Short term neoadjuvant androgen deprivation therapy does not affect prostate specific membrane antigen expression in prostate tissues

BACKGROUND Prostate specific membrane antigen (PSMA) is a transmembrane glycoprotein highly expressed in benign prostate secretory‐acinar epithelium and prostate carcinoma. The results of several studies suggest that PSMA expression is increased in prostate carcinoma cell lines subjected to androgen...

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Veröffentlicht in:Cancer 2000-01, Vol.88 (2), p.407-415
Hauptverfasser: Chang, Sam S., Reuter, Victor E., Heston, W. D. W., Hutchinson, Brian, Grauer, Lana S., Gaudin, Paul B.
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container_end_page 415
container_issue 2
container_start_page 407
container_title Cancer
container_volume 88
creator Chang, Sam S.
Reuter, Victor E.
Heston, W. D. W.
Hutchinson, Brian
Grauer, Lana S.
Gaudin, Paul B.
description BACKGROUND Prostate specific membrane antigen (PSMA) is a transmembrane glycoprotein highly expressed in benign prostate secretory‐acinar epithelium and prostate carcinoma. The results of several studies suggest that PSMA expression is increased in prostate carcinoma cell lines subjected to androgen deprivation and in androgen‐independent tumors. The authors studied the effects of short term (3‐month) androgen deprivation on PSMA expression in prostate carcinoma specimens using two anti‐PSMA monoclonal antibodies (mAbs), 7E11 and PM2J004.5. METHODS The study included patients with clinically localized prostate carcinoma who were prospectively randomized into 1 of 2 treatment groups: 3 months of neoadjuvant androgen deprivation therapy followed by radical prostatectomy (ADT/RP), or radical prostatectomy (RP) alone. Representative formalin fixed, paraffin embedded prostate sections were immunostained with the anti‐PSMA mAbs 7E11 and PM2J004.5 by the streptavidin‐biotin method. The authors recorded the staining intensity and the percentage of positive cells stained in benign epithelium, high grade prostatic intraepithelial neoplasia (PIN), and prostate carcinoma. They compared the results of 7E11 with those of PM2J004.5 in benign epithelium, high grade prostate, and carcinoma and also compared the results between the two treatment groups (ADT/RP vs. RP alone). RESULTS Both anti‐PSMA mAbs stained benign secretory‐acinar epithelium, high grade PIN, and prostate carcinoma. In both treatment groups, PM2J004.5 reacted with a significantly greater percentage of cells (P < 0.001) and with significantly greater intensity (P < 0.001) compared with 7E11 in benign epithelium and prostate carcinoma. With both anti‐PSMA mAbs, the percentage of cells stained and the intensity of staining in high grade PIN was similar to that in prostate carcinoma. In the group that received RP alone, the percentage of cells stained and the intensity of staining with 7E11 were significantly greater in high grade PIN and prostate carcinoma compared with benign epithelium (P < 0.001), and the intensity of staining with the PM2J004.5 was significantly greater in high grade PIN and prostate carcinoma compared with benign epithelium (P < 0.001). In the ADT/RP group, the percentage of cells stained and the intensity of staining with 7E11 and PM2J004.5 were significantly greater in prostate carcinoma compared with benign epithelium (P < 0.006). PSMA staining did not correlate with either Gleason s
doi_str_mv 10.1002/(SICI)1097-0142(20000115)88:2<407::AID-CNCR23>3.0.CO;2-0
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D. W. ; Hutchinson, Brian ; Grauer, Lana S. ; Gaudin, Paul B.</creator><creatorcontrib>Chang, Sam S. ; Reuter, Victor E. ; Heston, W. D. W. ; Hutchinson, Brian ; Grauer, Lana S. ; Gaudin, Paul B.