Prostatic volume and ratio of free-to-total prostate specific antigen in patients with prostatic cancer or benign prostatic hyperplasia

被引:37
作者
Haese, A
Graefen, M
Noldus, J
Hammerer, P
Huland, E
Huland, H
机构
[1] Department of Urology, University Clinic Eppendorf, Hamburg
关键词
prostate-specific antigen; prostatic neoplasms; prostatic hypertrophy;
D O I
10.1016/S0022-5347(01)68192-8
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: We correlated prostatic volume with the ratio of free-to-total prostate specific antigen (PSA) in serum from patients with prostatic cancer or benign prostatic hyperplasia (BPH) to evaluate how prostatic volume influences the ratio. Materials and Methods: We evaluated sera from 395 patients (mean age 65 years, range 45 to 88) with prostate cancer (239) or BPH (156) for total PSA, free PSA and ratio of free-to-total PSA. For detection of total and free PSA we used an Immulite* free and total PSA assay. Prostatic volume was determined With transrectal ultrasonography. Prostatic volume in BPH and prostate cancer patients was divided into 10 ml. groups, and mean ratio of free-to-total PSA was calculated for each volume group and both diseases. For statistical analysis Mann-Whitney U and Kruskal-Wallis tests were performed in addition to calculation of sensitivity and specificity, and receiver operator curves for prostates 60 ml. or less and greater than 60 ml. Results: For BPH patients the mean ratio of free-to-total PSA was 14.64 to 25.14% without a close relation to prostatic volume. In prostate cancer patients a proportional increase from 8.45 to 19.37% in the ratio of free-to-total PSA with volume was found. Mann-Whitney U analysis revealed significant differences in prostate cancer versus BPH only in patients with prostates of 60 ml. or smaller (p = 0.0008 to 0.029). No significant differences were seen when prostate cancer and BPH patients with prostates larger than 60 ml. were compared (p = 0.082 to 0.868). Kruskal-Wallis test confirmed independence of the ratio of free-to-total PSA from prostatic volume in BPH patients (p = 0.285) but dependence in prostate cancer patients (p < 0.0001). Sensitivity was higher in patients with prostates 60 ml. or smaller (86.72%) than in patients with prostates larger than 60 ml. (66%), and specificity was lower at 45.78 and 56.16%, respectively. Conclusions: We have shown that the ratio of free-to-total PSA is influenced by prostatic volume in patients with prostate cancer. The ratio of free-to-total PSA provides useful information for differentiate BPH from prostate cancer in patients with small prostates but it is less useful in patients with larger prostates, probably because of the larger proportion of benign hypertrophic tissue.
引用
收藏
页码:2188 / 2192
页数:5
相关论文
共 17 条
  • [1] THE USE OF PROSTATE SPECIFIC ANTIGEN DENSITY TO ENHANCE THE PREDICTIVE VALUE OF INTERMEDIATE LEVELS OF SERUM PROSTATE SPECIFIC ANTIGEN
    BENSON, MC
    WHANG, IS
    OLSSON, CA
    MCMAHON, DJ
    COONER, WH
    [J]. JOURNAL OF UROLOGY, 1992, 147 (03) : 817 - 821
  • [2] LONGITUDINAL EVALUATION OF PROSTATE-SPECIFIC ANTIGEN LEVELS IN MEN WITH AND WITHOUT PROSTATE DISEASE
    CARTER, HB
    PEARSON, JD
    METTER, J
    BRANT, LJ
    CHAN, DW
    ANDRES, R
    FOZARD, JL
    WALSH, PC
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1992, 267 (16): : 2215 - 2220
  • [3] MEASUREMENT OF PROSTATE-SPECIFIC ANTIGEN IN SERUM AS A SCREENING-TEST FOR PROSTATE-CANCER
    CATALONA, WJ
    SMITH, DS
    RATLIFF, TL
    DODDS, KM
    COPLEN, DE
    YUAN, JJJ
    PETROS, JA
    ANDRIOLE, GL
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1991, 324 (17) : 1156 - 1161
  • [4] SERUM PROSTATE-SPECIFIC ANTIGEN COMPLEXED TO ALPHA-1-ANTICHYMOTRYPSIN AS AN INDICATOR OF PROSTATE-CANCER
    CHRISTENSSON, A
    BJORK, T
    NILSSON, O
    DAHLEN, U
    MATIKAINEN, MT
    COCKETT, ATK
    ABRAHAMSSON, PA
    LILJA, H
    [J]. JOURNAL OF UROLOGY, 1993, 150 (01) : 100 - 105
  • [5] CIRCULATING ANTIBODY TO PROSTATE ANTIGEN IN PATIENTS WITH PROSTATIC-CANCER
    CHU, TM
    KURIYAMA, M
    JOHNSON, E
    PAPSIDERO, LD
    KILLIAN, CS
    MURPHY, GP
    WANG, MC
    [J]. ANNALS OF THE NEW YORK ACADEMY OF SCIENCES, 1983, 417 (DEC) : 383 - 389
  • [6] Free-to-total prostate specific antigen ratio as a single test for detection of significant stage T1c prostate cancer
    Elgamal, AAA
    Cornillie, FJ
    VanPoppel, HP
    VandeVoorde, WM
    McCabe, R
    Baert, LV
    [J]. JOURNAL OF UROLOGY, 1996, 156 (03) : 1042 - 1047
  • [7] ESTEVE J, 1993, FACTS FIGURES CANC E, P1
  • [8] HAMMERER P, 1996, UROLOGE A S, V35, P82
  • [9] Hara M., 1971, JPN J LEGAL MED, V25, P322
  • [10] LILJA H, 1991, CLIN CHEM, V37, P1618