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)

1. PIN can present as a hypoechoic lesion on ultrasound. 2. Biopsy results prove a close relationship between PIN and cancer. 3. Measurements of age, lesion size, and PSA for diagnoses of PIN were intermediate values between non-cancer and cancer. 4. Sequential, precise transrectal ultrasound-guided biopsies of hypoechoic lesions are now possible, and close follow-up of patients with diagnoses of PIN is therefore possible.
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PMID:Use of transrectal ultrasound and prostate-specific antigen in diagnosis of prostatic intraepithelial neoplasia. 248 62

PSA represents a major advance in our tumor marker armamentarium. PIN fulfills the majority of requirements for a premalignant change. If we could determine a subset of individuals with PIN, an enriched population on which to base screening studies would emerge. In this regard the observation that PIN may be associated with elevation of the serum PSA is particularly intriguing. Considerable interest exists for early detection of prostate cancer. The high morbidity and mortality associated with this tumor coupled with the late stage at presentation by conventional means underscore the justification for such enthusiasm. However, the wisdom of screening for a cancer for which the mortality is far less than the histologic incidence remains to be proven. In the final analysis, the question is not whether we can detect more carcinoma, but rather whether we can significantly decrease patient morbidity and mortality. Until prospective randomized clinical trials demonstrate the effectiveness of early detection programs for carcinoma of the prostate, it is difficult to recommend such screening to the general public.
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PMID:Prostate-specific antigen and premalignant change: implications for early detection. 248 17

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

"Incidental" cancer refers to predominantly well differentiated cancer that arises in the transition zone and is found by chance in TURP chips. These tumours are frequently small and may be completely resected by TURP, although a significant number have an additional tumour that is unreachable with a resectoscope. These tumours often co-exist with benign prostatic hyperplasia. Putative precursors of incidental carcinoma include high grade PIN and AAH, and these lesions are frequently found in the transition zone in prostatectomies for cancer. The single most significant question in treating incidental adenocarcinoma is how to separate tumours that will progress from those that will not progress during the expected lifetime of the patient. The 1992 revision of the TNM staging system separated non-aggressive (T1a) and aggressive (T1b) incidental cancer according to the number of foci of cancer, using more than three foci as the cutpoint to identify more aggressive cancer. However, 8-37% of patients with T1 a cancer will develop cancer progression within 10 years if untreated, with the risk of progression increasing with additional years of follow-up. Important prognostic factors include the patient's age, tumour location (peripheral zone v. transition zone), tumour grade, tumour volume, serum PSA concentrations and morphometric factors such as nuclear roundness. Studies directed at early detection allow discovery of increasingly smaller cancers.
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PMID:The pathology of incidental carcinoma. 762 75

Prostatic intraepithelial neoplasia (PIN) fulfils the majority of requirements for a premalignant change in the human prostate. Forty-eight patients were diagnosed to have high grade PIN on prostatic needle biopsy. During a follow-up period, 23 (47.9%) were found to have adenocarcinoma on subsequent biopsies. We compared the patients age, the digital examination, the transrectal ultrasound appearance (TRUS) and the serum PSA level between those in whom cancer was detected subsequently and those with PIN alone. There was a statistically significant difference in the transrectal ultrasound appearance (TRUS) and the serum PSA level between the two groups (p < 0.001, p < 0.016 respectively). In conclusion, patients with high grade PIN, elevated serum PSA with hypoechoic zone on TRUS should be rebiopsied 3 months after the initial diagnosis. If the results are negative, close follow-up is mandatory.
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PMID:[High-grade intraepithelial prostatic neoplasms: diagnosis and association with prostate cancer]. 865 30

PSA-based screening substantially increases the prostate cancer detection rate and the percentage of organ-confined tumors. It appears that there is some benefit from screening for prostate cancer because of the increased amount of potentially curable disease discovered and the fact that 96% of the pathologically staged tumors detected have histologic features associated with aggressive cancer. Additional evidence that nearly all tumors detected on the basis of initial PSA screening are apt to be clinically significant may be derived from the information that PSA-based screening decreases the incidence of incidental A1 grade III and A2 tumors but does not increase the detection of clinically insignificant A1 grade I and II tumors. At this time, PSA represents the most effective and valuable tool to detect early prostate cancer; therefore, PSA should be used to improve early diagnosis of prostate cancer. Some advances have been made with the introduction of age-specific reference ranges and the ability to measure free to total PSA ratios. The data presented support the clinical usefulness of age-specific reference ranges for serum PSA. Calculation of the free to total PSA ratio is valuable in deciding which screening volunteers require further evaluation, increases the specificity of PSA screening, and as demonstrated may be useful in deciding which patients with isolated PIN should undergo repeat biopsies. Based on these facts, PSA truly can be described as the most important and useful marker for adenocarcinoma of the prostate. Based on these encouraging results and the obligingness of the social insurances, we will be able to continue PSA screening for early detection of prostate cancer for all concerned Tyrolean men in the future.
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PMID:Prostate-specific antigen as a screening test. The Austrian experience. 912 29

