Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0001418 (adenocarcinoma)
 68,496 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recently, the concept of PSA density has been introduced in order to increase the diagnosis sensitivity obtained with serum PSA dosing. The usefulness of this parameter has been assessed in 47 patients with benign prostate hyperplasia (BHP) and 26 patient with non-disseminated prostate adenocarcinoma. Using 0.15 as cut-off value, below which were 97% of patients with uncomplicated BHP, we obtained a 73% overall sensitivity. This sensitivity was stage related, reaching 100% in stage C patients. On the contrary, the test specificity was relatively low, since it considered patients with complicated HPB with urinary infection or with in-dwelling vesical catheter, obtaining 41% false positives. These results suggest a special usefulness of this test for the correct diagnosis of those prostate cases with mild suspicion of cancer.
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PMID:[The diagnostic utility of PSA density]. 865 75

Prostatic intraepithelial neoplasia (PIN) fulfils the majority of requirements for a premalignant change in the human prostate. Forty-eight patients were diagnosed to have high grade PIN on prostatic needle biopsy. During a follow-up period, 23 (47.9%) were found to have adenocarcinoma on subsequent biopsies. We compared the patients age, the digital examination, the transrectal ultrasound appearance (TRUS) and the serum PSA level between those in whom cancer was detected subsequently and those with PIN alone. There was a statistically significant difference in the transrectal ultrasound appearance (TRUS) and the serum PSA level between the two groups (p < 0.001, p < 0.016 respectively). In conclusion, patients with high grade PIN, elevated serum PSA with hypoechoic zone on TRUS should be rebiopsied 3 months after the initial diagnosis. If the results are negative, close follow-up is mandatory.
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PMID:[High-grade intraepithelial prostatic neoplasms: diagnosis and association with prostate cancer]. 865 30

Over the last decade PSA has been widely acknowledged to be a very sensitive and specific marker of prostatic tumour pathologies. This paper reports the authors' experience relating to the use of PSA in the early diagnosis of prostatic heteroplasia on the basis of results obtained in a study performed in 805 dysuric patients who underwent rectal exploration and CAT. Echo-guided prostate biopsy according to Hodge was performed in 212 (26.4%) out of 805 patients and adenocarcinoma was found in 55 cases (25.9%). PSA ranged between 10-198 ng/ml in 42 out of 212 patients, between 4-10 ng/ml in 60, and was below 4 ng/ml in 110. In addition, PSAd was assayed in all patients with PSA < 10 mg/ml. Having established the cutoff of PSA at 10 ng/ml, it was found that some heteroplasia, above all at the initial sage, presented normal PSA blood values. In fact, in 8 cases, equivalent to 14.5% of the neoplasias diagnosed, values were under 4 ng/ml, and in 5 cases, equivalent to 9%, they ranged between 4-10 ng/ml. This finding showed that the threshold value of 10 ng/ml gives PSA a high specificity, but a lower sensitivity in the early diagnosis of prostatic adenocarcinoma. Moreover, the analysis of PSA-density does not significantly allow the diagnosis of a larger number of heteroplasias: in fact, out of 13 cases of adenocarcinoma with PSA < 10 ng/ml, PSAd was only > 0.15 in 2 patients. Therefore, in line with the data reported in the literature, the authors consider that PSA assay represents a sensitive and specific screening method for prostatic tumour pathologies in symptomatic patients, but in order to obtain an early diagnosis, and especially in cases with serum values between 4-10 ng/ml, it must be combined with both rectal exploration and, above all, transrectal scan.
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PMID:[PSA and prostatic adenocarcinoma. Experience with 805 patients]. 871 85

We report a rare case of bilateral primary seminal vesicle carcinoma in a 73 yr old Australian man. To our knowledge this case report is the 48th histologically confirmed case of primary seminal vesicle neoplasia and only the fourth reported case of primary bilateral seminal vesicle carcinoma. Macroscopically the tumor was localized to both seminal vesicles and the adjacent right lobe of the prostate. Histologically the tumor and metastases displayed a PSA, PAP and CEA negative, well differentiated papillary adenocarcinoma resembling the pattern of normal seminal vesicle epithelium. No other primary carcinoma in the body was demonstrated. The patient survived for 3 yrs and 4 mths without recurrence of tumor. The pathological criteria for acceptance of primary seminal vesicle carcinoma, difficulties in clinical/radiological detection of seminal vesicle tumors and CA-125 immunoreactivity are discussed.
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PMID:Bilateral primary seminal vesicle carcinoma. 874 30

The PSA levels in benign prostatic hyperplasia (BPH) and prostate adenocarcinoma (PA) overlap, both below and above 4 to 10 ng/mL. There is no known PSA level diagnostic of PA. In this study, data were obtained in 160 consecutive men aged 58 to 87. Prebiopsy PSA levels (PSA-1) were obtained prior to "sextant" gun biopsies in 97 cases diagnosed as noncarcinoma, and in 56 cases diagnosed as PA. Multiple hematoxylin and eosin sections were made of each biopsy, and Gleason scores given the PAs. Cases were followed up to 30 months with repeated PSA levels and additional biopsies. The highest PSA level in NPA in this series was 54.6 ng/mL.
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PMID:Minimum prostate-specific antigen (PSA) level diagnostic of prostate cancer. 875 58

