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A new promising indicator in prostate cancer screening: Prostate-specific antigen fluctuation rate 前列腺癌筛查的一个新指标：前列腺特异性抗原波动率

Actas urologicas espanolas

Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2024.02.006

U. Can , A. Coskun , C. Canakci , B. Simsek , Y. Karaca , K. Sabuncu , O. Akca

Objectives

To evaluate whether PSA fluctuation can be used to predict the risk of prostate cancer.

Materials and methods

The study included 1244 patients who underwent prostate biopsy at Kartal Dr. Lutfi Kirdar City Hospital between 2013 and 2021 (848 in non-cancer; 396 in cancer). The patient's age, last two PSA values (PSA₁ and PSA₂) within three months before the biopsy, the duration between two PSAs (days), prostate size (g) and PSA density (PSAD) were all recorded. PSA fluctuation rate (PSAfr) was defined as the change rate between two PSA values.

Results

PSAfr was significantly higher in the non-cancer group than in the prostate cancer group (15.2% (20.5) and 9.6% (14.4), P = .019). A Simple linear regression was used to examine the relationship between PSAfr and other factors such as age, PSA, PSAD, and prostate volume, but it was shown that these had no effect on PSA fluctuations. ROC analysis revealed a relatively low Area Under the Curve (AUC) for PSAfr (AUC, 0.584 (0.515–0.653)). However, the cut-off value of 12.35% was found to be significant, with a sensitivity of 58% and a specificity of 59% (P:.019, 95%CI). The odds ratio, adjusted for age, PSAD, and PSA2, was calculated as 0.545 (0.33−0.89) using logistic regression analysis to show the relationship between prostate cancer and PSAfr. As a result, those with high PSAfr were found to be 1.83 times less likely to be diagnosed with prostate cancer than those with low fluctuations.

Conclusion

PSAfr could be used in nomograms to predict prostate cancer risk and reduce the number of unnecessary biopsies.

目的：评估 PSA 波动是否可用于预测前列腺癌风险：评估 PSA 波动是否可用于预测前列腺癌风险：研究纳入了 2013 年至 2021 年期间在 Kartal Dr. Lutfi Kirdar 市医院接受前列腺活检的 1244 名患者（非癌症患者 848 名；癌症患者 396 名）。患者的年龄、活检前三个月内最后两次 PSA 值（PSA1 和 PSA2）、两次 PSA 之间的间隔时间（天数）、前列腺大小（g）和 PSA 密度（PSAD）均被记录在案。PSA波动率（PSAfr）是指两次PSA值之间的变化率：结果：非癌症组的 PSAfr 明显低于前列腺癌组（15.2% (20.5) 和 9.6% (14.4)，P = 0.019）。简单线性回归用于研究 PSAfr 与年龄、PSA、PSAD 和前列腺体积等其他因素之间的关系，但结果显示这些因素对 PSA 波动没有影响。ROC分析显示，PSAfr的曲线下面积（AUC）相对较低（AUC, 0.584 (0.515-0.653)），但12.35%的临界值具有显著性，灵敏度为58%，特异度为59%（p:0.019,95%CI）。结果发现，PSAfr值高的人被诊断为前列腺癌的几率是PSAfr值低的人的1.83倍：结论：PSAfr 可用于预测前列腺癌风险的提名图，减少不必要的活检次数。

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引用次数: 0

Laparoscopic approach for xanthogranulomatous pyelonephritis and pyonephrosis 黄疽性肾盂肾炎和肾盂积水的腹腔镜治疗方法。

Actas urologicas espanolas

Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2024.03.001

T. Telecan , I. Andras , N. Crousen , E.D. Cata , P. Medan , D.V. Stanca , A. Territo , I. Coman , N. Crisan

Introduction

Xanthogranulomatous pyelonephritis (XGPN) is a rare form of chronic renal inflammation, caused by long-term obstruction of the urinary tract. Pyonephrosis is a severe suppurative complication of acute obstructive pyelonephritis. Although minimally invasive approaches have many advantages, the safe dissection of the kidney may not be always achievable.

