• Title/Summary/Keyword: Prostate-Specific-Antigen (PSA)

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Utility of Digital Rectal Examination, Serum Prostate Specific Antigen, and Transrectal Ultrasound in the Detection of Prostate Cancer: A Developing Country Perspective

  • Kash, Deep Par;Lal, Murli;Hashmi, Altaf Hussain;Mubarak, Muhammed
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3087-3091
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    • 2014
  • Purpose: To determine the utility of digital rectal examination (DRE), serum total prostate specific antigen (tPSA) estimation, and transrectal ultrasound (TRUS) for the detection of prostate cancer (PCa) in men with lower urinary tract symptoms (LUTS). Materials and Methods: All patients with abnormal DRE, TRUS, or serum tPSA >4ng/ml, in any combination, underwent TRUS-guided needle biopsy. Eight cores of prostatic tissue were obtained from different areas of the peripheral prostate and examined histopathologically for the nature of the pathology. Results: PCa was detected in 151 (50.3%) patients, remaining 149 (49.7%) showed benign changes with or without active prostatitis. PCa was detected in 13 (56.5%), 9 (19.1%), 26 (28.3%), and 103 (74.6%) of patients with tPSA <4 ng/ml, 4-10 ng/ml, 10-20 ng/ml and >20 ng/ml respectively. Only 13 patients with PCa had abnormal DRE and TRUS with serum PSA <4 ng/ml. The detection rate was highest in patients with tPSA >20 ng/ml. The association between tPSA level and cancer detection was statistically significant (p<0.01). Among 209 patients with abnormal DRE and raised serum PSA, PCa was detected in 128 (61.2%). Conclusions: The incidence of PCa increases with increasing serum level of tPSA. The overall screening and detection rate can be further improved by using DRE, TRUS and TRUS-guided prostate needle biopsies.

Correlation between Low Gleason Score and Prostate Specific Antigen Levels with Incidence of Bone Metastases in Prostate Cancer Patients: When to Omit Bone Scans?

  • Sanjaya, I. Putu Gde;Mochtar, Chaidir Arief;Umbas, Rainy
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.4973-4976
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    • 2013
  • Background: To identify correlation and incidence of bone metastases in prostate cancer patient with low Gleason scores (GS) and prostate specific antigen (PSA) levels. Materials and Methods: This descriptive restrospective study covered patients with prostate cancer in Cipto Mangunkusumo Hospital in 2006-2011. Of a total of 478, those who had PSA values, histological examination, and bone scan were included, resulting in 358 eligible cases. PSA values were measured using the sandwich electrochemiluminescent immunoassay. Histological examination was graded according to Gleason's grading system and divided into 3 categories: well differentiated ($GS{\leq}6$), moderately differentiated (GS 7) and poorly differentiated (GS 8-10). Bone scans were performed using a radiopharmaceutical agent ($T_c$ 99m methylenen diphosphonate) with images captured by gamma camera. Results: The mean age was $67.5{\pm}7.8$, mean GS was $7.7{\pm}1.3$ and median PSA was 56.9 (range: 0.48-17000 ng/mL). There were 11 patients (3.0%) with positive bone scan with PSA<20 ng/mL and GS<8. Furthermore, there were 2 patients (0.6%) with $GS{\leq}6$ and PSA<10 ng/mL showing bone metastasis. Conclusions: In our study, there were still small percentage of patients with bone metastasis even when low values of PSA (PSA<10 ng/mL) and GS ($GS{\leq}6$) were applied.

Apoptosis-inducing Effect of Herba Patriniae Extract in the Prostate Cancer LNCaP Cells (전립선 암세포에서 패장 추출물의 세포고사 유도 효과)

  • Moon Hyung Cheal
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.3
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    • pp.863-867
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    • 2004
  • Herba Patriniae(HP) has been known to exert anti-inflammation and -tumoral activity in Korea. However, its molecular mechanism of action is not understood. In this study, we found that HP extract induced apoptosis in androgen-dependent prostate cancer LNCaP cells as evidenced by DNA fragmentation. Our data demonstrated that HP extract-induced apoptotic cell death was accompanied by inhibition of NF- κB activation, lowering effects of intracellular prostate specific antigen(PSA) and androgen reoeptor(AR) expression in a time dependent manner. Taken together, HP extract may inhibit the proliferation of prostate cancer LNCaP cell associated with inhibition of NF- κB activation, PSA and AR expression and that of apoptosis.

