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PubMedDate not supplied

Bladder drainage and glandular epithelial morphometry of the prostate in benign prostatic hyperplasia with severe symptoms.

OBJECTIVE: Morphometrically analyze the cells nuclei of the basal layer of the prostatic glandular epithelium in 20 patients aged between 57 and 85 years presenting benign prostatic hyperplasia with severe symptoms, catheterized or not. MATERIALS AND METHODS: Patients with score of severe prostatic symptoms (with indication for transurethral resection of the prostate) were distributed according to the presence or absence of bladder drainage previous to the surgery, in the treated group (n = 10, catheter during 3 months) and in the control group (n = 10, without catheter). After obtaining prostate fragments through transurethral resection and the use of morphometric techniques, 100 nuclei of prostatic glands epithelium cells were studied (as to size and form), and compared to 500 nuclei from patients submitted to catheter drainage and 500 nuclei of non-catheterized patients. RESULTS: Significantly reduced values of the major, medium and minor nuclear diameters, volume, area and perimeter, contour index and nuclear volume-nuclear area ratio were observed in the treated group in relation to the control group. As to the form, eccentricity and coefficient of nuclear form, there were significant differences between treated and control groups. CONCLUSION: Long-term catheter bladder drainage in patients presenting benign prostatic hyperplasia with severe symptoms is associated to the reduction of morphometric parameters of the nuclei of prostatic glands' epithelial cells, suggesting a likely decompressive duct effect.

Aged↗
PubMed2005

Cell death mechanisms associated with G2 radiosensitivity in patients with prostate cancer and benign prostatic hyperplasia.

Cells respond to genotoxic insults such as ionizing radiation by halting in the G2 phase of the cell cycle. Delayed cell death (mitotic death) can occur when the cell is released from G2, and specific spindle defects form endopolyploid cells (endoreduplication/tetraploidy). Enhanced G2 chromosomal radiosensitivity has been observed in many cancers and genomic instability syndromes, and it is manifested by radiation-induced chromatid aberrations observed in lymphocytes of patients. Here we compare the G2 chromosomal radiosensitivity in prostate patients with benign prostatic hyperplasia (BPH) or prostate cancer with disease-free controls. We also investigated whether there is a correlation between G2 chromosomal radiosensitivity and aneuploidy (tetraploidy and endoreduplication), which are indicative of mitotic cell death. The G2 assay was carried out on all human blood samples. Metaphase analysis was conducted on the harvested chromosomes by counting the number of aberrations and the mitotic errors (endoreduplication/tetraploidy) separately per 100 metaphases. A total of 1/14 of the controls were radiosensitive in G2 compared to 6/15 of the BPH patients and 15/17 of the prostate cancer patients. Radiation-induced mitotic inhibition was assessed to determine the efficacy of G2 checkpoint control in the prostate patients. There was no significant correlation of G2 radiosensitivity scores and mitotic inhibition in BPH patients (P = 0.057), in contrast to prostate cancer patients, who showed a small but significant positive correlation (P = 0.029). Furthermore, there was no significant correlation between G2 radiosensitivity scores of BPH patients and endoreduplication/ tetraploidy (P = 0.136), which contrasted with an extremely significant correlation observed in prostate cancer patients (P < 0.0001). In conclusion, cells from prostate cancer patients show increased sensitivity to the induction of G2 aberrations from ionizing radiation exposure but paradoxically show reduced mitotic indices and aneuploidy as a function of aberration frequency.

Aged↗
PubMed2005

Zinc and zinc transporters in normal prostate and the pathogenesis of prostate cancer.

Zinc is an essential metal for all cells. It plays a role in a wide variety of physiological and biochemical processes. In the prostate epithelial cell the accumulation of high cellular zinc is a specialized function that is necessary for these cells to carry out the major physiological functions of production and secretion of citrate. The production of citrate and its secretion into prostatic fluid is a differentiated function of the prostate epithelial cells that is apparently important for reproduction. The loss of citrate and zinc accumulation is the most consistent and persistent characteristic of prostate malignancy. This characteristic of prostate cancer indicates that the lost ability of the malignant cells to accumulate zinc and citrate is an important factor in the development and progression of malignancy. The lost ability of the epithelial cells to accumulate zinc and thus to also accumulate citrate is the result of decreased expression of specific zinc uptake transporters. The purpose of this presentation is to review the current understanding of zinc and zinc homeostasis in the prostate and the role of zinc and zinc transporters in the normal function of the prostate and the pathogenesis of prostate cancer.

