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OBJETIVO: O rastreamento com o PSA (antígeno prostático específico) para detecção precoce de câncer de próstata em uma comunidade nativa tem grande importância epidemiológica. Assim, realizou-se estudo com objetivo de verificar a ocorrência do câncer da próstata em uma tribo indígena da Amazônia e uma possível relação entre o aculturamento, a presença de sobrepeso (índice de massa corporal) e o aparecimento da doença. MÉTODOS: Foi realizado um levantamento dos hábitos e medidas antropométricas em 22 homens com idade presumida maior de 50 anos, de uma tribo isolada de 363 índios, autodenominados Parkatejê e Kikatêjê, vivendo na região Amazônica (Pará). Além dos exames físico e hematológicos, foram realizadas dosagens de PSA total e PSA livre. RESULTADO: Os níveis séricos de PSA total variaram de 0,35 a 25,8 ng/ml. Três nativos apresentaram PSA maior que 4,0 ng/ml e outros dois evidenciaram PSA entre 2,5 e 4,0 ng/ml. Biopsia prostática em dois nativos revelou a presença de adenocarcinoma de próstata em um e neoplasia intraepitelial em outro. Sobrepeso com índice de massa corporal >25 Kg/msuperscript two e relação cintura-quadril >0,9 foram observados em 68,1% e 72,7% do grupo estudado. CONCLUSÕES: Mudanças nutricionais decorrentes do contato com a civilização, como substituição da caça e fibras vegetais por alimentos mais calóricos, estão aumentando a freqüência de sobrepeso na comunidade indígena. Devido à associação entre incidência de câncer de próstata, dieta gordurosa e menor atividade física, pode-se presumir que o futuro testemunhará mais casos da neoplasia prostática, visto que vários de seus membros já evidenciaram altos níveis séricos de PSA.

The surgical specimens from 51 men submitted to radical prostatectomy for localized prostate cancer were examined by immunohistochemistry using proliferation cell nuclear antigen (PCNA) monoclonal antibody to evaluate the proliferative index (PI). The relationship between PI, biological variables and p53 protein expression was evaluated by immunohistochemistry. PI was low in invasive localized prostate carcinoma (mean, 12.4%) and the incidence of PCNA-positive cells was significantly higher in tumors with p53 expression (P = 0.0226). There was no statistical difference in PCNA values when biological parameters such as Gleason score, tumor volume, extraprostatic involvement, seminal vesicle infiltration or lymph node metastasis were considered. We conclude that proliferative activity is usually low in prostate carcinoma but is correlated with p53 immune staining, indicating that p53 is important in cell cycle control in this neoplasm.

Objective To evaluate sperm DNA fragmentation analysis in non-azoospermic male systemic lupus erythematosus (SLE) patients. Methods Twenty-eight consecutive male SLE patients (American College of Rheumatology criteria) and 34 healthy controls were evaluated for demographic/exposures data, urological evaluation, hormone profile and sperm analysis (including sperm DNA fragmentation). Clinical features, disease activity/damage scores and treatment were also evaluated. Results The median age (33 (20–52) vs. 36.5 (25–54) years, P = 0.329) and frequency of varicocele (25% vs. 32%, P = 0.183) were similar in SLE patients and healthy controls. Sperm DNA fragmentation showed significantly higher levels of cells class III (44 (9–88) vs. 16.5 (0–80)%, P = 0.001) and cell class IV (10.5 (3–86) vs. 7 (0–36)%, P = 0.039) in SLE. The sperm DNA fragmentation index was also significantly higher in SLE patients (62 (31–97) vs. 25.5 (0–100)%, P < 0.001). Conventional sperm parameters (including sperm count, motility and morphology) were similar in both groups. In SLE patients no correlations were observed between sperm DNA fragmentation index and age, disease duration, Systemic Lupus Erythematosus Disease Activity Index 2000 and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index scores, and cumulative dose of prednisone, hydroxychloroquine, intravenous cyclophosphamide, methotrexate, azathioprine and mycophenolate mofetil (P > 0.05). Further analysis of SLE patients treated with and without intravenous cyclophosphamide showed that total sperm motility was significantly lower in the former group (64% (15–83) vs. 72% (57–86), P = 0.024). The sperm DNA fragmentation index was alike in both groups (52.5 (31–95) vs. 67.5 (34–97)%, P = 0.185). Conclusions To our knowledge, this is the first demonstration that male non-azoospermic SLE patients have increased sperm DNA fragmentation without evident gonadal dysfunction. Intravenous cyclophosphamide does not seem to be a major determinant for this abnormality. Future prospective study is necessary to determine the impact of this alteration in these patients' fertility. [ABSTRACT FROM AUTHOR]