Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0282612 (PIN)
 2,291 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In many clinical situations a patient affected by pre-cancerous prostatic lesions, suspected cancer or true cancer (assessed through biopsies or incidentally) must undergo iterative bioptic examinations. Three groups can be sub-divided: A) Patients with no previous endoscopic resection. B) Patients with previous endoscopic resection for BPH. C) Patients with previous RP for cancer. A persistent clinical suspicion for high PSA, a bioptic assessment for Ca T1c or PIN belong to the first group. A suspected cancer in a patient who had already undergone TUR, or a T1a neoplasia assessed incidentally, or PIN found in the resected fragments constitute the second group. A suspected local relapse after a RP characterizes the third group. In 28 cases of these clinical diagnoses, we have applied a new method of bioptic trans-urethral sampling. We used an eco-reflectant, flexible needle and applied it under endoscopic vision to the transitional zone or to tissues of the already resected prostatic fossa. In the first case these biopsies were integrative of the usual randomized biopsies. If transrectal ultrasound had given evidence of altered structures, biopsy was carried out with selective ultrasound guided technique. This procedure has proved to be minimally invasive, easy to carry out and particularly adapted to bioptise zones that are easier to reach transurethrally or tissues with low thickness.
 ...
PMID:[Proposal of a new transurethral method for repeated prostatic biopsy]. 918 30

From March 1994 to September 1996 485 patients of median age 67 years (range 49-82) underwent transrectal prostate needle biopsy at the Urological Clinic JLF UK in Martin. PIN was detected in 31 (6.4%) patients. Median age of patients with PIN was 67 years (range 58-75). There were 21 (68%) patients with low-grade PIN and 10 (32%) patients with high-grade PIN. In this group concomitant invasive cancer of the prostate was detected in 6 (19.4%) patients with PIN, of whom 5 (16.0%) had high-grade PIN and 1 (3.4%) nad low-grade PIN. Median concentration of PSA in patients with PIN was 9.1 ng/ml (range 1.3-85 ng/ml), significantly higher (p < 0.001) than PSA concentration in patients with BPH. We did not find significant differences between PSA concentrations in patients with PIN and in those with prostate cancer (p = 0.77). In conclusion we recommend clinical management of patients newly diagnosed with PIN.
 ...
PMID:[Occurrence of prostatic intraepithelial neoplasia in needle biopsy of the prostate and its clinical significance]. 947 72

Prostatic intraepithelial neoplasia (PIN) is considered a premalignant lesion of the prostate. It is often encountered in prostate needle biopsy in cases where no cancer is identified. In order to evaluate its importance 25 patients with PIN in a former prostate needle biopsy underwent a second ultrasound guided needle biopsy. The first biopsy was performed in all patients as a result of positive DRE. In 13 patients (52%), prostate cancer was identified in the second specimen. All presented with high or intermediate grade PIN in the first biopsy. PSA values were compared with PIN grade and cancer presentation in the second biopsy, although no statistically significant difference was proven. In conclusion, when PIN is discovered in prostate needle biopsy in patients with positive DRE, a second biopsy has to be performed in order to exclude the possibility of a prostate carcinoma.
 ...
PMID:Evaluation of needle biopsy in the diagnosis of prostatic carcinoma in men with prostatic intraepithelial neoplasia. 960 81

With the purpose of establishing morphogenetic features of precancer and early cancer of the prostate gland a comparative immunomorphological evaluation was done of the prostate tumor markers (PAP, PSA, PCNA, and 34 beta E12). Due emphasis is given to the part the basal cell dysplasia plays in morphogenesis of prostatic cancer. The precancer lesions of the prostate include atypical adenomatous hyperplasia, grade I and II prostatic intraepithelial neoplasia (PIN). Grade III prostatic intraepithelial neoplasm is cancer in situ, or uninfiltrative (unpalpable) cancer of the prostate. PIN patients are at high risk for subsequent development of invasive prostatic carcinoma.
 ...
PMID:[The morphogenesis of cancer of the prostate (immunohistochemical research)]. 969 75

