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)

We report the development of a new sensitive nested reverse transcription-polymerase chain reaction (RT-PCR) assay, using primers derived from the prostate-specific membrane antigen (PSM) cDNA sequence, to detect an hematogenous spread of prostate adenocarcinoma cells. In 60 patients with a biopsy-proven prostate cancer, PSM and PSA RT-PCR detected circulating prostate cells in 40 and 20 patients, respectively. In pT4 M+ and pT3 M+ disease patients, nested PSM primers detected cells in 28 of 33 patients (85%), whereas nested PSA primers detected cells in 17 of 33 (51%). In patients with organ-confined cancer spread (pT2a and pT2b patients) before radical prostatectomy, nested PSM RT-PCR detected circulating prostatic epithelial cells in 6 of 17 patients (35%), which suggests that an hematogenous spread of prostate cells may occur early in prostate cancer history. Altogether, these results suggest that the detection of PSM-expressing cells in blood may predict the development of cancer in patients without clinically apparent prostate cancer. Nevertheless, the potential application and the clinical significance of detection of hematogenous prostate cells through the use of nested PSM primers need an extensive longitudinal study.
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PMID:Enhanced detection of hematogenous circulating prostatic cells in patients with prostate adenocarcinoma by using nested reverse transcription polymerase chain reaction assay based on prostate-specific membrane antigen. 749 5

According to the most recent US cancer statistics, prostatic cancer almost equals lung cancer as the most frequent cause of death from cancer in men. The search for diagnostic methods as well as control examinations have therefore gained great importance. The present study reveals that--in addition to rectal touch, sonography and biopsy of the prostate--the determination of both PSA as organ-specific marker and lipid-associated sialic acid (LSA) as a general tumor marker, is well suited for follow-up and monitoring treatment. With regard to the follow-up, the combined determination of PSA and LSA in serum of patients with prostatic cancer achieves a higher sensitivity as compared to PSA alone (increase of 30-40%). LSA is a good indicator for the presence of metastases. Therefore, the determination of LSA should become an integral part of treatment monitoring and detection of metastatic disease in patients with prostatic cancer.
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PMID:The role of lipid-associated sialic acid (LSA) and prostate specific antigen (PSA) in the follow-up of prostatic cancer. 750 44

The natural history of prostatic cancer has been regarded as unpredictable for a long period of time. The discrepancy between histologically identifiable (50%) and clinically diagnosed carcinomas (8%) led to the term of 'latent' prostatic cancer and to a considerable diagnostic and therapeutic dilemma. Based on our previous studies showing that biological aggressiveness of prostatic cancer is a direct function of tumor volume and that tumor volume and serum-PSA are proportional, we evaluated two basically different groups of patients. The first group consisted of 43 patients with untreated carcinomas of the prostate followed with serial PSA determinations. The exponential (log-linear) rise in PSA led us to the conclusion of an exponential tumor growth rate. The doubling time of organ-confined tumors was three to four years and became shorter with higher clinical stages and poorly differentiated histological grades. The second group consisted of 139 patients who underwent cystoprostatectomy for bladder cancer and had no evidence for simultaneously identifiable prostatic cancer. In 55 Patients (40%) unsuspected prostatic cancer was found in the specimen; the volume distribution of these carcinomas was exponential. Eleven of the 139 men (7.9%) had a prostatic cancer > or = 0.5 cc, corresponding to the 8%-risk for a man being diagnosed within his lifetime with a clinically significant carcinoma of the prostate. We conclude that the other 44 carcinomas < 0.5 cc will never reach clinical significance due to their small size and their long doubling time; in this sense they can be considered 'latent'.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Natural follow-up of prostate cancer and consequences for early detection]. 750 45

Three new potential biomarkers--PAC, PMA, and the 7E11-C5 glycoprotein--have been identified. All three have unique features that could augment current diagnostic and therapeutic modalities. Some of the important characteristics of these potential markers are summarized in Table 1. Further studies will be required to determine if any of them will provide clinical information beyond that provided by PSA and if they will have a significant impact on the management of patients with prostate cancer. The MAb 7E11-C5 (CYT-356), now in clinical trials, promises to offer new strategies for radioimmunodetection and radioimmunotherapy of prostate cancer.
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PMID:Biomolecular and clinical characteristics of PSA and other candidate prostate tumor markers. 750 67

The physician and laboratorian have several proven PSA assays from which to choose, and several more are likely to achieve FDA approval soon. Furthermore, an assay that is FDA approved offers considerable reassurance that the many aspects of assay design and manufacturing processes meet an acceptable standard. This will become even more critical as assays report values in the ultrasensitive range. We have attempted to review here some of the most important issues related to PSA assay performance and standardization. Standardization particularly is a complex problem for which solutions are just now appearing. Yet efforts must continue to minimize controversies, because many more assays will be forthcoming and because newer applications of PSA determinations will place more pressure on proper assay evaluations. For example, measurement of free PSA, PSA-ACT complexes, and the ratio of one to the other are intriguing possibilities for added clinical benefit. Also, ultrasensitive PSA assays add a new dimension to the detection of residual disease and may provide unique opportunities for the implementation of new therapies and their timely evaluation. In our opinion, the impact of PSA on the management of prostate cancer is still growing, and the opportunities for better and new assays are still great.
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PMID:Issues in the assessment of PSA immunoassays. 750 68