Materials and methods

We reviewed 27 cases diagnosed with either XGPN or pyonephrosis, who underwent laparoscopic total nephrectomy between October 2016 and March 2022 in our department. All interventions were performed using the Karl Storz 3D laparoscopic system. The surgical approach was standard transperitoneal nephrectomy for the majority of XGPN, while pyonephrosis cases were carried out in a retroperitoneally. All procedures were performed or supervised by the same surgeon.

Results

The mean operative time was 269.85 minutes (range 145–360). The mean hemoglobin drop after surgery was 1.41 g/dl (range 0.3–2.3 g/dl). Difficult dissection was encountered in 13 cases (48.14%). Nine out of 13 interventions were carried out in a complete intracorporeal fashion, while conversion to open surgery was needed in 4 cases. Vascular complications involving the major blood vessels comprised of one case of inferior vena cava (IVC) tear. Digestive tract-related complications comprised two fistulas of the descending colon and one peritoneal breach. Multiorgan resection was performed in 6 cases.

Conclusion

Total nephrectomy in cases of XGPN and pyonephrosis is a challenging procedure. The laparoscopic approach is feasible, as most complications are resolved intracorporeally. However, it may remain reserved for large-volume centers with experienced surgeons.

简介黄疽性肾盂肾炎（XGPN）是一种罕见的慢性肾脏炎症，由尿路长期梗阻引起。肾盂积脓是急性梗阻性肾盂肾炎的一种严重化脓性并发症。虽然微创方法有很多优点，但并非总能安全地剥离肾脏：我们回顾了 2016 年 10 月至 2022 年 3 月期间在我科接受腹腔镜全肾切除术的 27 例诊断为 XGPN 或肾盂肾炎的病例。所有手术均使用 Karl Storz 3D 腹腔镜系统进行。大多数XGPN的手术方式为标准的经腹膜肾切除术，而肾盂成形术则在腹膜后进行。所有手术均由同一名外科医生实施或指导：平均手术时间为 269.85 分钟（145-360 分钟不等）。术后血红蛋白平均下降 1.41 g/dl（范围 0.3-2.3 g/dl）。有 13 例（48.14%）患者遇到了剥离困难。13 例手术中有 9 例完全在体腔内完成，4 例需要转为开放手术。涉及大血管的并发症包括一例下腔静脉（IVC）撕裂。消化道相关并发症包括两例降结肠瘘和一例腹膜破损。6例患者进行了多器官切除术：结论：XGPN和肾盂肾炎病例的全肾切除术是一项具有挑战性的手术。腹腔镜方法是可行的，因为大多数并发症都能在体腔内解决。不过，腹腔镜手术仍需在拥有经验丰富外科医生的大型医疗中心进行。

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引用次数: 0

Changes in benign prostatic hyperplasia management in Valencia: a real-world evidence analysis 巴伦西亚良性前列腺增生管理的变化：真实世界证据分析。

Actas urologicas espanolas

Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2024.02.005

J. Navarro-Pérez , E. López Alcina , J. Calabiug Pérez , F. Brotons Muntó , A. Martínez , L. Vallejo , J. Jiménez

Introduction and objectives

A training program was developed to increase general practitioners' engagement in the optimal management of Benign Prostatic Hyperplasia (BPH). The goal of this study was to evaluate changes in BPH management after the implementation of a training program.

Material and Methods

This observational retrospective cohort study was conducted between 2019 and 2020. Aggregated data were analyzed in three evaluation periods (2010, 2012 and 2015), addressing quality indicators for diagnosis, treatment, and treatment outcomes.

Results

Overall, 118 795 patients who presented any data points were included. All quality indicators (number of IPSS and PSA determinations) increased between the first period and the last. Combination (α-blocker + 5-ARI) therapy was increasingly prescribed during the study periods whereas the proportion of prescriptions for single-agent α-blocker showed no significant differences among the periods analyzed. However, the total number of patients eligible for combination therapy who actually received this treatment was low in all periods (7.5%, 17.9%, and 20.1%, in 2010, 2012, and 2015, respectively). The outcome indicators revealed a decrease in referrals to the urology unit mostly among newly diagnosed patients. Even though the proportion of patients who underwent BPH-related surgeries increased significantly from the first to the second period, the number of surgeries remained stable between the second and third periods.

