Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0007112 (prostatic adenocarcinoma)
 2,574 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A total of 58 patients have undergone bilateral pelvic lymphadenectomy as a staging procedure for clinically localized adenocarcinoma of the prostate. Of these, 19 patients (33%) had pelvic lymph node involvement. When a cutoff value of 50 ng/ml was used, the preoperative prostate-specific antigen (PSA) value had a positive predictive value of 57% for pelvic lymph node metastasis. Of the patients with PSA < 20 ng/ml, only 1 (4%) had evidence of lymph node metastasis. None of the patients with well-differentiated tumor (Gleason 2-4) had lymphatic spreading. In contrast, 82% of patients with poorly differentiated tumor (Gleason 8-10) had positive pelvic lymph nodes. Those patients with high PSA (> or = 20 ng/ml) and high Gleason's score (> or = 8) had the highest incidence of nodal extension (90%).
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PMID:Prediction of lymphatic spreading in prostatic cancer by prostate-specific antigen and Gleason's score. 752 61

Instability of dinucleotide tandem repeat sequences has been reported to play a major role in the carcinogenic pathway of familial colon cancer, as well as a potential role in the carcinogenesis of other sporadic neoplasms. To determine the frequency of short tandem repeat instability in adenocarcinoma of the prostate, we studied 40 tumors that were stratified according to tumor grade. The tissue samples were screened with di-, tri- and tetranucleotide markers spanning a wide range of chromosomal loci, including an androgen receptor gene trinucleotide repeat. Microsatellite instability was observed overall in only one of the 40 (2.5%) prostate adenocarcinomas studied. This replication error-positive tumor demonstrated repeat length alterations at two loci. Five other tumors showed an alteration in microsatellite size at a single locus. These tumors were not considered to have the microsatellite instability phenotype. All changes were identified either within tetranucleotide sequences or within the androgen receptor gene repeat (4 or 20 total markers analyzed). Both repeat length expansions and contractions were identified. The replication error-positive case also included separate metastatic nodal tissue. Additional microsatellite analysis of the metastatic tumor tissue revealed allelic patterns identical with the normal tissue control. Our data indicate that microsatellite instability is rare in prostate adenocarcinoma. Therefore, observation of this low replication error frequency suggests that most prostate carcinomas develop in the absence of widespread accumulation of somatic mutations in short tandem repeat sequences. Additionally, these genetic alterations appear to occur more often in tetranucleotide repeat sequences as well as in an androgen receptor gene trinucleotide repeat.
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PMID:Microsatellite instability in adenocarcinoma of the prostate. 767 91

We used the monoclonal antibody BR96 to determine the expression of the Lewis Y antigen in benign and malignant prostatic tissues. Strong immuno-staining was detected within the basal cells of benign glands in 29 of 30 specimens examined. In contrast, weak immuno-staining of the secretory (luminal) epithelium was detected in only 10 of these same 30 specimens. Moderate to strong immuno-staining of luminal cells, however, was observed in prostatic intraepithelial neoplasia in 15 of 17 specimens. Immuno-staining was detected within the malignant cells in all 49 specimens of primary prostatic adenocarcinoma examined. We used a semiquantitative technique to compare the extent of immuno-staining among well (combined Gleason score less than 6), moderately (combined Gleason score 6 to 7) and poorly (combined Gleason score more than 7) differentiated tumors as well as metastatic lesions. Poorly differentiated tumors demonstrated the greatest extent of immuno-staining compared to moderately and well differentiated adenocarcinoma. Strong immuno-staining was also detected within the malignant cells in 7 metastatic (5 nodal lesions and 2 bone marrow biopsies) tumors. The extent of immuno-staining in the metastatic lesions was similar to that observed in the poorly differentiated primary tumors. In summary, the Lewis Y antigen, as detected by BR96, is widely expressed within prostatic adenocarcinomas. Furthermore, the poorly differentiated as well as metastatic lesions frequently demonstrated the highest expression of the Lewis Y antigen.
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PMID:Lewis Y antigen as detected by the monoclonal antibody BR96 is expressed strongly in prostatic adenocarcinoma. 771 79