Risk factors for prostate-specific antigen persistence in pT3aN0 prostate cancer after robot-assisted laparoscopic radical prostatectomy: a retrospective study

  • Jun Seop Kim;Jae Hoon Chung;Wan Song;Minyong Kang;Hyun Hwan Sung;Hwang Gyun Jeon;Byong Change Jeong;Seong Il Seo;Hyun Moo Lee;Seong Soo Jeon
    • Journal of Yeungnam Medical Science
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    • v.40 no.4
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    • pp.412-418
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    • 2023
  • Background: The aim of this study was to evaluate the risk factors for prostate-specific antigen (PSA) persistence in pathological stage T3aN0 prostate cancer (PCa) after robot-assisted laparoscopic radical prostatectomy (RALP). Methods: A retrospective study was performed on 326 patients with pT3aN0 PCa who underwent RALP between March 2020 and February 2022. PSA persistence was defined as nadir PSA of >0.1 ng/mL after RALP, and the risk factors for PSA persistence were evaluated using logistic regression analysis. Results: Among 326 patients, 61 (18.71%) had PSA persistence and 265 (81.29%) had PSA of <0.1 ng/mL after RALP (successful radical prostatectomy [RP] group). In the PSA persistence group, 51 patients (83.61%) received adjuvant treatment. Biochemical recurrence occurred in 27 patients (10.19%) in the successful RP group during the mean follow-up period of 15.22 months. Multivariate analysis showed that the risk factors for PSA persistence were large prostate volume (hazard ratio [HR], 1.017; 95% confidence interval [CI], 1.002-1.036; p=0.046), lymphovascular invasion (LVI) (HR, 2.605; 95% CI, 1.022-6.643; p=0.045), and surgical margin involvement (HR, 2.220; 95% CI, 1.110-4.438; p=0.024). Conclusion: Adjuvant treatment may be needed for improved prognosis in patients with pT3aN0 PCa after RALP with a large prostate size, LVI, or surgical margin involvement.

Prostate-Specific Antigen Levels in Relation to Background Factors: Are there Links to Endocrine Disrupting Chemicals and AhR Expression?

  • Bidgoli, Sepideh Arbabi;Jabari, Nasim;Zavarhei, Mansour Djamali
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6121-6125
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    • 2014
  • Background: Prostate-specific antigen (PSA) is a potential biomarker for early detection of prostate cancer (PCa) but its level is known to be affected by many background factors and roles of ubiquitous toxicants have not been determined. Endocrine disrupting chemicals (EDCs) are ubiquitous reproductive toxicants used in consumer products, which promote tumor formation in some reproductive model systems by binding to AhR, but human data on its expression in prostate cancer as well as its association with PSA levels are not clear. This study aimed to evaluate the expression levels of AhR and its association with serological levels of PSA and to detect possible effects of background factors and EDC exposure history on PSA levels in PCa cases. Materials and Methods: A cross-sectional study was conducted on the tissue levels of AhR and serum levels of PSA in 53 PCa cases from 2008-2011 and associations between each and background and lifestyle related factors were determined. Results: Although the AhR was overexpressed in PCa and correlated with the age of patients, it did not correlate with PSA levels.Of nutritional factors, increased intake of polysaturated fats and fish in the routine regimen of PCa cases increased the PSA levels significantly. Conclusions: AhR overexpression in PCa pontws to roles of EDCs in PCa but without any direct association with PSA levels. However, PSA levels are affected by exposure to possible toxicants in foods whichneed to be assessed as possible risk factors of PCa in future studies.

The Relationship Between Serum Prostate Specific Antigen and Prostate Volume of Measured by Transrectal Ultrasonography (혈청 전립선특이항원과 경직장초음파로 측정된 전립선 용적과의 상관관계)