Conclusions

The training program had a generally positive impact on the management of BPH patients in PC, but the overall study period may be insufficient to show an effect on some outcome indicators such as the number of surgeries.

简介和目标：为提高全科医生对良性前列腺增生症（BPH）最佳治疗的参与度，我们制定了一项培训计划。本研究旨在评估培训计划实施后良性前列腺增生症管理的变化：这项观察性回顾性队列研究于 2019 年至 2020 年间进行。针对诊断、治疗和治疗结果的质量指标，对三个评估期（2010 年、2012 年和 2015 年）的汇总数据进行了分析：总共纳入了 118 795 名提供任何数据点的患者。所有质量指标（IPSS和PSA测定次数）在第一个评估期和最后一个评估期之间都有所增加。在研究期间，联合（α-受体阻滞剂+5-ARI）疗法的处方量越来越多，而单药α-受体阻滞剂的处方比例在分析期间没有显著差异。然而，在所有研究期间，符合联合治疗条件并实际接受该治疗的患者总人数较少（2010 年、2012 年和 2015 年分别为 7.5%、17.9% 和 20.1%）。结果指标显示，转诊到泌尿科的患者有所减少，其中大部分是新确诊的患者。尽管接受良性前列腺增生相关手术的患者比例从第一期到第二期显著增加，但手术数量在第二期和第三期之间保持稳定：培训计划总体上对 PC 中良性前列腺增生症患者的管理产生了积极影响，但整个研究期间可能不足以显示对某些结果指标（如手术次数）的影响。

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引用次数: 0

Surgeon experience in second-look transurethral resection of bladder cancer – a prospective study 膀胱癌二期经尿道切除术的外科医生经验--一项前瞻性研究。

Actas urologicas espanolas

Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2023.12.007

C.N. Fernandes , L. Vale , J.V. Sousa , T. Antunes-Lopes , C.M. Silva , J. Silva

Introduction and objectives

Transurethral resection of bladder tumor (TURBT) is crucial in the treatment of bladder tumors and when incorrectly performed can cause staging mistakes. To avoid these errors, a second resection is recommended in selected cases. The aim of this study is to evaluate the surgeon's ability to predict histologically complete primary resection of newly diagnosed bladder tumors avoiding the need for a second TURBT.

Methods

This is a prospective, observational study involving 47 consecutive patients with newly diagnosed bladder tumors who had previously undergone primary TURBT, and met EAU criteria for second-look TURBT. Second-look TURBT specimens were analyzed for routine histological assessment and compared with the surgeon's impression of the tumor at initial resection.

Results

Of 91 patients submitted to primary TURBT, 47 met the criteria for second-look TURBT. Second-look specimens revealed residual disease in 20.9% of patients and 3 (6.4%) of patients showed upstaging disease. The sensitivity of a senior to detect disease on second-look TURBT in relation to muscle invasion was 75%, and the specificity was 85%.

Conclusions

Second-look TURBT is crucial in the treatment of bladder cancer and cannot be replaced by a surgeon's opinion, so international recommendations should be followed. Supervision of less experienced surgeons is a cornerstone.

导言和目的：经尿道膀胱肿瘤切除术（TURBT）是治疗膀胱肿瘤的关键，如果操作不当，会导致分期错误。为避免这些错误，建议在选定的病例中进行第二次切除。本研究的目的是评估外科医生预测新诊断的膀胱肿瘤在组织学上完成初次切除的能力，以避免需要进行第二次 TURBT：这是一项前瞻性观察研究，涉及 47 名连续的新确诊膀胱肿瘤患者，他们之前都接受过初次膀胱肿瘤切除术，并符合 EAU 关于二次膀胱肿瘤切除术的标准。研究人员对二次TURBT标本进行了常规组织学评估分析，并将其与外科医生初次切除肿瘤时对肿瘤的印象进行了比较：结果：在91名接受初次前列腺电切术的患者中，有47人符合二次前列腺电切术的标准。二诊标本显示，20.9%的患者有残留病灶，3 例（6.4%）患者有病灶上移。一名资深医师在二次TURBT检查中发现与肌肉侵犯有关的疾病的敏感性为75%，特异性为85%：结论：二诊 TURBT 对膀胱癌的治疗至关重要，外科医生的意见无法取代，因此应遵循国际建议。对经验不足的外科医生进行指导是基础。

