Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1519176 (PSA)
 5,490 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Diseases of the prostate are of high socioeconomic importance owing to their high incidence and prevalence rates. Benign prostatic hyperplasia (BPH) can be detected in 80% of males over the age of 80. Clinical symptoms do not correlate with organ enlargement. Only 10% of patients with BPH need surgical treatment. The decision for surgical treatment is made as a result of objective findings and the symptoms reported by the patient. Preoperative evaluation of BPH must include digital rectal examination (DRE), measurement of peak flow rate, sonographic estimation of residual urine, transrectal ultrasound (TRUS), urethrocystography and the assessment of subjective complaints using symptom scores. Prostatic carcinoma is the most common malignancy in men. An abnormal DRE, increased PSA level and/or hypoechogenic lesions in TRUS are indications for prostate biopsy. The sensitivity of TRUS is superior to that of CT and MRI. New MRI techniques are promising with regard to local tumour extent. Whereas CT and MRI are not useful in screening of patients, these methods are valuable diagnostic tools in the follow-up of prostate cancer.
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PMID:[The value of diagnostic imaging in benign prostatic hyperplasia and prostatic cancer]. 751 94

Prostate inhibin peptide (PIP) is a polypeptide synthesized by the prostate gland that is involved in prostatic growth and differentiation. The objective of this study was to evaluate PIP as an immunocytochemical marker for prostatic adenocarcinoma (PCA) by comparing it with PSA and PAP. A total of 71 cases of primary PCA and 5 cases of metastatic PCA were studied. Primary tumors were specially selected to include a disproportionate number of high-grade tumors. The distribution of cases by Gleason score was 2-5, 14 cases; 6-7, 24 cases; and 8-10, 33 cases. Four metastases were to bone (decalcified tissue) and one to soft tissue. All 71 cases of primary PCA stained positively for the three antibodies tested, with none demonstrating obvious superiority, although individual case variability was seen. In one bone metastasis, staining for PSA was negative, with both PAP and PIP giving positive results. All non-prostatic carcinomas tested were negative. These results indicate that PIP is as sensitive and specific an immunohistochemical marker as PSA and PAP in untreated prostate adenocarcinomas. Further, the androgen-independent nature of PIP may give it an advantage over PSA/PAP in tumors exposed to androgen ablating agents.
Cancer Lett 1994 Apr 01
PMID:Prostate inhibin peptide (PIP) in prostate cancer: a comparative immunohistochemical study with prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP). 751 89

This paper reports the results of studies on the possible role of biochemical markers in monitoring the effects of ionizing radiations and in the follow-up of cancer patients submitted to radiotherapy. Three different case series were analyzed: patients with head and neck cancer, prostate carcinoma and residual thyroid tumors or uptaking metastases (131-Iodine therapy). Serum TPA and amylase were serially determined in patients with head and neck or thyroid cancer to measure the radiation damage to the salivary glands. In the former group a statistically significant correlation between the increase of both molecules and the total dose administered after the first day of treatment (2, 3, 4 or 6 Gy) was observed. In patients treated for thyroid cancer the damage to the salivary glands was revealed by an increase in TPA and amylase serum levels, dependent on the dose of 131-Iodine administered. Moreover, an association was demonstrated between pretreatment values of TPA in patients with head and neck tumors and prognosis: patients with values below the cutoff have significantly higher survival rates than those with higher values. In patients with prostate carcinoma PSA was confirmed to have better diagnostic and prognostic value than PAP. Patients with metastases show an inversion or lack of negative trend in PSA levels observed in the disease-free patients. This precedes the clinical diagnosis of metastases by 1 to 15 months.
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PMID:Marker determination for response monitoring: radiotherapy and disappearance curves. 751 52