  • Kim, Mi-Young
    • Journal of radiological science and technology
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    • v.33 no.3
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    • pp.239-243
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    • 2010
  • Even though clinical use DRE, PSA and TRUS for screening while diagnosing prostate cancer early, however, we cannot achieve to diagnose it accurately by one method. Thus, mutual supplements are strongly required in diagnosis. It means that we should identify relationship between prostate volume and serum PSA under different ages for better diagnosis. The subjects(405 men) visited the department of diagnostic radiology in a general university hospital from January 2008 to December 2008, who was going to take the prostatic evaluation by TRUS. 13 men, who did definite diagnosis of prostate cancer before through biopsy, were excluded in this study. All data were expressed as mean and standard deviations by using SPSS 14.0 package programs and were analyzed by using one-way ANOVA to evaluate the effect of different ages. And Scheffe Post hoc comparison is accomplished in order to make significant difference in prostate volume, PSA and PSAD according to ages. Pearson correlation was used for ages, prostate volume, PSA and PSAD. According to examination, the subjects' prostate volume and serum PSA level increase as person's age. We can see significant difference between group over 70 years and group from 40 and 50 years. Moreover, age, prostate volume and serum PSA have significant positive correlation. Even though we can get variations in serum PSA level by changing prostate volume according to ages, it is worthwhile to mention that more strong association for prostate volume is observed than ages in elevation of serum PSA. Therefore, it is strongly recommended to consider prostate volume weightly when it comes to evaluate for men with elevated PSA level. Finally, TRUS is an excellent extra equipment to diagnose prostate cancer because it can contribute to early diagnose and pertinent treatment of prostate cancer.

Prostate-specific Antigen Velocity (PSAV) and PSAV per Initial Volume (PSAVD) for Early Detection of Prostate Cancer in Chinese Men

  • Zheng, Xiang-Yi;Zhang, Peng;Xie, Li-Ping;You, Qi-Han;Cai, Bo-Sen;Qin, Jie
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5529-5533
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    • 2012
  • Aim: To investigate the utility of prostate-specific antigen velocity (PSAV) and PSAV per initial volume (PSAVD) for early detection of prostate cancer (PCa) in Chinese men. Methods: Between January 2009 and June 2012, a total of 193 men (aged 49-84 years, median 67 years) with at least 2 transrectal ultrasonography (TRUS) procedures and concurrent serum PSA measurements underwent prostate biopsy because of suspicion of PCa. The total group were classified into PCa and non-PCa groups, and the variables of the two groups were compared. Univariate and multivariate analyses were used to investigate which variables were predictove. The diagnostic values of PSAV, PSAVD and prostate-specific antigen density (PSAD) were compared using receiver operating characteristic (ROC) analysis. Results: Prostate cancer was diagnosed in 44 (22.8%) of the 193 men. There were significant differences between the groups in last and initial prostate volumes determined by TRUS, initial age, last serum PSA levels, PSAV, PSAD and PSAVD. After adjusting for confounding factors, the odds ratios of PCa across the quartile of PSAVD were 1, 4.06, 10.6, and 18.9 (P for trend <0.001).The area under the ROC curves (AUCs) of PSAD (0.779) and PSAVD (0.776) were similar and both significantly greater than that of PSA (AUC 0.667). PSAVD was a significantly better indicator of PCa than PSAV (AUC 0.736). There was no statistical significant difference between the AUC of PSAV and that of last serum PSA level. The sensitivity and specificity of PSAVD at a cutoff of 0.023ng in participants with last serum PSA levels of 4.0ng/mL-10.0ng was 73.7% and 70.7%, respectively. Conclusions: The results of this study demonstrated PSAVD may be a useful tool in PCa detection, especially in those undergoing previous TRUS examination.

Biomarkers for Evaluation of Prostate Cancer Prognosis

  • Esfahani, Maryam;Ataei, Negar;Panjehpour, Mojtaba
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.2601-2611
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    • 2015
  • Prostate cancer, with a lifetime prevalence of one in six men, is the second cause of malignancy-related death and the most prevalent cancer in men in many countries. Nowadays, prostate cancer diagnosis is often based on the use of biomarkers, especially prostate-specific antigen (PSA) which can result in enhanced detection at earlier stage and decreasing in the number of metastatic patients. However, because of the low specificity of PSA, unnecessary biopsies and mistaken diagnoses frequently occur. Prostate cancer has various features so prognosis following diagnosis is greatly variable. There is a requirement for new prognostic biomarkers, particularly to differentiate between inactive and aggressive forms of disease, to improve clinical management of prostate cancer. Research continues into finding additional markers that may allow this goal to be attained. We here selected a group of candidate biomarkers including PSA, PSA velocity, percentage free PSA, $TGF{\beta}1$, AMACR, chromogranin A, IL-6, IGFBPs, PSCA, biomarkers related to cell cycle regulation, apoptosis, PTEN, androgen receptor, cellular adhesion and angiogenesis, and also prognostic biomarkers with Genomic tests for discussion. This provides an outline of biomarkers that are presently of prognostic interest in prostate cancer investigation.