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引用次数: 0

Association between COVID-19 and increased incidence of overactive bladder symptoms in female patients: A retrospective analysis COVID-19与女性患者膀胱过度活动症状发病率增加之间的关系：一项回顾性分析。

Actas urologicas espanolas

Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2024.01.002

A. Coşkun , K. Erdem , U. Can

Introduction and objectives

To investigate female patients' post-COVID-19 voiding symptoms and to research how they relate to overactive bladder (OAB).

Patients

One hundred and forty patients aged 20–50 years who were hospitalised and discharged due to COVID-19 at Kartal Dr. Lütfi Kırdar City Hospital between 2021 and 2022 and 50 patients with a history of COVID-19 among two hundred female patients who presented to the urology outpatient clinic with symptoms related to OAB were retrospectively analysed. Bladder diary, overactive bladder symptom score (OABSS), uroflowmetry values and time of onset of symptoms of symptomatic patients were recorded for all patients. Disease-free individuals for control purposes were not included in the study.

Results

It was observed that 38% of 140 hospitalized patients had a symptomatic change related to OAB, and there was a significant difference in voiding diary, OABSS, and uroflowmetry Qmax values between symptomatic and non-symptomatic patients after COVID-19. (p:0.001) There was a significant difference between the pre-COVID-19 (estimated) and post-COVID-19 (current) voiding diary and OABSS values of all symptomatic patients (with and without a history of hospitalization). (p:0.001) When these two groups were compared with each other, there was a significant difference between the post-COVID-19 voiding diary, OABSS values, and the meantime to the onset of symptoms in inpatients and outpatients (p:0.001)

Conclusion

COVID-19 may be associated with urgency/urge incontinence and overactive bladder in female patients.

简介和目的：调查女性患者 COVID-19 后的排尿症状，并研究这些症状与膀胱过度活动症 (OAB) 的关系：回顾性分析了2021年至2022年期间在Kartal Dr. Lütfi Kırdar市医院因COVID-19住院并出院的140名20-50岁患者，以及泌尿科门诊就诊的200名有OAB相关症状的女性患者中50名有COVID-19病史的患者。所有患者的膀胱日记、膀胱过度活动症状评分（OABSS）、尿流率测量值和有症状患者的发病时间均被记录在案。研究不包括作为对照的无症状患者：结果显示：在 140 名住院患者中，有 38% 的患者出现了与 OAB 相关的症状变化，在 COVID-19 治疗后，有症状和无症状患者的排尿日记、OABSS 和尿流测定 Qmax 值存在显著差异（P:0.001）。(p:0.001) COVID-19 前（估计值）和 COVID-19 后（当前值）所有症状患者（有住院史和无住院史）的排尿日记和 OABSS 值之间存在显著差异。(结论：COVID-19 可能与女性患者的急迫性/紧急性尿失禁和膀胱过度活动症有关。

{"title":"Association between COVID-19 and increased incidence of overactive bladder symptoms in female patients: A retrospective analysis","authors":"A. Coşkun , K. Erdem , U. Can","doi":"10.1016/j.acuroe.2024.01.002","DOIUrl":"10.1016/j.acuroe.2024.01.002","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>To investigate female patients' post-COVID-19 voiding symptoms and to research how they relate to overactive bladder (OAB).</p></div><div><h3>Patients</h3><p>One hundred and forty patients aged 20–50 years who were hospitalised and discharged due to COVID-19 at Kartal Dr. Lütfi Kırdar City Hospital between 2021 and 2022 and 50 patients with a history of COVID-19 among two hundred female patients who presented to the urology outpatient clinic with symptoms related to OAB were retrospectively analysed. Bladder diary, overactive bladder symptom score (OABSS), uroflowmetry values and time of onset of symptoms of symptomatic patients were recorded for all patients. Disease-free individuals for control purposes were not included in the study.</p></div><div><h3>Results</h3><p>It was observed that 38% of 140 hospitalized patients had a symptomatic change related to OAB, and there was a significant difference in voiding diary, OABSS, and uroflowmetry Qmax values between symptomatic and non-symptomatic patients after COVID-19. (p:0.001) There was a significant difference between the pre-COVID-19 (estimated) and post-COVID-19 (current) voiding diary and OABSS values of all symptomatic patients (with and without a history of hospitalization). (p:0.001) When these two groups were compared with each other, there was a significant difference between the post-COVID-19 voiding diary, OABSS values, and the meantime to the onset of symptoms in inpatients and outpatients (p:0.001)</p></div><div><h3>Conclusion</h3><p>COVID-19 may be associated with urgency/urge incontinence and overactive bladder in female patients.</p></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 6","pages":"Pages 454-460"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139379097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Initial results of pulsed thulium fiber laser (Dornier®) for the treatment of renal and ureteral stones with ureteroscopy 脉冲铥光纤激光器（Dornier®）治疗输尿管镜下肾结石和输尿管结石的初步结果。