Biological Transport↗
PubMed2005

Prostate specific antigen as a clinical biomarker for prostate cancer: what's the take home message?

Prostate specific antigen (PSA) continues to be challenged as a legitimate clinical biomarker in early detection of prostate cancer due to lack of specificity for malignant transformation. Skepticism surrounding the utility of serum PSA as a clinical marker is not new and many questioned its initial use in widespread prostate cancer screening due to non-specific expression and low predictive value for cancer detection. Despite these initial concerns, serum PSA measurement along with digital rectal examination (DRE) is currently the accepted practice for prostate cancer screening in the United States with hundreds of thousands of men undergoing serum PSA measurement annually. In contrast to its role for early detection, serum PSA measurement as a surrogate for prostate cancer recurrence (biochemical failure) following curative intent therapy has consummate clinical utility in post-treatment surveillance. As thousands of men each year are aggressively treated for potentially curable prostate cancer, development of simple and effective diagnostic tools for detecting treatment failures should be an important area of biomedical and clinical investigation. We have constructed and tested a home-based prostate cancer surveillance device for use by patients to detect PSA from blood obtained by finger stick. Our initial results suggest that home based PSA testing is feasible and may have clinical utility in management of men treated for prostate cancer.

Feasibility Studies↗
PubMed1998

Prostate-specific antigen testing in Australia and association with prostate cancer incidence in New South Wales.

OBJECTIVE: To describe patterns and trends in prostate-specific antigen (PSA) testing in Australia and assess its role in the increasing incidence of prostate cancer. DESIGN: Descriptive analysis of (i) Medicare records of PSA testing in Australia, and (ii) prostate cancer recorded incidence in New South Wales. DATA: (i) Medicare data for all males who received a Medicare-reimbursed PSA test between August 1989 and December 1996. (ii) NSW Central Cancer Registry data for all males in NSW with prostate cancer diagnosed between 1988 and 1995. MAIN OUTCOME MEASURES: (i) Number of PSA tests, age-standardised rates of PSA tests by State and Territory, and proportions of males who had a PSA test. (ii) Recorded incidence of prostate cancer in NSW. RESULTS: (i) More than 2.2 million PSA tests were done on more than 1.1 million Australians between 1989 and 1996. The annual number of males tested increased fivefold in this period and peaked in 1995. Twenty-seven per cent of Australian men aged 50 years or over had at least one PSA test in 1995 or 1996; 33% of men aged 60-69 years had a test in this period. (ii) In NSW the number of PSA tests per quarter was highly correlated with the number of new cases of prostate cancer (R2 = 0.92). CONCLUSIONS: Although no organised program for prostate cancer screening exists, and despite repeated advice against it, opportunistic screening has been occurring at high rates. There was a high correlation between PSA testing and prostate cancer incidence between 1990 and 1995 in NSW.

Acid Phosphatase↗
PubMed2005

Urban-rural differences in prostate cancer mortality, radical prostatectomy and prostate-specific antigen testing in Australia.

OBJECTIVE: To assess differences in trends for prostate cancer mortality, radical prostatectomy and prostate-specific antigen (PSA) testing for Australian men aged 50-79 years living in capital cities compared with regional and rural areas. DESIGN: Descriptive, population-based study based on data from official sources from 1985 to the 2002/03 financial year (depending on data availability). MAIN OUTCOME MEASURES: Age-standardised rates per 100,000 men aged 50-79 years of mortality from prostate cancer, incidence of prostate cancer, PSA tests and radical prostatectomy. RESULTS: We found a statistically significant and increasing (age-standardised) mortality excess for prostate cancer in regional and rural areas. In 2000-2002 the excess (compared with capital cities) was 21% (95% CI, 14%-29%). Rates of radical prostatectomy in rural and regional Australia were 29% lower (95% CI, 23% lower to 35% lower) than in capital cities. Although PSA testing is common across the whole of Australia, age-standardised rates in 2002/03 were 16% lower (95% CI, 15% lower to 17% lower) in regional and rural areas than in capital cities. CONCLUSIONS: Our results show that the probability of a man having a PSA test and the management of his prostate cancer depend on where he lives. The cause or causes of the prostate cancer mortality excess in regional/rural areas cannot be established in a descriptive study, but fewer radical prostatectomies in regional and rural areas, perhaps associated with less PSA screening, remain among the several competing hypotheses. Other possibilities are related to other differences in management, perhaps associated with access to urologists. Governments and other budget holders need good evidence about the effectiveness of prostate cancer screening and early treatment, but also about the best strategies for providing equitable access to cancer services in both urban and rural areas.

