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)

We retrospectively evaluated 51 prostate cancer patients found to have pelvic lymph node metastases at the time of pelvic lymphadenectomy and 125I implantation. All of them were followed until death or for a minimum of 70 months. Rabbit polyclonal anti-PSA, anti-PAP, anti-PSP-94, and mouse TURP-27 monoclonal antibodies were used in immunohistochemical evaluation of the metastatic lesions. In addition, Gleason grade and ploidy were assessed and correlated. No tumor with a Gleason grade of less than 7 could be found in the metastatic lymph nodes. Time to progression (P = .003), disease-specific survival (P = .009), and overall survival (P = .003) were significantly shorter in patients whose tumors had a primary Gleason pattern of 5 (grade 9 or 10). In the PSA study, patients whose tumors were reactive in more than 75% of cancer cells experienced significantly longer survival than those with less than 75% of cancer cells expressing PSA (P = .0006 log rank test). The means of overall survival +/- SEM were 71.5 +/- 5.0 and 34.9 +/- 5.4 months, respectively. Similar correlations were found with disease-specific survival and time to progression. Patterns of PAP expression and TURP-27 reactivity were not prognostically useful, whereas PSP-94 expression may add some additional information. These data suggest that evaluation of tissue PSA heterogeneity in lymph node metastases may offer additional prognostic information on prostate cancer patients. Better prediction of individual prognosis may be possible with the combined use of Gleason grade, flow cytometry, and PSA expression.
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PMID:Prognostic significance of antigenic heterogeneity, Gleason grade, and ploidy of lymph node metastases in patients with prostate cancer. 137 12

A total of 133 patients underwent transperineal ultrasound-guided iodine 125 seed implantation for Stages A and B prostate cancer with a twenty-seven-month follow-up. There has been no mortality and our morbidity is no more than experienced after transurethral resection of the prostate. By using a Mick applicator our operating time is well under one hour, and our patients go home the same day without a Foley catheter. Our results indicate that patients with PSA values of less than 20 ng/mL (Yang method) and/or Gleason scores of 6 or less are excellent candidates for brachytherapy. By subdividing the percentage of normal PSA values in the follow-up periods according to the patient's original PSA value, further credence is given to the PSA value as a strong aid in staging when the Gleason score is 6 or less. Although the follow-up at twenty-seven months is small, our preliminary results indicate that brachytherapy is a viable option to radical surgery in those patients who are not good candidates for surgery or who prefer nonsurgical treatment.
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PMID:Guided brachytherapy for treatment of confined prostate cancer. 137 45

Screening for prostate cancer represents a clinical dilemma with no clear evidence to suggest decreased mortality from any diagnostic test. We now possess new knowledge regarding optimal combinations of DRE, TRUS, and PSA. While DRE and TRUS may be too subjective and PSA too nonspecific, their combined predictive values identify not only men at high risk but also those for whom continued frequent screening may not be cost effective. A monoclonal PSA decision level of no more than 4.0 ng/ml should be used, since 40 percent of cancers detected from 4.0 to 10.0 ng/ml already have extracapsular extension. Assuming that DRE is performed by experienced examiners, the combination of PSA and DRE should produce cost-effective early detection and minimize missed cancers below 4.0 ng/ml. TRUS should be reserved for those patients with either PSA elevations and/or DRE abnormalities. The use of TRUS gland volume data to further modify PSA decision levels, such as the "predicted" PSA concept, may also improve TRUS biopsy criteria and predictive values. Prostate cancer detection can then be objectively limited to a small percentage of the population and better selected for earlier, more localized disease. The ultimate decrease in mortality from screening remains to be demonstrated in randomized trials or observed only after decades of increased public awareness about prompt early detection combined with effective, definitive therapy.
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PMID:Prostate cancer screening: current trends and future implications. 137 79

Twenty-seven of 152 patients (18%) with progressing hormone resistant prostate cancer had normal serum levels of prostate specific antigen (PSA less than or equal to 10 micrograms l-1), when referred for secondary treatment. PSA was significantly correlated with the extent of skeletal metastases (R: 0.35) and the levels of hemoglobin (R: -0.19) and serum alkaline phosphatase (R: 0.30). In a multivariate Cox regression analysis the survival of the 152 patients was not correlated with the PSA level but with the patients performance status, the level of hemoglobin, and the time between primary hormone treatment and relapse. The lack of serum PSA to predict survival may be explained by a heterogenous composition of hormone resistant prostate cancer as regards differentiated and/or PSA producing vs undifferentiated and/or PSA non-producing cells.
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PMID:The prognostic significance of prostate specific antigen in metastatic hormone-resistant prostate cancer. 137 59

This paper examines the behaviour of PSA in 70 patients with metastatic prostate cancer. PSA serum concentration, prior to therapy, was directly related to the tumoral mass and inversely related to the histological degree, which does not constitute a prognostic factor with regard to the disease evolution. Within 3 months of therapy, PSA concentration decreased more noticeably in clinically responding patients, down to less than 10 ng/ml in 93% of them. Also, this level represented a prognostic factor with regard to the free-of-progression interval of the disease.
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PMID:[Value of prostate-specific antigen as prognostic factor of metastatic cancer of the prostate]. 138 Jul 54

During the last four years approximately 400 men were evaluated in the early detection program for prostate cancer at The Ohio State University. Of these 400 men, 25 were found to have cancer. Eleven of the 25 had normal PSAs at the time cancer was diagnosed. The rise with a Hybritech assay, PSA of 1.2 ng/ml per year, one to two and subsequent years of greater than 1.2 ng/ml in this study indicates a higher likelihood of having a diagnosis of prostate cancer. Of the 25 patients who have been evaluated, only 4 patients had a subsequent drop of PSA from year one to two when the value dropped less than 0.6 ng/ml. Prostate intraepithelial neoplasia grade III has also been associated in these patients.
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PMID:Changes in PSA and early diagnosis of cancer of the prostate. 138 69