Prostate specific antigen has become an important adjunct to the digital rectal examination in screening for prostate cancer. The clinician should be familiar with interpretation of this test. Many men with BPH have elevated serum PSA concentrations; however, the majority of these men will have other pathologic processes such as occult cancer, PIN, or acute inflammation that may account for the elevations in serum PSA. Certainly, serial increases in serum PSA should increase concern that occult carcinoma is present. Patients with PIN may also have elevated PSA concentrations. When PIN is associated with elevated PSA, a high incidence of invasive carcinoma is noted on subsequent biopsy. Further investigation into the associations will further refine the clinical utility of this powerful tumor marker.
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PMID:PSA in benign prostatic hyperplasia and prostatic intraepithelial neoplasia. 750 69

The evidence is mounting that PSA-based screening for prostate cancer is rational and effective at detecting a high proportion of cancer that is both clinically significant and curable by radical prostatectomy. However, more information is necessary to define the optimal ages at which screening should be performed and to determine the appropriate role of repetitive PSA measurement, PSA density, and PSA slope in serial screening. Formal demonstration of a significant screening-induced reduction of cancer-specific morbidity and mortality is necessary to unambiguously justify screening for prostate cancer. A randomized trial evaluating prostate cancer screening will soon be started under the auspices of the National Cancer Institute. Additionally, refinements in serum PSA testing that consider the variable binding of PSA derived from benign and malignant prostatic tissues to serum proteins may further enhance the performance of PSA testing in the screening setting. For these reasons, PSA-based screening for prostate cancer seems destined to remain an important strategy for minimizing the health consequences of this disease.
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PMID:Using PSA to screen for prostate cancer. The Washington University experience. 750 72

An evaluation of longitudinal changes in PSA in men with and without prostate disease revealed that with age, the development of prostate disease is the most important factor influencing changes in PSA. Furthermore, the PSA changes with age are significantly different in men with and without prostate disease. The PSA velocity is greater in men with prostate cancer than in men with BPH and greater in men with prostate cancer and BPH than in men without any prostate disease. Thus, evaluation of PSA changes may help distinguish between men with prostate cancer and those without the disease. This idea will need to be confirmed prospectively. Finally, estimation of PSA doubling time from changes in PSA suggests that changes reflect prostatic growth. Therefore, PSA velocity could be of benefit in identifying men with prostate cancer that is destined to progress.
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PMID:PSA velocity for the diagnosis of early prostate cancer. A new concept. 750 74

Although PSA is a most valuable tool for the practicing physician, it lacks sufficient sensitivity and specificity for detecting early prostate cancer to be the perfect tumor marker. The parameters PSAD and PSA velocity are useful attempts to make PSA a better tumor marker, but they likewise are not always reliable on an individual basis. There is now evidence from several investigations that the serum PSA concentration in healthy men without clinical evidence of prostate cancer increases with advancing age. This is primarily attributable to the concomitant increase in prostate size over the same time period. As a result, age-specific reference ranges have been determined and have the potential to make PSA a more sensitive tumor marker for men less than 60 years of age and a more specific tumor marker for men beyond 60 years of age. If one utilizes the age-specific reference ranges for serum PSA, it appears that PSAD can be eliminated as a parameter in the diagnostic evaluation of patients suspected of having prostate cancer. Thus, a new algorithm utilizing age-specific reference ranges has been developed.
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PMID:Influence of patient age on the serum PSA concentration. An important clinical observation. 750 75

Prostate specific antigen is an abundant prostate-derived serine protease in the seminal fluid. Low concentrations of the protein are normally released into blood, but above normal concentrations are frequently detected in prostate disease. The PSA-ACT complex is the predominant molecular form of serum PSA (up to approximately 95%) although complex formation is slow between the purified proteins in vitro. A free, noncomplexed form of PSA constitutes a minor fraction of the serum PSA, although serum ACT occurs in large molar excess. The free, noncomplexed form of serum PSA is reported to constitute a significantly smaller proportion of the PSA in untreated prostate cancer than in BPH. The molecular basis for this finding is unclear, but measurements of the proportion of the free form of serum PSA or the proportion of serum PSA-ACT may facilitate discrimination between prostate cancer and BPH.
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PMID:Significance of different molecular forms of serum PSA. The free, noncomplexed form of PSA versus that complexed to alpha 1-antichymotrypsin. 750 76


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