An Evaluation of the Immunochemical Measurement of Prostatic Acid Phosphatase and Prostatic Specific Antigen in Carcinoma of the Prostate

The Value of the Measurement of Serum Prostate Specific Antigen in Patients with Benign Prostatic Hyperplasia and Untreated Prostate Cancer

“…In trying to define a possible role in screening for prostate cancer of a sensitive tumour marker such as PSA, account has to be taken of other factors which may affect the level of the marker in question. The upper limit of normal of PSA has been quoted as 4ng/ml (Lange et al, 1986), although an operational upper limit of normal of 10 ng/ml has been suggested (Siddall et al, 1986) and it is well known that BPH can cause elevations above this level (Heaney et a[., 1987;Stamey et al, 1987). In this series we have shown that the risk of an apparently benign prostate harbouring a malignancy rises with increasing levels of PSA at the time of presentation for surgery, until at levels >lOng/ml nearly a third of the patients will subsequently be found to have cancer of the prostate (Fig.…”

“…Since the identification of prostate specific antigen (Wangetal., 1979)there has beenincreasing interest in this antigen as a marker of prostate cancer, and commercial kits using monoclonal antibodies are now available. The increased sensitivity of PSA has been repeatedly demonstrated (Killian et al, 1986;Siddall et al, 1986;Ferro er al., 1987) and several publications have shown its potential for monitoring metastatic disezse and providing earlier warning of relapse (Killian et al, Read at the 44th Annual Meeting of the British Association of Urological Surgeons in Buxton, June 1988 1986; Ahmann and Schifman 1987). A second application, mainly cited by American clinicians, is the assessment of residual disease after radical prostatectomy or curative radiotherapy (Stamey et al, 1987).…”

Comparative Study of the Clinical Usefulness of Prostate Specific Antigen and Prostatic Acid Phosphatase in Prostatic Disease

“…A recent comparison (Killian et al, 1986) of the value of monoclonal antibody-based PSA and PAP tests in the diagnosis and management of prostatic carcinoma showed that 43% of 91 patients with untreated non-metastatic prostatic cancer had increased serum PSA but only 19% had increased serum PAP. For 60 patients with metastatic prostatic cancer the sensitivity of the monoclonal PSA test increased to 92% and the PAP test to 60% (Siddall et al, 1986). Another study of 80 patients with metastatic disease found increased PSA in 76%, increased PAP antigen in 60% and increased PAP activity in 49% (Ahmann and Schifman, 1987).…”

New Cancer Markers

“…Siddall et al 55 have shown in a study of 44 patients with recurrent prostatic disease that seven patients showed a concordant rise of both PSA and PAP, 13 gave a rise of PSA alone but PAP was elevated in only two patients where PSA was normal. In another follow-up study using serial levels of PSA, elevated concentrations were found pre-clinically in 92% of 26 patients, the mean lead time being 12 months."…”