Free Prostate-specific Antigen Is a Better Tool Than Total Prostate-specific Antigen at Predicting Prostate Volume in Patients With Lower Urinary Tract Symptoms

Kayikci, Ali; Çam, Kamil; Kacagan, C.; Tekın, Ali; Ankaralı, Handan

doi:10.1016/j.urology.2012.08.004

Cited by 14 publications

(17 citation statements)

References 23 publications

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“…Serum fPSA has been also evaluated as a predictor of TPV in men with LUTS and it has been suggested that the efficacy of serum fPSA testing is equal or superior to that of serum PSA testing for estimating the TPV 1011. Morote et al 10.…”

Section: Discussionmentioning

confidence: 99%

“…Approximately 10%–30% of circulating PSAs are not bound to proteins and are referred to as free PSAs (fPSAs) 9. A few studies have suggested that TPV can be estimated using serum fPSA levels 1011. Several studies, however, have reported that obesity is negatively associated with serum PSA concentration, a phenomenon attributed to hemodilution 121314.…”

Section: Introductionmentioning

confidence: 99%

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Does prostate-specific antigen (PSA) mass or free PSA mass improve the accuracy of predicting total prostate volume in relation to obesity in men with biopsy-proven benign prostatic hyperplasia?

Jung

Lee

et al. 2019

Asian J Androl

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We evaluated whether the prostate-specific antigen (PSA) mass or free PSA (fPSA) mass (i.e., absolute amount of total circulating PSA or fPSA protein, respectively), versus serum PSA or fPSA concentration, improves the accuracy of predicting the total prostate volume (TPV) in relation to obesity. Among men whose multicore (≥12) transrectal prostate biopsy was negative, 586 who had a PSA of ≤10 ng ml and underwent the fPSA test prior to biopsy were enrolled. The PSA mass or fPSA mass (μ g) was calculated by multiplying the serum level by plasma volume. At each TPV cut-off point (30 ml, 40 ml, and 50 ml), the areas under the receiver operating characteristics curve (AUCs) of each variable were compared in obesity-based subgroups. AUCs of fPSA and fPSA mass for predicting TPV were significantly larger than those for PSA and PSA mass by 8.7%-12.1% at all cut-off points. Subgroup analyses based on obesity showed that, although PSA mass and fPSA mass enhanced accuracy by 4% (P = 0.031) and 1.8% (P = 0.003), respectively, for determining TPVs of ≥30 ml and ≥50 ml in obese and overweight men, they did not improve the accuracy in most other combinations of the degrees of obesity with TPV cut-off points. Thus, compared with serum PSA or fPSA, the absolute amount of PSA or fPSA protein mass improved the accuracy of predicting TPV in obese men very minimally and only for certain TPV cut-off points. Hence, these indicators may not provide clinically meaningful improvement in predicting TPV in obese men.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Does prostate-specific antigen (PSA) mass or free PSA mass improve the accuracy of predicting total prostate volume in relation to obesity in men with biopsy-proven benign prostatic hyperplasia?

Jung

Lee

et al. 2019

Asian J Androl

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“…They suggested that a cut-off of fPSA might provide clinically important information because the European Association of Urology guideline recommends not prescribing 5-alpha reductase inhibitors to patients with a prostate volume less than 40 cm 3 . They proposed a cutoff of free PSA of 0.495 for predicting a prostate volume of 40 cm 3 [4]. …”

Section: Discussionmentioning

confidence: 99%

“…Several authors have estimated an equation for predicting prostate volume by use of serum in Caucasian men [4]. The Korean population has also been subjected to investigation of the relationship between PSA and prostate volume, predictably showing a general concordant association as well [5,6].…”