Thirteen patients, mean age 61 years (range 54 to 71), diagnosed with prostate adenocarcinoma underwent radical prostatectomy. To achieve a diagnosis they were all performed blood PSA determination, digital rectal examination, transrectal ultrasound and a prostate ultrasound-guided biopsy by automatic gun puncture. Serum PSA quantification, digital rectal examination and transrectal ultrasound were repeated in the immediate post-operative, and three and six months after surgery. Through the information obtained with endocavitary ultrasound, the lumen of the cervicourethral anastomosis and the perianastomotic tissue was assessed. Transrectal ultrasound plays a relevant role in the follow-up of patients undergoing radical prostatectomy. When a patient with prostate radical surgery shows an elevation of serum PSA and/or abnormal digital rectal examination, an ultrasound-guided biopsy (at the node or perianastomotic area) is indicated.
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PMID:[Ultrasonographic (intra- and extraluminal) pattern of cervico-urethral anastomosis after radical prostatectomy]. 876 2

To determine if patients with bladder cancer have a higher incidence of unsuspected prostate cancer, 40 cases were studied. All except one case had no evidence of prostate cancer on preoperative clinical assessment. Detailed pathological evaluation of cystoprostatectomy specimens with sections at 2- to 3-mm intervals was done. Adenocarcinoma of the prostate was identified in 18 of 40 patients (45%). Multifocal prostatic intraepithelial neoplasia (PIN) was present in 19 cases (47.5%); 4 (10%) without an associated prostate cancer and 15 (37.5%) in conjunction with adenocarcinoma of the prostate. Twelve cases of unsuspected prostate cancer were stage pT1a, 4 were pT1b, and 2 were pT3. No patients exhibited nodal or distance metastases by the prostate cancer. At a mean follow-up of 15.2 months (range 3-34 months), 37 of the 40 patients are alive. Among prostate cancer patients, no clinical or biochemical evidence of disease recurrence or prostate cancer related mortality has been observed. Our findings support the previously reported high incidence rate of prostate cancer in patients undergoing cystoprostatectomy for bladder cancer. This, though, may not be higher than the observed incidence in an age-matched general population. We recommend DRE and PSA as part of the bladder cancer workup in males, and complete removal of the prostate at cystoprostatectomy to prevent the dilemma of residual prostate cancer.
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PMID:Incidental prostatic adenocarcinoma in patients undergoing radical cystoprostatectomy for bladder cancer. 893 64

We studied laparoscopic urological procedures in 14 cases between July 1995 and October 1996. We applied retroperitoneal lomboscopic technique for 2 cases with symptomatic renal cyst (over 500 ml) and laparoscopic retroperitoneal lymphadenectomy in 12 cases (adenocarcinoma of the prostate-5 cases, pT2-3bMo, Gleason score between 3-9, PSA between 11-46 ng/ml and invasive bladder tumors-7 cases, pT2-3bMoG2-3). For the renal cyst we used extraperitoneal approach and for the pelvic lymph nodes we used in 8 cases intraperitoneal approach and in 4 cases extraperitoneal approach (patients with multiple prior abdominal surgeries). Lymph node tissue was present in 11 cases. For the bladder tumors we did first iliac lymph nodes dissection and for the prostate adenocarcinoma we did first obturator lymph nodes dissection. We didn't describe complications. For our patients it was 3 days long hospitalization. So, we consider that laparoscopic lymphadenectomy is essential for evaluation of the patients with prostate adenocarcinoma having markedly elevated prostate specific antigen, high Gleason grade, large clinical burden of tumor. For the invasive bladder tumors, radical cystectomy and especially bladder replacement surgery need absolutely evaluation of regional lymph nodes. For the symptomatic renal cysts (over 500 ml) laparoscopic surgery is with very good results, minimally invasive.
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PMID:[Preliminary data on our laparoscopy experience in urinary pathology]. 909 Oct 86

PSA remains an immensely valuable tool in the diagnosis of prostate adenocarcinoma. Factors such as prostatitis, urinary retention, ejaculation, and inpatient versus outpatient measurement, however, may have a profound effect on the serum PSA concentration. Furthermore, prostate biopsy and TURP result in an increase in the serum PSA value that resolves in 4 to 6 weeks. It is imperative that these factors be taken into account to interpret serum PSA values, to optimize the diagnostic utility of the PSA test.
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PMID:The effect of prostatitis, urinary retention, ejaculation, and ambulation on the serum prostate-specific antigen concentration. 912 25

Metastatic carcinoma to the testis is very rare. Metastasis of prostate adenocarcinoma to testis was detected incidentally after bilateral orchiectomy for hormonal management of metastatic prostate carcinoma. The metastatic lesion was not identified in physical examination or in macroscopic dissection of the testis after surgery. Microscopy revealed an adenocarcinoma which, given the history of the patient and a positive immunohistochemical stain for PSA, was identified as metastatic prostatic adenocarcinoma.
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PMID:Metastasis of prostate adenocarcinoma to testis. 917 80


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