Analysis Of Prostate-specific Antigen Research Articles

Correlation between Prostate-Specific Antigen Levels and Prostate Imaging Reporting and Data System score: A Retrospective Study

Introduction: Prostate cancer is a prevalent and potentially lethal malignancy affecting men worldwide. To enhance early detection and accurate risk stratification, various diagnostic methods have been developed. Prostate cancer diagnoses include a digital rectal examination, prostate-specific antigen analysis and prostate biopsy in case prostate cancer is suspected. Total prostate-specific antigen (tPSA) is a widely used, first line and acceptable biomarker for prostate cancer screening. Rising tPSA levels cannot be a definitive diagnosis for prostate cancer and further examination is needed. Мagnetic resonance imaging (MRI) is an irreplaceable part of prostate cancer diagnosis. The introduction of Prostate Imaging-Reporting and Data System (PI-RADS) in MRI of prostate gland precises the cases in which performance of target biopsy is needed by classifying suspected prostate lеsions according to the probability of detecting prostate cancer. Objectivе: The objective of this study is to assess the correlation between tPSA levels and PI-RADS scores in patients who underwent MRI of the prostate gland due to elevated tPSA levels. Material and methods: A retrospective study of 374 patients medical records was carried out from January 2019 to June 2023. All patients had tPSA over 4 ng/ml and underwent MRI. Lesions were classified according to PI-RADS v2.1. Results: Patients mean age was 67.8 ± 8.2 years. Mean prostate volume was 52.67 ± 19.6 cc. 87.5 % of the patients had a negative rectal digital exam and 12.5 % had a positive one. tPSA levels ranged from 4.10 to 500 ng/ml. Patients were categorized in four groups according to their tPSA levels: group A with tPSA levels ranging from 4 to 9.9 ng/ml; group B – tPSA from 10 to 19.9 ng/ ml; group C – tPSA from 20 to 39.9 ng/ml; group D – tPSA over 40 ng/ml. MRI and PI-RADS v2 scoring were performed in all patients. 29.4 % of the MRI exams found lesions scored as PI-RADS 3, 47.1 % – as PI-RADS 4 and 22.5 % as PI-RADS 5. There were only 3 cases of lesions categorized as PI-RADS 2 in the study. These patients did not undergo a biopsy and were followed up. 33.9 % of patients in group A were c assified with PI-RADS score 3, 52.3 % – PI-RADS score 4 and 13.8 % – PI-RADS 5. In group B 1.8 %were categorized in PI-RADS score 2, 28.9 % – PI-RADS score 3, 44.7 % were PI-RADS 4 and 24.6 % PI-RADS 5. In group C the majority of patients (47.9 % and 32.6 %) had lesions classified as PI-RADS 4 and 5. In group D most of the patients` lesions – 60.7 %, were categorized as PI-RADS 5. Conclusion: There is a significant correlation between PI-RADS score and serum total PSA levels with a tendency of higher PI-RADS scores as the tPSA level reaches 10 ng/ml. Elevation of tPSa levels over 4 ng/ml requires MRI of the prostate gland and PI-RADS classification as a diagnostic and confirmation tool for further decision making.

P112 - Analysis of prostate-specific antigen (PSA) kinetics in the third month of treatment with apalutamide in metastatic castration-sensitive prostate cancer (mCSPC)

P112 - Analysis of prostate-specific antigen (PSA) kinetics in the third month of treatment with apalutamide in metastatic castration-sensitive prostate cancer (mCSPC)