Correct forecasting of prostatic carcinoma by means of serum PSA is limited. Prostatic carcinoma is said to increase PSA 10 times as much as prostatic adenoma. Therefore we evaluated whether PSA in the prostatic fluid is more specific for prostatic carcinoma than the level in the serum. In 31 consecutive patients with prostatic disease blood was taken for serum PSA first and then prostatic fluid (10 microliters) was expressed. The PSA was determined by the Pros-Check test in both the serum and in the prostatic fluid. The collection of the prostatic fluid failed in 7 (22.6%) patients. Of the remaining 24 patients, 5 had documented bacterial prostatitis, 4 had prostatic carcinoma and 15 had benign prostatic hyperplasia (BPH). The serum PSA was 5.6 +/- 5.0 micrograms/l in prostatitis, 148 +/- 208 micrograms/l in prostatic carcinoma and 6.9 +/- 6.8 micrograms/l in BPH. The serum PSA was significantly higher in prostatic cancer (P < or = 0.01) than in prostatitis and BPH. The PSA levels in the prostatic fluid were 14.0 +/- 25.7 x 10(6) micrograms/l in prostatitis, 7.6 +/- 9.7 x 10(6) micrograms/l in carcinoma and 14.0 +/- 14.6 x 10(6) micrograms/l in BPH. There were no statistically significant differences. In the expressed prostatic fluid no significantly different PSA was found in carcinoma, bacterial prostatitis or BPH. In contrast to this, the serum PSA was significantly higher in cancer patients than in prostatitis or BPH. Therefore PSA in the expressed prostatic fluid is no more specific than that in the serum.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[PSA in prostatic fluid]. 751 4

To examine prospectively the usefulness of measurement of rate of change in serum prostate specific antigen levels (PSA slope) in detecting prostate cancer in a PSA-based prostate cancer screening study, we evaluated 982 serially screened men whose initial screening was negative for cancer. All men had at least 1 PSA value greater than 4.0 ng./ml. and all ultimately underwent prostatic biopsy. For those who entered the study with normal PSA levels, a PSA slope cutoff point of 0.75 ng./ml. per year or more maximized sensitivity and specificity for predicting cancer (odds ratio 7.20, 95% confidence interval 4.52 to 11.47). This cutoff point was most predictive for men 70 years old or younger. For men who entered the study with elevated PSA levels (greater than 4.0 ng./ml.) a lower PSA slope cutoff point (0.4 ng./ml. per year or more) maximized sensitivity and specificity for predicting cancer (odds ratio 2.73, 95% confidence interval 1.82 to 4.07). We conclude that PSA slope is useful for serial prostate cancer screening, although its predictive value varies with patient age and initial PSA level.
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PMID:Rate of change in serum prostate specific antigen levels as a method for prostate cancer detection. 752 Sep 50

Prostate cancer is the most common neoplasia in males and, since it is curable only when detected in the early stages, it was estimated that screening would detect tumours in curable stages which would enhance the results in the fight against the disease. This, however, has not been elucidated since the condition's natural history in many cases unknown and it may be that unnecessary and iatrogenic overtreatment is being induced. The paper analyzes the various tests and diagnostic procedures available, primarily digital rectal examination, PSA determination, and transrectal ultrasound all used individually and in combination. Several unknown aspects await to be answered and many long-term studies continue to be necessary to explain whether early diagnosis of asymptomatic disease and subsequent treatment can improve life expectancy and quality of life as compared to plain treatment of symptomatic cases. We hope the answer will be available shortly and that we are "able to diagnose cancer in time but treat it only when we know it is required.
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PMID:[Early diagnosis of prostatic cancer]. 752 Nov 14

The information contained in this article indicates that PSA will have an increasing role in the management of prostate cancer. For example, it is now essential for optimal diagnosis if prostate cancer detection is the goal. Prospects are high that more information about PSA density relationships, PSA velocity phenomenologies, and possible PSA isoforms will increase diagnostic accuracy. It would also seem that PSA will improve staging accuracy not only by better manipulation of multiple preoperative parameters (eg, cancer grade, volume, PSA, etc) but possibly by the molecular detection of minute amounts of occult prostate cancer cells in bone, blood or lymph nodes, or by improved use of immune scanning. Finally, the use of these more sophisticated staging approaches together with increasingly sensitive PSA assays and possibly androgen provocative testing might allow the prospect that the potentially curative therapies can be almost immediately assessed for efficacy, thereby increasing prospects for therapeutic progress. Finally, PSA may become even more important for manipulating hormone therapies (eg, IAS therapy) or it could form a basis for new treatments such as immune or gene therapy.
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PMID:Newer applications of serum prostate-specific antigen in the management of prostate cancer. 752 53

