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Query: UMLS:C0376358 (prostate cancer)
 59,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Prostate cancer is a polyclonal tumor. There are about 70 bis 75% responders after hormone therapy among previously untreated patients in EORTC trials. Therefore 25 to 30% of the tumors are resistant to androgen. Surgical and hormonal castration show similar results. After progression under hormone therapy response can be reached with antiandrogenic therapy in 30 to 38%. All this leads to the conclusion that it is necessary to base treatment on tumor adaptation and selection. Cell clones insensitive to androgen therefore need cytostatic chemotherapy. It is not yet proofed whether polychemotherapy really shows better results than monotherapy does. Following the thesis of a polyclonal tumor, therapy of advanced prostate cancer must be based on hormone therapy and cytostatic chemotherapy. Prostate specific antigen is a marker for an early recognition of progression.
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PMID:[Therapy of advanced prostatic cancer]. 304 20

Prostate specific antigen (PSA) in serum of patients with benign prostatic hyperplasia (BPH) or prostate cancer (P-CA) not bound to alpha-1-antichymotrypsin (ACT) was analyzed by chromatofocusing. The procedure allowed the simultaneous separation of complexed and free PSA and the fractionation of the free PSA fraction into several isoenzymes. The detection of the isoenzymes was strongly dependent on the combination of antibodies introduced in the applied commercially available immunoassays (Cobas Core, Delfia). Isoenzymes in sera of patients with benign prostatic hyperplasia were mainly situated in the pI range of 6.6 to 7.3. Isoenzymes in sera of prostate cancer patients or in PSA from LNCAP cells were mainly situated in the pI range 7.0 to 8.3. Neuraminidase treatment of the sera shifted the isoelectric points of all three sources towards more basic pHs. An irregular glycosylation process in the dysplastic cells of the prostate is suggested to be the cause for the shift of the isoelectric points. The difference of isoenzyme distribution along the pH axis is discussed as a diagnostic tool to differentiate between BPH and P-CA.
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PMID:Serum free prostate specific antigen: isoenzymes in benign hyperplasia and cancer of the prostate. 868 58

Since 1989 we have used serum prostate specific antigen (PSA) levels as an indication for ultrasound guided systematic biopsies of the prostate. Realizing that the PSA level in part reflects prostatic glandular epithelial volume, we reviewed the accumulated data on our last 2,340 biopsies to determine if the quotient of PSA and prostatic volume, prostate specific antigen density, provided any further diagnostic information. There were evaluable data for 2,020 patients. Prostate specific antigen density levels are shown to have a strong correlation with the diagnosis of prostate cancer and provide a more reliable indication for ultrasound guided biopsy of the prostate than PSA alone.
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PMID:The use of prostate specific antigen and prostate specific antigen density in the diagnosis of prostate cancer in a community based urology practice. 750 48

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

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

As part of the search for alternatives to transurethral resection of the prostate (TURP) attention has (re)turned to laser methods. We describe our experience with the currently available endoscopic beam deflection devices, particularly the Prolase II. 25 patients, generally with medical reasons to avoid TURP, and with proven bladder outlet obstruction (BOO) due to benign prostatic enlargement (BPH) underwent prostatic laser coagulation. Average age was 72 years (range 57-84), mean prostatic size by transrectal ultrasound (TRUS) was 48 g (15-100), average pretreatment peak flow rate (FR) was 7.6 ml/s (4.56-12.4). All patients were markedly symptomatic. Patients underwent clinical examination, Prostate specific antigen assay (PSA = 3.75, range 0.1-10.2), and TRUS preoperatively to exclude prostate cancer. After cystoscopic assessment the prostate was lasered according to the device manufacturers recommendations and clinical experience. A suprapubic catheter (SPC) and urethral catheters were inserted, the urethral for 24 hours. If voiding was satisfactory the SPC was removed after 24-48 hrs. Alternatively the patient was discharged and assessed at weekly intervals for SPC removal. Mean duration of SPC drainage was 11 days. Total mean impatient stay was 4.5 days (2-13) during a mean of 2 admissions. Blood loss was minimal and there were no other significant complications. At a minimum follow up of 3 months mean peak FR was 15.3 ml/s (9-31). Symptom scores (IPSS) fell from a mean of 21 to 10 by 3 months after treatment. There was an initial period of irritability for up to 12 weeks but symptomatic improvement was noted in all.
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PMID:[Therapy by endoscopic laser for prostatic obstruction]. 751 89