Sixty-six patients with prostatic adenocarcinoma were screened for somatic instability at 8 microsatellite marker loci on 5 chromosomes. Differences in unrelated microsatellites for tumor and normal DNA were detected in 13 (19.7%) patients. Only extraglandular spread (nodal involvement and distant metastasis) was found to show significant association with somatic instability after controlling for other clinicopathological variables (P < 0.05). Microsatellite instability may possibly occur during the early stages of neoplastic transformation in a subset of prostate cancer rather than as a late event. This may be related to a phenotype with growth advantage. The frequency of this mutator phenotype is much higher in the United States than Japan, reflecting racial differences in the molecular tumorigenesis of this malignancy.
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PMID:Genomic instability of microsatellite repeats in prostate cancer: relationship to clinicopathological variables. 775 95

The results of external beam radiotherapy for clinically localized adenocarcinoma of the prostate in 448 patients treated in the period 1980-90 were reviewed. The average follow up was 4.9 years. The patients were aged 44-87 years (median 69 years) and all had histopathological evidence of adenocarcinoma by needle biopsy or transurethral resection of prostate. The histopathological grading was: 127 G1; 154 G2; 127 G4; 28 Gx. Clinical staging according to TNM (American Urological Association) was: 29 T0 (A2); 4 T1 (B1); 173 T2 (B2); 176 T3 (C1); 63 T4 (C2); 3 Tx. Routine surgical pelvic lymph node staging was not performed but patients had radiological (computerized tomography scan or lymphogram) nodal staging: 350 N0; 22 N1; 12 N2; 64 Nx. High energy linear accelerator external beam radiotherapy was given by multiple fields to total doses of 50-70 Gy (median 60 Gy). The majority of patients (307, 69%) was treated by a uniform policy under the care of one radiation oncologist (HM). The rates of local and distant failure at 5 years were 10% (s.e. = 2%) and 42% (s.e. = 3%), respectively. The late complication rate at 5 years was 25% (s.e. = 2%), comprising mild 16%, moderate 7% and severe 1.3%. The 5 year overall survival rate was 64% (s.e. = 2%) and the cancer-specific survival rate was 74% (s.e. = 3%). Both histological grade and clinical stage were strongly predictive of overall survival and distant failure. Only histological grade was predictive of local failure.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Results of external beam radiotherapy in 448 patients with clinically localized adenocarcinoma of the prostate. 751 52

Neuroendocrine differentiation of prostatic adenocarcinoma has received considerable attention in recent years. The objectives of this study were to characterize the incidence, pattern of distribution and peptide hormone immunoreactivities of neuroendocrine differentiated tumor cells in prostatic carcinoma metastases; determine the correlation of neuroendocrine differentiation and deoxyribonucleic acid content in lymph node metastases, and determine the prognostic role of neuroendocrine differentiation of metastases in stage D1 cancer. We examined immunohistochemically 62 metastatic lesions (41 pelvic lymph nodes and 21 bone metastases) for the presence of chromogranin-A expressing tumor cells. Of 41 lymph nodes and 21 bone metastases 19 (46%) and 11 (52%), respectively, contained chromogranin-A immunoreactive cells. These cells were commonly found to comprise the minority of tumor cells in the metastases and typically were distributed in a dispersed pattern. Serotonin and peptide hormone immunocytochemistry in 19 cases (12 lymph nodes and 7 bone metastases) demonstrated neuroendocrine cells containing thyroid-stimulating hormone and serotonin in 17 (89%) and 10 (53%), respectively. All 7 bone metastases contained thyroid-stimulating hormone immunoreactive cells. The presence of chromogranin-A positive cells did not correlate statistically with deoxyribonucleic acid content of lymph node metastases nor with disease specific survival in patients with stage D1 prostate cancer. Our results indicate that a substantial proportion of prostate cancer metastases contain a subpopulation of cells expressing a neuroendocrine phenotype similar to primary tumors. These cells are capable of elaborating certain biogenic amines and peptide hormones. However, in stage D1 prostate cancer nodal lesions expressing neuroendocrine differentiation do not appear to have significant prognostic value.
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PMID:Neuroendocrine differentiation in metastatic prostatic adenocarcinoma. 812 24

