Use of Prostate-Specific Antigen (PSA) Isoforms for the Detection of Prostate Cancer in Men with a PSA Level of 2–10 ng/ml: Systematic Review and Meta-Analysis

Roddam, Andrew; Duffy, Michael J.; Hamdy, Freddie C.; Ward, A. Milford; Patnick, Julietta; Price, Christopher P.; Rimmer, Janet; Sturgeon, C.; White, Peter; Allen, Naomi E.

doi:10.1016/j.eururo.2005.04.015

Cited by 234 publications

(149 citation statements)

References 99 publications

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“…The pooled sensitivity of f/tPSAo0.15 was 0.69(95%CI: 0.64B0.73), and the pooled specificity 0.82(95%CI: 0.80B0.83), had the similar result to the tPSA410.0 ng/ml. A prior systematic study, 16 showed that f/tPSAo0.15 had a relative high sensitivity and specificity with tPSA levels from 4.0 ng/ ml to 10.0 ng/ml.…”

Section: Discussionmentioning

confidence: 92%

Performance of tPSA and f/tPSA for prostate cancer in Chinese. A systematic review and meta-analysis

Wang

Sun

Pan

et al. 2006

Prostate Cancer Prostatic Dis

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Performing a systematic review and meta-analysis to evaluate the diagnostic performance of the total prostate-specific antigen (tPSA) tests for diagnosis of prostate cancer among Chinese. Literatures related to diagnosis of prostate cancer by tPSA and the ratio of free to total PSA (f/tPSA) being retrieved in five electronic databases. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio (DOR) were pooled using random effects models. Summary receiver operating characteristic curves (SROC) used to summarize overall test performance. In total 10 studies meting the inclusion criteria, 2256 patients were included. Among them 423 were patients of prostate cancer compared to 1833 were patients of benign prostate hyperplasia (BPH). The pooled sensitivity and specificity of tPSA44.0 ng/ml, tPSA410.0 ng/ml and f/tPSAo0.15 as threshold for the diagnosis of prostate cancer were heterogeneity. The areas under SROC (AUC) were 80, 85 and 87%, respectively (Po0.05). The pooled DOR were 8.44(95%CI: 4.45B16.00), 9.94(95%CI: 4.15B23.77) and 13.75(95%CI: 6.35B29.76), respectively (Po0.05). v 2 test used for testing the heterogeneity. tPSA and f/tPSA made an important performance for diagnosis of prostate cancer in decade among Chinese. The use of f/tPSAo0.15 as threshold maintain a high prognostic accuracy for prostate cancer.

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Section: Discussionmentioning

confidence: 92%

Performance of tPSA and f/tPSA for prostate cancer in Chinese. A systematic review and meta-analysis

Wang

Sun

Pan

et al. 2006

Prostate Cancer Prostatic Dis

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“…14 Furthermore, we recently reported that the PCa rate in Chinese men with PSAs of 4.0-10.0 ng ml 21 was 20.2%, much lower than the rates reported for Western men in the literature. 6,14 Thus, the Asian PSA 'grey zone' should be higher than the traditional Western PSA 'grey zone'. There are limited published data regarding the association of PV and PCa risk in Asian men with PSAs higher than the traditional Western PSA 'grey zone'.…”

Section: Introductionmentioning

confidence: 99%

Prostate volume as an independent predictor of prostate cancer in men with PSA of 10–50 ng ml−1

Tang¹,

Jin²,

Uhlman³

et al. 2013

Asian J Androl

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Prostate volume (PV) has been shown to be associated with prostate cancer (PCa) detection rates in men with a prostate-specific antigen (PSA) in the 'grey zone' (2.0-10.0 ng ml 21 ). However, the PSA 'grey zone' in Asian men should be higher because the incidence of PCa in Asian men is relatively low. Therefore, we evaluated the association between PV and PCa detection rates in men with PSAs measuring 10-50 ng ml 21 . Men who underwent a 13-core prostatic biopsy with PV documentation participated in the study. A multivariate stepwise regression was used to evaluate whether the PV at time of prostate biopsy could predict the risk of PCa. The rates of PCa among men in different PSA ranges, stratified by PV medians (,60 and o60 ml), were calculated. There were 261 men included in the final analysis. PV was the strongest predictor of PCa risk (odds ratio, 0.02; P,0.001) compared to other variables. The PCa rates in men with PVs measuring ,60 and o60 ml in the 10-19.9 ng ml 21 PSA group were 40.6% and 15.1%, respectively, while the rates for men with PSAs measuring 20-50 ng ml 21 were 65.1% and 26.8%. PV is an independent predictor of PCa in men with PSA measuring 10-50 ng ml 21 . In clinical practice, particularly for those countries with lower incidences of PCa, PV should be considered when counselling patients with PSAs measuring 10-50 ng ml 21 regarding their PCa risks.

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“…Overall, use of %fPSA can potentially reduce the number of unnecessary prostate biopsies by 25-40% for men with tPSA levels 4 -10 mg/L. 32,33 A small number of cancers (approximately 10%), however, may be missed. %fPSA is most useful at low and high values.…”

Section: Percent Fpsamentioning

confidence: 99%

“…31 Most of the studies involving %fPSA contained small numbers of patients and were retrospective in design. Roddam et al 32 carried out a systematic review of the literature on these studies published between January 1986 and December 2004. In total, 66 eligible reports were identified.…”

Section: Percent Fpsamentioning

confidence: 99%

Prostate-specific antigen: does the current evidence support its use in prostate cancer screening?

Duffy

2011

Ann Clin Biochem

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Although widely used, the value of prostate-specific antigen (PSA) in screening asymptomatic men for prostate cancer is controversial. Reasons for the controversy relate to PSA being less than an ideal marker in detecting early prostate cancer, the possibility that screening for prostate cancer may result in the overdetection and thus overtreatment of indolent disease and the lack of clarity as to the definitive or best treatment for men diagnosed with localized prostate cancer. Although the results from some randomized prospective trials suggest that screening with PSA reduces mortality from prostate cancer, the overall benefit was modest. It is thus currently unclear as to whether the modest benefit of reduced mortality outweighs the harms of overdetection and overtreatment. Thus, prior to undergoing screening for prostate cancer, men should be informed of the risks and benefits of early detection. Newly emerging markers that may complement PSA in the early detection of prostate cancer include specific isoforms of PSA and PCA3.

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Use of Prostate-Specific Antigen (PSA) Isoforms for the Detection of Prostate Cancer in Men with a PSA Level of 2–10 ng/ml: Systematic Review and Meta-Analysis

Cited by 234 publications

References 99 publications

Performance of tPSA and f/tPSA for prostate cancer in Chinese. A systematic review and meta-analysis

Performance of tPSA and f/tPSA for prostate cancer in Chinese. A systematic review and meta-analysis

Prostate volume as an independent predictor of prostate cancer in men with PSA of 10–50 ng ml−1

Prostate-specific antigen: does the current evidence support its use in prostate cancer screening?

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