We detail the performance characteristics of the new IMx PSA immunoassay developed by Abbott Laboratories, addressing PSA recovery, assay reproducibility, standard curve storage, lower limit of detection, dilution linearity, and correlation with the Hybritech Tandem-R PSA immunoassay. We analyzed 686 sera for PSA retrospectively, testing 555 of these concurrently with the IMx and the Tandem-R immunoassays. The IMx PSA standard curve was linear from 0 to 100 micrograms/L, and curve storage was maintained for 4 weeks. The lower limit of detection of the IMx PSA assay was < or = 0.03 microgram/L; allowing for the assay precision yielded a biological detection limit of 0.06 microgram/L. We conservatively set the clinical threshold at 0.1 microgram/L. Regression analysis of dilution linearity involving 10 samples (0.44-200 micrograms/L) resulted in coefficients of correlation ranging from 0.9972 to 1.000. Reproducibility studies with 18 specimens within the range of 0.39-413.67 micrograms/L gave intra- and interassay CVs < 6.5%. The interassay 95% confidence interval for a specimen containing 0.06 microgram of PSA per liter was 0.03-0.09 microgram/L. Correlation between IMx and Tandem-R PSA assay results was excellent: r = 0.9909 and slope = 0.95. Overall, the IMx PSA immunoassay, with the conveniencies of automation, curve storage, and nonisotopic handling, provided an improved lower limit of PSA detection, which allows for earlier indication of residual or recurrent disease after radical prostatectomy.
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PMID:Evaluation of the Abbott IMx automated immunoassay of prostate-specific antigen. 138 93

Natural killer (NK) cell activity was studied together with tumor marker serotests (PSA, PAP) and blood testosterone, estradiol, cortisol, and prolactin concentrations in treated prostate cancer patients. NK cell activity data were correlated with tumor stage (stage D0 + D1 versus stage D2) and showed statistically insignificant differences. Both tumor progression and stabilization of metastatic disease, triggered by the application of more appropriate therapy in progressive subjects, yielded low NK activity data. By contrast, normal NK activity was found during both partial remission of stage D2 tumor and stabilization of the same disease, after an initial period of tumor remission. Differences between NK activity data from the aforementioned two groups are statistically significant (P less than 0.01). In subjects examined, the application of NK activity assay to those with advanced disease reflected changes in the outcome of the treatment more closely than it did routine tumor marker assessment. The activity of NK cells seems unaffected by changes in basal blood estradiol, cortisol, testosterone, and prolactin concentrations that occur during therapy with pharmacological agents (estradiol, cyproterone acetate, diethylstilbestrol, and flutamide) and during surgical castration. The reported NK activity recordings in treated prostate cancer patients might be indicative of the presence of tumor cells in the circulation. If this holds true, the measurement of NK activity would appear to furnish urological oncology with a new tool for early, rapid recognition of progressive metastatic tumors.
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PMID:NK cell activity in treated prostate cancer patients as a probe for circulating tumor cells: hormone regulatory effects in vivo. 138 13

This study investigated the serum prostate-specific antigen concentration in 100 healthy men (mean age, 26.3 years; range, 20-29 years) with a clinically normal prostate gland. The effect of digital rectal examination and ejaculation on the serum concentration, and the variability of the serum concentration over 1-week and 1-month periods were examined. In the 100 subjects, the serum prostate-specific antigen concentration ranged from less than 0.1-2.6 ng/ml. The mean, median, and mode were 0.68 ng/ml, 0.6 ng/ml, and 0.4 ng/ml, respectively. The 97.5th percentile value was 2.1 ng/ml. The mean and median changes in the serum concentration after digital rectal examination were -0.013 +/- 0.11 ng/ml and 0.0 ng/ml, respectively (P = 0.59 compared with control group). The mean change after ejaculation was 0.05 +/- 0.12 ng/ml, and the median change was 0.0 ng/ml (P = 0.14 compared with control group). Diurnal variation showed minimal change in 16 patients over a 1-week period. The mean change (p.m. value-a.m. value) was 0.003 ng/ml (range, -0.2-0.06 ng/ml). In addition, the serum concentration showed minimal intrapatient variability in 20 patients throughout a 1-month period; the average coefficient of variation (standard deviation/mean) in these subjects was 16.5% (range, 6.4-45.2%). These results indicate that the range in the serum concentration of prostate-specific antigen for healthy men with a clinically normal prostate gland is significantly lower (0.0-2.6 ng/ml) than the currently employed range (0.0-4.0 ng/ml; Tandem-R PSA assay); in addition, digital rectal examination and ejaculation have no significant effect on the serum concentration. Finally, the time of day has little effect, and the variability in the serum concentration of prostate-specific antigen over a 1-week and 1-month interval is minimal.
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PMID:Prostate-specific antigen: establishment of the reference range for the clinically normal prostate gland and the effect of digital rectal examination, ejaculation, and time on serum concentrations. 138 15

No screening test has been proven to reduce prostate cancer mortality. DRE has been the traditional method of screening, and it is often used to detect other diseases in addition to prostate cancer. Newer modalities, such as TRUS and PSA, can identify patients with nonpalpable prostate cancer, but the use of these tests will also result in many false-positives. In addition, it is not known whether the use of these tests will reduce prostate cancer mortality, or instead cause harm to those patients screened. Given the potential for harm, and the extraordinary expense, routine screening of asymptomatic men with newer modalities should be considered experimental.
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PMID:Prostate cancer screening. 138 77


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