Purification of a Human Prostate Specific Antigen

Wang, M.C.; Valenzuela, Luis; Murphy, Gerald P.; Chu, T. Ming

doi:10.1016/j.juro.2016.10.100

Cited by 277 publications

(53 citation statements)

References 6 publications

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“…It was first identified in the late 1970s and subsequently confirmed for clinical use about a decade later. 3 , 4 After its widespread clinical application in early cancer detection, PCa prevalence was found to have increased dramatically worldwide, which was recognized as the post-PSA era. PSA screening in older men is controversial.…”

Section: Discussionmentioning

confidence: 99%

Prognosis of prostate cancer with initial prostate-specific antigen >1,000 ng/mL at diagnosis

Kan¹,

Hou²,

Lin³

et al. 2017

OTT

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PurposeProstate cancer patients with surprisingly high prostate-specific antigen (PSA) are encountered clinically. However, descriptions of this group of patients are extremely rare in the published literature. This study reports treatment outcome and long-term prognosis for this group of patients.Patients and methodsBetween January 2007 and December 2012, 2,064 patients with PCa diagnosed at a tertiary medical center were retrospectively reviewed. A total of 90 PCa cases were identified with initial PSA (iPSA) >1,000 ng/mL at diagnosis. A retrospective study was conducted in this cohort, with comparison among stratified patient age groups, PSA, treatment options, and overall survival.ResultsThe mean PSA at PCa diagnosis in this cohort was 3,323 ng/mL (1,003–23,126, median: 2,050 ng/mL). Most patients were in the age group 65–79 years (55/90, 61%). Males older than 80 years had a poor prognosis (P<0.001). Forty-six patients (51%) underwent orchiectomy with a median follow-up period of 16.2 (1.3–72.7) months, compared to 44 patients treated with medical castration and a median follow-up of 9.1 (0.3–70.5) months. Kaplan–Meier analysis revealed survival benefit from treatment with orchiectomy (P<0.001). PSA reduction >90% of iPSA following primary androgen deprivation therapy (reaching true nadir) could be a predictor of longer survival (P<0.001). Cox regression revealed the hazard ratio (HR) of variables were age (HR: 4.57, 95% confidence interval [CI]: 1.45–14.37, P=0.009), reaching true nadir (HR: 0.12, 95% CI: 0.03–0.58, P=0.008), and the treatment option with orchiectomy (HR: 0.22, 95% CI: 0.65–0.76, P=0.016).ConclusionAge ≥80 years indicated poor overall survival in PCa patients with iPSA >1,000 ng/mL. Reaching a true nadir of PSA following primary androgen deprivation therapy could be a predictor of longer survival. Bilateral orchiectomy is recommended for this group of patients.

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Section: Discussionmentioning

confidence: 99%

Prognosis of prostate cancer with initial prostate-specific antigen >1,000 ng/mL at diagnosis

Kan¹,

Hou²,

Lin³

et al. 2017

OTT

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“…1 Since the 1990s, primary screening for prostate cancer in the United States has relied on prostate-specific antigen (PSA), 2 a serum marker of prostatic tissue identified at the Roswell Park Cancer Institute in 1979. 3 The PSA test for clinical use was first approved by the Food and Drug Administration in 1986 for monitoring recurrence and responses to treatment and later for the early detection of prostate cancer. 4 Despite a 39% decline in prostate cancer-specific mortality since 1991, controversy about the benefits and harms of PSAbased screening remain.…”

Section: Introductionmentioning

confidence: 99%

Testing and referral patterns in the years surrounding the US Preventive Services Task Force recommendation against prostate‐specific antigen screening

Hutchinson

Akhtar

Haridas

et al. 2016

Cancer

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“…After Wang et al [21] isolated PSA from the prostate, rectal examination and PSA have been widely used as the rst methods to detect prostate cancer. A prostate biopsy is a necessary process for diagnosing prostate cancer, but when performing prostate biopsy on men with PSA levels in the gray zone, several aspects need to be considered.…”

Section: Discussionmentioning

confidence: 99%

Is PSA Density of the Peripheral Zone as a Useful Predictor for Prostate Cancer in Patients With Gray Zone PSA Levels?

Lee

Yang

Jin

et al. 2020

Preprint

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BackgroundSerum prostate-specific antigen (PSA) is widely used in screening tests for prostate cancer. As the low specificity of PSA results in unnecessary and invasive prostate biopsies, we evaluated the clinical significance of various PSAs and PSA density (PSAD) related to peripheral zones in patients with gray zone PSA level (4-10 ng/mL).MethodsA total of 1,300 patients underwent transrectal ultrasonography-guided prostate biopsy from 2014 to 2019. Among them, 545 patients in the gray zone were divided into the prostate cancer diagnosis group and the non-prostate cancer diagnosis group, and PSA, relative extra transitional zone PSA (RETzPSA), estimated post holmium laser enucleation of the prostate PSA (EPHPSA), PSAD, peripheral zone PSA density (PZPSAD) and extra-transitional zone density (ETzD) were compared and analyzed using receiver-operating characteristics (ROC) analysis after 1:1 matching using propensity score.ResultsArea under the ROC curve values of PSA, EPHPSA, RETzPSA, PSA density, ETzD, and PZPSAD were 0.553 (95% CI: 0.495-0.610), 0.611 (95% CI: 0.554-0.666), 0.673 (95% CI: 0.617-0.725), 0.745 (95% CI: 0.693-0.793), 0.731 (95% CI: 0.677-0.780) and 0.677 (95% CI: 0.611-0.719), respectively. PSAD had 67.11% sensitivity, 71.71% specificity, and 70.34% positive predictive rate at 0.18 ng/mL/cc. ETzD had 69.08% sensitivity, 64.47% specificity, and 66.04% positive predictive rate at 0.04 ng/mL/cc. When the cut-off value of PSAD was increased to 0.18 ng/mL/cc, the best results were obtained with an odds ratio of 5.171 (95% CI: 3.171-8.432), followed by ETzD with 4.054 (95% CI: 2.513-6.540).ConclusionsThese results suggested that volume-adjusted parameters (ETzD and PSAD) might be more sensitive and accurate than various PSA in gray zone patients who required prostate biopsy to reduce unnecessary biopsy.

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Purification of a Human Prostate Specific Antigen

Cited by 277 publications

References 6 publications

Prognosis of prostate cancer with initial prostate-specific antigen >1,000 ng/mL at diagnosis

Prognosis of prostate cancer with initial prostate-specific antigen >1,000 ng/mL at diagnosis

Testing and referral patterns in the years surrounding the US Preventive Services Task Force recommendation against prostate‐specific antigen screening

Is PSA Density of the Peripheral Zone as a Useful Predictor for Prostate Cancer in Patients With Gray Zone PSA Levels?

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Purification of a Human Prostate Specific Antigen

Cited by 277 publications

References 6 publications

Prognosis of prostate cancer with initial prostate-specific antigen &gt;1,000 ng/mL at diagnosis

Prognosis of prostate cancer with initial prostate-specific antigen &gt;1,000 ng/mL at diagnosis

Testing and referral patterns in the years surrounding the US Preventive Services Task Force recommendation against prostate‐specific antigen screening

Is PSA Density of the Peripheral Zone as a Useful Predictor for Prostate Cancer in Patients With Gray Zone PSA Levels?

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Prognosis of prostate cancer with initial prostate-specific antigen >1,000 ng/mL at diagnosis

Prognosis of prostate cancer with initial prostate-specific antigen >1,000 ng/mL at diagnosis