Limited usefulness of the free-to-total prostate-specific antigen ratio for the diagnosis and staging of prostate cancer in Japanese men

被引:11
作者
Sakai I. [1 ]
Harada K.-I. [1 ]
Hara I. [2 ]
Eto H. [1 ]
Miyake H. [1 ]
机构
[1] Department of Urology, Hyogo Medical Center for Adults, Akashi 673-8558
[2] Department of Urology, Kobe University School of Medicine, Kobe
关键词
Diagnosis; Free/total PSA ratio; Prostate cancer; Staging;
D O I
10.1007/s10147-003-0365-1
中图分类号
学科分类号
摘要
Background. The objective of this study was to evaluate the clinical significance of measuring the free-to-total (f/t) prostate-specific antigen (PSA) ratio for the differentiation of prostate cancer from benign prostatic hypertrophy (BPH) and for the staging of prostate cancer in Japanese men. Methods. Before treatment, tPSA and fPSA were measured in 147 patients with prostate cancer and in 253 with BPH, using immunofluorometric techniques. Furthermore, the f/t PSA ratio and the tPSA density of the whole prostate (PSAD) were calculated. Results. The tPSA and PSAD levels in patients with prostate cancer paralleled the clinical stage, and were significantly higher than the levels in patients with BPH, while the f/t PSA ratio was not associated with clinical stage, despite the significantly lower values in prostate cancer patients than in BPH patients. Furthermore, the tPSA and PSAD values, but not the f/t PSA ratio, were significantly different between patients with pathologically extraprostatic disease and those with organ-confined disease. Calculation of the specificity of each assay within the range of 80%-95% sensitivity showed that tPSA and PSAD provided better specificities than the f/ t PSA ratio. However, there was no significant difference in specificities among these three assays. In prostate cancer and BPH patients with PSA values of 4.1-10 ng/ml, the specificities of tPSA and PSAD were also superior to that of the f/t PSA ratio. Conclusion. These findings suggest that measurement of the f/t PSA ratio does not provide any significant additional information for the diagnosis and staging of prostate cancer in Japanese men when tPSA and PSAD values are available.
引用
收藏
页码:64 / 67
页数:3
相关论文
共 13 条
[1]  
Polascik T.J., Oesterling J.E., Partin A.W., Prostate specific antigen: A decade of discovery - What we have learned and where we are going, J Urol, 162, pp. 293-306, (1999)
[2]  
Benson M.C., Whang I.S., Olsson C.A., Et al., The use of prostate specific antigen density to enhance the predictive value of intermediate levels of serum prostate specific antigen, J Urol, 147, pp. 815-816, (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, 267, pp. 2215-2220, (1992)
[4]  
Oesterling J.E., Jacobson S.J., Klee G.G., Et al., Free, complexed and total serum prostate specific antigen: The establishment of appropriate reference ranges for their concentrations and ratios, J Urol, 154, pp. 1090-1095, (1995)
[5]  
Stenman U.A., Leinonen J., Alfthan H., Et al., A complex between prostate-specific antigen and α <sub>1</sub>-antichymotrypsin is the major form of prostate-specific antigen in serum of patients with prostatic cancer: Assay of the complex improves clinical sensitivity for cancer, Cancer Res, 51, pp. 222-226, (1991)
[6]  
Catalona W.J., Beiser J.A., Smith D.S., Serum free prostate specific antigen and prostate specific antigen density measurements for predicting cancer in men with prior negative prostatic biopsies, J Urol, 158, pp. 2162-2167, (1997)
[7]  
Masters J.G., Keegan P.E., Hildreth A.J., Et al., Free/total serum prostate-specific antigen ratio: How helpful is it in detecting prostate cancer?, Br J Urol, 81, pp. 419-423, (1998)
[8]  
Melchior S.W., Noteboom J., Gillitzer R., Et al., The percentage of free prostate-specific antigen does not predict extracapsular disease in patients with clinically localized prostate cancer before radical prostatectomy, BJU Int, 88, pp. 221-225, (2001)
[9]  
Okihara K., Cheli C.D., Partin A.W., Et al., Comparative analysis of complexed prostate specific antigen, free prostate specific antigen and their ratio in detecting prostate cancer, J Urol, 167, pp. 2017-2023, (2002)
[10]  
Pannek J., Rittenhouse H.G., Chan D.W., Et al., The use of percent free prostate specific antigen for staging clinically localized prostate cancer, J Urol, 159, pp. 1238-1242, (1998)