Heat shock protein 27 (hsp-27) is a cytosol protein of unknown function that is concentrated in many estrogen-sensitive normal target organs and is expressed to a varying degree in many tumors, including ductal carcinoma of the breast, malignant fibrous histiocytoma (MFH) of the soft tissues, adenocarcinoma of the prostate, and transitional cell carcinoma (TCC) of the urinary bladder. Overexpression of hsp-27 has independent prognostic significance in patients with breast cancer and MFH, but its potential predictive value with prostate and bladder cancers has not been evaluated. Differential expression of hsp-27 may occur between invasive cancer and host tissue that could aid in diagnosis, and varying expression among invasive cancers may have potential prognostic significance that could influence the use of adjuvant therapy. To test these hypotheses, hsp-27 expression was evaluated by immunohistochemistry in archival formalin-fixed paraffin-embedded sections of primary prostate and bladder carcinomas where the outcome of the patient was known. In 36 prostate cancer specimens from patients who had undergone radical prostatectomy (Stages T1, T2; N0; M0), no normal glandular elements or invasive cancers expressed this protein. In 24 bladder cancer specimens from patients who had undergone radical cystectomy (Stages T2, T3A, T3B, T4A; N0, N1; M0), 12 (50%) cancers overexpressed this protein. Hsp-27 did not correlate with degree of histologic differentiation, T-stage, nodal status, local recurrence, metastases, or survival. From these observations, we conclude that hsp-27 expression has neither diagnostic nor prognostic significance and will not serve as a predictive biologic marker with these important genitourinary cancers.
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PMID:Hsp-27 has no diagnostic or prognostic significance in prostate or bladder cancers. 813 1

Between March 1970 and December 1987, 1,078 patients with adenocarcinoma of the prostate were treated with pelvic lymph node dissection and permanent 125iodine implantation. Before implantation, 257 patients (27%) underwent transurethral resection of the prostate, while 702 (73%) did not and their diagnosis was established by needle biopsy. A total of 119 patients (10%) underwent hormonal therapy before implantation and they were excluded from the present analysis. Clinical stage and pathological grade were similar in both groups. A higher percentage of patients in the transurethral resection group had nodal metastases at implantation. Positive lymph nodes were found in 121 patients (47%) in the transurethral resection group versus 199 (26%) who did not undergo resection (p < 0.001). The actuarial 5, 10 and 15-year distant metastasis-free survival rates among the patients who underwent transurethral resection of the prostate were 79%, 42% and 16%, respectively, compared to 86%, 52% and 27%, respectively, in the group without transurethral resection (p < 0.0001). Similarly, the actuarial disease-free and local relapse-free survival rates were significantly inferior in the transurethral resection group. A negative impact of transurethral resection of the prostate could be demonstrated among patients with grade I/II tumors. However, when stratified for nodal status, no difference in outcome in any clinical parameter was noted between the groups with and without transurethral resection of the prostate. Specifically, distant metastasis-free survival among transurethral resection group patients with negative nodes was 78%, 57% and 47% at 5, 10 and 15 years, respectively, compared to 80%, 59% and 47%, respectively, among the patients with negative nodes who did not undergo transurethral resection of the prostate (p = 0.38). Similarly, the differences between the 2 groups among patients with positive lymph nodes were not significant. When stratified by the clinical stage, grade and nodal status, the negative impact of transurethral resection of the prostate could not be demonstrated in any combination. A multivariate analysis failed to demonstrate transurethral resection of the prostate to be an independent variable in predicting the metastatic, local control or disease-free survival outcome. In conclusion, the long-term results in these pathologically staged cases indicate that transurethral resection of the prostate does not impact negatively on the clinical outcome.
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PMID:Impact of transurethral resection on the long-term outcome of patients with prostatic carcinoma. 805 73

