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PSA Concentration (psa + concentration)
Selected AbstractsPredictors of prostate cancer on repeat transrectal ultrasound-guided systematic prostate biopsyINTERNATIONAL JOURNAL OF UROLOGY, Issue 2 2003SOO-JEON PARK AbstractBackground: We analyzed the outcome of repeated transrectal ultrasound (TRUS)-guided systematic prostate biopsy in Japanese men whose clinical findings were suspected of prostate cancer after previous negative biopsies. Methods: Between January 1993 and March 2002, 1045 patients underwent TRUS-guided prostate biopsy. Among them, 104 patients underwent repeat biopsy due to indications of persistent elevated serum prostate-specific antigen (PSA), abnormal digital rectal examination (DRE) or TRUS, increased PSA velocity, and/or previous suspicious biopsy findings. Several clinicopathological factors were evaluated for their ability to predict the detection of prostate cancer on repeat biopsy. Results: Prostate cancer was detected in 22 of 104 patients (21.2%) who underwent repeat biopsies. PSA concentration and PSA density at both the initial and repeat biopsies, and PSA velocity in men with positive repeat biopsy were significantly greater than those in men with negative repeat biopsy. The incidence of abnormal findings in DRE and TRUS at initial biopsy in men with positive repeat biopsy was also significantly higher than that in men with negative repeat biopsy. However, neither the presence of prostatic intraepithelial neoplasia nor number of biopsy cores at initial biopsy had a significant association with the results of the repeat biopsy. Furthermore, multivariate analysis revealed that PSA and PSA density at both the initial and repeat biopsies, PSA velocity, and DRE and TRUS findings at initial biopsy were independent predictors of malignant disease on repeat biopsy. Conclusion: Despite an initial negative biopsy, repeat TRUS-guided biopsy should be carried out to exclude prostate cancer in cases of suspicious clinical findings, such as elevated PSA or PSA-related parameters, or abnormal findings of DRE or TRUS. [source] The impact of HMG-CoA reductase therapy on serum PSA,THE PROSTATE, Issue 6 2010David J. Mener Abstract BACKGROUND 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase inhibitors, otherwise known as statins, inhibit the enzyme that controls the conversion of HMG-CoA to mevalonate, a precursor for cholesterol. Statins may be important to prostate cancer biology by inhibiting cell growth, inflammation, and oxidative stress. The purpose of this study was to assess the influence of statin therapy on serum prostate-specific antigen (PSA) levels. METHODS The computerized medical records at the University of Rochester Medical Center were used to identify men who filled statin prescriptions between May 31st, 2008 and September 30th, 2008. Men with at least one PSA assay performed within 2 years before and at least one PSA assay performed within 1 year after starting a statin medication were included. The primary endpoint was the change in PSA concentration computed as the difference between PSA levels before and after starting a statin medication. Paired t -tests were used to analyze the mean differences in PSA values. RESULTS A total of 962 patients were identified. The mean difference in serum PSA level after statin administration was ,0.29,ng/ml (,8.04%). Subgroup analyses for mean PSA concentration change before and after statin administration by age group revealed: 50,59 years old (,0.1609, 95% CI: ,0.2444, ,0.0775, P,<,0.0002), 60,69 years old (,0.3393, 95% CI: ,0.4641, ,0.2145, P,<,0.0001), and >70 years old (,0.351, 95% CI: ,0.490, ,0.212, P,<,0.0001). CONCLUSIONS These observations suggest a statistically significant reduction in serum PSA level that is associated with the onset of statin therapy. Prostate 70: 608,615, 2010. © 2009 Wiley-Liss, Inc. [source] PSA and body composition by dual X-Ray absorptiometry (DXA) in NHANESTHE PROSTATE, Issue 2 2010Jay H. Fowke Abstract BACKGROUND Obese men are at higher risk for advanced prostate cancer and have a poorer prognosis following treatment. Several studies also report that obese men have lower blood PSA levels, suggesting that obesity may be interfering with the ability to detect early-stage prostate cancer. METHODS Dual X-ray absorptiometry (DXA) is considered a gold-standard measurement of body composition. We investigated the association between PSA levels and body composition measured by DXA among 1,360 men participating in NHANES (2001,2004), a representative sample of the U.S. male population. RESULTS After controlling for age, race, and other factors, PSA concentration was ,15% lower for men with the highest level of total mass, lean mass, fat mass, trunk lean mass, and trunk fat mass (all P for trend <0.05). We then multiplied PSA concentration by estimated plasma volume to calculate the amount of PSA in circulation (i.e., PSA mass). Total body fat mass and fat mass located in the body trunk were not significantly associated with PSA mass, however, PSA mass was ,10,15% higher across low versus high categories of total body lean mass and bone mineral content (all P -trend <0.05). CONCLUSION Our results using DXA to measure body composition confirm that a greater body mass, not just fat mass, is associated with a lower PSA concentration. This is consistent with PSA hemodilution within men with a higher body mass index. The separate associations between measured lean and fat mass on calculated PSA mass require further investigation. Prostate 70: 120,125, 2010. ©2009 Wiley-Liss, Inc. [source] Reg IV is an independent prognostic factor for relapse in patients with clinically localized prostate cancerCANCER