Prostate cancer diagnosis as part of high-tech advanced outpatient medical care

Introduction. The primary focus for improving medical care is introduction of inpatient-replacement forms of healthcare for patients, particularly, with prostate cancer (PCa). Day-care facilities at outpatient institutions and hospitals are considered the most cost-effective and convenient for patients. It is expected that the introduction of new survey methodologies and the optimization of their use in day-hospitals of outpatient clinics will reduce the use of other diagnostic procedures, including invasive ones, and will allow the specialist to determine the treatment tactics and method.Objective. To improve the quality of PCa diagnosis with the use of high-tech advanced outpatient medical care.Materials & methods. To assess the appropriateness and effectiveness of transrectal prostate biopsies (TRPBs) in the day hospital, we have compared the statistics obtained in outpatient clinics with inpatient hospital divisions of the corresponding urban district. A comparative analysis of the data obtained using a standard examination algorithm was carried out: prostate-specific antigen analysis, digital rectal examination and transrectal ultrasound examination with a group of men who used multiparametric magnetic resonance imaging (mpMRI) in the examination algorithm prior to TRPB.Results. The average annual number of TRPBs performed in inpatient urology divisions (three сapital hospitals from Western urban district) was 344, and the PCa detection was 142 (41%). In the outpatient urological unit of the Branch No. 2, Moscow Outpatient Clinics No. 195 for the period from 2010 to 2017, the average annual number of TRPBs was 440, and the PCa detection was 153 (35%) Thus, from the above data, it appears that with inpatient-like PCa detection, one large outpatient urological unit performed on average 24% more TRPBs (440 versus 344) than three inpatient urological divisions in a comparable period of time. When comparing histological data obtained after TRPBs in the absence and presence of pelvic mpMRT, a reliable difference (42% vs 35%) was found in PCa detection, respectively.Conclusion. mpMRI due to its high sensitivity and specificity in PCa diagnosis, which can be recommended as a mandatory diagnostic step before TRPB. In addition, mpMRI can significantly reduce the number of unnecessary TRPBs, increase the effectiveness of timely PCa diagnosis at the early stages.

Prostate Cancer Review: Genetics, Diagnosis, Treatment Options, and Alternative Approaches.

Simple SummaryProstate cancer affects men of all racial and ethnic groups and leads to higher rates of mortality in those belonging to a lower socioeconomic status due to late detection of the disease. There is growing evidence that suggests the contribution of an individual’s genetic profile to prostate cancer. Currently used prostate cancer treatments have serious adverse effects; therefore, new research is focusing on alternative treatment options such as the use of genetic biomarkers for targeted gene therapy, nanotechnology for controlled targeted treatment, and further exploring medicinal plants for new anticancer agents. In this review, we describe the recent advances in prostate cancer research.Prostate cancer is one of the malignancies that affects men and significantly contributes to increased mortality rates in men globally. Patients affected with prostate cancer present with either a localized or advanced disease. In this review, we aim to provide a holistic overview of prostate cancer, including the diagnosis of the disease, mutations leading to the onset and progression of the disease, and treatment options. Prostate cancer diagnoses include a digital rectal examination, prostate-specific antigen analysis, and prostate biopsies. Mutations in certain genes are linked to the onset, progression, and metastasis of the cancer. Treatment for localized prostate cancer encompasses active surveillance, ablative radiotherapy, and radical prostatectomy. Men who relapse or present metastatic prostate cancer receive androgen deprivation therapy (ADT), salvage radiotherapy, and chemotherapy. Currently, available treatment options are more effective when used as combination therapy; however, despite available treatment options, prostate cancer remains to be incurable. There has been ongoing research on finding and identifying other treatment approaches such as the use of traditional medicine, the application of nanotechnologies, and gene therapy to combat prostate cancer, drug resistance, as well as to reduce the adverse effects that come with current treatment options. In this article, we summarize the genes involved in prostate cancer, available treatment options, and current research on alternative treatment options.

Integrating Near-Infrared Visual Fluorescence with a Photoelectrochemical Sensing System for Dual Readout Detection of Biomolecules.

Compared with traditional visible light-driven fluorescence visualization (FV), near-infrared (NIR)-induced FV is an interesting and promising method, while photoelectrochemical (PEC) immunoassay sensing possesses the advantages of high sensitivity, low cost, and simple instrumentation. We combined PEC sensing with NIR-induced FV together and developed a dual readout sensing platform. In this protocol, based on the antibody-analyte (i.e., antigen, DNA, and RNA) reaction and the sandwich-type structure, CuInS2 microflowers as the matrix provided the original background photocurrent; chlorin e6 (Ce6) was conjugated to antibody-modified upconversion nanoparticles and formed a signal label for the PEC sensing and naked-eye readout. Different from traditional PEC immunosensors, under NIR illumination, the developed dual mode sensing platform could achieve quick qualitative analysis and quantitative analysis. Preliminary application performance of the proposed biosensor in prostate-specific antigen analysis is acceptable, indicating its promising potential in clinical/biological studies.