Actas urologicas espanolas

Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2024.04.004

M.C. Cano-García , C. Abad Rodríguez-Hesles , V. Yuste-Mascarós , M.Á. Arrabal Polo

引用次数: 0

Clinical evaluation and treatment in men with low testosterone levels and prostate cancer 男性睾酮水平低和前列腺癌患者的临床评估和治疗。

Actas urologicas espanolas

Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2023.12.001

B.M. Ljubetic, F. Parada, J.M. Flores

Introduction

A high prevalence of low testosterone levels has been reported in men with prostate cancer. The use of testosterone therapy in men with a history of prostate cancer is still controversial, and there is uncertainty regarding the management of these patients.

Methods

We analyzed the European and American guidelines on this topic and presented the clinical experience in the management of patients with low testosterone levels and a history of prostate cancer in one of the world's leading cancer centers.

Results

According to the published evidence to date, testosterone therapy in men with prostate cancer does not increase the risk of prostate cancer recurrence in the short and medium term, but there is a lack of data on the long term. Symptomatic men with low testosterone levels who are candidates for this therapy need a thorough clinical evaluation before commencing testosterone therapy. Evaluation of prostate cancer history including type of treatment administered, pathologic stage of prostate cancer and prostate specific antigen should be requested before and during testosterone treatment to assess its trend.

Conclusion

Prostate-specific antigen should remain undetectable after radical prostatectomy or stable after radiotherapy. Otherwise, it would be a sign of uncontrolled prostate cancer, and the patient may require cessation of testosterone therapy and referral to oncology for further evaluation.

导言：据报道，在患有前列腺癌的男性中，睾酮水平低的发病率很高。对有前列腺癌病史的男性使用睾酮治疗仍存在争议，对这些患者的管理也存在不确定性：方法：我们分析了欧洲和美国的相关指南，并介绍了世界领先的癌症中心之一在治疗睾酮水平低且有前列腺癌病史的患者方面的临床经验：结果：根据迄今为止已发表的证据，前列腺癌男性患者接受睾酮治疗在短期和中期内不会增加前列腺癌复发的风险，但缺乏长期治疗的数据。睾酮水平低且有症状的男性患者在开始睾酮治疗前需要进行全面的临床评估。在睾酮治疗前和治疗期间，应要求评估前列腺癌病史，包括治疗类型、前列腺癌病理分期和前列腺特异性抗原，以评估其趋势：前列腺特异性抗原在根治性前列腺切除术后应保持检测不到，或在放疗后保持稳定。结论：前列腺特异性抗原在根治性前列腺切除术后应保持检测不到，或在放疗后保持稳定，否则将是前列腺癌未得到控制的迹象，患者可能需要停止睾酮治疗，并转到肿瘤科做进一步评估。

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引用次数: 0

Biomarkers in kidney transplantation: Where do we stand? 肾移植中的生物标志物：我们的现状如何？

Actas urologicas espanolas

Pub Date : 2024-07-01 DOI: 10.1016/j.acuroe.2024.01.003

A. López-Abad , A. Piana , T. Prudhomme , B. Bañuelos Marco , M.I. Dönmez , A. Pecoraro , R. Boissier , R. Campi , A. Breda , A. Territo , en representación del grupo de trabajo de trasplante renal de la sección de Jóvenes Urólogos Académicos (YAU) de la Asociación Europea de Urología (EAU)

