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)

Prostate specific antigen (PSA) based screening nearly doubles the detection rate of early prostate cancer. However, it is unknown whether the additional tumors detected are medically important. Traditional clinical and pathological features associated with medically important cancer include a palpable tumor, multifocal or diffuse involvement and moderately or poorly differentiated histology. In contrast, microfocal, well differentiated tumors are considered to be possibly medically unimportant. We sought to examine the clinical and pathological tumor stage and tumor grade in 1,169 consecutive men whose prostate cancer was detected during serial PSA based screening protocols involving 24,346 men screened at 6-month intervals. Of the patients 97% had clinically localized (clinical stage T1 or T2) tumors, of which 39% were not palpable (stage T1). Of the men whose cancer was detected through initial screening who underwent surgical staging 69% had pathologically organ confined (pathological stage whose cancer was detected through initial screening pT1 or pT2) disease compared to 74% whose cancer was detected through serial screening (after an initially negative screening). Impalpable, clinically focal, well differentiated minimal tumors were noted in 16% of the men. However, only 3% of the men who underwent surgical staging had impalpable, pathologically microfocal, well differentiated minimal tumors. We conclude that the majority of tumors detected through PSA based screening have the clinical and pathological features associated with medically important prostate cancer.
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PMID:The nature of prostate cancer detected through prostate specific antigen based screening. 752 17

Recent developments have permitted accurate seed placement and dosimetry for interstitial brachytherapy of selected patients with localized prostate cancer. We present our experience with 76 patients divided into 2 groups. Group 1 included 45 patients with smaller, more well differentiated tumors, usually less than 2 cm. in diameter on digital rectal examination or transrectal ultrasound and a Gleason score of less than 7 who were treated with 125iodine alone. Group 2 consisted of 31 patients with localized tumors greater than 2 cm. in diameter and/or a Gleason sum equal to or greater than 7 who were treated with low dose external beam radiation followed by 125iodine boost 4 weeks later. Complete clinical progression-free survival, including prostate specific antigen, digital rectal examination and biopsy, was 51% for group 1 and 63.3% for group 2, with a mean followup of 26.3 months. Prostate specific antigen progression-free survival was 97.7% for group 1 and 94.7% for group 2. These results appear to be superior to external beam radiation only although longer followup is needed to substantiate these favorable early results. The procedures were well tolerated with good potency sparing. They were performed on an outpatient or short stay basis and provided a good alternative to external beam radiation only or hormonal treatment for select patients with localized prostate cancer who may not be candidates for radical prostatectomy.
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PMID:Detailed preliminary analysis of 125iodine implantation for localized prostate cancer using percutaneous approach. 753 84

Prostate specific antigen (PSA) and PSA-density (PSAd) were studied in 120 symptomatic patients with benign prostatic hyperplasia at digital rectal examination. PSA and PSAd were measured before and 3 months after transurethral resection. Comparisons were made between patients in whom histologic examination showed benign hyperplasia and those with histologically demonstrated prostatic cancer. The influence of age and of serum testosterone on PSA and PSAd was determined. PSAd in benign prostatic hyperplasia was the same in the transition zone (the adenomas) and the peripheral zone (mean 0.065), indicating no increased synthesis or leakage of PSA. PSAd with cut-off value 0.10 ng x ml-1 x cc-1 showed higher sensitivity and positive predictive value (75% vs 50% and 0.33 vs 0.15, respectively) in nonpalpable prostatic cancer than did PSA with cut-off at 4 ng x ml-1. No statistically significant influence of testosterone and/or age on serum-PSA or PSAd was found.
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PMID:Influence of benign prostatic hyperplasia, testosterone and age on serum levels of prostate specific antigen. 753 25