Aged↗
PubMed1997

[The concentration of Tamsulosin hydrochloride in the blood and prostatic tissue of the patients in benign prostatic hyperplasia].

BACKGROUND: The penetration of Tamsulosin hydrochloride into the blood and the prostatic tissue was examined. METHODS: Fifty-two patients with benign prostatic hyperplasia treated with transurethral resection of the prostate were entered in this study. This drug was administered orally in a dose of 2.0 mg once a day for 7 to 179 days preoperatively. The blood samples were taken simultaneously at the time of the prostatic tissue sampling. RESULTS: 1. The correlation coefficient was hardly significant between aging and concentration of the drug in the blood or in the prostatic tissue. 2. The correlation coefficient was hardly significant between the duration of the drug administration and concentration of the drug in the blood or the prostatic tissue. 3. The correlation coefficient was significant between the concentration of the drug in the blood and the prostatic tissue. 4. The fifty-two patients showed no significant adverse reactions during administration of the drug. CONCLUSION: These results suggest that the drug can be administered safely to the aged even in a long-term and can be penetrated into the blood and the prostatic tissue with a positive correlation.

Adrenergic alpha-Antagonists↗
PubMed1999

[Detection of prostate-specific antigen mRNA in preoperative peripheral blood of patients with prostate cancer: relationship to pathological parameters of the surgical specimens].

PURPOSE: Up to 40% of surgically treated prostate cancers are bound to be understaged by using current diagnostic modalities. To improve on current staging methods for prostate cancer, we evaluated whether nested reverse transcriptase-polymerase chain reaction (RT-PCR) for prostate-specific antigen (PSA) mRNA can improve preoperative staging of prostate cancer. MATERIALS AND METHODS: From May 1996 through November 1997, 30 patients with prostate cancer (T1-T3) were evaluated for PSAmRNA in their peripheral blood by nested RT-PCR before radical retropubic prostatectomy. RESULTS: A highly sensitive RT-PCR assay employed detected one PSA-expressing cell (LNCaP) diluted into ten million mononuclear cells. All 15 controls, including 9 women, showed negative PSAmRNA in their peripheral blood, whereas 16 of 30 (53%) patients with prostate cancer showed positive PSAmRNA in their preoperative peripheral blood. Interestingly, 7 patients with positive PSAmRNA had pathologically organ-confined prostate cancer. No significant relationship was demonstrated between positive PSA-PCR results and clinico-pathological parameters such as clinical stage, pretherapeutic serum PSA, pathological stage, seminal vesicle invasion, lymph node metastasis, vascular invasion, or Gleason sum. CONCLUSION: Our present study showed that the results of PCR-based PSAmRNA assay had no significant association with clinico-pathological parameters. However, the prognostic significance of detecting the circulating prostate-specific signals requires a longer follow-up, which is currently under study.

Aged↗
PubMed2000

Trends in mortality rates in patients with prostate cancer during the era of prostate specific antigen screening.

PURPOSE: We assess the influence of prostate specific antigen screening on trends in mortality rates in patients with prostate cancer. MATERIALS AND METHODS: The incidence based mortality method was applied to prostate cancer data from the Surveillance, Epidemiology, and End Results Program. This method links data on patients diagnosed with cancer to vital status and cause of death, such that mortality can be evaluated by factors associated with disease at diagnosis. Prostate and nonprostate cancer mortality rates were evaluated according to patient age at death, disease stage and grade at diagnosis, race and whether additional cancers involving other sites were present. RESULTS: Mortality due to prostate cancer decreased from 37% in 1988 to 30% in 1995 largely as a result of a sharp increase in nonprostate cancer mortality rates. The overall trend in prostate cancer mortality rates increased from 1988 through 1992 and then decreased. The increase and decrease in rates occurred across categories of age, race, grade and number of cancer primaries. However, the increase in rates did not occur in distant staged cases, nor did the subsequent decrease in rates occur in nondistant staged cases. CONCLUSIONS: Prostate specific antigen screening influenced the increase and decrease in prostate cancer mortality rates.