Prostate specific antigen (PSA) and gamma-seminoprotein (gamma-Sm) are revealed to be the same protein. However, the serum concentrations of PSA and gamma-Sm in the same samples are frequently different. We previously measured a ratio of serum PSA concentration and gamma-Sm concentration (P/S ratio), and evaluated its usefulness for diagnosis of prostate cancers. In this paper, we tried to determine the cutoff value which brings better efficiency and diagnose prostate cancer by means of P/S Ratio. Between April 1988 and September 1992, 221 men underwent prostatic biopsy and/or TUR-P, and were diagnosed pathologically. Of 221 patients, 130 were diagnosed as BPH, prostatis or normal prostate (no cancer; NC) and 91 were diagnosed as prostate cancer (CaP). 1) The mean +/- SD of P/S ratio in 130 patients with NC was 0.919 +/- 0.563. While, the mean +/- SDs of P/S ratio were 12.447 +/- 44.353 in 91 patients with CaP and 2.052 +/- 0.751 in 39 Cap patients with serum PSA level of < or = 10 ng/ml. The mean P/S Ratios in CaP patients with serum PSA of < or = 10 ng/ml as well as in all CaP patients were significantly higher than those in NC patients (p < 0.0001). 2) When the cutoff value of P/S Ratio was determined to be 1.45, the highest efficiency (= sensitivity x specificity divided by 100), 83.4, was obtained. The sensitivity and specificity were 91.2% and 91.5%, respectively as a cutoff value of 1.45.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Diagnosis of prostate cancer by means of the ratio of prostate specific antigen/gamma-seminoprotein (P/S ratio)]. 751 68

Prostate specific antigen (PSA) has become the best marker for prostatic carcinoma. PSA is secreted by the glandular cells of prostatic epithelium and is specific for any normal, hyperplasic and tumoral prostatic tissue. PSA is excreted in blood that render its dosage accessible for clinical purpose. Two different tests are now used: Tandem test R is a radioimmunological test (N1:0-4 ng/mL), and Pros check test uses an immunoenzymatic method and is considered to be more sensitive (N1: < 2.5 ng/mL). PSA increases of 35 ng/mL for every other gram of hyperplastic prostatic tissue and of 3.5 ng/mL by gram of prostatic cancer. This test allows detection of prostate carcinoma with a positive predictive value of 49% when PSA > 4 ng/mL and 75% when PSA > 10 ng/mL. However, only biopsies will confirm the diagnostic of prostate cancer. For the patients with an increased PSA and no cancer founded by random biopsies, an increase of PSA level in the next year suggests prostate carcinoma. When the diagnostic of prostate cancer has been made, a PSA < 15 ng/mL suggests a low stage carcinoma (B1 or B2). When PSA > 75 ng/mL, there is a high probability that this cancer is node positive. Between this values, PSA cannot make the difference between stage B, C or D. The more sensitive test (Pros check) must give undetectable level after radical prostatectomy. For high stage lesion treated by hormonotherapy, or chemotherapy or radiation therapy, PSA is a good indicator of response to therapy and recurrence after therapy.
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PMID:[Proper use of prostate specific antigen]. 752 May 97

Prostate specific antigen (PSA) is the most accurate serum marker for prostate cancer. However, sensitivity and specificity are suboptimal, especially at the intermediate levels between 4.1 and 10.0 ng/ml (monoclonal). For intermediate PSA levels, PSA density (PSAD) provides unique information regarding the need for biopsy and the likelihood of prostate cancer. The authors prospectively used PSAD to determine the need for biopsy in 68 patients with PSAD values below 0.150 and normal results from a digital rectal examination. Ten patients have undergone biopsy secondary to a rising serum PSA. Three were found to harbor prostate cancer and have undergone therapy. The remaining 65 patients continue on surveillance. PSAD can predict treatment outcomes for patients with clinically localized prostate cancer treated with radical prostatectomy. PSADs at low values are 90% accurate in predicting operative success. PSADs at high values are 67% accurate in predicting failure. Cancer 1994; 74: 1667-73.
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PMID:Prostate specific antigen and prostate specific antigen density. Roles in patient evaluation and management. 752 83

Prostate specific antigen (PSA), digital rectal examination (DRE) and transrectal ultrasonography (TRUS) are widely used for the detection of prostate cancer. The sensitivity and positive predictive value of PSA are most excellent among these modalities. However, the sensitivity of PSA was 73% when the cut off value was 6ng/ml. In the general clinical practice the use of three screening modalities must be recommended to improve the detection rate. However, the mass screening which has to diagnose many subjects during a short period should be mainly conducted by PSA, because blood sampling for PSA was performed with other kind of mass screening without any specialists (urologists). We are now investigating the effects of age specific PSA and PSA velocity to improve the sensitivity of PSA. It is estimated that the prostate cancer death and the prevalence will rapidly increase in Japan. Therefore, we had better start the preventative research including mass screening. To prove the significance of mass screening program, pilot studies in well executed randomized prospective protocols are urgently needed.
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PMID:[Screening test for prostate cancer]. 752


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