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01-06-2004 | Free Paper

Probability of prostate cancer as a function of the percentage of free prostate-specific antigen in patients with a non-suspicious rectal examination and total prostate-specific antigen of 4–10 ng/ml

Authors: L. Martínez-Piñeiro, J. M. García Mediero, P. González Gancedo, A. Tabernero, D. Lozano, J. J. López-Tello, J. M. Alonso-Dorrego, C. Núñez, M. L. Picazo, R. Madero, J. J. De La Peña

Published in: World Journal of Urology | Issue 2/2004

Abstract

Our aim was to assess the usefulness of measuring the percentage of free prostate specific antigen (PSA) in serum in relation to reducing the number of prostate biopsies in men with benign prostate examinations and serum PSA levels between 4 and 10 ng/ml. The percentage of free PSA (Immulite) in serum was analyzed prospectively in 500 men, all of whom underwent ultrasound-guided sextant prostate biopsies. Cancer was detected in 21.4% (107/500) of the patients. Using a free PSA cutoff of ≤23% as a criterion for performing prostate biopsy would have detected 94.4% of cancers, avoided 18.8% of benign biopsies and yielded a positive predictive value of 25.3%. The percentage of free PSA increased with prostate volume. Mean total PSA and mean free percent PSA values increased as patient age increased, influencing the calculation of cutoff values, sensitivity and specificity. PSA density had a sensitivity and specificity not significantly different than the percentage of free PSA. Measurement of the percentage of free serum PSA improves the specificity of prostate cancer detection in patients with elevated total serum PSA levels and benign prostate examinations.

Bangma CH, Kranse R, Blijenberg BG, Schröder FH (1995) The value of screening tests in the detection of prostate cancer. Part II. Retrospective analysis of free/total prostate-specific analysis ratio, age-specific reference ranges, and PSA density. Urology 46:779–784CrossRefPubMed

Bangma CH, Rietbergen JBW, Kranse R, Blijenberg BG, Petterson K, Schröder FH (1997) The free-to-total prostate specific antigen ratio improves the specificity of prostate specific antigen in screening for prostate cancer in the general population. J Urol 157:2191–2196CrossRefPubMed

Catalona WJ (1997): Editorial comment. J Urol 157:2196CrossRef

Catalona WJ, Richie JP, Ahmann FR, Hudson MA, Scardino PT, Flanigan RC, DeKernion JB, Ratliff TL, Kavoussi LR, Dalkin BL, Waters WB, MacFarlane MT, Southwick PC (1994) Comparison of digital rectal examination and serum prostate specific antigen in the early detection of prostate cancer: Results of a multicenter clinical trial of 6,630 men. J Urol 151:1283–1290PubMed

Catalona WJ, Smith DS, Wolfert RL, Wang TJ, Rittenhouse HG, Ratliff TL, Nadler RB (1995) Evaluation of percentage of free serum prostate-specific antigen to improve specificity of prostate cancer screening. JAMA 274:1214–1220CrossRefPubMed

Catalona WJ, Ornstein DK, Humphrey PA, Smith DS (1997) Factors effecting the percentage of free serum prostate-specific antigen levels in men without clinically detectable prostate cancer. J Urol 157 [Suppl 4]:111

Catalona WJ, Smith DS, Ornstein DK (1997) Prostate cancer detection in men with serum PSA concentrations of 2.6 to 4.0 ng/ml and benign prostate examination. JAMA 277:1452–1455CrossRefPubMed

Catalona WJ, Partin AW, Slawin KM, Brawer MK, Flanigan RC, Patel A, Richie JP, deKernion JB, Walsh PC, Scardino PT, Lange PH, Subong ENP, Parson RE, Gasior GH, Loveland KG, Southwick PC (1998) Use of the percentage of free PSA to enhance differentiation of prostate cancer from benign prostatic disease: a prospective multicenter clinical trial. JAMA 279:1542–1547CrossRefPubMed

Catalona WJ, Southwick PC, Slawin KM, Partin AW, Brawer MK, Flanigan RC, Patel A, Richie JP, Walsh PC, Scardino PT, Lange PH, Gasior GH, Loveland KG, Bray KR (2000) Comparison of percent free PSA, PSA density, and age-specific PSA cutoffs for prostate cancer detection and staging. Urology 56:255–260CrossRefPubMed

10.