Aged↗
PubMed1999

Outcomes of transrectal ultrasound scan of the prostate with sector biopsies for 323 New Zealand men with suspicion of prostate cancer.

AIMS: To assess the results and clinical outcomes of the first four years of transrectal ultrasound scanning (TRUS) with sector biopsies of the prostate, as the definitive second-line investigation for men with suspicion of prostate cancer, including comparability with subsequent information from histology of surgical specimens. METHODS: Information was collated from the author's ongoing surgical audit. TRUS and sector biopsies were carried out as a rooms procedure using a Toshiba Sono-Layer SSA-270A ultrasound machine with a PVL 725 RT transrectal probe and biopsy guide. Six or eight sector biopsies were taken with a Manan biopsy gun using 18 French gauge biopsy needles. Prophylactic ciprofloxacin and tinidazole were administered. Men with suspicion of prostate-specific antigen assay or digital rectal examination were considered for the investigation, especially if they were candidates for potentially curative treatments. RESULTS: Of 330 TRUS procedures performed on 323 men, 328 were done in rooms under local anaesthetic. The only significant complication was a transient bacteraemia in one patient not taking the antibiotics. Twenty men had prostate intraepithelial neoplasia or atypia, and 94 (29%) had cancer, of whom 24 (25%) had evidence of metastases. Curative treatment by radical prostatectomy or radiotherapy was attempted in 62 men (66%) and 28 are being managed by surveillance only. Comparisons with subsequent radical prostatectomy in 44 men showed that if only one TRUS biopsy core was involved with cancer (15 men), surgical margins were clear. For those with more cores involved (29 men), one-third (9 men) had positive margins or capsular perforation. The Gleason Score was different, more often higher, for 29 men by histology at radical prostatectomy compared to TRUS. Twenty-eight men had a subsequent transurethral resection of the prostate of which the histology resulted in management changes for ten of the 28, including three who were placed on surveillance and seven who underwent radical prostatectomy. CONCLUSIONS: TRUS and sector biopsy is a tolerable rooms procedure for men with suspician of prostate cancer. Complications are rare if prophylactic antibiotics are taken. The procedure provides information of sufficient quality to advise patients further. No defects in specificity were detected. Defects in sensitivity were demonstrated by comparison with later histology following transurethral resection. Therefore, men with benign results at TRUS need ongoing follow-up. TRUS histology tends to underestimate the extent of cancer present as determined by subsequent radical prostatectomy histology. When used with prostate-specific antigen and digital rectal examination, TRUS and sector biopsy is capable of detecting prostate cancer before it has metastasized, more reliably than if symptoms are awaited before diagnosis is attempted. It may also recognize forms of cancer of apparent low clinical significance which can be managed by surveillance.

Adenocarcinoma↗
PubMed2000

Prostate cancer detection at low prostate specific antigen.