</creatorcontrib><description>BACKGROUND Prostate specific membrane antigen (PSMA) is a transmembrane glycoprotein highly expressed in benign prostate secretory‐acinar epithelium and prostate carcinoma. The results of several studies suggest that PSMA expression is increased in prostate carcinoma cell lines subjected to androgen deprivation and in androgen‐independent tumors. The authors studied the effects of short term (3‐month) androgen deprivation on PSMA expression in prostate carcinoma specimens using two anti‐PSMA monoclonal antibodies (mAbs), 7E11 and PM2J004.5. METHODS The study included patients with clinically localized prostate carcinoma who were prospectively randomized into 1 of 2 treatment groups: 3 months of neoadjuvant androgen deprivation therapy followed by radical prostatectomy (ADT/RP), or radical prostatectomy (RP) alone. Representative formalin fixed, paraffin embedded prostate sections were immunostained with the anti‐PSMA mAbs 7E11 and PM2J004.5 by the streptavidin‐biotin method. The authors recorded the staining intensity and the percentage of positive cells stained in benign epithelium, high grade prostatic intraepithelial neoplasia (PIN), and prostate carcinoma. They compared the results of 7E11 with those of PM2J004.5 in benign epithelium, high grade prostate, and carcinoma and also compared the results between the two treatment groups (ADT/RP vs. RP alone). RESULTS Both anti‐PSMA mAbs stained benign secretory‐acinar epithelium, high grade PIN, and prostate carcinoma. In both treatment groups, PM2J004.5 reacted with a significantly greater percentage of cells (P &lt; 0.001) and with significantly greater intensity (P &lt; 0.001) compared with 7E11 in benign epithelium and prostate carcinoma. With both anti‐PSMA mAbs, the percentage of cells stained and the intensity of staining in high grade PIN was similar to that in prostate carcinoma. In the group that received RP alone, the percentage of cells stained and the intensity of staining with 7E11 were significantly greater in high grade PIN and prostate carcinoma compared with benign epithelium (P &lt; 0.001), and the intensity of staining with the PM2J004.5 was significantly greater in high grade PIN and prostate carcinoma compared with benign epithelium (P &lt; 0.001). In the ADT/RP group, the percentage of cells stained and the intensity of staining with 7E11 and PM2J004.5 were significantly greater in prostate carcinoma compared with benign epithelium (P &lt; 0.006). PSMA staining did not correlate with either Gleason score (in the group that received RP alone) or pathologic stage (in both the RP‐alone and ADT/RP groups) and did not differ between the two treatment groups. CONCLUSIONS Short term neoadjuvant ADT does not affect PSMA expression in benign prostate secretory‐acinar epithelium, high grade PIN, or prostate carcinoma. Prostate carcinoma and high grade PIN express significantly higher levels of PSMA than benign prostate secretory‐acinar epithelium. Compared with 7E11, the PM2J004.5 anti‐PSMA mAb is a more sensitive immunohistochemical marker of prostate carcinoma in formalin fixed, paraffin embedded tissue. Cancer 2000;88:407–15. © 2000 American Cancer Society. Short term neoadjuvant androgen deprivation therapy does not affect prostate specific membrane antigen (PSMA) expression in benign prostate tissue or prostate carcinoma. Compared with benign prostate tissue, prostate carcinoma expresses higher levels of PSMA.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/(SICI)1097-0142(20000115)88:2&lt;407::AID-CNCR23&gt;3.0.CO;2-0</identifier><identifier>PMID: 10640975</identifier><identifier>CODEN: CANCAR</identifier><language>eng</language><publisher>New York: John Wiley &amp; Sons, Inc</publisher><subject>Aged ; Androgen Antagonists - pharmacology ; Androgen Antagonists - therapeutic use ; androgen deprivation therapy ; Antibodies, Monoclonal ; Antigens, Surface ; Antineoplastic agents ; Biological and medical sciences ; Carboxypeptidases - analysis ; Carboxypeptidases - biosynthesis ; Chemotherapy ; Glutamate Carboxypeptidase II ; Humans ; Immunohistochemistry ; Male ; Medical sciences ; Middle Aged ; monoclonal antibody ; Neoadjuvant Therapy ; Pharmacology. Drug treatments ; Prostate ; prostate carcinoma ; prostate specific membrane antigen ; Prostatectomy ; Prostatic Neoplasms - drug therapy ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - surgery ; Sensitivity and Specificity</subject><ispartof>Cancer, 2000-01, Vol.88 (2), p.407-415</ispartof><rights>Copyright © 2000 American Cancer Society</rights><rights>2000 INIST-CNRS</rights><rights>Copyright 2000 American Cancer Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3953-c7819775d707472dbe04671cf8b14c589f267047e750cc97a2498838dcd7b12a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2F%28SICI%291097-0142%2820000115%2988%3A2%3C407%3A%3AAID-CNCR23%3E3.0.CO%3B2-0$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2F%28SICI%291097-0142%2820000115%2988%3A2%3C407%3A%3AAID-CNCR23%3E3.0.CO%3B2-0$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,1433,27924,27925,45574,45575,46409,46833</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=1251030$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10640975$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chang, Sam S.