Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0376358 (prostate cancer)
 59,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Analysis of the results of chemotherapy in patients with carcinoma of unknown primary site is complicated by the small sizes of most treatment series and patient heterogeneity. Careful evaluation of clinical and pathologic information may identify patients with a relatively high likelihood of response to systemic therapy. This includes patients in whom immunohistochemical studies or electron microscopy, or both, suggest a likely tumor type responsive to systemic therapy, such as prostate cancer, lymphoma, or a neuroendocrine tumor. Clinical evaluation can also identify potentially responsive patients, particularly those with clinical features in common with the extragonadal germ cell tumor syndrome. For patients who do not fit into these more treatable categories, most combination chemotherapy programs have response rates of less than 30% and median survivals of less than one year. Randomized trials have not established any clearly superior chemotherapy program. Regimens containing both Adriamycin (doxorubicin) and mitomycin-C produce response rates of approximately 25% but are associated with the possibility of severe hematologic toxicity, and rarely a syndrome resembling the hemolytic-uremic syndrome. The choice between chemotherapy and supportive care only must be individualized, and the latter option is appropriate for many patients. More detailed clinical and pathologic analyses in conjunction with clinical trials, particularly employing newer diagnostic techniques, are vital to provide better prospective data from which to identify relevant clinical subsets that allow an estimate of an individual patient's likelihood of response and the suitability of systemic chemotherapy.
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PMID:Empiric chemotherapy in patients with carcinoma of unknown primary site. 240 56

We identified 26 cases of metastatic prostatic carcinoma in supradiaphragmatic lymph nodes from 1972-1987. All involved nodes (15 supraclavicular, eight cervical, two axillary, and one mediastinal) were taken from the left side. Of those cases with available data, serum acid phosphatase was normal in five of 21 (24%). Seven of 20 (35%) had no evidence of bone metastases. Rectal examination was normal in eight of 19 cases (42%). While seven cases had a history of prostate cancer, the rest presented with enlarged nodes alone or with simultaneous urinary obstructive symptoms. Eighteen patients died following node biopsy (mean 19.8 months, range 1-46 months). Twenty-two of 26 metastases were high grade and often were not histologically suggestive of prostate carcinoma. In general, immunohistochemical staining for prostate-specific acid phosphatase (PSAP) was more intense than for prostate-specific antigen (PSA), in contrast to several other reports using these antisera. Metastatic prostate carcinoma should be ruled out by using immunoperoxidase for PSA and PSAP in all men over 45 presenting with carcinoma of unknown primary origin in left-sided supradiaphragmatic lymph nodes, even in the absence of bony disease, elevated serum acid phosphatase (SAP), abnormal rectal examination, and a histologic picture suggesting prostate carcinoma.
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PMID:Metastatic prostatic carcinoma to supradiaphragmatic lymph nodes. A clinicopathologic and immunohistochemical study. 243 55

The human prostatic acid phosphatase is a specific marker for the prostatic epithelial cells. By using an immunoperoxidase staining method for this enzyme, it is possible both to identify the prostatic epithelial cells and to recognize the prostatic origin of metastatic lesions of prostate cancer. Of the tissues containing prostatic epithelial cells from 120 patients, positive staining reaction was detected in 114 (95%), and negative in 6. In nonprostatic tissues from 242 patients, weak but positive staining reaction was detected in 8 (3.3%), including tissues from one renal cell carcinoma and 7 breast carcinomas. Of 27 patients in whom tumor tissues were tested at a time when tumor origin was unknown, the staining reaction was positive in 14 patients later found to have prostate cancer. It was negative in 6 patients with nonprostatic carcinoma and 7 patients with carcinoma of unknown primary. Although this immunohistochemical technique for prostatic acid phosphatase appears promising in diagnosing metastatic prostate cancer, its clinical significance and limitations remain unclear, and there are considerable technical problems yet to be solved. These problems are best approached by joint collaborative efforts of the various investigators interested in prostate cancer.
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PMID:Immunohistochemistry of prostatic acid phosphatase. 702 61

Cancer of unknown primary is a clinical challenge that occurs in about 10% of the cancer patients. The major goal is to identify curable patients, while unnecessary efforts and discomfort should be avoided in intreatable patients. Extensive radiological examinations and serum tumour markers have turned out to be unsatisfactory means to establish the origin of the metastasis in patients with cancer of unknown origin. The crucial step for precise diagnosis is histopathological examination of the malignant tissue. Transmission electron microscopy and immunocytochemistry and genetic analysis are being increasingly used in the diagnostic evaluation of patients with cancer of unknown primary. Once a diagnosis is strongly suggested, specific treatment can be administered according to treatment in advanced known cancer. While regional disease is amenable to surgery and/or radiation therapy, multimodality treatment should be considered in treatable disseminated disease. Subsets of patients with a favourable prognosis include non-Hodgkin's and Hodgkin's lymphoma, germ cell tumours and thyroid cancer. A fair response to combination therapy can be expected in breast, ovarian and prostate cancer, while metastatic gastrointestinal or urogenital tumours remain difficult to treat. If it is not possible to identify the primary, empiric chemotherapy may provide a chance for cure in about 5% of the cases. The most common regimen employs 5-fluorouracil, adriblastin and mitomycin C. All in all, the prognosis of patients with the CUP-syndrome remains poor--the median survival in somewhat less than six months.
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PMID:Cancer of unknown primary site. 805 45

