The clinical value of the ratio of free prostate specific antigen to total prostate specific antigen

被引：1
作者：
Dalva I. [1 ]
Akan H. [1 ]
Yildiz O. [1 ]
Telli C. [1 ]
Bingol N. [1 ]
机构：
[1] Department of Urology, Bayindir Medical Center, Ankara
来源：
International Urology and Nephrology | 1999年 / 31卷 / 5期
关键词：
Public Health; Cancer Patient; Prostate Cancer; Prostate Specific Antigen; Specific Antigen;
D O I：
10.1023/A:1007116807012
中图分类号：
学科分类号：
摘要：
Objective: To examine the usefulness of the ratio of free prostate specific antigen (FPSA) to total prostate specific antigen (TPSA) in men with serum TPSA concentration of 4 to 10 ng/mL by using the cut off value of 0.15 for avoiding unnecessary biopsies. Patients and methods: Two hundred thirty-six men aged between 52 and 91 with symptoms of prostatism were evaluated with digital rectal examination (DRE), FPSA and TPSA measurements. Patients with TPSA values under 4 ng/mL were biopsied if they had positive DRE and/or a FPSA/TPSA ratio lower than 0.15. All patients with TPSA values higher than 4 ng/mL were also biopsied. The predictive value and sensitivity of FPSA/TPSA ratio and TPSA alone were calculated. Results: Eleven patients out of 170 with a TPSA value lower than 4 ng/mL were biopsied. Fifty-five patients had a value between 4.1 and 10 ng/mL. We performed transrectal ultrasound (TRUS) and prostate biopsy in these men except one patient. Biopsy proven prostate cancer was detected only in 12 patients. In this group of patients the predictive value of TPSA was 21%, but the predictive value of FPSA/TPSA ratio of 0.15 was 78% maintaining at least 90% sensitivity. Eleven of the patients had a prostate specific antigen (PSA) value higher than 10 ng/mL. In 6 of these patients the biopsy result was prostate cancer and 10 of these patients had a FPSA/TPSA ratio lower than 0.15. Conclusion: In patients with TPSA values between 4-10 ng/mL the cut off value of FPSA/TPSA ratio of 0.15 can be used to eliminate unnecessary biopsies with minimal loss of cancer patients.
引用
收藏
页码：675 / 680
页数：5
相关论文
共 15 条
  • [1] Stamey T.A., Yang N., Hay A.R., Mcneal J.E., Freiha F.S., Redwine E., Prostate specific antigen as a serum marker for adenocarcinoma of the prostate, N. Engl. J. Med., 317, (1992)
  • [2] Lilja H., Cockett A.T.K., Abrahamsson P.A., Prostate specific antigen predominantly forms a complex with α1-antichymotrypsin in blood. Implications for procedures to measure prostate specific antigen in serum, Cancer (Suppl.), 70, (1992)
  • [3] Carter H.B., Pearson J.D., Metter E.J., Et al., Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease, JAMA, 67, (1992)
  • [4] Benson M.C., Whang I.S., Olsson C.A., Mcmahon D.J., Cooner W.H., The use of prostate specific antigen density to enhance the predictive value of intermediate levels of serum prostate specific antigen, J. Urol., 147, (1992)
  • [5] Oesterling J.E., Jacobsen S.J., Chute C.G., Et al., Serum prostate-specific antigen in a community-based population of healthy men. Establishment of age-specific reference ranges, JAMA, 270, (1993)
  • [6] Catalona W.J., Richie J.P., Dekernion J.B., Et al., Comparison of prostate specific antigen concentration versus prostate specific antigen density in the early detection of prostate cancer: Receiver operating characteristic curves, J. Urol., 152, (1994)
  • [7] Catalona W.J., Hudson M.A., Scardino P.T., Et al., Selection of optimal prostate specific antigen cutoffs for early detection of prostate cancer: Receiver operating characteristic curves, J. Urol., 152, (1994)
  • [8] Seaman E., Katz A., Cooner W.C., Et al., An algorithm for prostate cancer detection based upon PSA, TRUS, DRE, PSA density and PSA velocity, J. Urol., 149, 2 PART, (1993)
  • [9] Christensson A., Bjork T., Nilsson O., Et al., Serum prostate specific antigen complexed to alpha 1-antichymotrypsin as an indicator of prostate cancer, J. Urol., 150, (1993)
  • [10] Stenman U.-H., Hakama M., Knekt P., Aromaa A., Teppo L., Leiyonen J., Serum concentrations of prostate specific antigen and its complex with a1-antichymotrypsin before diagnosis of prostatic cancer, JAMA, 273, (1995)
12