PURPOSE: At low prostate specific antigen (PSA) the indication for prostate biopsy is usually an abnormal digital rectal examination. We evaluate the diagnostic value of PSA, digital rectal examination, transrectal ultrasonography and tumor characteristics at low PSA (0 to 4.0 ng./ml.). We confirm and add to recent evidence that digital rectal examination has a low predictive value and that many significant cancers at this PSA range may be missed. MATERIALS AND METHODS: From 1994 to 1997 a total of 10,523 participants 54 to 74 years old were randomized to screening in the Rotterdam section of the European Randomized Study of Screening for Prostate Cancer. Of the participants 9,211 (87.5%) had PSA less than 4.0 ng./ml., and underwent digital rectal examination and transrectal ultrasonography. Expected rates of prostate cancer detection were calculated using logistic regression analysis. Radical prostatectomy was performed in about half of the 478 men diagnosed with prostate cancer. Tumors were characterized by pT category, Gleason score and cancer volume in 166 processed radical prostatectomy specimens. In 50 of these cases PSA was 0 to 4.0 ng./ml. RESULTS: The positive predictive value of digital rectal examination and transrectal ultrasonography at PSA 0 to 4.0 ng./ml. was only 9.7%. Positive predictive value strongly depended on PSA. Sensitivity was calculated by using estimates of the prevalence of sextant biopsy detectable prostate cancers. Of 760 detectable cancers 478 (67%) were diagnosed irrespective of PSA in men screened with digital rectal examination, transrectal ultrasonography and PSA. Only 127 of 348 detectable prostate cancers (36.5%) were actually diagnosed in men with PSA 2 to 4 mg./ml. The importance of these missed cancers was evaluated with parameters of tumor aggressiveness within PSA ranges. CONCLUSIONS: Approximately half of the tumors missed with PSA 0 to 4 ng./ml. had aggressive characteristics (Gleason score 7 or greater, Gleason 4-5 components) and were organ confined. These tumors should be diagnosed and treated according to the present understanding of their natural history. More sensitive and selective screening strategies are needed. Presently a wrong "window of opportunity" is used for early detection of prostate cancer.

Aged↗
PubMed2000

Percent free prostate specific antigen and cancer detection in black and white men with total prostate specific antigen 2.5 to 9.9 ng./ml.

PURPOSE: The ratio of free-to-total prostate specific antigen (PSA), or percent free PSA, is a useful adjunct to total PSA for estimating the risk of prostate cancer when total PSA is 2.5 to 9.9 ng./ml. Relationships between cancer detection and total PSA are influenced by race but to our knowledge relationships between cancer detection and percent free PSA have not been studied. MATERIALS AND METHODS: A total of 222 black and 298 white consecutive and evaluable men with total PSA 2.5 to 9.9 ng./ml. underwent prostate biopsy for suspected cancer at a Veterans Affairs Medical Center. Clinical measurements included digital rectal examination, total and free serum PSA, prostate volume, PSA density and Gleason score of malignant biopsy specimens. RESULTS: Median percent free PSA was 14.1 (range 3.6 to 49.2) in 201 men with prostate cancer and 21.9 (range 5.7 to 83.3) in 319 without detectable cancer (p <0.0001). Significant racial differences in demographic characteristics and clinical measurements were limited to total PSA, which was higher in black men (p = 0.03). Cancer was detected in 156 black (47%) and 206 white (33%) men (p = 0.001). Areas under receiver operating characteristics curves for percent free PSA and total PSA were 0.66 and 0.58, respectively, for black men (p = 0.15), and 0.76 and 0.58, respectively, for white men (p <0.00001). Percent free PSA was 35.2 in black men and 29.2 in white men, and specificity was 9.1% and 28.7%, respectively, when sensitivity for percent free PSA was set at 95%. Of 156 black and 206 white men with percent free PSA less than 25, 83 (53%) and 85 (41%), respectively, had detectable cancer (p = 0.03). Of 66 black and 92 white men with percent free PSA 25 or greater 21 (32%) and 12 (13%), respectively, had detectable cancer (p = 0.005). CONCLUSIONS: Our study demonstrates racial differences in relationships between percent free PSA and cancer detection in men with suspected prostatic carcinoma and total PSA 2.5 to 9.9 ng./ml. Clinical application of the commonly used percent free PSA cutoff of less than 25 to determine the advisability of prostate biopsy may lead to under diagnosis of early stage prostate cancer in black men, who are at greater risk of morbidity and mortality from disease than white men.

Aged↗
PubMed2001

Molecular genetic profiling of Gleason grade 4/5 prostate cancers compared to benign prostatic hyperplasia.