</creatorcontrib><creatorcontrib>Reuter, Victor E.</creatorcontrib><creatorcontrib>Heston, W. D. W.</creatorcontrib><creatorcontrib>Hutchinson, Brian</creatorcontrib><creatorcontrib>Grauer, Lana S.</creatorcontrib><creatorcontrib>Gaudin, Paul B.</creatorcontrib><title>Short term neoadjuvant androgen deprivation therapy does not affect prostate specific membrane antigen expression in prostate tissues</title><title>Cancer</title><addtitle>Cancer</addtitle><description>BACKGROUND Prostate specific membrane antigen (PSMA) is a transmembrane glycoprotein highly expressed in benign prostate secretory‐acinar epithelium and prostate carcinoma. The results of several studies suggest that PSMA expression is increased in prostate carcinoma cell lines subjected to androgen deprivation and in androgen‐independent tumors. The authors studied the effects of short term (3‐month) androgen deprivation on PSMA expression in prostate carcinoma specimens using two anti‐PSMA monoclonal antibodies (mAbs), 7E11 and PM2J004.5. METHODS The study included patients with clinically localized prostate carcinoma who were prospectively randomized into 1 of 2 treatment groups: 3 months of neoadjuvant androgen deprivation therapy followed by radical prostatectomy (ADT/RP), or radical prostatectomy (RP) alone. Representative formalin fixed, paraffin embedded prostate sections were immunostained with the anti‐PSMA mAbs 7E11 and PM2J004.5 by the streptavidin‐biotin method. The authors recorded the staining intensity and the percentage of positive cells stained in benign epithelium, high grade prostatic intraepithelial neoplasia (PIN), and prostate carcinoma. They compared the results of 7E11 with those of PM2J004.5 in benign epithelium, high grade prostate, and carcinoma and also compared the results between the two treatment groups (ADT/RP vs. RP alone). RESULTS Both anti‐PSMA mAbs stained benign secretory‐acinar epithelium, high grade PIN, and prostate carcinoma. In both treatment groups, PM2J004.5 reacted with a significantly greater percentage of cells (P &lt; 0.001) and with significantly greater intensity (P &lt; 0.001) compared with 7E11 in benign epithelium and prostate carcinoma. With both anti‐PSMA mAbs, the percentage of cells stained and the intensity of staining in high grade PIN was similar to that in prostate carcinoma. In the group that received RP alone, the percentage of cells stained and the intensity of staining with 7E11 were significantly greater in high grade PIN and prostate carcinoma compared with benign epithelium (P &lt; 0.001), and the intensity of staining with the PM2J004.5 was significantly greater in high grade PIN and prostate carcinoma compared with benign epithelium (P &lt; 0.001). In the ADT/RP group, the percentage of cells stained and the intensity of staining with 7E11 and PM2J004.5 were significantly greater in prostate carcinoma compared with benign epithelium (P &lt; 0.006). PSMA staining did not correlate with either Gleason score (in the group that received RP alone) or pathologic stage (in both the RP‐alone and ADT/RP groups) and did not differ between the two treatment groups. CONCLUSIONS Short term neoadjuvant ADT does not affect PSMA expression in benign prostate secretory‐acinar epithelium, high grade PIN, or prostate carcinoma. Prostate carcinoma and high grade PIN express significantly higher levels of PSMA than benign prostate secretory‐acinar epithelium. Compared with 7E11, the PM2J004.5 anti‐PSMA mAb is a more sensitive immunohistochemical marker of prostate carcinoma in formalin fixed, paraffin embedded tissue. Cancer 2000;88:407–15. © 2000 American Cancer Society. Short term neoadjuvant androgen deprivation therapy does not affect prostate specific membrane antigen (PSMA) expression in benign prostate tissue or prostate carcinoma. Compared with benign prostate tissue, prostate carcinoma expresses higher levels of PSMA.