Additional use of [−2] precursor prostate-specific antigen and “benign” PSA at diagnosis in screen-detected prostate cancer

Vries, Stijn H. de; Raaijmakers, René; Blijenberg, B. G.; Mikolajczyk, Stephan D.; Rittenhouse, Harry G.; Schröder, Fritz H.

doi:10.1016/j.urology.2004.11.030

Cited by 24 publications

(19 citation statements)

References 25 publications

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“…Using a multivariate analysis, Guazzoni et al [ 25 ] showed that the inclusion of %[ − 2] proPSA and phi significantly increased the predictive accuracy of a model based on patient age, PSA, %fPSA, clinical stage and biopsy Gleason score in the prediction of high pathologic stage or high pathologic Gleason score. Similarly, de Vries et al [ 26 ] indicated promising results for %[ − 2] proPSA in selecting treatment strategies for men with prostate cancer using Epstein ' s criteria to differentiate between non-aggressive and aggressive tumors. Finally, in a recently published study Isharwal et al [ 27 ] described that %[ − 2] proPSA and phi predicts unfavorable biopsy conversion at an annual surveillance biopsy examination among men enrolled in an active surveillance program.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of [−2] proPSA and Prostate Health Index (phi) for the detection of prostate cancer: a systematic review and meta-analysis

Filella

Giménez

2012

Clinical Chemistry and Laboratory Medicine (CCLM)

132

100

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The usefulness of %[ − 2] proPSA and Prostate Health Index (phi) in the detection of prostate cancer are currently unknown. It has been suggested that these tests can distinguish prostate cancer from benign prostatic diseases better than PSA or %fPSA. We performed a systematic review and meta-analysis of the available scientific evidence to evaluate the clinical usefulness of %[ − 2] proPSA and phi. Relevant published papers were identified by searching computerized bibliographic systems. Data on sensitivity and specificity were extracted from 12 studies: 10 studies about %[ − 2] proPSA (3928 patients in total, including 1762 with confirmed prostate cancer) and eight studies about phi (2919 patients in total, including 1515 with confirmed prostate cancer). The sensitivity for the detection of prostate cancer was 90% for %[ − 2] proPSA and phi, while the pooled specificity was 32.5% (95% CI 30.6 -34.5) and 31.6% (95% CI 29.2 -34.0) for %[ − 2] proPSA and phi, respectively. The measurement of %[ − 2] proPSA improves the accuracy of prostate cancer detection in comparison with PSA or %fPSA, particularly in the group of patients with PSA between 2 μ g/L and 10 μ g/L. Similar results were obtained measuring phi. Using these tests, it is possible to reduce the number of unnecessary biopsies, maintaining a high cancer detection rate. Published results also showed that %[ − 2] proPSA and phi are related to the aggressiveness of the tumor.

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Section: Discussionmentioning

confidence: 99%

Evaluation of [−2] proPSA and Prostate Health Index (phi) for the detection of prostate cancer: a systematic review and meta-analysis

Filella

Giménez

2012

Clinical Chemistry and Laboratory Medicine (CCLM)

132

100

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“…In another study, de Vries, et al reported data from 61 men participating in the screening arm of a large cancer screening study in which men with less aggressive prostate cancer had a median BPSA value of 172 pg/mL and those men with more aggressive prostate cancer had a median BPSA value of 264 pg/mL, again, falling into approximately the 91 st and 95 th percentile of the BPSA distribution observed for the combined cohorts. 5 Linton, et al reported median BPSA levels of 220 pg/mL and 170 pg/mL in 79 men with BPH (defined as elevated PSA with negative biopsy) and 91 men with prostate cancer, respectively. 20 These median values reported by Linton for BPSA were both above the 90 th percentile of the BPSA distribution for this study.…”

Section: Discussionmentioning

confidence: 99%

“…1, 3–5 These studies provide initial support for the usefulness of BPSA as a marker for benign prostate disease; however, they may not reflect the full spectrum of men with and without benign prostate disease. The objective of this paper is to provide normative data in a population-based, biracial sample of men and to describe the cross-sectional associations between baseline values of BPSA and common clinical urologic measures.…”

