Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Approximately 50 per cent of patients with carcinoma of the prostate have either advanced local disease or metastases at the time of diagnosis. To achieve earlier diagnosis of prostate cancer in its localized, most treatable stages, it will be necessary to develop safe, cost-effective screening tests with sufficiently high sensitivity and specificity rates. To date, no single test fulfills these criteria, although advances in the measurement of serologic markers of prostate cancer such as prostate-specific antigen, fine-needle aspiration cytology of the prostate, and transrectal prostatic ultrasonography are being widely investigated as potential screening tests.
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PMID:Early diagnosis of prostate cancer. 331 60

Thirteen cases of prostatic adenocarcinoma with endometrioid features were reviewed. The patients were older men (49-81 years) presenting with symptoms of hematuria and urinary obstruction. Each of the tumors displayed exophytic growth into the prostatic urethra, with involvement of the verumontanum. The urethral orifices of the large (primary) prostatic ducts were uniformly involved, and coexistent invasive (acinar) adenocarcinoma was identified in 10 cases (77%). The tumors exhibited a complex glandular pattern strikingly similar to uterine endometrial carcinoma, with prominent papillary formation in six cases. All cases demonstrated intense cytoplasmic immunoreactivity for prostatic acid phosphatase and prostate-specific antigen in at least part of the tumor. Focal staining for carcinoembryonic antigen was seen in three cases. Five tumors examined ultrastructurally demonstrated typical features of prostatic adenocarcinoma. Follow-up information was available on all 13 patients (6-83 months). Seven patients died of metastatic tumor (9-70 months after diagnosis), and the other six patients exhibited recurrent local or metastatic tumor. The sites of metastases were identical to those seen with invasive "acinar" prostatic adenocarcinoma, including pelvic lymph nodes, bones, and lungs. Crude 5-year survival was 15%, with a mean survival of 37 months. Adjuvant therapy provided palliative relief for many patients, but did not appear to influence survival. These findings indicate that endometrioid carcinoma is a histologically distinct variant of prostatic adenocarcinoma, with a more aggressive clinical behavior than previously thought.
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PMID:Prostatic adenocarcinoma with endometrioid features. Clinical, pathologic, and ultrastructural findings. 409 Nov 89

An immunoperoxidase technique for prostate-specific antigen was used to evaluate autopsy material from 8 patients with multiple prostatic metastases, 22 primary prostatic carcinomas and 12 nonprostatic tumors. All specimens of primary and metastatic prostatic carcinomas stained positively, irrespective of the Gleason grade. None of the nonprostatic tumors showed immunostaining. Thus, the method appeared to be highly specific and highly sensitive for the detection of the prostatic origin of metastases.
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PMID:Prostatic origin of metastases: immunoperoxidase localization of prostate-specific antigen. 620 2

A case of prostatic carcinoid tumor with lymph node metastases is reported. The patient was a 78-year-old male who died in ventricular fibrillation. At autopsy, a 2 X 2 cm, white, irregular tumor was found in the prostate and there were several enlarged para-aortic lymph nodes. Both specimens contained a characteristic carcinoid tumor. Argyrophil stains revealed strong positivity in the primary as well as in the metastatic tumors. Electron micrographs prepared from formalin-fixed tissue demonstrated numerous membrane-bound dense-core granules. Immunoperoxidase-labeled antibodies against both prostatic acid phosphatase and prostate-specific antigen localized in the tumor cells. The ultrastructural and immunohistochemical results support differentiation of the tumor cells toward both prostatic epithelial cells and endocrine cells. We believe that this is the first reported case of a prostatic carcinoid tumor in which specific prostatic tissue markers have been demonstrated in the tumor cells.
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PMID:Primary prostatic carcinoid tumor with intracytoplasmic prostatic acid phosphatase and prostate-specific antigen. 620 47

This report characterizes a prostate-specific monoclonal antibody, KP-P8, which was prepared against the human prostate cell line PC3. The antigen detected by KR-P8 was identified on the surfaces of 90% of cells of the PC3 line, as well as on 67% of cells of the Du-145 prostate line, but it was absent from the surfaces of normal peripheral blood leukocytes and cells of a number of lymphoblastoid lines. As judged by immunoperoxidase staining techniques, KR-P8 reacted with the glandular epithelium of all specimens of normal, benign hypertrophic, and malignant prostate glands tested. However, no reactivity was noted with numerous other human tissues including normal bladder, lung, liver, kidney, testis, colon, parotid gland, thyroid gland, and spleen. These results indicate that the antigen detected by KR-P8 is prostate organ-specific. Competitive blocking studies showed that the antibody did not recognize the previously described prostate-specific antigen or the alpha-Pro-3 antigen described by other investigators. The KR-P8 antibody also did not bind to purified prostatic acid phosphatase. The presence of the KR-P8 antigen was demonstrated in cell-free preparations of dilute seminal plasma by radioimmunoassay, indicating that this antigen is secreted by the glandular cells of the prostate gland. The clinical significance of this marker was demonstrated by its ability to identify prostate metastases of the lymph node.
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PMID:Characterization of a monoclonal antibody, KR-P8, that detects a new prostate-specific marker. 620 70

