Analysis of variation in prostate-specific antigen values

Riehmann, Morten; Rhodes, Patsy R.; Cook, Thomas D.; Grose, Gregory S.; Bruskewitz, Reginald C.

doi:10.1016/0090-4295(93)90364-g

Cited by 80 publications

(32 citation statements)

References 29 publications

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“…In 80% of the patients the variations were in the range of -1.0 to +1.2 ng/ml. Reihmann et al [15] found a mean coefficient of variation of serum PSA concentration of 58% in a group of 39 patients without cancer in whom 3 or more assays were performed in a period of over 1 year.…”

Section: Discussionmentioning

confidence: 99%

Intraindividual Variations of Total and Percent Free Serum Prostatic-Specific Antigen Levels in Patients with Normal Digital Rectal Examination

Moróte¹,

Raventós²,

Lorente³

et al. 1999

Eur Urol

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Section: Discussionmentioning

confidence: 99%

Intraindividual Variations of Total and Percent Free Serum Prostatic-Specific Antigen Levels in Patients with Normal Digital Rectal Examination

Moróte¹,

Raventós²,

Lorente³

et al. 1999

Eur Urol

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“…We subsequently back-calculated the CV b by subtracting CV a from CV t : CV b ϭ ͌ CV t 2 Ϫ CV a 2 (7 ). Fifteen studies reported considerable variability of serial tPSA concentrations, but it was impossible to derive the CV b because of sufficient information on CV t and CV a was lacking (33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47).…”

Section: Biological Variation Estimatesmentioning

confidence: 99%

Biological Variation of Total Prostate-Specific Antigen: A Survey of Published Estimates and Consequences for Clinical Practice

Sölétormos¹,

et al. 2005

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Background:The objectives of this study were to determine whether a single result for total prostate-specific antigen (tPSA) can be used confidently to guide the need for prostate biopsy and by how much serial tPSA measurements must differ to be significant. tPSA measurements include both analytical and biological components of variation. The European Group on Tumor Markers conducted a literature survey to determine both the magnitude and impact of biological variation on single, the mean of replicate, and serial tPSA measurements. Methods: The survey yielded 27 studies addressing the topic, and estimates for the biological variation of tPSA could be derived from 12 of these studies. Results: The mean biological variation was 20% in the concentration range 0.1-20 g/L for men over 50 years. The biological variation means that the one-sided 95% confidence interval (CI) of the dispersion for a single tPSA

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“…8 Riehmann et al reported 39 subjects without prostate cancer in which PSA was measured more than three times during an average measurement interval of 10.3 months, and the biological variation was 55%, which was approximately fourfold higher than the 13% on interassay variation. 9 These results demonstrated that the rapid PSA fluctuations were due to various physiological conditions and the existence of benign prostatic diseases, and were not due to prostate cancer. It is necessary to optimize the calculation method, measurement interval, and cut-off value of PSAV to distinguish the PSA rise due to prostate cancer tissue from that due to the physiological fluctuation of PSA.…”

Section: Discussionmentioning

confidence: 71%

Usefulness of prostate‐specific antigen velocity in screening for prostate cancer

et al. 2002

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Background: The cut-off value of prostate-specific antigen velocity (PSAV) was investigated in relation to the initial prostate-specific antigen (PSA) value in subjects with initial values of 1.0-4.0 ng/mL, and the usefulness and limitations of PSAV as a screening test for prostate cancer were examined. Methods: In this study, 4883 men who underwent mass screening for prostate cancer two or more times between 1987 and 1998 and had initial PSA levels of 1.0-4.0 ng/mL were investigated. The subjects ranged in age from 42 to 96 years (mean: 68.0 ± 6.6 years). The cut-off value of PSAV was set at 0.1-1.5 ng/mL per year, and the sensitivity, specificity, efficiency and positive predictive value (PPV) of PSAV for detecting prostate cancer were determined according to the initial PSA value. A similar examination of the average PSAV was carried out in 2888 subjects with three or more visits for mass screening for prostate cancer. Results:The diagnostic efficiency of PSAV was optimal with cut-off values of 0.3 and 0.75 ng/mL per year in those subjects with initial PSA levels of 1.0-1.9 and 2.0-4.0 ng/mL, respectively, but the PPV was low at 1.8% in subjects with initial PSA levels of 1.0-1.9 ng/mL. When the cutoff value of PSAV was set at 1.2 ng/mL per year in individuals with initial PSA levels of 1.0-1.9 ng/mL, the PPV increased to 7.3% and the sensitivity was 40%. The diagnostic efficiency of the average PSAV was optimal at the cut-off values of 0.2 and 0.4 ng/mL per year in subjects with initial PSA levels of 1.0-1.9 and 2.0-4.0 ng/mL, respectively, but the PPV was low at 2.2% in the subjects with initial PSA values of 1.0-1.9 ng/mL. When the cut-off value of PSAV was set at 0.75 ng/mL per year in individuals with initial PSA levels of 1.0-1.9 ng/mL, the PPV was 9.8% and the sensitivity was 46%. Conclusion: It is possible to improve the diagnostic accuracy of prostate cancer screening using the cut-off value of PSAV and average PSAV in subjects with initial PSA levels of 1.0-4.0 ng/mL. The cut-off values of PSAV should be set at 1.2 and 0.75 ng/mL per year in individuals with initial PSA levels of 1.0-1.9 and 2.0-4.0 ng/mL, respectively. The cut-off values of the average PSAV should be set at 0.75 and 0.4 ng/mL per year in individuals with initial PSA levels of 1.0-1.9 and 2.0-4.0 ng/mL, respectively.Key words average prostate-specific antigen velocity, prostate cancer, prostate-specific antigen velocity.

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Analysis of variation in prostate-specific antigen values

Cited by 80 publications

References 29 publications

Intraindividual Variations of Total and Percent Free Serum Prostatic-Specific Antigen Levels in Patients with Normal Digital Rectal Examination

Intraindividual Variations of Total and Percent Free Serum Prostatic-Specific Antigen Levels in Patients with Normal Digital Rectal Examination

Biological Variation of Total Prostate-Specific Antigen: A Survey of Published Estimates and Consequences for Clinical Practice

Usefulness of prostate‐specific antigen velocity in screening for prostate cancer

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