引用次数: 0

The effect of diagnosis delay in testis cancer on tumor size, tumor stage and tumor markers 睾丸癌延迟诊断对肿瘤大小、分期及肿瘤标志物的影响。

Actas urologicas espanolas

Pub Date : 2024-06-01 DOI: 10.1016/j.acuroe.2023.11.004

O. Gercek , K. Topal , A.K. Yildiz , K. Ulusoy , V.M. Yazar

Introduction

In testicular cancer, the positive effect of early diagnosis on survival has been known for many years. In this study, we aimed to determine the diagnostic features of testicular cancer patients, to examine the effect of duration of diagnosis delay (DD) on tumor size, tumor stage, and serum tumor markers, and to reveal the possible benefits of early diagnosis.

Methods

A total of 71 patients who underwent inguinal orchiectomy due to suspicion of testicular cancer and whose pathology was found to be the germ cell tumor were included in the study. The relationship between the duration of diagnosis delay and tumor size, level of tumor markers, TNM stage, presence of LAP, and presence of metastasis were examined.

Results

Seminoma was detected in 39 (54.9%) patients and non-seminoma tumor was detected in 32 (45.1%) patients. In the correlation analysis between the markers, a significant and positive correlation was found between DD and radiological tumor size, pathological tumor size, retroperitoneal LAP detection rate, LDH and AFP levels, and N stage (respectively; r = 0.345 p = 0.003, r = 0.324 p = 0.006, r = 0.244 p = 0.041, r = 0.286 p = 0.015, r = 0.244 p = 0.040, r = 0.238 p = 0.046). It was determined that a 1-day increase in DD caused an increase of 0.431 mm in the pathological size of the tumor.

Conclusion

Duration of diagnosis delay is an issue that still keeps its importance for testicular tumors. Delay in diagnosis not only leads to an increase in tumor size but also negatively affects tumor stage and prognostic factors.

导读:在睾丸癌中，早期诊断对生存率的积极作用已经知道很多年了。在本研究中，我们旨在确定睾丸癌患者的诊断特征，探讨诊断延迟时间(DD)对肿瘤大小、肿瘤分期和血清肿瘤标志物的影响，并揭示早期诊断可能带来的益处。方法:对71例因怀疑睾丸癌行腹股沟睾丸切除术，病理检查为生殖细胞瘤的患者进行研究。检查诊断延迟时间与肿瘤大小、肿瘤标志物水平、TNM分期、LAP存在、转移存在的关系。结果:精原细胞瘤39例(54.9%)，非精原细胞瘤32例(45.1%)。在各项指标的相关性分析中，DD分别与影像学肿瘤大小、病理肿瘤大小、腹膜后LAP检出率、LDH、AFP水平、N分期呈显著正相关;r = 0.345, p = 0.003, p = 0.006 r = 0.324, p = 0.041 r = 0.244, p = 0.015 r = 0.286, p = 0.040 r = 0.244, r = 0.238, p = 0.046)。结果表明，DD增加1天，肿瘤病理大小增加0.431 mm。结论:睾丸肿瘤的诊断延迟时间仍然是一个重要的问题。延迟诊断不仅会导致肿瘤大小的增加，而且会对肿瘤分期和预后因素产生负面影响。

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引用次数: 0

Quality of information about urologic pathology in English and Spanish from ChatGPT, BARD, and Copilot 来自 ChatGPT、BARD 和 Copilot 的英语和西班牙语泌尿科病理学信息的质量。

Actas urologicas espanolas

Pub Date : 2024-06-01 DOI: 10.1016/j.acuroe.2024.02.009

J.J. Szczesniewski , A. Ramos Alba , P.M. Rodríguez Castro , M.F. Lorenzo Gómez , J. Sainz González , L. Llanes González

Introduction and objective

Generative artificial intelligence makes it possible to ask about medical pathologies in dialog boxes. Our objective was to analyze the quality of information about the most common urological pathologies provided by ChatGPT (OpenIA), BARD (Google), and Copilot (Microsoft).