Real-world analysis of prostate-specific antigen (PSA) outcomes among patients with metastatic castration-resistant prostate cancer (mCRPC) treated with enzalutamide (ENZA).

33 Background: ENZA showed efficacy in chemotherapy-naïve men with mCRPC in a clinical trial setting (PREVAIL). We report real-world outcomes with ENZA for this population in a urology practice setting. Methods: This retrospective cohort study included men with prostate cancer newly initiating ENZA in the IntrinsiQ Specialty Solutions™ urology electronic medical records database between September 1, 2014 and February 28, 2018. Due to the approved indication in the study time frame, prescription of ENZA (first claim date = index date) was used as a proxy for mCRPC. Patients with evidence of prior chemotherapy and/or abiraterone were excluded. PSA value closest to index date (±30 days) was used as baseline. Men were followed until the earliest of: discontinuing ENZA, leaving practice, death, or study end. Best PSA response (largest decline or smallest increase in absence of decline from baseline), PSA declines of ≥50% and ≥90%, undetectable PSA, and time to PSA progression were analyzed. Results: We identified 931 eligible men. Most (>95%) were ≥60 years old; hypertension (54.6%) and diabetes (17.0%) were the most common comorbidities. Median (interquartile range [IQR]) baseline PSA was 9.0 (2, 37) ng/dL. Median (IQR) follow-up time was 12.5 (7.6, 19.4) months, during which a median (IQR) of 4 (3, 6) PSA tests were observed. Median time between two adjacent PSA tests was 2.0 months. A ≥50% and ≥90% PSA decline was observed in 55.0% and 23.8%, respectively. Best PSA response was a median (IQR) PSA decline of 58% (-89%, 1%), with 14.2% reaching an undetectable PSA value. Median time to PSA progression was 18.5 months (95% confidence interval 15.6, 23.7). Conclusions: This real-world study supports the effectiveness of ENZA in patients with mCRPC. The median PSA at treatment was much lower than PREVAIL, potentially explaining the longer time to PSA progression vs. PREVAIL. However, a lower proportion had PSA declines of ≥50% and ≥90% vs. PREVAIL, which may be attributed to more frequent PSA monitoring within a clinical trial setting and thus more opportunity to capture the true best PSA response.

An Evaluation of the Novel i-CHROMA™ Point-of-Care Testing (POCT) Method for the Analysis of Prostate-Specific Antigen (PSA) in Serum

An Evaluation of the Novel i-CHROMA™ Point-of-Care Testing (POCT) Method for the Analysis of Prostate-Specific Antigen (PSA) in Serum

Effects of the Aqueous Extract of Mimosa Pudica on Experimentally-Induced Prostatic Hyperplasia

Benign prostatic hyperplasia, a non-cancerous condition of unknown etiology, is the most common prostatic disease in men globally. The present study investigated the possible ameliorative effects of aqueous extracts of Mimosa pudica on experimentally-induced prostatic hyperplasia in Wistar rats.
 Twenty adult, male Wistar rats weighing 120-180 g were randomly divided into four groups (A, B, C, D) of five animals each. Group A, normal control, was given corn oil only; Group B rats were hormone-treated. Groups C and D rats were hormone and extract treated, and received continuous doses of 300 μg and 80 μg of testosterone and estradiol, respectively, on alternate days for three weeks subcutaneously in the inguinal region. The extract-treated rats received an additional 400 mg/kg b. w and 800 mg/kg b. w. of M. pudica orally for another four weeks. Immediately after induction of benign prostatic hypertrophy, some animals were randomly selected and sacrificed for gross inspection of prostate enlargement, prostate specific antigen analysis (PSA) and sperm count evaluation. These procedures were repeated again after four weeks of extract treatment. The prostates were excised and processed routinely for paraffin embedding and stained with hematoxylin and eosin (H&E).
 Results obtained showed significant (P<0.05) reduction in PSA levels, increase in sperm count and also a reversal of histological hyperplastic changes.