The newly reported human prostate-specific antigen (PA) is a specific histiotypic product of human prostate. With the use of a sensitive enzyme immunoassay, the circulating PA in prostatic cancer patients has been evaluated clinically. In 96 patients with advanced stage of disease (D2) and receiving chemotherapies, the pretreatment serum PA levels were found to be of prognostic value with regard to the patient survival. Ten patients with metastatic prostate cancer were monitored for more than 32 weeks by 183 serial PA values and were found generally to respond to the treatment. Additionally, in another group of 32 patients who underwent curative therapies for localized prostate cancer, 161 serum samples were evaluated during periods of 12 to 114 weeks (average 56 weeks). Of these patients, five developed metastases during follow-up, and all were shown to exhibit increasingly elevated PA values, either corresponding to or preceding the clinical diagnosis of disease recurrence. These results suggest that PA is a new marker with potential value to merit further clinical study.
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PMID:Use of human prostate-specific antigen in monitoring prostate cancer. 728 95

Combination antimicrotubule therapy with estramustine phosphate (EMP) and vinblastine has reproducible activity in metastatic hormone-refractory prostate cancer (HRPC) with an objective response rate of 31%. Although paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) by 24-hour infusion was inactive in HRPC, 0.5 to 1.0 nmol/L concentrations of paclitaxel combined with EMP exerted synergistic cytotoxicity in DU-145 androgen-independent human prostate cancer cell lines. Based on these results, we treated 24 patients with HRPC using the combination of paclitaxel 120 to 140 mg/m2 by 96-hour intravenous infusion every 3 weeks plus daily oral EMP at 600 mg/m2/d. Of seven patients with measurable soft tissue metastases, three have attained partial responses and a fourth patient is nearing partial response status. Of 16 patients with bone-only disease evaluated by change in serum prostate-specific antigen levels, 11 patients (68.8%) have had decreases of > or = 50% from pretreatment baseline. The prostate-specific antigen decrease has exceeded 80% in six of 16 (37.5%) patients. For all 23 evaluable patients, the prostate-specific antigen has decreased by > or = 50% in 15 (65.2%) and by > or = 80% in eight (34.7%). Grade 4 leukopenia occurred in one of 21 patients treated at the paclitaxel dose of 120 mg/m2/96 hr and one of three patients treated at 140 mg/m2/96 hr. The incidence of nausea (50%) and peripheral edema (37.5%) was similar to that associated with single-agent EMP. These results demonstrate that 96-hour paclitaxel plus EMP is active in HRPC and provide further evidence that the rational combination of antimicrotubule agents leads to synergistic antitumor activity in HRPC.
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PMID:Paclitaxel plus estramustine in metastatic hormone-refractory prostate cancer. 748 60

Critical analysis of the evidence supporting the use of prognostic markers is needed for these to be used most appropriately in patient management. The College of American Pathologists recently sponsored a national conference to review the status of tumor markers for carcinomas of the breast, colon, and prostate gland. The conclusions of the Prostate Cancer Working Group are presented in this report. Currently, the TNM (Tumor, Lymph Node, Metastasis) staging system, histologic grading (Gleason system), and serum prostate-specific antigen are recommended for general use as prognostic markers in prostate cancer. Data support the use of DNA ploidy analysis in specific clinical settings, although general use is not currently recommended. The Working Group concluded that other markers do not have sufficient support in the literature to recommend routine use at the present time.
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PMID:College of American Pathologists Conference XXVI on clinical relevance of prognostic markers in solid tumors. Report of the Prostate Cancer Working Group. 750 60

Early diagnosis and monitoring of progression for relapsed prostatic carcinoma after primary treatment is necessary, and early intervention recommended. This has now been made possible with rising prostate-specific antigen levels as an indication of the endpoint of treatment failure. Patients with relapsed disease can be divided into three groups: those relapsing following curative treatment with surgery or radiotherapy with local or distant metastases; patients who have been treated with primary hormonal palliative therapy or combination hormonal-chemotherapy relapsing after the first palliative treatment, and patients relapsing after all acceptable therapies for the treatment of prostate cancer. The management of these groups of patients is discussed.
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PMID:Management of relapsed prostatic carcinoma following primary treatment. 750 34

The clinical and pathologic staging of prostate cancer involves determination of the anatomic extent and burden of tumor based on the best available data. Two major classification schemes are currently used: the modified American system and the TNM system [primary tumor (T), regional lymph node (N), and metastases (M)]. Both systems stratify patients according to the method of tumor detection, separating nonpalpable "incidental" prostate cancers detected during transurethral resection for clinically benign prostatic hyperplasia (BPH) and palpable cancers detected by digital rectal examination. These staging systems also recognize nonpalpable tumors detected by an elevated serum prostate-specific antigen (PSA) level or an abnormal transrectal ultrasound image. Current staging is limited by a significant level of clinical understaging (up to 59%, in our experience) and overstaging (up to 5%) according to comparison with pathologic examination of resected specimens. Proposed improvements in staging include preoperative systematic sextant biopsies to assess tumor volume, volume-based prognostic index, and a multiple prognostic index. In this report, we evaluate the current aspects of clinical and pathologic staging of prostate cancer with emphasis on the early stages in which there is the greatest chance of cure.
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PMID:Staging of prostate cancer. 750 5


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