BACKGROUND: Prostate cancer is the most common malignancy in men in the United States. Both at diagnosis and throughout the disease progression, it can metastasize to multiple organs, most commonly bone and lymph nodes. Effusions (either pleural or abdominal) are relatively uncommon. PATIENTS AND METHODS: We reviewed the medical literature including the case reports and post-mortem studies relating ascites to prostate cancer, identified through a MEDLINE search (human; all languages; 1969-2004). RESULTS: We found 12 published cases. Forty two percent of patients presented initially with ascites, in 50% ascites developed later with progressive disease, and 8% had ascites being the only site of recurrence. The response rate to endocrine therapy, including orchiectomy, was 25%. Ascites in these patients conferred a poorer prognosis. CONCLUSION: The development of ascites secondary to prostate cancer, either as an initial manifestation or recurrent disease, is not well known and may be unfamiliar to many physicians. If patients with history of prostate cancer develop malignant effusions, prostate specific antigen (PSA) immunohistostaining of the fluid can serve as a valuable adjunctive study for the diagnosis. This clinical situation becomes particularly important in patients with ascites with a carcinoma of unknown primary. Palliation can be achieved in patients with ascites secondary to prostate cancer using hormone manipulation. Lack of knowledge about this complication of prostate cancer may delay the diagnosis and treatment of this hormonally responsive malignancy.
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PMID:Malignant Ascites Associated with Carcinoma of the Prostate. 2022 15

6-Fluoro-((18)F)-L-3,4-dihydroxyphenylalanine (FDOPA) is an amino acid analogue for positron emission tomography (PET) imaging which has been registered since 2006 in several European Union (EU) countries and by several pharmaceutical firms. Neuroendocrine tumour (NET) imaging is part of its registered indications. NET functional imaging is a very competitive niche, competitors of FDOPA being two well-established radiopharmaceuticals for scintigraphy, (123)I-metaiodobenzylguanidine (MIBG) and (111)In-pentetreotide, and even more radiopharmaceuticals for PET, including fluorodeoxyglucose (FDG) and somatostatin analogues. Nevertheless, there is no universal single photon emission computed tomography (SPECT) or PET tracer for NET imaging, at least for the moment. FDOPA, as the other PET tracers, is superior in diagnostic performance in a limited number of precise NET types which are currently medullary thyroid cancer, catecholamine-producing tumours with a low aggressiveness and well-differentiated carcinoid tumours of the midgut, and in cases of congenital hyperinsulinism. This article reports on diagnostic performance and impact on management of FDOPA according to the NET type, emphasising the results of comparative studies with other radiopharmaceuticals. By pooling the results of the published studies with a defined standard of truth, patient-based sensitivity to detect recurrent medullary thyroid cancer was 70 % [95 % confidence interval (CI) 62.1-77.6] for FDOPA vs 44 % (95 % CI 35-53.4) for FDG; patient-based sensitivity to detect phaeochromocytoma/paraganglioma was 94 % (95 % CI 91.4-97.1) for FDOPA vs 69 % (95 % CI 60.2-77.1) for (123)I-MIBG; and patient-based sensitivity to detect midgut NET was 89 % (95 % CI 80.3-95.3) for FDOPA vs 80 % (95 % CI 69.2-88.4) for somatostatin receptor scintigraphy with a larger gap in lesion-based sensitivity (97 vs 49 %). Previously unpublished FDOPA results from our team are reported in some rare NET, such as small cell prostate cancer, or in emerging indications, such as metastatic NET of unknown primary (CUP-NET) or adrenocorticotropic hormone (ACTH) ectopic production. An evidence-based strategy in NET functional imaging is as yet affected by a low number of comparative studies. Then the suggested diagnostic trees, being a consequence of the analysis of present data, could be modified, for some indications, by a wider experience mainly involving face-to-face studies comparing FDOPA and (68)Ga-labelled peptides.
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PMID:18F-fluorodihydroxyphenylalanine vs other radiopharmaceuticals for imaging neuroendocrine tumours according to their type. 2341 99

Real-time, single-cell multiplex immunophenotyping of circulating tumor cells (CTCs) is hypothesized to inform diagnosis of tissue of origin in patients with carcinoma of unknown primary (CUP). In 20 to 50% of CUP patients, the primary site remains unidentified, presenting a challenge for clinicians in diagnosis and treatment. We developed a post-CellSearch CTC assay using multiplexed Q-dot or DyLight conjugated antibodies with the goal of detecting multiple markers in single cells within a CTC population. We adapted our approach to size-based CTC enrichment protocols for capturing CTCs and subsequent immunofluorescence (IF) using a minimal set of markers to predict the primary sites for common metastatic tumors. The carcinomas are characterized with cytokeratin 7 (CK7), cytokeratin 20 (CK20), thyroid transcription factor 1 (TTF-1), estrogen receptor (ER) or prostate-specific antigen (PSA. IF has been optimized in cultured tumor cells with individual antibodies, then with conjugated antibodies to form a multiplex antibody set. With IF, we evaluated antibodies specific to these 5 markers in lung, breast, colorectal, and prostate cancer cell lines and blood from metastatic prostate and breast cancer patients. This advanced technology provides a noninvasive, diagnostic blood test as an adjunct to routine tissue biopsy. Its further implementation requires prospective clinical testing.
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PMID:A multiplexed marker-based algorithm for diagnosis of carcinoma of unknown primary using circulating tumor cells. 2669 46