Effects of Methanolic Extract of Trichosanthes Cucumerina Seed on Experimentally-Induced Prostatic Hyperplasia

Benign prostatic hyperplasia, a non-cancerous condition of unknown cause, is the most common prostate disease in men globally. The present study investigated the possible ameliorative effects of methanolic extract of Trichosanthes cucumerina seeds (METCS) on experimentally-induced prostatic hyperplasia in Wistar rats.Twenty adult, male Wistar rats weighing 150-250 g were randomly divided into four groups of five animals each. Group I, normal control, was given corn oil only; Group II, hormone-treated control (HTC), Groups III and IV, hormone- and extract-treated, received continuous doses of 300 μg and 80 μg of testosterone and estradiol, respectively, on alternate days for three weeks subcutaneously in the inguinal region; while the extract-treated rats received additional 400 mg/kg b.w. (low dose) and 800 mg/kg b.w. (high dose) of METCS orally for another three weeks. Immediately after induction of benign prostatic hypertrophy, some animals were randomly selected and sacrificed for gross inspection of prostate enlargement, prostate specific antigen analysis (PSA) and sperm count evaluation. These procedures were repeated again after three weeks of extract treatment. The prostates were harvested and processed routinely for paraffin embedding, and stained with hematoxylin and eosin (H&E).Results obtained showed significant (P<0.05) reduction in PSA levels following high doses of METCS and also a reversal of histological hyperplasic changes.

Surrogacy analysis of prostate-specific antigen (PSA) decline for improved overall survival (OS) with enzalutamide (ENZ) in AFFIRM.

Surrogacy analysis of prostate-specific antigen (PSA) decline for improved overall survival (OS) with enzalutamide (ENZ) in AFFIRM.

Surrogacy analysis of prostate-specific antigen (PSA) decline for improved overall survival (OS) with enzalutamide (ENZ) in AFFIRM.

266 Background: ENZ significantly increased OS for men with metastatic castration-resistant prostate cancer (mCRPC) vs. placebo and significantly decreased PSA levels. However, the prognostic significance and role of PSA falls as a surrogate for OS are not established. Methods: Men in the AFFIRM trial were grouped by maximal unconfirmed PSA decline during the 1st 90 days of treatment in a post-hoc analysis. Each PSA decline criterion was assessed for surrogacy for OS by the proportion of treatment effect (PTE)-explained and Prentice criteria. We also assessed the association of PSA decline with OS, progression-free survival (PFS), and pain response. Results: ENZ improved OS (hazard ratio 0.63, p &lt; 0.001) and was associated with higher rates of PSA declines when compared to placebo (odds ratio &gt; 19.0, p &lt; 0.001). Greater declines in PSA were associated with longer OS, PSA PFS, radiographic PFS, and higher pain response when compared with no PSA decline or PSA increase (table). All decline measures from baseline were highly prognostic for OS and several ( &gt; 0%, ≥ 30%, ≥ 50% declines) explained a proportion of the treatment effect (PTE 1.07–1.29, 95% CI lower bounds &gt; 0.63), in which treatment was no longer significant after adjustment for the decline measures (p &gt; 0.20). Full surrogacy was not demonstrated. Conclusions: In AFFIRM, &gt; 0, ≥30%, and ≥50% PSA declines within 90 days of treatment fulfilled Prentice surrogacy criteria 1–3. Prentice 4, equivalency of survival adjusting for PSA decline outcomes, could not be demonstrated. PSA declines are associated with longer PFS and improved pain response. External prospective validation is needed. Clinical trial information: NCT00974311. [Table: see text]

Potential Application of Quantitative Prostate-specific Antigen Analysis in Forensic Examination of Seminal Stains

The aims of this study are to use quantitative analysis of the prostate-specific antigen (PSA) in the seminal stain examination and to explore the practical value of this analysis in forensic science. For a comprehensive analysis, vaginal swabs from 48 rape cases were tested both by a PSA fluorescence analyzer (i-CHROMA Reader) and by a conventional PSA strip test. To confirm the results of these PSA tests, seminal DNA was tested following differential extraction. Compared to the PSA strip test, the PSA rapid quantitative fluorescence analyzer provided the more accurate and sensitive results. More importantly, individualized schemes based on quantitative PSA results of samples can be developed to improve the quality and procedural efficiency in the forensic seminal inspection of samples prior to DNA analysis.