Chemoprevention is the administration of agents to prevent induction and inhibit or delay progression of cancers. For prostate, as for other cancer targets, successful chemopreventive strategies require well-characterized agents, suitable cohorts, and reliable intermediate biomarkers of cancer for evaluating chemopreventive efficacy. Agent requirements are experimental or epidemiological data showing chemopreventive efficacy, safety on chronic administration, and a mechanistic rationale for the observed chemopreventive activity. On this basis, promising chemopreventive drugs in prostate include retinoids, antiandrogens, antiestrogens, steroid aromatase inhibitors, 5alpha-reductase inhibitors, vitamins D and E, selenium, lycopene, and 2-difluoromethylornithine. Phase II trials are critical for evaluating chemopreventive efficacy. Cohorts in these trials should be suitable for measuring the chemopreventive activity of the agent and the intermediate biomarkers chosen as endpoints. Many cohorts proposed for phase II trials are patients with previous cancers or premalignant lesions. For such patients, trials should be conducted within the context of standard treatment. Two cohorts currently used in phase II prostate cancer chemoprevention trials are patients with PIN and patients scheduled for prostate cancer surgery. Biomarkers should fit expected biological mechanisms, be assayed reliably and quantitatively, measured easily, and correlate to decreased cancer incidence. Protocols for adequately sampling tissue are essential. Changes in PIN provide prostate biomarkers with the ability to be quantified and a high correlation to cancer. PIN measurements include nuclear polymorphism, nucleolar size and number of nucleoli/nuclei, and DNA ploidy. Other potentially useful biomarkers are associated with cellular proliferation kinetics (e.g. PCNA and apoptosis), differentiation (e.g. blood group antigens, vimentin), genetic damage (e.g. LOH on chromosome 8), signal transduction (e.g. TGFalpha, TGFbeta, IGF-I, c-erbB-2 expression), angiogenesis, and biochemical changes (e.g. PSA levels).
 ...
PMID:Chemoprevention of prostate cancer: concepts and strategies. 1032 87

High-grade prostatic intraepithelial neoplasia (PIN) is most likely a precursor of prostate cancer and is frequently associated with it whereas the direct link between low-grade PIN and cancer is not established. The clinical evolution of isolated high-grade PIN has been the object of much concern because of the possibility of undiagnosed prostate cancer or the evolution of this premalignant lesion in invasive carcinoma. Parameters predictive of the later finding of prostate cancer on repeat biopsy in patients with PIN are of evident interest and we have reviewed our experience and recent data from the literature on this topic as well as on the clinical management of these patients. Low-grade PIN is not by itself a risk of later cancer found on repeat biopsy unless other factors such as PSA increase the cancer suspicion. Patients with low-grade PIN and high serum PSA should therefore undergo repeat biopsies. Patients with low-grade PIN and without additional factors should be followed. Patients with high-grade PIN should systematically be rebiopsied. If a second set is still consistent with PIN, they should undergo additional biopsies again within 3-6 months because they are likely to have an undiagnosed cancer.
 ...
PMID:Clinical evolution of prostatic intraepithelial neoplasia. 1032 13

Based on autopsy and epidemiologic data the lifetime risk of developing prostate cancer for a 50-year-old man is 42%, but only 9.5% will develop a clinically manifest disease and only 2.9% will die from this disease. The actual rate of carcinoma detection using PSA, digital rectal examination and transrectal ultrasound is 1%-3%. The majority of prostate carcinoma never progress to clinically significant disease, a minor portion remains confined to the prostate for many years and other carcinomas progress rapidly to a life threatening disease. The dilemma for clinicians and pathologists dealing with this tumor is how to distinguish these three biologically different types. Pathologists play an important role in preoperative diagnosis and in the postoperative prognosis oriented evaluation of the prostatectomy material. Volunteer PSA screening trials have led to an enormous increase in core-needle biopsies of the prostate. Since biopsies are often performed in men without palpable or ultrasound-visible nodules, are now faced with an increasing number of equivocal morphological features which can not be clearly defined, even with standardized criteria. Further investigations are also required to elucidate the clinical importance of PIN detection in biopsies. The heterogeneous histomorphology of prostate carcinoma can not be used as a prognostic factor. Therefore the histological grading is a very important factor for the assessment of prognosis. Carcinoma grading in biopsies is also of limited value in predicting tumor stage. Currently, several different grading systems are in use. Gleason's grading is the most favored, although its reproducibility is very low. The stage of the prostate carcinoma is still the best prognostic factor. In order to accurately assess the pTNM stage, TUR or prostatectomy material must be subject to extensive and standardized processing. Additionally, the volume of the tumor, the vascular invasion, the amount of extension of the tumor through the prostate capsule and perhaps the neoangiogenesis might be valid prognostic factors for disease progress and for survival. The value of novel methods (p53, bcl-2, apoptosis, microvessel density, interphase cytogenetics, androgen receptor mutation, neuroendocrine cells, E-Cadherin) remains to be proved. DNA ploidy is a good prognostic factor after prostatectomy and can be used to plan adjuvant hormone therapy.
 ...
PMID:Pathology of prostate cancer. Old problems and new facts. 1035 66

