Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: 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)

Paneth cell-like change (PCLC) of the prostatic epithelium is considered to be a distinct form of neuroendocrine differentiation characterized by isolated cells or small groups of cells with prominent eosinophilic cytoplasmic granules. We evaluated 300 serially sectioned radical prostatectomy specimens from patients with prostatic adenocarcinoma who had not received prior adjuvant therapy (pathologic stages T2NOMO [177 patients], T3NOMO [100 patients], and TxN1MO [23 patients]). Paneth cell-like change was identified in 30 cases (10%), ranging from 1 to 20 high-power fields/positive case (mean, 4.1 high-power fields/case). There was no correlation of PCLC with prostate volume, prostate weight, Gleason grade, nuclear grade, lymph node metastases, serum prostate-specific antigen levels, cancer volume, area or presence of capsular perforation, seminal vesicle invasion, or glandular mucin (all P > .05), although a positive correlation was seen with cribriform pattern (r = 0.50, P = .0015). Immunohistochemistry revealed cytoplasmic immunoreactivity within cells of PCLC for chromogranin (seven of seven cases), neuron-specific enolase (seven of seven cases), serotonin (six of seven cases), prostate-specific antigen (five of seven cases), and prostatic acid phosphatase (four of seven cases); lysozyme was negative (seven cases). Our findings indicate that PCLC is more common than previously reported, but that it is not associated with tumor grade, serum PSA levels, or pathologic stage. This study also shows that PCLC represents neuroendocrine differentiation, suggesting that the term "Paneth cell-like change" be deleted from the pathologist's lexicon in relation to prostatic adenocarcinoma; a more appropriate term might be "neuroendocrine cells with large eosinophilic granules."
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PMID:Paneth cell-like change in prostatic adenocarcinoma represents neuroendocrine differentiation: report of 30 cases. 811 11

Tissue specimens from 150 patients with localised prostatic carcinomas and 116 patients with prostatic carcinomas with distant metastases were analysed for histological grade (WHO and Gleason) and immunoreactivity for prostate acid phosphatase (PAP), prostate-specific antigen (PSA), neurone-specific enolase (NSE), p53 protein, c-erbB-2 protein, cytokeratins (AE1/AE3) and vimentin. After stratification for the presence or absence of distant metastases, multivariate regression analysis revealed that WHO grading was the most powerful independent prognosticator, followed by age and prostate acid phosphatase expression. There was a trend towards reduced survival with decreasing prostate-specific antigen reactivity. The Gleason system showed poor prognostic ability. The analysis predicted reduced survival in the presence of extensive neurone-specific enolase reactivity, mostly because of one case of small-cell carcinoma.
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PMID:Prostatic carcinoma: a multivariate analysis of prognostic factors. 751 29

Metastases to the thyroid gland are an uncommon occurrence, and metastasis to a preexisting thyroid neoplasm is even more rare. We report two cases of tumor-to-tumor metastasis where a prostatic and a breast carcinoma metastasized to follicular adenoma of the thyroid gland. The metastatic process in case 1 was initially diagnosed by fine-needle aspiration biopsy and later confirmed with the hemithyroidectomy. Immunostaining for prostate-specific antigen and prostatic acid phosphatase in case 1 and estrogen and progesterone receptors in case 2 demonstrated strong immunoreactivity in the metastatic tumor cells. Flow cytometric DNA analysis of the primary and the metastatic tumors in both cases demonstrated stemline fidelity that supported their association. Our cases exemplify why attention should be given to the possibility of metastasis when distinctly different morphologic features are seen in an otherwise typical tumor and the utility of ancillary tests that may assist in establishing the diagnosis.
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PMID:Carcinomas metastatic to follicular adenomas of the thyroid gland. Report of two cases. 751 64