Prostate specific antigen (PSA) levels after total prostatectomy or radiation therapy to localized prostate cancer and also during endocrine therapy are within normal range. Therefore, it is necessary to use hyper sensitive PSA assay kits for early detection of relapse. The present study was undertaken to evaluate two hyper sensitive assay kits (Delfia kit, lower limit 0.1 ng/ml, Kabi Pharmacia Diagnostics Co. and Markit M kit, 0.5 ng/ml, Dainippon Pharmaceutical Co.) and to compare them with conventional PSA kit (Eiken Chemical Co., 1.0 ng/ml). Total of 291 sera were examined: patients consisted of 10 total prostatectomy+endocrine therapy, 9 radiation therapy+endocrine therapy, 5 radiation therapy alone and 44 endocrine therapy alone. Values of endocrine therapy alone were divided into two groups according to duration after start of treatment; more or less than 5 years. The following results were obtained. 1. In non-relapse patients after total prostatectomy+endocrine therapy and radiation+endocrine therapy, PSA showed under lower limit with hyper sensitive kit. On the contrary, conventional kit indicated more than 1.0 ng/ml. 2. Radiation therapy alone kept PSA in detectable range with hyper sensitive kit in spite of no sign of relapse. 3. In non-relapsed patients under endocrine therapy alone, long duration (more than 5 years after start of treatment) decreased PSA in non detectable values with hyper sensitive kits. In this case, conventional kit still showed PSA as more than 1 ng/ml. 4. Doubling time at relapse was estimated similar with Delfia kit and Markit M kit, and much longer with conventional kit. It is concluded that hyper sensitive kit is more useful to manage patients after therapy than conventional kit.
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PMID:[Usefulness of hyper sensitive PSA assay kits for determination on low range of prostate specific antigen in prostate cancer]. 753 43

Prostate specific antigen (PSA) and gamma-seminoprotein (gamma-Sm) have been revealed to be the same protein and used as tumor markers for prostate cancer (CaP). However, it seems impossible to detect prostate cancer in the cases with PSA levels of 10.0 ng/ml or less. We now report on PSA/gamma-Sm ratio in the cases with PSA levels of 10.0 ng/ml or less, and on the relation between PSA and gamma-Sm in those cases. Serum samples were obtained from the patients with no cancer (NC) (n = 118) and CaP (n = 39). In the cases with PSA ranging from 4.1 to 10.0 ng/ml, gamma-Sm levels in the patient with CaP were significantly lower than in those with NC (3.744 +/- 2.481 (mean +/- SD, n = 27) VS. 7.573 +/- 4.182 (n = 41), p < 0.0001) though PSA levels in both groups were not significantly different, and consequently, PSA/gamma-Sm ratio in the patients with CaP were significantly higher than in those with NC (2.181 +/- 0.802 VS. 1.095 +/- 0.804, p < 0.0001). In the cases with PSA levels of 4.0 ng/ml or less, gamma-Sm levels in the patient with CaP were significantly lower than in those with NC (1.600 +/- 0.705 (n = 12) VS. 3.243 +/- 2.456 (n = 77), p = 0.0064), while PSA levels in the patients with CaP were not significantly different from those in the patients with NC, and consequently, PSA/gamma-Sm ratio in the patients with CaP were significantly higher than in those with NC (1.762 +/- 0.544 VS. 0.808 +/- 0.330, p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Prostate specific antigen (PSA)/gamma-seminoprotein ratio in the cases with PSA levels less than or equal to 10.0 ng/ml]. 753 45

Prostate specific antigen (PSA) is the most important tumour marker which, used routinely, proved to have a positive correlation with tumour volume and pathological stage. To evaluate the relationship between serum PSA and histologic grading of prostatic carcinoma, preoperative PSA determinations were made in 25 patients with prostatic cancer. Biopsy materials were evaluated and the Gleason scores were adjusted for histologic grading. The higher values of PSA were proportional to the Gleason scores of the primary prostatic biopsy.
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PMID:Relationship between histologic grading and serum prostate specific antigen in prostatic carcinoma. 753 81