</description><subject>Aged</subject><subject>Androgen Antagonists - pharmacology</subject><subject>Androgen Antagonists - therapeutic use</subject><subject>androgen deprivation therapy</subject><subject>Antibodies, Monoclonal</subject><subject>Antigens, Surface</subject><subject>Antineoplastic agents</subject><subject>Biological and medical sciences</subject><subject>Carboxypeptidases - analysis</subject><subject>Carboxypeptidases - biosynthesis</subject><subject>Chemotherapy</subject><subject>Glutamate Carboxypeptidase II</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>monoclonal antibody</subject><subject>Neoadjuvant Therapy</subject><subject>Pharmacology. Drug treatments</subject><subject>Prostate</subject><subject>prostate carcinoma</subject><subject>prostate specific membrane antigen</subject><subject>Prostatectomy</subject><subject>Prostatic Neoplasms - drug therapy</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - surgery</subject><subject>Sensitivity and Specificity</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkV1rFDEYhYNY7Lr6FyQXIu3FrPmY2WS2IpaxrQvFBatQvAmZzDs2Zb5MstX9Af5vM8xqBQWHwJDkvE8O5yD0hpIFJYS9PLpaF-tjSnKREJqyI0biR2l2LOWKvUqJWK1O12-T4n3xgfHXfEEWxeaEJeQBmv0eeohmcUgmWcqvD9Fj72_jVrCMP0KHlCzTqMtm6MfVTe8CDuBa3EGvq9vtne4C1l3l-i_Q4QoGZ-90sH2Hww04Pexw1YPHXR9VdQ0m4MH1PugA2A9gbG0NbqEtne4gcoIdMfB9cOD9SLHd_UCw3m_BP0EHtW48PN3_5-jT-dnH4l1yublYF6eXieF5xhMjJM2FyCpBRCpYVQJJl4KaWpY0NZnMa7YUJBUgMmJMLjRLcym5rEwlSso0n6MXEzca-BrfDaq13kDTRKv91itBpOA8rjm6noQmOvUOahVTaLXbKUrUWJFSY0VqTFuNaatfFSkpFVOxIqViRWqqSHFFVLGJFySin-09bMsWqj_AUydR8Hwv0N7opo45GuvvdSyjhI-cz5Psm21g95e__9r7p7v9Cf8JwF-8HQ</recordid><startdate>20000115</startdate><enddate>20000115</enddate><creator>Chang, Sam S.</creator><creator>Reuter, Victor E.</creator><creator>Heston, W. D. W.</creator><creator>Hutchinson, Brian</creator><creator>Grauer, Lana S.</creator><creator>Gaudin, Paul B.</creator><general>John Wiley &amp; Sons, Inc</general><general>Wiley-Liss</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20000115</creationdate><title>Short term neoadjuvant androgen deprivation therapy does not affect prostate specific membrane antigen expression in prostate tissues</title><author>Chang, Sam S. ; Reuter, Victor E. ; Heston, W. D. W. ; Hutchinson, Brian ; Grauer, Lana S. ; Gaudin, Paul B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3953-c7819775d707472dbe04671cf8b14c589f267047e750cc97a2498838dcd7b12a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Aged</topic><topic>Androgen Antagonists - pharmacology</topic><topic>Androgen Antagonists - therapeutic use</topic><topic>androgen deprivation therapy</topic><topic>Antibodies, Monoclonal</topic><topic>Antigens, Surface</topic><topic>Antineoplastic agents</topic><topic>Biological and medical sciences</topic><topic>Carboxypeptidases - analysis</topic><topic>Carboxypeptidases - biosynthesis</topic><topic>Chemotherapy</topic><topic>Glutamate Carboxypeptidase II</topic><topic>Humans</topic><topic>Immunohistochemistry</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>monoclonal antibody</topic><topic>Neoadjuvant Therapy</topic><topic>Pharmacology. Drug treatments</topic><topic>Prostate</topic><topic>prostate carcinoma</topic><topic>prostate specific membrane antigen</topic><topic>Prostatectomy</topic><topic>Prostatic Neoplasms - drug therapy</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatic Neoplasms - surgery</topic><topic>Sensitivity and Specificity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chang, Sam S.</creatorcontrib><creatorcontrib>Reuter, Victor E.</creatorcontrib><creatorcontrib>Heston, W. D. W.</creatorcontrib><creatorcontrib>Hutchinson, Brian</creatorcontrib><creatorcontrib>Grauer, Lana S.</creatorcontrib><creatorcontrib>Gaudin, Paul B.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chang, Sam S.</au><au>Reuter, Victor E.</au><au>Heston, W. D. W.</au><au>Hutchinson, Brian</au><au>Grauer, Lana S.