Difference in Willingness-to-pay for Prostate Cancer Screening Between Ill-informed and Well-informed Men: A Contingent Valuation Survey

To use a contingent valuation method to compare the willingness of well-informed and ill-informed men to pay for PSA screening. Prostate cancer screening by analysis of prostate-specific antigen (PSA) levels has recently been confirmed to reduce prostate cancer death. However, PSA screening is associated with considerable risks, and men should be well informed about the risks before deciding to undergo the test. A total of 1800 men aged 50-69 years old participated in an Internet-based, computer-assisted questionnaire survey. The subjects were randomly divided into 2 groups. Group 1 (n = 900) was provided with information about the procedure, detection rate, and mortality-reducing effects of PSA screening. Additional information was given to group 2 (n = 900), including the possibility of false-positive or false-negative results, the risks of close examination, and the possibility of overdiagnoses. The willingness to pay (WTP) was assessed using a double-bound dichotomous choice method. The average WTP was significantly greater in group 1 than in group 2 ($31.1 vs $25.1, P < .01). Weibull regression analysis showed that patients with a history of receiving PSA screening or with greater incomes had a significantly greater WTP. Although providing information on the risks of PSA screening significantly decreased men's WTP for such tests, the well-informed group was still willing to pay $25.1. These findings suggest that men can balance the potential disadvantages of PSA screening against its effectiveness in saving lives.

Prostate Cancer: To Treat or Not to Treat?

To treat or not to treat is one of the most difficult dilemmas facing prostate cancer patients, especially elderly men with early prostate cancer or small cancer that is contained within the prostate. The primary objective of this review is to analyse the treatment options for patients with localised prostate cancer. This information can be considered alongside other important factors like natural history of disease and diagnostic tests. Several randomised and nonrandomised clinical trials published in the literature investigating the natural history of the disease, diagnostic tests, and treatment options for localised prostate cancer have been reviewed for this paper. Analysis of prostate-specific antigen (PSA) kinetics should play a major role in the management of localised prostate cancer. Trials investigating long-term outcomes of active surveillance are under way. Taking all these factors into consideration, the data support active surveillance as an appropriate choice for patients with well-differentiated or moderately differentiated, low-volume prostate cancer who have a life expectancy of <10 yr. Men with higher grade tumours and longer life expectancy may be at excess risk of death from prostate cancer if managed with active surveillance. Treatment options for localised prostate cancer can be considered in the treatment decision-making process alongside other important factors, such as the individual patient's values and situation as well as the potential impact of treatment on his quality of life.

Two-Dimensional Electrophoresis in Prostate Cancer Research and Diagnostics

Two-dimensional electrophoresis (2-DE) is the most commonly-used technique for large-scale identification of proteins in clinical samples. Here, we review the use of this method to improve prostate cancer diagnostics, especially on the analysis of prostate-specific antigen (PSA). Two-dimensional electrophoresis is a powerful method, which makes possible the detection and analysis of thousands of proteins and their post-translational modifications. However, it is a sophisticated technique, which does not resolve all kind of proteins. Some groups were able to improve prostate cancer diagnostics using the 2-DE pattern of free PSA isoforms on prostate cancer and non-prostate cancer sera. To this end, it would be very interesting to further investigate and develop these new diagnostic approaches.

Combination Treatment of Prostate Cancer Cell Lines with Bioactive Soy Isoflavones and Perifosine Causes Increased Growth Arrest and/or Apoptosis