SCIENCE, Issue 8 2008Shinya Ohara Regenerating islet-derived family, member 4 (REG4, which encodes Reg IV) is a candidate marker for cancer and inflammatory bowel disease. We investigated the potential prognostic role of Reg IV immunostaining in clinically localized prostate cancer (PCa) after radical prostatectomy. Immunohistochemical staining of Reg IV was performed in 98 clinically localized PCa tumors obtained during curative radical prostatectomy. Intestinal and neuroendocrine differentiation was investigated by MUC2 and chromogranin A immunostaining, respectively. The prognostic significance of immunohistochemical staining for these factors on prostate-specific antigen (PSA)-associated recurrence was assessed by Kaplan,Meier analysis and a Cox regression model. Phosphorylation of the epidermal growth factor receptor (EGFR) by Reg IV was analyzed by Western blot. In total, 14 (14%) of the 98 PCa cases were positive for Reg IV staining. Reg IV positivity was observed frequently in association with MUC2 (P = 0.0182) and chromogranin A positivity (P = 0.0012). Univariate analysis revealed that Reg IV staining (P = 0.0004), chromogranin A staining (P = 0.0494), Gleason score (P < 0.0001) and preoperative PSA concentration (P = 0.0167) were significant prognostic factors for relapse-free survival. Multivariate analysis indicated that Reg IV staining (P = 0.0312), Gleason score (P = 0.0014) and preoperative PSA concentration (P = 0.0357) were independent predictors of relapse-free survival. In the LNCaP cell line, EGFR phosphorylation was induced by the addition of Reg IV-conditioned medium. These results suggest that Reg IV expression is an independent prognostic indicator of relapse after radical prostatectomy. (Cancer Sci 2008; 99: 1570,1577) [source] Clinical efficacy of prostate cancer detection using power doppler imaging in American and Japanese menJOURNAL OF CLINICAL ULTRASOUND, Issue 4 2002Koji Okihara MD Abstract Purpose The aim of this study was to compare the detection rates of tumor vascular flow as measured by power Doppler imaging (PDI) in 2 populations and to determine whether PDI can reduce the number of unnecessary prostate biopsies in men with serum prostate-specific antigen (PSA) concentrations less than 10.1 ng/ml. Methods The patient populations were Japanese (group 1) and American (group 2) men with either serum PSA concentrations of 4.1,10.0 ng/ml or abnormal findings on digital rectal examination (DRE) plus PSA concentrations less than 4.1 ng/ml. We compared the overall diagnostic accuracy of DRE, gray-scale transrectal sonography (TRUS), and PDI between the 2 groups. Results In total, 275 men were studied, 154 in group 1 and 121 in group 2. Cancer was identified in 27% of men in group 1 and in 60% of group 2. Men with cancer in both groups differed significantly in age, peripheral zone volume, and mean number of positive biopsy cores. The sensitivity and specificity of PDI in group 2 were significantly inferior to those in group 1. The negative predictive value (NPV) of PDI was significantly higher for group 1 than for group 2. The NPV of PDI in group 1 was equivalent to that for the combination of DRE and TRUS, whereas the NPV for PDI in group 2 was significantly inferior to that of DRE and TRUS. Conclusions Tumor vascularity could be detected by PDI more effectively in Japanese men with cancer than in American men with cancer. We hypothesize that this difference was a result of larger cancer volumes and smaller prostates in the Japanese men. PDI did not provide any performance advantage over DRE and TRUS in avoiding unnecessary biopsies. © 2002 Wiley Periodicals, Inc. J Clin Ultrasound 30:213,221, 2002; Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/jcu.10054 [source] Expression of toll-like receptor-9 is increased in poorly differentiated prostate tumors,THE PROSTATE, Issue 8 2010Marja-Riitta Väisänen Abstract BACKGROUND Toll-like receptor-9 (TLR9) is a cellular receptor for bacterial and vertebrate DNA. In addition to cells of the immune system, it is also expressed in various human cancer cell lines, including prostate cancer. We demonstrated previously that synthetic TLR9 ligands induce matrix metalloproteinase-13-mediated invasion in TLR9-expressing prostate cancer cells in vitro. Other studies have suggested possible sex steroid regulation of the function of the various TLRs. The role of TLR9 in the pathophysiology of prostate or any cancer is, however, unknown. METHODS Expression of TLR9, androgen receptor (AR), or the estrogen receptors , (ER,) and , (ER,) were studied with immunohistochemistry in prostate cancer (n,=,62) and benign prostatic hyperplasia (n,=,45) specimens. TLR9 staining scores were compared with tumor stage, Gleason score, prostate-specific antigen (PSA) concentrations before tissue sampling and with the staining scores of AR, ER,, and ER,. RESULTS TLR9 expression was statistically significantly increased in prostate cancer epithelium and stroma, as compared with the same cellular compartments in benign hyperplasia. Significantly increased (P,=,0.04) TLR9 expression was detected in cancers with high Gleason score (>7, n,=,23), as compared with lower Gleason scores (,7, n,=,39). No statistically significant associations were detected between TLR9 expression scores and PSA concentrations or tumor staging. Prostate adenocarcinoma cells were all positive for TLR9, AR, and ER, but negative for ER, expression. In cancer stroma cells, increased TLR9 expression was associated with increased ER, expression. CONCLUSIONS Expression of TLR9 is increased in prostate cancer specimens, especially in the most poorly differentiated forms. Prostate 70: 817,824, 2010. © 2010 Wiley-Liss, Inc. [source] | ||||||||||