</au><au>Gaudin, Paul B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Short term neoadjuvant androgen deprivation therapy does not affect prostate specific membrane antigen expression in prostate tissues</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2000-01-15</date><risdate>2000</risdate><volume>88</volume><issue>2</issue><spage>407</spage><epage>415</epage><pages>407-415</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><coden>CANCAR</coden><abstract>BACKGROUND Prostate specific membrane antigen (PSMA) is a transmembrane glycoprotein highly expressed in benign prostate secretory‐acinar epithelium and prostate carcinoma. The results of several studies suggest that PSMA expression is increased in prostate carcinoma cell lines subjected to androgen deprivation and in androgen‐independent tumors. The authors studied the effects of short term (3‐month) androgen deprivation on PSMA expression in prostate carcinoma specimens using two anti‐PSMA monoclonal antibodies (mAbs), 7E11 and PM2J004.5. METHODS The study included patients with clinically localized prostate carcinoma who were prospectively randomized into 1 of 2 treatment groups: 3 months of neoadjuvant androgen deprivation therapy followed by radical prostatectomy (ADT/RP), or radical prostatectomy (RP) alone. Representative formalin fixed, paraffin embedded prostate sections were immunostained with the anti‐PSMA mAbs 7E11 and PM2J004.5 by the streptavidin‐biotin method. The authors recorded the staining intensity and the percentage of positive cells stained in benign epithelium, high grade prostatic intraepithelial neoplasia (PIN), and prostate carcinoma. They compared the results of 7E11 with those of PM2J004.5 in benign epithelium, high grade prostate, and carcinoma and also compared the results between the two treatment groups (ADT/RP vs. RP alone). RESULTS Both anti‐PSMA mAbs stained benign secretory‐acinar epithelium, high grade PIN, and prostate carcinoma. In both treatment groups, PM2J004.5 reacted with a significantly greater percentage of cells (P &lt; 0.001) and with significantly greater intensity (P &lt; 0.001) compared with 7E11 in benign epithelium and prostate carcinoma. With both anti‐PSMA mAbs, the percentage of cells stained and the intensity of staining in high grade PIN was similar to that in prostate carcinoma. In the group that received RP alone, the percentage of cells stained and the intensity of staining with 7E11 were significantly greater in high grade PIN and prostate carcinoma compared with benign epithelium (P &lt; 0.001), and the intensity of staining with the PM2J004.5 was significantly greater in high grade PIN and prostate carcinoma compared with benign epithelium (P &lt; 0.001). In the ADT/RP group, the percentage of cells stained and the intensity of staining with 7E11 and PM2J004.5 were significantly greater in prostate carcinoma compared with benign epithelium (P &lt; 0.006). PSMA staining did not correlate with either Gleason score (in the group that received RP alone) or pathologic stage (in both the RP‐alone and ADT/RP groups) and did not differ between the two treatment groups. CONCLUSIONS Short term neoadjuvant ADT does not affect PSMA expression in benign prostate secretory‐acinar epithelium, high grade PIN, or prostate carcinoma. Prostate carcinoma and high grade PIN express significantly higher levels of PSMA than benign prostate secretory‐acinar epithelium. Compared with 7E11, the PM2J004.5 anti‐PSMA mAb is a more sensitive immunohistochemical marker of prostate carcinoma in formalin fixed, paraffin embedded tissue. Cancer 2000;88:407–15. © 2000 American Cancer Society. Short term neoadjuvant androgen deprivation therapy does not affect prostate specific membrane antigen (PSMA) expression in benign prostate tissue or prostate carcinoma. Compared with benign prostate tissue, prostate carcinoma expresses higher levels of PSMA.</abstract><cop>New York</cop><pub>John Wiley &amp; Sons, Inc</pub><pmid>10640975</pmid><doi>10.1002/(SICI)1097-0142(20000115)88:2&lt;407::AID-CNCR23&gt;3.0.CO;2-0</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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subjects Aged
Androgen Antagonists - pharmacology
Androgen Antagonists - therapeutic use
androgen deprivation therapy
Antibodies, Monoclonal
Antigens, Surface
Antineoplastic agents
Biological and medical sciences
Carboxypeptidases - analysis
Carboxypeptidases - biosynthesis
Chemotherapy
Glutamate Carboxypeptidase II
Humans
Immunohistochemistry
Male
Medical sciences
Middle Aged
monoclonal antibody
Neoadjuvant Therapy
Pharmacology. Drug treatments
Prostate
prostate carcinoma
prostate specific membrane antigen
Prostatectomy
Prostatic Neoplasms - drug therapy
Prostatic Neoplasms - pathology
Prostatic Neoplasms - surgery
Sensitivity and Specificity
title Short term neoadjuvant androgen deprivation therapy does not affect prostate specific membrane antigen expression in prostate tissues
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