Section: Introductionmentioning

confidence: 99%

Prostate-Specific Antigen Mass and Free Prostate-Specific Antigen Mass for Predicting the Prostate Volume of Korean Men With Biopsy-Proven Benign Prostatic Hyperplasia

et al. 2013

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PurposeIt has been reported that prostate-specific antigen (PSA) correlates with prostate volume. Recently, some studies have reported that PSA mass (PSA adjusted for plasma volume) is more accurate than PSA at predicting prostate volume. In this study, we analyzed the accuracy of PSA and the related parameters of PSA mass, free PSA (fPSA), and fPSA mass in predicting prostate volume.Materials and MethodsWe retrospectively investigated 658 patients who underwent prostate biopsy from 2006 to 2012 and had a confirmed negative biopsy result. International Prostate Symptom Score (IPSS) questionnaire, PSA, fPSA, and prostate volume were investigated. PSA mass and fPSA mass were calculated by use of established formulas. The association between PSA-related parameters and IPSS and prostate volume was assessed by using Pearson correlation coefficient and receiver operating characteristic curves.ResultsThere was no significant difference between PSA and PSA mass, fPSA, or fPSA mass in predicting prostate volume except in obese patients (p-value of PSA-PSA mass for 40 cm3, 0.54; p-value of fPSA-fPSA mass for 40 cm3, 0.34). fPSA performed significantly better than PSA at predicting prostate volume (p-value for 40 cm3, <0.001). IPSS and the aforementioned PSA-related parameters were not significantly correlated.ConclusionsPSA mass was not a better predictive value than PSA for estimating the prostate volume in Korean men except in obese men. This finding was also applicable to the relationship of fPSA and fPSA mass, which appeared to be more accurate predictors of prostate volume than either PSA or PSA mass.

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“…The PSA level is a reasonable predictor of prostate volume and can aid physicians in making clinical decisions for these patients. 19 Any abnormalities noted in the patient's history, physical examination findings, or laboratory evaluation should be addressed by the physician or referred to the appropriate specialist. 20,21 Male patients with LUTS should be referred to a urologist if diagnostic evaluation reveals any of the following: abnormal prostate examination findings, elevated PSA level, urinary retention, history of genitourinary trauma or recurrent urinary tract infections, meatal stenosis, hematuria, or previous genitourinary surgery.…”

Section: Diagnostic Evaluationmentioning

confidence: 99%

Primary Care Evaluation and Treatment of Men With Lower Urinary Tract Symptoms

Hale

Choi

Lohri

2014

Journal of Osteopathic Medicine

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Lower urinary tract symptoms (LUTS) affect 50% to 90% of men aged 50 years or older. Primary care physicians should be knowledgeable about the diagnosis and management of this condition. The authors performed detailed PubMed searches using the terms lower urinary tract symptoms, benign prostatic hyperplasia, benign prostatic enlargement, and overactive bladder. The authors then reviewed the relevant literature on the evaluation and treatment of men with LUTS. According to the literature, accurate recognition of LUTS is predicated on a focused history and physical examination, as well as serum prostate-specific antigen measurement and urinalysis. For patients with mild symptoms, watchful waiting with ongoing monitoring and lifestyle modifications may be appropriate. For patients with moderate to severe symptoms, pharmacologic therapy is effective. When substantial LUTS persist despite appropriate pharmacologic therapy, specialty urologic evaluation and treatment is warranted.

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Free Prostate-specific Antigen Is a Better Tool Than Total Prostate-specific Antigen at Predicting Prostate Volume in Patients With Lower Urinary Tract Symptoms

Cited by 14 publications

References 23 publications

Does prostate-specific antigen (PSA) mass or free PSA mass improve the accuracy of predicting total prostate volume in relation to obesity in men with biopsy-proven benign prostatic hyperplasia?

Does prostate-specific antigen (PSA) mass or free PSA mass improve the accuracy of predicting total prostate volume in relation to obesity in men with biopsy-proven benign prostatic hyperplasia?

Prostate-Specific Antigen Mass and Free Prostate-Specific Antigen Mass for Predicting the Prostate Volume of Korean Men With Biopsy-Proven Benign Prostatic Hyperplasia

Primary Care Evaluation and Treatment of Men With Lower Urinary Tract Symptoms

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