PURPOSE: Because Gleason grade 4/5 cancer is the primary cause of failure to cure prostate cancer, we examined the molecular profiles of this high grade cancer in search of potentially new therapeutic interventions as well as better serum markers than prostate specific antigen. MATERIALS AND METHODS: We compared the gene expressions in fresh frozen tissues from 9 men with Gleason grade 4/5 cancer to 8 men with benign prostatic hyperplasia (BPH) treated with radical retropubic prostatectomy. Labeled complementary RNA from each of the 17 tissues was applied to HuGeneFL probe arrays representing approximately 6,800 genes (Affymetrix, Inc., Santa Clara, California). After removing all genes undetectable in BPH and grade 4/5 cancers, and transforming the data into a parametric distribution, we chose only those up and down-regulated genes with a p difference in fluorescence between grade 4/5 cancer and BPH of p <0.0005. This value reduced the data set to 40 up-regulated and 111 down-regulated genes. We then eliminated all genes that were not expressed in all 8 BPH and 9 grade 4/5 tissues, which produced a final set of 86 genes, of which 22 were up-regulated and 64 were down-regulated. RESULTS: Cluster analysis cleanly separated men with grade 4/5 cancers from those with BPH. Only 17 of the 86 candidate genes (20%) were known to be prostate cancer related and 42 (49%) were related to other cancers. The most up-regulated gene is Hepsin, a trypsin-like serine protease with its enzyme catalytic domain oriented extracellularly. Prostate specific membrane antigen is the second most up-regulated gene (all other reports on prostate specific membrane antigen have been at the protein level). The genes for prostate specific antigen (hK3) and human glandular kallikrein2 (hK2) showed equivalent expression levels 10 times the average of other genes. Complete lists of all 22 up-regulated genes and 64 down-regulated genes, together with their locus on the chromosome, are presented in rank order. CONCLUSIONS: We characterize for the first time 64 down-regulated and 22 up-regulated genes in Gleason grade 4/5 cancer, using the gene profile from BPH as control tissue. A number of interesting new genes, previously undescribed in prostate cancer, are presented as possibilities for further study.

Aged↗
PubMed2001

Lack of association of prostate carcinoma nuclear grading with prostate specific antigen recurrence after radical prostatectomy.

PURPOSE: Grading prostate cancer using the Gleason system relies only on architectural tumor growth, in contrast to other systems, such as the WHO system, which grade prostate carcinoma based on nuclear features as well as architectural patterns. The prognostic significance of nuclear grading remains controversial since most studies were performed before prostate specific antigen (PSA) screening became widely available. We evaluated the significance of nuclear grade for predicting PSA recurrence in a contemporary cohort of patients treated with radical prostatectomy for clinically localized prostate carcinoma. MATERIALS AND METHODS: Nuclear grades 1 to 3 were determined in 141 consecutive radical prostatectomies in 1995. Predominant and worst nuclear grade was determined by a consensus of 3 pathologists. Statistical analysis compared nuclear grade with Gleason score using the chi-square test. The Cox proportional hazards analysis was performed to calculate the ability of nuclear grade, Gleason score and other variables to predict PSA recurrence. RESULTS: We identified a significant association of Gleason score with worst nuclear grade (p = 0.007). All 6 cases with a Gleason score of 8 or greater had a worst nuclear grade of 3, in contrast to 36 of 60 (60%) with a score 6 or less, in which the worst nuclear grade was 3. Of the 141 patients 31 (21.9%) had PSA recurrence at a median followup of 3.7 years. The univariate Cox model revealed significant associations of PSA recurrence with Gleason score 8 or greater (hazards ratio 5.5, p = 0.005), extraprostatic extension (hazards ratio 3.4, p = 0.001), positive surgical margin (hazards ratio 2.6, p = 0.009), seminal vesicle involvement (hazards ratio 7.3, p <0.001), preoperative serum PSA (hazards ratio 1.03, p = 0.007), tumor stage (hazards ratio 3.6, p = 0.001) and maximal tumor dimension (hazards ratio 2.4, p <0.001). However, overall and worst nuclear grade did not predict PSA recurrence (p = 0.89 and 0.13, respectively). Nuclear grade did not fit any multivariate model tested, which otherwise included Gleason score, log(PSA), surgical margin status, extraprostatic extension, seminal vesicle status, tumor size and pathological stage. By varying sample fixation time we also showed that benign prostate tissue in the same section as prostate carcinoma had grade 2 or 3 nuclear changes, that is moderate to marked anaplasia. CONCLUSIONS: High nuclear grade is associated with high Gleason score. However, prostate carcinoma with a Gleason score of 6 or less shows extreme variability. Nuclear grade determined by light microscopy failed to predict PSA recurrence in a contemporary series of men with clinically localized prostate cancer treated with radical prostatectomy. Nuclear morphology is subject to tissue fixation and processing artifact. Any nuclear morphometric study must consider this artifact.