Monoclonal antibodies (mAbs) specific for cytokeratins are potent probes for the identification of disseminated individual epithelial tumour cells in mesenchymal organs such as bone marrow. We have used a monoclonal antibody (mAB) against cytokeratin 18 (CK18) for the detection of individual metastatic tumour cells in bone marrow aspirates from 84 patients with carcinoma of the prostate. CK18+ cells were detected in a sensitivity of 1 per 8 x 10(5) marrow cells using the alkaline phosphatase anti-alkaline phosphatase (APAAP) system for staining. We were able to detect CK18+ tumour cells in the marrow of 33% of patients with stage N0M0 prostate cancers. The incidence of CK18+ cells showed a significant correlation with established risk factors, such as local tumour extent, distant metastases and tumour differentiation. For further characterization of such cells in patients with prostate cancer, we developed an immunocytochemical procedure for simultaneous labelling of cytokeratin component no. 18 (CK18) and prostate-specific antigen (PSA). In a first step, cells were incubated with a murine mAb against PSA, followed by gold-conjugated goat anti-mouse antibodies. In a second step, a biotinylated mAb to CK18 was applied as primary antibody and subsequently incubated with complexes of streptavidin-conjugated alkaline phosphatase, which were developed with Newfuchsin substrate. The binding of gold-labelled antibodies was visualized by silver enhancement. CK18+ cells co-expressing PSA were found in bone marrow aspirates from 5 out of 14 patients with carcinomas of the prostate. The specificity of CK18 for epithelial tumour cells in bone marrow was supported by negative staining of 12 control aspirates from patients with benign prostatic hyperplasia (BPH).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Immunocytochemical detection and phenotypic characterization of micrometastatic tumour cells in bone marrow of patients with prostate cancer. 752 Oct 88

Staging in prostate cancer, as in any other cancer has significant ramifications in management. Currently, prostate-specific antigen (PSA) determination and the bone scan are two important procedures in the pretreatment staging workup of prostate cancer. PSA is a very useful serum tumor marker in the management of prostate cancer patients. We retrospectively evaluated 90 patients at the time of initial diagnosis of prostate cancer, all of whom had initial PSA levels measured, as well as bone scans obtained. In addition to the PSA level, we considered clinical stage and pathologic grade in the prediction of bone scan for metastases, at the time of initial diagnosis of prostate cancer. Negative predictive value for PSA values < 10 ng/ml (27 patients), clinical stage A (9 patients) and pathologic grade 1 (19 patients) was 100%. The number of patients with bone scan evidence of metastasis with < 10 ng/ml and > 10 ng/ml PSA levels were 0% (0/27 patients) and 27% (17/63 patients) (p = .0022 [Fisher's Exact test]; p = .003 [chi-square test]). In patients with higher stage (p = .688), grade (p = .039), or PSA levels (p = .0001), the incidence of bone metastases increased. However, none of these three parameters can predict reliably bone scan evidence of metastases (i.e., positive predictive value). The negative predictive values did not improve when a combination of the two or three of the above parameters were used.
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PMID:Can prostate-specific antigen levels predict bone scan evidence of metastases in newly diagnosed prostate cancer? 752 94

Prostate-specific antigen is the most important, accurate, and clinically useful biochemical marker in the prostate. It is manufactured by the secretory epithelial cells and drains into the ductal system, where it catalyzes the liquefaction of the seminal coagulum after ejaculation. Serum levels are normally less than 4 ng/mL (monoclonal) but vary according to patient age and race; any process that disrupts the normal architecture of the prostate allows diffusion of prostate-specific antigen into the stroma and microvasculature. Elevated serum prostate-specific antigen levels are seen with prostatitis, infarcts, hyperplasia, and transiently after biopsy, but the most clinically important increases are seen with prostatic adenocarcinoma. Cancer produces less prostate-specific antigen per cell than benign epithelium, but the greater number of malignant cells and the stromal disruption associated with cancer account for the increased serum prostate-specific antigen level. Serum prostate-specific antigen level correlates positively with clinical stage, tumor volume, histologic grade, and the presence of capsular perforation and seminal vesicle invasion; despite these strong correlations, its value is limited in predicting stage for individual patients. It may also predict the presence of lymph node metastases, bone metastases, and survival after androgen-deprivation therapy. The use of prostate-specific antigen has resulted in an increase in the early detection rate of cancer, and it is now advocated for annual routine use in men older than 40 years who are at increased risk and in all men older than 50 years. It is a test with high sensitivity and specificity that is rapid, inexpensive, minimally invasive, and acceptable to patients. In addition to serum prostate-specific antigen level, five derivatives of serum prostate-specific antigen were recently described that may increase the predictive value by accounting for confounding variables such as patient age, prostate volume, and cancer volume: age-specific reference ranges, prostate-specific antigen density, prostate-specific antigen velocity, prostate-specific antigen cancer density, and prostate-specific antigen doubling times. Serum prostate-specific antigen detects a heterogeneous group of cancers (clinical stage T1c) that are clinically important and potentially curable. Immunohistochemical expression of prostate-specific antigen in tissue sections allows determination of the prostatic origin of some metastatic adenocarcinomas, although extraprostatic expression of prostate-specific antigen has been reported in several tissues and tumors, including periurethral gland adenocarcinoma in women, rectal carcinoid, and extramammary Paget disease.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Prostate-specific antigen. Current role in diagnostic pathology of prostate cancer. 752 5