Prostate specific antigen (PSA) is generally believed to be expressed only by prostate epithelium. If this were true of PSA, RNA, then detecting PSA RNA in cells outside of the prostate would indicate metastasis. PCR can detect rare prostate cancer cells. To enhance sensitivity, we developed "nested primer" PCR to detect PSA RNA. With this method, PSA RNA is present in several non-prostate cell lines, including BG-1 (ovarian), SK-MES-1 (lung), and HL-60 (myeloid leukemia), and some normal blood. A low level of PSA RNA detectable by nested primer PCR is present in some cells of non-prostate origin and may interfere with sensitive methods to detect micrometastases. Transcripts of other genes thought to be organ specific may have similar limitations.
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PMID:Prostate-specific antigen messenger RNA is expressed in non-prostate cells: implications for detection of micrometastases. 754 Jan 8

Prostate cancer is increasing in incidence, particularly because of the control of competing causes of death and the lengthening life span of western men. Screening and early detection initiatives among symptom free men show that the disease can be detected at earlier stages when hope for cure is reasonable. Prostate specific antigen is the most useful marker for prostate cancer. Analytical methods to improve its sensitivity and specificity include PSA density, age specific PSA reference ranges and PSA velocity or the rate of change in PSA. Older paradigms of the natural history of prostate cancer have been heavily influenced by characteristics of clinical disease. However, improved detection of the disease through better diagnostic tools and heightened public awareness may be changing the dynamics of the disease. The prevalence of advanced disease is falling, and more knowledge is accumulating on the identification of clinically significant disease. The most appropriate definition of clinically significant disease today must be based on a new paradigm, one that can build on but not be bound by older models.
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PMID:Screening strategies: a clinical perspective. 754 65

Prostate cancer in most European countries is the second most frequent cancer in males and the second most frequent cause of cancer death. Prostate specific antigen (PSA) is an important tumour marker, which relates to many aspects of this disease. It has been shown that PSA is helpful in the early diagnosis of prostate cancer and in this respect is superior to other available tests like rectal examination and transrectal ultrasonography. PSA is also helpful in staging of locally confined disease. It can be used to identify or exclude local extension of disease, if combined with T category and grade of differentiation determined on biopsy. The same parameters also give an indication of the presence of lymph node metastases, which may prevent unnecessary and invasive staging procedures in certain groups of patients with favourable prognostic factors and a low PSA value. PSA is less suitable as a marker for metastatic disease. Progression of untreated prostate cancer in various stages can be monitored by PSA. The true value of the marker in this respect is still underexplored. It may be possible that PSA will be shown to differentiate effectively between aggressive and non-progressive disease. In this respect, it could become an essential tool to identify those patients that may not require treatment at all. PSA is also a useful marker for therapy response. An elevation of PSA after radical prostatectomy indicates local or metastatic progression, which will occur within 1-2 years. PSA is an androgen dependent enzyme and decreases under endocrine treatment. It is unexplained why in spite of its endocrine dependent character, PSA rises with endocrine independent progression of prostate cancer.
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PMID:Prostate-specific antigen: its clinical use and application in screening for prostate cancer. 754 83

Prostate specific antigen (PSA) in serum has recently been shown to occur in complex with alpha 1-antichymotrypsin and as an approximately 30 kDa. noncomplexed molecular form. We characterized PSA by 3 different assays in samples from 144 patients with benign prostatic hyperplasia (BPH) and 121 with carcinoma of the prostate. One of these noncompetitive assays measured total PSA by detecting PSA complexed to serine proteinase inhibitors and the noncomplexed molecular form, a second measured only PSA in complex with alpha 1-antichymotrypsin, whereas a third detected the noncomplexed form. PSA in complex with alpha 1-antichymotrypsin was the predominant form in all patient sera. Noncomplexed PSA constituted a minor fraction that was significantly smaller in patients with untreated prostate cancer than in those with BPH (p < 0.0001). The proportion of noncomplexed PSA does not correlate to the serum concentration of PSA or that of alpha 1-antichymotrypsin. In men with a serum PSA concentration of less than 10 micrograms./l. the combination of assays measuring total PSA immunoreactivity, the noncomplexed molecular form and PSA in complex with alpha 1-antichymotrypsin may facilitate discrimination between prostate cancer and BPH.
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PMID:Serum prostate specific antigen complexed to alpha 1-antichymotrypsin as an indicator of prostate cancer. 768 16


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