naito S. Gleason score correlation between biopsy and prostatectomy specimens and prediction of high-grade Gleason patterns: significance of central pathologic review. Urolo gy 2011;77:407–11. | spa |
dc.relation.references | 28. Moussa AS, Li J, Soriano M, et al. Prostate biopsy clinical and pathological variables that predict significant grading changes in patients with intermediate and high grade prostate cancer. BJU Int 2009;103:43–8. | spa |
dc.relation.references | 29. Ruijter E, van Leenders G, Miller G, et al. Errors in histological grading by prostatic needle biopsy specimens: frequency and pre- disposing factors. J Pathol 2000;192: 229-33 | spa |
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dc.subject.proposal | GLEASON | spa |
dc.subject.proposal | PROSTATECTOMIA | spa |
dc.subject.proposal | BIOPSIA | spa |
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