Possible advantages of computed tomography (CT) and beam's eye view (BEV) display in the design of pelvic irradiation fields were studied in 20 consecutive patients with localized adenocarcinoma of the prostate. Pelvic fields were designed with standard four-field techniques. Then, CT and BEV display were done to define the reduced prostate tumor volumes. With treatment-planning CT, the location of the pelvic vascular structures (internal and external iliac artery and vein) was outlined. These were used as an approximation of the location of the lymph nodes. A BEV display of these lymph node volumes was then compared with the pelvic fields designed without CT and BEV display. Nineteen of the 20 patients had part of the CT-defined lymph node volume (a portion of the internal iliac lymph node volume) excluded from the original field design. Thirteen patients also had part of the external iliac nodal volume excluded. Dose-volume histograms showed that up to 30% of the lymph node volume received only 56% of the prescribed dose.
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PMID:Advantages of CT and beam's eye view display to confirm the accuracy of pelvic lymph node irradiation in carcinoma of the prostate. 843 Feb 3

Proteins encoded by bcl-2 family genes are important regulators of programmed cell death and apoptosis. Alterations in the expression of these apoptosis-regulating genes can contribute to the origins of cancer, as well as adversely influence tumor responses to chemo- and radiotherapy. Using antibodies specific for the Bcl-2, Bax, Bcl-X, and Mcl-1 proteins in combination with immunohistochemical methods, we examined for the first time the expression of these bcl-2 family genes in 64 cases of adenocarcinoma of the prostate, including 10 Gleason grade 2 to 4 tumors, 21 grade 5 to 7 tumors, 17 grade 8 to 10 tumors, 8 lymph node metastases, and 8 bone metastases. In addition, 24 cases of prostatic intraepithelial neoplasia (PIN) or PIN coexisting with carcinoma were also evaluated. All immunostaining results were scored with regard to approximate percentage of positive tumor cells and relative immunostaining intensity. Expression of the anti-apoptotic protein Bcl-2 was present in 16 of 64 (25%) adenocarcinomas and tended to be more frequent in high grade tumors (Gleason grade 8 to 10; 41%) and nodal metastases (38%) than in lower grade (Gleason 2 to 7) primary tumors (16%; P < 0.05). Bcl-X was expressed in all 64 (100%) tumors evaluated. Bcl-X immunointensity was generally stronger in high grade primary tumors (grade 8 to 10) and metastases compared with PIN and low grade neoplasms (P < 0.0001). In addition, the proportion of specimens with > 50% Bcl-X-immunopositive tumor cells also was higher in advanced grade primary tumors (Gleason 8 to 10) and metastases than in PIN and low grade tumors (Gleason 2 to 7; P < 0.005). The anti-apoptotic protein Mcl-1 was expressed in 52 of 64 (81%) tumors, compared with only 9 of 24 (38%) cases of PIN (P < 0.001). In addition, the percentage of Mcl-1-positive cells was typically higher in Gleason grade 8 to 10 tumors and metastases than in PIN or lower grade tumors (P = 0.025). In contrast, the pro-apoptotic protein Bax was expressed in all prostate cancers evaluated, with high percentages of immunopositive cells and strong immunointensity typically occurring regardless of tumor grade. The findings suggest that expression of several anti-apoptotic members of the bcl-2 gene family, including bcl-2, bcl-X, and mcl-1 increases during progression of prostate cancers, a finding that may be relevant to the hormone-insensitive, metastatic phenotype of most advanced adenocarcinomas of the prostate.
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PMID:Immunohistochemical analysis of bcl-2, bax, bcl-X, and mcl-1 expression in prostate cancers. 862 25


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