Section: Introductionmentioning

confidence: 92%

Benign Prostate Specific Antigen Distribution and Associations With Urological Outcomes in Community Dwelling Black and White Men

et al. 2012

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Purpose To describe the cross-sectional associations of benign prostate-specific antigen (BPSA) with clinical urologic measures, and to examine the risk of future urologic outcomes in two population-based cohorts of black and white men. Materials and Methods Two population-based, cohort studies were established to characterize the natural history and risk factors for progression of prostate disease in white and black male residents of Olmsted County, Minnesota and Genesee County, Michigan, respectively. Results The distribution of BPSA levels was similar in blacks (median (25th, 75th percentiles) =32.9 (17.3, 68.0) pg/mL) and whites (median=32.2 (16.6,68.9) pg/mL), p=0.71, but much lower than previous reports. For Olmsted County men in the upper quartile of BPSA, there was a 15-fold increased risk of prostate cancer (CaP; hazard ratio (HR): 14.6 95% confidence interval (CI): 3.1, 68.6) and a 2-fold higher risk of treatment for benign prostatic hyperplasia (BPH; HR: 2.2, 95% CI: 1.2, 4.2) after adjusting for age. After additional adjustment for baseline PSA, the association between BPSA and CaP risk was attenuated, but remained nearly 9-fold higher for men in the upper BPSA quartile (HR: 8.7, 95% CI: 1.8, 42.4). The 2-fold higher risk of treatment for BPH also remained after adjustment for baseline PSA for men in the upper BPSA quartile (HR: 1.9, 95% CI: 0.9, 4.0). Conclusions These results suggest that elevated BPSA level may help to identify men at risk of treatment for BPH and identify men with prostate cancer.

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“…Mikolajczyk et al [39] also pointed out to higher specificity, and positive predictive value of % pPSA rather than % fPSA for PCa in cases with tPSA values between 4, and 10 ng/mL. While de Viries et al [40] reported that at tPSA values below 15 ng/mL, % pPSA did not correlate with prognosis of PCa patients, and they also expressed that higher % pPSA values at tPSA interval of 4-10 ng/mL were associated with poor prognosis.…”

Section: Propsa (Ppsa)mentioning

confidence: 97%

“…[51] In a multivariate analysis, Guazzoni et al [52] demonstrated that in the prediction of higher Gleason score or pathological stage, combined use of % p2PSA, and phi increased accuracy rate of prediction in a model based on combination of biopsy GS, and clinical stage, % sPSA, tPSA, and age of the patients. Similarly, de Vries et al [40] used Epstein criteria to differentiate between aggressive, and non-aggressive tumors, and stated that % p2PSA test results provide promising guidelines in the selection of treatment strategies for PCa patients Finally, in a study by Isharwal et al [53] use of % p2PSA, and phi decreased the number of biopsies in patients on active surveillance. Based on the results obtained, % p2PSA, and ve phi can make a discrimination between high-, and low-risk prostate cancers.…”

mentioning

confidence: 99%

PSA, PSA derivatives, proPSA and prostate health index in the diagnosis of prostate cancer

Ayyıldız¹,

Ayyıldız²

2014

Turkish Journal of Urology

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Currently, prostate-specific antigen (PSA) is the most common oncological marker used for prostate cancer screening. However, high levels of PSA in benign prostatic hyperplasia and prostatitis decrease the specificity of PSA as a cancer marker. To increase the specificity of PSA, PSA derivatives and PSA kinetics have been used. However, these new techniques were not able to increase the diagnostic specificity for prostate cancer.Therefore, the search for new molecules and derivatives of PSA continues. With the aim of increasing the specificity of prostate cancer diagnosis, proPSA and the Prostate Health Index have been introduced. In this review, the roles of PSA, PSA derivatives, proPSA and the Prostate Health Index in Prostate Cancer diagnosis are examined.

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Additional use of [−2] precursor prostate-specific antigen and “benign” PSA at diagnosis in screen-detected prostate cancer

Cited by 24 publications

References 25 publications

Evaluation of [−2] proPSA and Prostate Health Index (phi) for the detection of prostate cancer: a systematic review and meta-analysis

Evaluation of [−2] proPSA and Prostate Health Index (phi) for the detection of prostate cancer: a systematic review and meta-analysis

Benign Prostate Specific Antigen Distribution and Associations With Urological Outcomes in Community Dwelling Black and White Men

PSA, PSA derivatives, proPSA and prostate health index in the diagnosis of prostate cancer

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