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Adel T Aref, Andrew D Vincent, Michael E O’Callaghan, Sean A Martin, Peter D Sutherland, Andrew J Hoy, Lisa M Butler and Gary A Wittert

Introduction Prostate cancer is the most common cancer affecting men in developed countries ( Torre et al. 2015 ). Although the advent of prostate specific antigen (PSA) testing has resulted in earlier detection of prostate cancer, its role

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Takeshi Sasaki, Takehisa Onishi and Akira Hoshina

, including advanced disease ( Cooperberg et al . 2009 ). Nadir prostate-specific antigen (PSA) level after hormone therapy has been reported as an important tool to predict progression in patients with metastatic PC ( Matzkin et al . 1992 , Kwak et al

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D C Parish

Prostate Specific Antigen (PSA) is a serine protease and is a single chain glycoprotein of around 33kDa molecular weight (see reviews by Peehl 1995 , Duffy 1996 and Lilja 1997). It was first described in seminal plasma (Hara et al. 1971) and was later isolated from the prostate (Wang et al. 1979). PSA is a product of the epithelial cells of the prostate and is secreted into the seminal fluid. It is believed that the main biological role of this protease in semen is to digest the protein semenogellin on ejaculation (Lilja 1985) which will liquify the seminal fluid and allow increased sperm motility. However it should be noted that PSA is present in such high concentrations in semen that even after considerable dilution it could possibly have proteolytic effects on substrates in the female reproductive tract.

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T L Veveris-Lowe, M G Lawrence, R L Collard, L Bui, A C Herington, D L Nicol and J A Clements

deaths in the USA ( American Cancer Society 2004 , Jemal et al. 2004 ). Prostate-specific antigen (PSA), also known as kallikrein 3 ( KLK3 /hK3), is a serine protease secreted by normal and malignant prostatic epithelial cells and is the current serum

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A F Nash and I Melezinek

The introduction of prostate specific antigen (PSA) testing has revolutionised the early detection, management and follow-up of patients with prostate cancer and it is considered to be one of the best biomedical markers currently available in the field of oncology. Its use with annual digital rectal examination in prostate cancer screening programmes has led to a marked change in the distribution of stage at presentation towards earlier disease and led to a significant increase in the detection of potentially curable disease. In order to improve the specificity of PSA testing and thereby reduce the number of unnecessary prostatic biopsies, a number of refinements of PSA evaluation have been proposed. These include free to total PSA ratio, PSA density, PSA density, PSA density of the transition zone, PSA velocity and age-specific PSA reference ranges. The utility of these approaches is considered in this review. The role of PSA monitoring in the detection of recurrence following radical prostatectomy and radiotherapy is discussed, as well as its role in monitoring patients treated with endocrine therapy is discussed, as well as its role in monitoring patients treated with endocrine therapy in terms of correlating PSA response with outcome, in detecting disease progression and in guiding the use of subsequent therapies. Large continuing multicentre screening and outcome studies will provide important information enabling greater refinement of the use of this important diagnostic and monitoring tool in the future detection and management of prostate cancer.

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Suresh Veeramani, Ta-Chun Yuan, Siu-Ju Chen, Fen-Fen Lin, Juliette E Petersen, Syed Shaheduzzaman, Shiv Srivastava, Richard G MacDonald and Ming-Fong Lin

an indicator of the response to treatment ( Huggins & Hodges 1941 ). As a consequence, serum PAcP had been studied extensively as a surrogate marker for prostate cancer prior to the establishment of prostate-specific antigen (PSA) as the new standard

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Eiji Kashiwagi, Masaki Shiota, Akira Yokomizo, Momoe Itsumi, Junichi Inokuchi, Takeshi Uchiumi and Seiji Naito

), as well as exert antitumor effects. The COX2 inhibitor celecoxib decreased patients' rising prostate-specific antigen (PSA) rates after radical therapies ( Pruthi et al . 2004 , Smith et al . 2006 ). NSAIDs may suppress prostate cancer incidence

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Zhigang Zhao and Guohua Zeng

specificity of 94% and a sensitivity of 91% in separating normal men with prostate specific antigen (PSA) < and >2.5 ng/ml, and men with BPH from those with PCa at a cut-off of 0.5 ng/ml and above ( Leman et al . 2009 ). These data have shown the potential of

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Takeshi Ujike, Motohide Uemura, Atsunari Kawashima, Akira Nagahara, Kazutoshi Fujita, Yasushi Miyagawa and Norio Nonomura

testosterone; PSA, prostate-specific antigen; PSAD, PSA density; PV, prostate volume; TT, total testosterone. Table 2 Logistic analysis of variables associated with cancer detection in all cases. Variables Univariate Multivariate

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Y Dong, L T Bui, D M Odorico, O L Tan, S A Myers, H Samaratunga, R A Gardiner and J A Clements

Introduction Prostate cancer is the most common non-skin malignancy and the second leading cause of cancer death in males in the USA and other Western countries ( Jemal et al. 2004 ). Prostate-specific antigen (PSA), also known as