The use of the serum marker prostate-specific antigen (PSA) has altered drastically the follow-up after prostate cancer. PSA is far superior to any other method of detecting recurrences after either radiation therapy or radical prostatectomy. Once the PSA reaches a nadir level after radiation therapy or becomes undetectable after radical prostatectomy, it should remain at that level. PSA provides a lead time of approximately 3 to 7 years prior to identification of recurrence or metastases by other traditional methods. The yield of diagnostic studies to identify the site of recurrence in patients with very low levels of PSA after radical prostatectomy is quite low. A substantial dilemma remains about optimal therapy once a rising PSA is identified.
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PMID:Follow-up after radical prostatectomy or radiation therapy for prostate cancer. 752 13

Prostate-specific antigen (PSA) is the most sensitive and clinically useful method for monitoring patients following definitive therapy for prostate cancer. A "detectable" value following radical prostatectomy and an increasing level following radiation therapy are both indicative of recurrent/residual disease. The persistent cancer may be local or distant; the rate of increase of serum PSA can be useful in distinguishing between local and metastatic disease. A computed tomography or magnetic residence imaging scan may be useful for evaluating abdominal and pelvic lymph nodes, and the radionuclide bone scan is an effective tool for assessing the skeleton when the serum PSA concentration becomes elevated following treatment.
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PMID:Patient evaluation if prostate-specific antigen becomes elevated following radical prostatectomy or radiation therapy. 752 14

A highly sensitive nested reverse transcriptase-PCR assay, with primers derived from the prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSM) cDNA sequences, has been used to detect occult hematogenous micrometastatic prostate cells. In 77 patients with prostate cancer, PSM and PSA primers detected circulating prostate cells in 48 (62.3%) and 7 (9.1%) patients, respectively. In treated stage D disease patients, PSM primers detected cells in 16 of 24 patients (66.7%), while PSA primers detected cells in 6 of 24 (25%). In post-radical prostectomy patients with negative serum PSA values, PSM primers detected metastases in 21 of 31 patients (67.7%), whereas PSA primers detected cells in only 1 of 33 (3.0%), indicating that micrometastatic spread may be a relatively early event in prostate cancer. The analysis of 40 individuals without known prostate cancer provides evidence that this assay is highly specific and suggests that PSM expression may predict the development of cancer in patients without clinically apparent prostate cancer. Using PSM primers, we detected micrometastases in 4 of 40 controls, 2 of whom had known benign prostatic hyperplasia and were later found to have previously undetected prostate cancer. The clinical significance of detection of hematogenous micrometastic prostate cells using PSM primers and potential applications of this molecular assay, as well as the assay for PSA, merit further study.
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PMID:Sensitive nested reverse transcription polymerase chain reaction detection of circulating prostatic tumor cells: comparison of prostate-specific membrane antigen and prostate-specific antigen-based assays. 752 94

We compared tumor grade and DNA content with expression of E-cadherin (E-CD), a cell adhesion molecule associated with cell-cell and cell-matrix interaction, leukocyte function, and tumor invasion and metastases, on 56 prostate carcinoma needle biopsies. The findings were correlated with final pathologic stage at subsequent prostatectomy, preoperative serum prostate-specific antigen level and further development of metastases during an initial 2.4-yr mean clinical follow-up period (range 0.5 to 5.5 yr). E-CD expression (uvomorulin, L-CAM, cell CAM 80/120, ARC-1, Sigma, St. Louis, MO) was measured by double-linked immunoalkaline phosphatase immunohistochemistry quantified with a the Roche RPW image analyzer (Roche Image Analysis Systems, Elon College, NC). DNA ploidy was determined on formalin-fixed, paraffin-embedded Feulgen-stained 5-microns tissue sections of the narrow-bore initial prostate carcinoma biopsies with the Roche RPW image analyzer. The 51% mean positive area E-CD expression in the group of 56 adenocarcinomas was significantly less than the 76% expression level for 15 normal control prostate tissues (P < 0.001). E-CD expression was also decreased in aneuploid (39%) versus diploid tumors (54%, P < 0.001); and in high-grade (44%) versus low-grade lesions (54%; P < 0.01). The 44% E-CD expression level in patients with metastases was lower than the 52% level in the nonmetastatic cases, but this finding was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:E-cadherin expression in prostatic carcinoma biopsies: correlation with tumor grade, DNA content, pathologic stage, and clinical outcome. 753 Aug 50


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