Adult↗
PubMed2001

[Expression of COX-2 in prostatic cancer and benign prostatic hyperplasia].

OBJECTIVE: To investigate the expression of COX-2 in and benign prostatic hyperplasia and prostate cancer and its clinical implications. METHODS: Forty-two patients with and benign prostatic hyperplasia and 16 with prostate cancer were studied by immunohischemistry and western blot. RESULTS: Immunohischemiscal study showed positive results in 15 of the 16 patients and 11 of the 42 patients. Western blot showed that the expression of COX-2 was higher in prostate cancer than in and benign prostatic hyperplasia tissues(P < 0.01). CONCLUSION: Overexpression of COX-2 in prostate cancer may be related to the staging of prostate cancer.

Blotting, Western↗
PubMed1992

[Prostatic specific antigen (PA) in mass screening for prostate cancer].

The usefulness of prostatic specific antigen (PA) was compared with that of prostatic acid phosphatase (PAP). PA was determined in the serum of 2,183 patient examined by the mass screening for prostate cancer from 1987 to 1990. The serum samples of these patients were obtained from our serum bank. PA was measured by the E test "TOSOH" II (PA). The relationship of PA and PAP to prostate size estimated by digital rectal examination (DRE) and ultrasound tomography (US), and age was investigated. PA and PAP correlated with aging and prostate size estimated by DRE. However PA was more apparently related with these things. The correlation between PA and prostatic size estimated by US was relatively high (r = 0.53), but the correlation between PAP and prostate size estimated by US was low (r = 0.20). When the upper limit of normal range was set at 6.0 ng/ml, the sensitivity, specificity and efficiency was 64%, 97% and 62%, respectively. PA was more sensitive than PAP and could be more useful since none of the patients with prostate cancer was PAP positive and PA negative. We conclude that PA should be a reliable tumor marker in our mass screening system.

Acid Phosphatase↗
PubMed1992

Nephrogenic adenomas of the urethra involving the prostate gland: a report of two cases of a lesion that may be confused with prostatic adenocarcinoma.

Two cases of urethral nephrogenic adenoma involving the prostate are described. A diagnosis of prostatic carcinoma was raised in both cases and was seriously entertained in one of them. The patients, who were 65 and 68 yr old, underwent transurethral resection because of difficulty voiding; both had had a prior similar procedure. Microscopic examination in each case showed small tubules and clusters of cells in the fibromuscular stroma of the prostate. In one case the lesional cells had abundant clear cytoplasm, and in both cases some of the nuclei had prominent nucleoli. In each case a minor component of the cystic pattern of nephrogenic adenoma was also present. Features pointing to a diagnosis of nephrogenic adenoma were a morphology that was diagnosis of nephrogenic adenoma were a morphology that was focally characteristic of that lesion, an origin from overlying prostatic urethra in both cases, and negative immunohistochemical staining of the lesional cells for prostate-specific antigen and prostate-specific acid phosphatase. These cases illustrate that nephrogenic adenoma occasionally involves the prostate and in these cases can potentially be confused with prostatic adenocarcinoma.

Adenocarcinoma↗
PubMed1992

Prostate specific antigen: clinical use in the diagnosis and management of prostate cancer.

Prostate specific antigen (PSA) has replaced prostatic acid phosphatase as the preeminent clinical tumor marker in the management of patients with prostate cancer. Serum PSA levels have been shown to be proportional to clinical and pathologic stage of prostate cancer and in particular to correlate closely with prostate cancer volume. Serum levels of PSA thus serve as a useful adjunct in the initial clinical staging of men with prostate cancer. Serum PSA values provide a unique and valuable tool in monitoring prostate cancer progression over time and its response to surgical, radiation, and/or hormonal therapies. Unfortunately, its lack of specificity for prostate cancer leaves many questions unanswered as to the efficacy and advisability of using PSA as a screening test for this cancer.

Aged↗