Introduction. Prostate cancer (PCa) is a common and relevant disease, especially in developed countries. Radical prostatectomy (RP) remains the gold standard for the treatment of localized PCa. However, research findings often show conflicting results regarding the potential dividends in patients that choose this option. A recent meta- analysis demonstrated that the greatest benefits were observed in the high-risk group of PCa patients. Therefore, the identification of this contingent of patients is highly relevant.
Biomarkers remain promising in this context. In particular, PCA3, the use of which is actively discussed, taking into account the heterogeneity of the research results. In our opinion, this can be associated with the studies designs. Objectives. In this work, we tried to evaluate the relationship between the PCa patients urine PCA3 levels and the tumor dominant growth pattern (TDGP) according to the tumor zone origin (TZO) in the context of the postoperative ISUP class (ISUP-GG). Materials and methods. The inclusion criteria were the presence of results: urine PCA3, total PSA, prostate MRI, ISUP-GG. The study included 130 participants, that were divided into subgroups depending on the TZO and TDGP: aPCa (anterior), aPZ-PCa (anterior, peripheral zone) and pPZ-PCa (posterior, peripheral zone). Results. The zones of origin of tumors according to the division into subgroups determined on the basis of MRI were confirmed by the results of patho- histological conclusion. A statistically significant difference between the study subgroups was observed only in PCA3 levels. The PSA level was significantly different only between the aPZ-PCa and pPZ-PCa groups. Based on the results of Spearman's rank correlation analysis, a statistically significant positive relationship between the level of PCA3 and ISUP- GG was obtained in the pPZ-PCa group. Conclusions. It is worth taking into account the TZO and TDGP of PCa when PCA3 urine levels is interpreted.
Testicular cancer is the most common malignancy in young men, with early and accurate diagnosis being critical for effective management and prognosis. Traditionally, the diagnostic approach relies on scrotal ultrasound and serum tumor markers, which, while effective, have limitations in characterizing complex lesions and detecting small, non- palpable tumors or metastatic disease. Recent advancements in imaging technology have introduced multiparametric MRI (mpMRI) as a promising tool in the diagnostic armamentarium for testicular cancer. MpMRI combines multiple imaging sequences, including T2-weighted imaging, diffusion-weighted imaging (DWI), and dynamic contrast- enhanced MRI (DCE-MRI), providing detailed anatomical and functional information about testicular lesions. This systematic review consolidates and evaluates current evidence regarding the role of mpMRI in the diagnosis, staging, and follow-up of testicular cancer.
Key findings from the literature suggest that mpMRI offers superior sensitivity and specificity compared to conventional imaging techniques, particularly in distinguishing between benign and malignant lesions. It is also highly effective in the precise localization and staging of tumors, including the detection of small lymph node metastases, which are often missed by ultrasound or CT. This review highlights the potential of mpMRI to enhance diagnostic precision and influence treatment strategies in testicular cancer, while also identifying areas for further research, such as the optimization of imaging protocols and the assessment of mpMRI's impact on long-term clinical outcomes. The review underscores the importance of mpMRI as a non-invasive, highly informative imaging modality that could lead to more personalized and effective management of testicular cancer.