Complexed Prostate Specific Antigen Improves Specificity for Prostate Cancer Detection: Results of a Prospective Multicenter Clinical Trial

Partin, Alan W.; Brawer, Michael K.; Bartsch, Georg; Horninger, Wolfgang; Taneja, Samir S.; Lepor, Herbert; Babaian, R. Joseph; Childs, Stacy J.; Stamey, Thomas A.; Fritsche, Herbert A.; Sokoll, Lori J.; Chan, Daniel W.; Thiel, Robert; Cheli, Carol D.

doi:10.1097/01.ju.0000092695.55705.dd

Cited by 108 publications

(64 citation statements)

References 19 publications

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“…39 However, its diagnostic superiority over free PSA is not yet established and warrants further investigation. 40 The remainder of total PSA exists as a free, noncomplexed and enzymatically inactive form (free PSA). Catalona et al 41,42 initially reported that the measure of the percentage of free PSA ((free PSA/total PSA) Â 100) could improve the diagnostic accuracy of the PSA test in men with a PSA level between 4 and 10 ng ml À1 .…”

Section: Psa Velocitymentioning

confidence: 99%

New circulating biomarkers for prostate cancer

Bensalah

Lotan

Karam

et al. 2007

Prostate Cancer Prostatic Dis

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Section: Psa Velocitymentioning

confidence: 99%

New circulating biomarkers for prostate cancer

Bensalah

Lotan

Karam

et al. 2007

Prostate Cancer Prostatic Dis

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“…Regarding its clinical use, the 3.2 ng/mL cutoff was estimated to be equivalent to the 4.0 ng/mL tPSA threshold and shows similar diagnostic performance in cancer detection (37). To date, no study has shown superiority of the cPSA or the cPSA/tPSA ratio, compared with %fPSA, to enhance the specificity of prostate cancer detection (38). Despite the fact that, theoretically, cPSA has a small advantage compared to tPSA as a first-line parameter, only the ratio of cPSA to tPSA could reach specificity levels comparable to %fPSA.…”

Section: Psa Isoformsmentioning

confidence: 99%

Prostatic specific antigen for prostate cancer detection

Nogueira¹,

Corradi²,

Eastham³

2009

Int. braz j urol.

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Prostate-specific antigen (PSA) has been used for prostate cancer detection since 1994. PSA testing has revolutionized our ability to diagnose, treat, and follow-up patients. In the last two decades, PSA screening has led to a substantial increase in the incidence of prostate cancer (PC). This increased detection caused the incidence of advanced-stage disease to decrease at a dramatic rate, and most newly diagnosed PC today are localized tumors with a high probability of cure. PSA screening is associated with a 75% reduction in the proportion of men who now present with metastatic disease and a 32.5% reduction in the age-adjusted prostate cancer mortality rate through 2003. Although PSA is not a perfect marker, PSA testing has limited specificity for prostate cancer detection, and its appropriate clinical application remains a topic of debate. Due to its widespread use and increased over-detection, the result has been the occurrence of over-treatment of indolent cancers. Accordingly, several variations as regards PSA measurement have emerged as useful adjuncts for prostate cancer screening. These procedures take into consideration additional factors, such as the proportion of different PSA isoforms (free PSA, complexed PSA, pro-PSA and B PSA), the prostate volume (PSA density), and the rate of change in PSA levels over time (PSA velocity or PSA doubling time). The history and evidence underlying each of these parameters are reviewed in the following article.

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“…Although many new serologic markers for prostate cancer have been evaluated as an adjunct test to PSA (2,3), there are a limited number of studies examining genetic-based factors.…”

mentioning

confidence: 99%

The Use of Genetic Markers to Determine Risk for Prostate Cancer at Prostate Biopsy

Nam¹,

Zhang²,

Jewett

et al. 2005

Clinical Cancer Research

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Purpose: We examined a panel of 13 polymorphisms in 13 different genes to determine whether specific genotypes can help predict prostate cancer at the time of biopsy among men prescreened with prostate-specific antigen and digital rectal exam. Experimental Design: We examined 2,088 consecutive men who were referred for prostate biopsy from 1997 to 2003. Thirteen genes were examined, including TNF308, GSTT1, KLK2, endostatin, MCRA, MCRV, tyrosinase, MSR1, CHK2, RNasel, HOGG1-326, HOGG1-11657, and HRAS1. Odds ratio for detection of prostate cancer were adjusted for age, race, prostatespecific antigen, digital rectal exam, family history of prostate cancer, and urinary symptoms. Results: Of the 2,088 men, 996 (47.7%) had cancer detected. Four genes (TNF308, GSTT1, KLK2, and HOGG1-326) were significantly associated with prostate cancer. The adjusted odds ratios (OR) for prostate cancer for patients with the AA genotype of the TNF308 gene was 1.92 [95% confidence interval (95% CI), 1.0-1.5, P = 0.05], compared with those with the GG genotype, and for patients with theTTgenotype of the KLK2 gene, the OR was 1.5 (95% confidence interval, 1.0-2.2, P = 0.04), compared with the CC genotype. The OR for patients with a homozygous deletion of the GSTT1gene was 0.81 (95% CI, 0.6-1.0, P = 0.06) compared with those with the deletion, and the OR for patients with the GG genotype of the HOGG1-326 gene was 0.68 (95% CI, 0.5-1.0, P = 0.05) compared with the CC genotype. Patients who had all four alleles that were positively associated with prostate cancer had an OR of 9.33 (95% CI, 2.4-35.8, P = 0.0005) for prostate cancer compared with patients with alleles that were negatively associated with prostate cancer. Conclusions: Of the 13 polymorphisms, two were found to be positively associated with prostate cancer (TNF308 and KLK2) and two were negatively associated with prostate cancer (GSTT1 and HOGG1-326). Future studies are required to confirm these results.

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Complexed Prostate Specific Antigen Improves Specificity for Prostate Cancer Detection: Results of a Prospective Multicenter Clinical Trial

Abstract: The use of cPSA as a single test provided improved specificity over tPSA. Percent fPSA and percent cPSA offered little to no additional benefit in the differentiation of benign and malignant disease at clinically relevant cPSA concentrations.

Cited by 108 publications

References 19 publications

New circulating biomarkers for prostate cancer

New circulating biomarkers for prostate cancer

Prostatic specific antigen for prostate cancer detection

The Use of Genetic Markers to Determine Risk for Prostate Cancer at Prostate Biopsy

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