In a total of 59 prostate cancer (PCa) patients, 9 patients with PIN. 29 subjects with BPH and 26 healthy men serum TPS and PSA values were measured together with NK cell activity, number and proportion of CD16+ cells, and reactivity of lymphocytes to mitogens (Con A. PHA and PWM). NK activity data indicate highly significant differences between both of patients with local tumor and those with disseminated disease (P < 0.01) and b) responders and nonresponding patients to hormonal therapy (P < 0.01). The number and proportion of CD16+ cells is lowest in BPH patients in comparison with controls and PCa patients. Since benign enlargement is attributed mainly to stromal cell proliferation in the absence of cell death in this compartment, gene expressions which control these events may participate in the surprisingly low CD16+ cell proportion. The reactivity of lymphocytes to mitogens (PHA. Con A and PWM) showed lower numerical values in all categories of PCa and BPH patients when compared with healthy men. The reactivity of T and B lymphocytes reported herein as immunological responses to mitogens (PHA. Con A and PWM) was performed 4-6 months after the beginning of therapy. Our data fit in well with those previously reported. Numerically lowest respective reactivity parameters to all mitogens were assessed in PIN subjects. Reported results show the specific significance of the changes in NK cell activity in regard with both metastatic extention of PCa and tumor response to therapy. These alterations match in their reliability changes with tumor marker values related to prostate cancer activity (TPS) and tumor differentiation (PSA). Lymphocyte reactivity to mitogens (Con A. PHA. PWM) may help in a subclinical discrimination between BPH and PIN patients that is still an important goal of clinical urology.
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PMID:Analysis of NK cell activity, lymphocyte reactivity to mitogens and serotest PSA and TPS values in patients with primary and disseminated prostate cancer, PIN and BPH. 917 16

In many clinical situations a patient affected by pre-cancerous prostatic lesions, suspected cancer or true cancer (assessed through biopsies or incidentally) must undergo iterative bioptic examinations. Three groups can be sub-divided: A) Patients with no previous endoscopic resection. B) Patients with previous endoscopic resection for BPH. C) Patients with previous RP for cancer. A persistent clinical suspicion for high PSA, a bioptic assessment for Ca T1c or PIN belong to the first group. A suspected cancer in a patient who had already undergone TUR, or a T1a neoplasia assessed incidentally, or PIN found in the resected fragments constitute the second group. A suspected local relapse after a RP characterizes the third group. In 28 cases of these clinical diagnoses, we have applied a new method of bioptic trans-urethral sampling. We used an eco-reflectant, flexible needle and applied it under endoscopic vision to the transitional zone or to tissues of the already resected prostatic fossa. In the first case these biopsies were integrative of the usual randomized biopsies. If transrectal ultrasound had given evidence of altered structures, biopsy was carried out with selective ultrasound guided technique. This procedure has proved to be minimally invasive, easy to carry out and particularly adapted to bioptise zones that are easier to reach transurethrally or tissues with low thickness.
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PMID:[Proposal of a new transurethral method for repeated prostatic biopsy]. 918 30

From March 1994 to September 1996 485 patients of median age 67 years (range 49-82) underwent transrectal prostate needle biopsy at the Urological Clinic JLF UK in Martin. PIN was detected in 31 (6.4%) patients. Median age of patients with PIN was 67 years (range 58-75). There were 21 (68%) patients with low-grade PIN and 10 (32%) patients with high-grade PIN. In this group concomitant invasive cancer of the prostate was detected in 6 (19.4%) patients with PIN, of whom 5 (16.0%) had high-grade PIN and 1 (3.4%) nad low-grade PIN. Median concentration of PSA in patients with PIN was 9.1 ng/ml (range 1.3-85 ng/ml), significantly higher (p < 0.001) than PSA concentration in patients with BPH. We did not find significant differences between PSA concentrations in patients with PIN and in those with prostate cancer (p = 0.77). In conclusion we recommend clinical management of patients newly diagnosed with PIN.
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PMID:[Occurrence of prostatic intraepithelial neoplasia in needle biopsy of the prostate and its clinical significance]. 947 72

Prostatic intraepithelial neoplasia (PIN) is considered a premalignant lesion of the prostate. It is often encountered in prostate needle biopsy in cases where no cancer is identified. In order to evaluate its importance 25 patients with PIN in a former prostate needle biopsy underwent a second ultrasound guided needle biopsy. The first biopsy was performed in all patients as a result of positive DRE. In 13 patients (52%), prostate cancer was identified in the second specimen. All presented with high or intermediate grade PIN in the first biopsy. PSA values were compared with PIN grade and cancer presentation in the second biopsy, although no statistically significant difference was proven. In conclusion, when PIN is discovered in prostate needle biopsy in patients with positive DRE, a second biopsy has to be performed in order to exclude the possibility of a prostate carcinoma.
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PMID:Evaluation of needle biopsy in the diagnosis of prostatic carcinoma in men with prostatic intraepithelial neoplasia. 960 81


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