To determine whether targeting the androgen receptor (AR) and Akt pathways using a combination of genistein combined polysaccharide (GCP) and perifosine is more effective at inducing growth arrest/apoptosis in prostate cancer cells compared with treatment with GCP or perifosine as single agents. The effect of GCP and perifosine treatment was assessed in five prostate cancer cell lines: LNCaP (androgen sensitive), LNCaP-R273H, C4-2, Cds1, and PC3 (androgen insensitive). A clonogenic assay assessed the long-term effects on cell growth and survival. Flow cytometry and Western blot analysis of poly(ADP)ribose polymerase cleavage were used to assess short-term effects. Preliminary studies to investigate mechanism of action included Western blot for P-Akt, Akt, P-p70S6K, p70S6K, p53, and p21; prostate-specific antigen analysis; and the use of myristoylated Akt and AR-specific small interfering RNA. Combination treatment with GCP and perifosine caused a decrease in clonogenic potential in all cell lines. In short-term assays, growth arrest was observed in the majority of cell lines, as well as increased inhibition of Akt activity and induction of p21 expression. Increased apoptosis was only observed in LNCaP. Knockdown of AR caused a further increase in apoptosis. Combination treatment with GCP and perifosine targets the Akt pathway in the majority of the prostate cancer cell lines and causes increased inhibition of cell growth and clonogenicity. In LNCaP, combination treatment targets both the Akt and AR pathways and causes increased apoptosis. These data warrant clinical validation in prostate cancer patients.

An Ecologic Study of Prostate-specific Antigen Screening and Prostate Cancer Mortality in Nine Geographic Areas of the United States

Ecologic studies of cancer screening examine cancer mortality rates in relation to use of population screening. These studies can be confounded by treatment patterns or influenced by choice of outcome and time horizon. Interpretation can be complicated by uncertainty about when mortality differences might be expected. The authors examined these issues in an ecologic analysis of prostate-specific antigen (PSA) screening and prostate cancer mortality across nine cancer registries in the United States. Results suggested a weak trend for areas with greater PSA screening rates to have greater declines in prostate cancer mortality; however, the magnitude of this trend varied considerably with the time horizon and outcome measure. A computer model was used to determine whether divergence of mortality declines would be expected under an assumption of a clinically significant survival benefit due to screening. Given a mean lead time of 5 years, the model projected that differences in mortality between high- and low-use areas should be apparent by 1999 in the absence of other factors affecting mortality. The authors concluded that modest differences in PSA screening rates across areas, together with additional sources of variation, could have produced a negative ecologic result. Ecologic analyses of the effectiveness of PSA testing should be interpreted with caution.

DNA-BASED ASSAY FOR PROTEINS

A NEW METHOD DEVELOPED by Northwestern University chemistry professor Chad A. Mirkin and coworkers provides ultrasensitive protein detection and maybe useful in diagnosing several types of cancer [ Science, 301 , 1884 (2003)]. In the analysis of prostate-specific antigen (PSA), for example, the assay is three orders of magnitude more sensitive than the best methods in the literature and six orders of magnitude more sensitive than current clinical methods. PSA is an extremely useful marker for detecting prostate cancer. It also is being explored as a target for detecting breast cancer because it is found in the serum of breast cancer patients at levels too low to be picked up by current diagnostic tests. Mirkin and graduate students Jwa-Min Nam and C. ShadThaxtonuse two different types of particles to capture the PSA from a serum sample. Monoclonal anti-bodies on the surface of a magnetic microparticle bind the PSA. Then a gold nanoparticle coated with double-stranded DNA and ...

Interferon-alpha prevents selection of doxorubicin-resistant undifferentiated-androgen-insensitive metastatic human prostate cancer cells.

We determined whether treatment of metastatic prostate cancer cells with doxorubicin (DOX) and interferon-alpha (IFN-alpha) prevented the emergence of highly undifferentiated tumor cells. The state of cell differentiation was determined by analysis of prostate-specific antigen (PSA), E-cadherin, keratin, and vimentin. Human prostate cancer LNCaP-LN3 cells growing in culture as multicell spheroids expressed higher levels of E-cadherin and E-cadherin-associated beta-catenin than LNCaP-LN3 cells growing as monolayers. Treatment of cells with DOX downregulated PSA, E-cadherin, and keratin, and upregulated expression of vimentin and vascular endothelial growth factor (VEGF) mRNA. While treatment of cells with IFN-alpha did not alter gene expression, the addition of IFN-alpha to cultures treated with DOX produced synergistic toxicity and abrogated the changes in gene expression observed in cells treated with DOX alone. Treatment with IFN-alpha and DOX should be further explored as a therapeutic strategy for androgen-insensitive prostate cancer.