Chen YT, Luderer AA, Thiel RP, Carlson G, Cuny CL, Soriano TF (1996) Using proportions of free to total prostate-specific antigen, age, and total prostate-specific antigen to predict the probability of prostate cancer. Urology 47:518–524CrossRefPubMed

11.

Djavan B, Zlotta AR, Byttebier G, Shariat S, Omar M, Schulman CC, Marberger M (1998) Prostate specific antigen density of the transition zone for early detection of prostate cancer. J Urol 160:411–419CrossRefPubMed

12.

Djavan B, Zlotta A, Remzi M, Ghawidel K, Basharkhah A, Schulman CC, Marberger M (2000) Optimal predictors of prostate cancer on repeat prostate biopsy: a prospective study of 1051 men. J Urol 163:1144–1149PubMed

13.

España F, Martínez M, Sánchez-Cuenca J, Vera CD, Estellés A, Jiménez-Cruz JF (1996) Prostate-specific antigen and its complexes with alpha1-antichymotripsin in the plasma of patients with prostatic disease. Eur Urol 30:512–518PubMed

14.

Fowler JEJr, Sanders J, Bigler SA, Rigdon J, Kilambi NK, Land SA (2000) Percent free prostate specific antigen and cancer detection in black and white men with total prostate specific antigen 2.5 to 9.9 ng/ml. J Urol 163:1467–1470CrossRefPubMed

15.

Morote J, Raventós CX, Lorente JA, Lopez-Pacios MA, Encabo G, De Torres I, Andreu J (1997) Comparison of percent free prostate specific antigen and prostate specific antigen density as methods to enhance prostate specific antigen specificity in early prostate cancer detection in men with normal rectal examination and prostate specific antigen between 4.1 and 10 ng/ml. J Urol 158:502–504CrossRefPubMed

16.

Partin AW, Catalona WJ, Southwick PC, Subong ENP, Gasior GH, Chan DW (1996) Analysis of percent free prostate-specific antigen (PSA) for prostate cancer detection: influence of total PSA, prostate volume, and age. Urology 48:55–61

17.

Prestigiacomo AF, Lilja H, Pettersson K, Wolfert RL, Stamey TA (1996) A comparison of the free fraction of serum prostate specific antigen in men with benign and cancerous prostates: the best case scenario. J Urol 156:350–354PubMed

18.

Stephan C, Lein M, Jung K, Schnorr D, Loening SA (1997) The influence of prostate volume on the ratio of free to total prostate specific antigen in serum of patients with prostate carcinoma and benign hyperplasia. Cancer 79:104–109CrossRefPubMed

19.

Vessella RL, Lange PH, Partin AW, Chan DW, Sokoll LJ, Sasse EA, Crawford ED (2000) Probability of prostate cancer detection based on results of a multicenter study using the AxSym free PSA and total PSA assays. Urology 55:909–914PubMed

20.

Woodrum DL, Brawer MK, Partin AW, Catalona WJ, Southwick PC (1998) Interpretation of free prostate specific antigen clinical research studies for the detection of prostate cancer. J Urol 159:5–12PubMed

Title: Probability of prostate cancer as a function of the percentage of free prostate-specific antigen in patients with a non-suspicious rectal examination and total prostate-specific antigen of 4–10 ng/ml
Authors: L. Martínez-Piñeiro
J. M. García Mediero
P. González Gancedo
A. Tabernero
D. Lozano
J. J. López-Tello
J. M. Alonso-Dorrego
C. Núñez
M. L. Picazo
R. Madero
J. J. De La Peña
Publication date: 01-06-2004
Publisher: Springer-Verlag
Published in: World Journal of Urology / Issue 2/2004
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-003-0393-5

Keynote webinar | Spotlight on medication adherence

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Probability of prostate cancer as a function of the percentage of free prostate-specific antigen in patients with a non-suspicious rectal examination and total prostate-specific antigen of 4–10 ng/ml

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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