Methods

We analyzed information on the following pathologies and their treatments as provided by AI: prostate cancer, kidney cancer, bladder cancer, urinary lithiasis, and benign prostatic hypertrophy (BPH). Questions in English and Spanish were posed in dialog boxes; the answers were collected and analyzed with DISCERN questionnaires and the overall appropriateness of the response. Surgical procedures were performed with an informed consent questionnaire.

Results

The responses from the three chatbots explained the pathology, detailed risk factors, and described treatments. The difference is that BARD and Copilot provide external information citations, which ChatGPT does not. The highest DISCERN scores, in absolute numbers, were obtained in Copilot; however, on the appropriacy scale it was noted that their responses were not the most appropriate. The best surgical treatment scores were obtained by BARD, followed by ChatGPT, and finally Copilot.

Conclusions

The answers obtained from generative AI on urological diseases depended on the formulation of the question. The information provided had significant biases, depending on pathology, language, and above all, the dialog box consulted.

导言和目标：生成人工智能使在对话框中询问病理信息成为可能。我们的目的是分析 ChatGPT（OpenIA）、BARD（谷歌）和 Copilot（微软）提供的最常见泌尿科病理信息的质量：我们分析了人工智能提供的有关以下病症及其治疗方法的信息：前列腺癌、肾癌、膀胱癌、尿路结石和良性前列腺肥大（BPH）。在对话框中以英语和西班牙语提出问题；通过 DISCERN 问卷收集和分析答案以及回答的总体适当性。手术程序是在知情同意问卷的基础上进行的：三个聊天机器人的回复都解释了病理、详细说明了风险因素并描述了治疗方法。不同之处在于 BARD 和 Copilot 提供了外部信息引用，而 ChatGPT 没有。就绝对数量而言，Copilot 获得的 DISCERN 分数最高；但在适当性量表上，他们的回答并不是最适当的。手术治疗得分最高的是 BARD，其次是 ChatGPT，最后是 Copilot：从生成式人工智能中获得的有关泌尿系统疾病的答案取决于问题的表述。所提供的信息有很大的偏差，这取决于病理、语言，尤其是所咨询的对话框。

{"title":"Quality of information about urologic pathology in English and Spanish from ChatGPT, BARD, and Copilot","authors":"J.J. Szczesniewski , A. Ramos Alba , P.M. Rodríguez Castro , M.F. Lorenzo Gómez , J. Sainz González , L. Llanes González","doi":"10.1016/j.acuroe.2024.02.009","DOIUrl":"10.1016/j.acuroe.2024.02.009","url":null,"abstract":"<div><h3>Introduction and objective</h3><p>Generative artificial intelligence makes it possible to ask about medical pathologies in dialog boxes. Our objective was to analyze the quality of information about the most common urological pathologies provided by ChatGPT (OpenIA), BARD (Google), and Copilot (Microsoft).</p></div><div><h3>Methods</h3><p>We analyzed information on the following pathologies and their treatments as provided by AI: prostate cancer, kidney cancer, bladder cancer, urinary lithiasis, and benign prostatic hypertrophy (BPH). Questions in English and Spanish were posed in dialog boxes; the answers were collected and analyzed with DISCERN questionnaires and the overall appropriateness of the response. Surgical procedures were performed with an informed consent questionnaire.</p></div><div><h3>Results</h3><p>The responses from the three chatbots explained the pathology, detailed risk factors, and described treatments. The difference is that BARD and Copilot provide external information citations, which ChatGPT does not. The highest DISCERN scores, in absolute numbers, were obtained in Copilot; however, on the appropriacy scale it was noted that their responses were not the most appropriate. The best surgical treatment scores were obtained by BARD, followed by ChatGPT, and finally Copilot.</p></div><div><h3>Conclusions</h3><p>The answers obtained from generative AI on urological diseases depended on the formulation of the question. The information provided had significant biases, depending on pathology, language, and above all, the dialog box consulted.</p></div>","PeriodicalId":94291,"journal":{"name":"Actas urologicas espanolas","volume":"48 5","pages":"Pages 398-403"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139907265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0