High-grade prostatic intraepithelial neoplasia (PIN) is now accepted as the most likely preinvasive stage of adenocarcinoma, a decade after its first formal description. PIN has a high predictive value as a marker for adenocarcinoma, and its identification warrants repeat biopsy for concurrent or subsequent invasive carcinoma. The only method of detection is biopsy; PIN does not significantly elevate serum PSA concentration or its derivatives and cannot be detected by ultrasonography. Most studies suggest that most patients with PIN will develop carcinoma within 10 years. PIN is associated with progressive abnormalities of phenotype and genotype, which are similar to cancer rather than normal prostatic epithelium, indicating impairment of cell differentiation with advancing stages of prostatic carcinogenesis. Androgen deprivation therapy decreases the prevalence and extent of PIN, suggesting that this form of treatment may play a role in chemoprevention.
 ...
PMID:Prostatic intraepithelial neoplasia is a risk factor for cancer. 1063 20

Arachidonic acid (AA) metabolites are implicated in the oncogenesis of several tumors, including prostate cancer. 15-Lipoxygenase-2 (15-LOX-2) is a novel AA-metabolizing enzyme with a limited tissue distribution, which includes prostate, lung, skin, and cornea. Previous studies have shown that 15-LOX-2 is present in benign prostate secretory cells and reduced in prostate adenocarcinoma and that production of the 15-LOX-2 metabolite 15S-hydroxyeicosatetraenoic acid is reduced in malignant compared with benign prostate. The objective of this study was to determine the frequency with which 15-LOX-2 immunostaining is reduced in prostate carcinoma and to correlate reduced expression with tumor differentiation (grade) and other pathologic parameters in radical prostatectomy specimens. Paraffin immunoperoxidase with a polyclonal antibody specific for 15-LOX-2 was performed on tumors and benign portions from 70 cases, and the percentage of tumor immunostaining for 15-LOX-2 was assessed. Whereas uniform 15-LOX-2 immunostaining was observed in secretory cells of benign glands, it was markedly reduced or absent in most adenocarcinomas: 23 of 70 tumors showed completely absent 15-LOX-2 immunostaining, and 45 of 70 cases showed negative immunostaining in more than 50% of the tumor. The extent of reduced 15-LOX-2 immunostaining correlated with tumor differentiation, with retained expression particularly in Gleason score 5 tumors versus a significant reduction of 15-LOX-2 in higher-grade tumors (mean +/- SD tumor 15-LOX-2 positive: Gleason score 5 = 67%+/-30%, Gleason score 6 = 16%+/-30%, Gleason score 7 = 23%+/-28%, Gleason score > or =8 = 41%+/-46%). In 16 cases with multifocal tumors or different foci of the same tumor with different grades, the higher-grade foci had significantly reduced 15-LOX-2 expression compared with the lower-grade foci. In peripheral zone tumors without complete loss of 15-LOX-2 expression, there was a significant inverse relationship between 15-LOX-2 immunostaining and tumor volume. There was not a significant correlation between 15-LOX-2 immunostaining and serum PSA or pathologic stage. In a subset of 27 cases, 15-LOX-2 expression in high-grade prostatic intraepithelial neoplasia (HGPIN) glands was significantly reduced compared with benign glands. These data show that in contrast to the uniform expression of 15-LOX-2 in differentiated secretory cells of benign prostate, reduced 15-LOX-2 is a common alteration in prostate carcinoma, and this correlates with tumor cell differentiation. That reduced expression is seen in HGPIN suggests that this may be an early alteration in carcinoma development.
 ...
PMID:Reduced 15-lipoxygenase-2 immunostaining in prostate adenocarcinoma: correlation with grade and expression in high-grade prostatic intraepithelial neoplasia. 1101 84

High-grade prostatic intraepithelial neoplasia (PIN) is the most likely precursor of prostatic carcinoma. PIN has a high predictive value as a marker for carcinoma, and its identification in biopsy specimens warrants repeat biopsy for concurrent or subsequent carcinoma. The only methods of detection are biopsy and transurethral resection; PIN does not significantly elevate serum PSA concentration or its derivatives, nor does it induce a palpable mass, and cannot be detected by ultrasound. Androgen deprivation therapy decreases the prevalence and extent of PIN, suggesting that this form of treatment may play a role in chemoprevention. Radiation therapy is also associated with a decreased incidence of PIN.
 ...
PMID:Diagnosis of prostatic intraepithelial neoplasia: Prostate Working Group/consensus report. 1114 2


<< Previous 1 2 3 4 5 6 7 Next >>