PSA and PSAP were examined in 198 prostatic biopsies and correlated with PSA and PSAP serum levels evaluated before biopsies. In every type of lesion there was no relation between PSA or PSAP serum levels and their expression in biopsy specimens. PSA and PSAP staining was similar in both cancer and benign hyperplasia and lower in dysplasia, atrophy and prostatitis; while serum levels were higher in adenocarcinomas than in other lesions. A significant difference of PSAP serum levels was noted in different Gleason's grading of neoplasia, found neither with PSA serum levels/nor with PSA and PSAP tissue staining.
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PMID:Correlation between immunohistochemical patterns and serum levels of PSA and PSAP in prostatic pathology: evaluation of 198 prostatic fine needle biopsies. 752 71

We report the results of two pilot studies for the early detection of prostatic carcinoma in resident men aged 60-75 years, using combined digital rectal examination (DRE) and transrectal ultrasonography (TRUS) versus prostate-specific antigen (PSA; cutoff: 4 ng/ml) as screening tests. Both screening protocols exhibited high cancer detection rates (DRE + TRUS = 1.82%, PSA = 1.67%), with a high prevalence/incidence ratio (observed/expected ratio: DRE-TRUS = 13.8:1, PSA = 11.3:1) and a diagnostic anticipation of about 6-7 years. Stage (DRE + TRUS: A = 0%, B = 69%, C-D = 31%; PSA:A = 14%, B = 77%, C-D = 9%) and grading distribution (no case with Gleason score < 5) suggests that most screen-detected cancers were clinically assessable but the extent of overdiagnosis of latent carcinomas cannot be estimated. Both screening protocols proved to be cost-effective (biopsy rate: DRE + TRUS = 2.7%, PSA = 2.8%; cost per screened subject: DRE + TRUS = L. 33,750, PSA = L. 30,400; cost per cancer detected: DRE + TRUS = L. 1,854,000, PSA = L. 1,817,500) but screening by PSA was much better accepted (attendance rate: DRE + TRUS = 33.7%, PSA = 66.9%), which makes it the screening test of choice for controlled studies on screening efficacy. This study allows no definitive conclusions to be drawn on screening efficacy but confirms only that screening is feasible at a reasonable cost and yields high diagnostic anticipation. Whether this benefits the screened population is currently debated and needs to be confirmed by controlled studies. Screening may have upsetting negative outcomes such as overdiagnosis, overtreatment, increased treatment-related mortality rates and worsened quality of life, and there is no evidence supporting the recommendation of screening as a routine practice.
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PMID:[Comparison between 2 techniques of screening for prostatic carcinoma. Rectal exploration and transrectal ultrasonography vs. prostate specific antigen]. 752 16

With the inevitable increase in non-surgical management of the many thousands of patients with assumed benign prostatic enlargement, the issue of undiagnosed prostatic cancer needs to be addressed. Currently our knowledge is incomplete in many areas, especially that pertaining to the outcome of therapy of incidentally discovered prostate cancers. Nonetheless common sense dictates that all patients presenting with clinical BPH should undergo DRE and those with palpable induration or asymmetry should be biopsied in the knowledge that around a third will prove positive. Ideally all patients with clinical BPH should also have a PSA determination, however, the result should be interpreted with care, taking into account the age and estimated life-expectancy of the patient. Patients younger than 75 with a PSA > 10 ng/ml should probably be biopsied routinely--around half will have cancer. Patients with PSA values between 4 and 10 (around 50% of cases of BPH) may legitimately be carefully observed for a period. Biopsy should be performed if an increase of > 20% in the PSA occurs during the year of follow-up especially in younger patients. Evidence is mounting that TRUS has serious deficiencies in identifying prostate cancers, nonetheless it does provide the most effective means of accomplishing transrectal prostatic biopsy. Further studies are required to critically evaluate the competing claims for improved diagnostic accuracy of PSAD, PSAV and age-adjusted PSA, the last of which does have the advantage of practicability.
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PMID:BPH: when to rule out carcinoma of the prostate. 752 2


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