Improving the utility of prostate specific antigen (PSA) in the diagnosis of prostate cancer: the use of PSA derivatives and novel markers

Jain, Sarika; Bhojwani, A; Mellon, J. Kilian

doi:10.1136/pmj.78.925.646

Cited by 22 publications

(12 citation statements)

References 49 publications

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“…PSA is an androgen‐regulated serine protease that functions in the liquefaction of semen in the seminal coagulum by cleaving semenogelins (Balk et al ., ). In men with prostate abnormalities, PSA levels increase in the blood as more PSA leaks out due to the disruption of the prostate architecture (Jain et al ., ). PSA testing has become useful for detecting prostate cancer over the years, but several concerns arise with its testing.…”

Section: Introductionmentioning

confidence: 97%

“…PSA levels often shows an inflammation rather than malignant growth of prostate (Nadler et al ., ). PSA testing has improved by focusing on PSA derivatives that account for variables such as age, prostate volume and the growth of the prostate over time (Jain et al ., ). PSA has also been known to form complexes in the blood of prostate cancer patients, making the ratio of free to complexed, or complexed to total PSA helpful in detecting the cancer (Jung et al ., ).…”

Section: Introductionmentioning

confidence: 97%

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Presence of PSA auto-antibodies in men with prostate abnormalities (prostate cancer/benign prostatic hyperplasia/prostatitis)

Lokant

Naz

2014

Andrologia

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Prostate-specific antigen (PSA), produced by the prostate, liquefies post-ejaculate semen. PSA is detected in semen and blood. Increased circulating PSA levels indicate prostate abnormality [prostate cancer (PC), benign prostatic hyperplasia (BPH), prostatitis (PTIS)], with variance among individuals. As the prostate has been proposed as an immune organ, we hypothesise that variation in PSA levels among men may be due to presence of auto-antibodies against PSA. Sera from healthy men (n = 28) and men having prostatitis (n = 25), BPH (n = 30) or PC (n = 29) were tested for PSA antibody presence using enzyme-linked immunosorbent assay (ELISA) values converted to standard deviation (SD) units, and Western blotting. Taking ≥2 SD units as cut-off for positive immunoreactivity, 0% of normal men, 0% with prostatitis, 33% with BPH and 3.45% with PC demonstrated PSA antibodies. One-way analysis of variance (anova) performed on the mean absorbance values and SD units of each group showed BPH as significantly different (P < 0.01) compared with PC and prostatitis. All others were nonsignificant (P < 0.05). Men (33%) with BPH had PSA antibodies by ELISA and Western blot. These discoveries may find clinical application in differential diagnosis among prostate abnormalities, especially differentiating BPH from prostate cancer and prostatitis.

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Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 97%

Presence of PSA auto-antibodies in men with prostate abnormalities (prostate cancer/benign prostatic hyperplasia/prostatitis)

Lokant

Naz

2014

Andrologia

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“…Currently, the traditional cutoff PSA value of 4 ng/mL results in a 75% sensitivity for PCa detection with only a 40% specificity. 42 Using our method, we far outperform this traditional use of the PSA test with sensitivities and specificities of 96.6% and 87.5%, respectively, demonstrating potential utility for this type of test in the clinic, but further study is needed.…”

Section: Discussionmentioning

confidence: 85%

Detecting Prostate Cancer Using Pattern Recognition Neural Networks With Flow Cytometry-Based Immunophenotyping in At-Risk Men

Dominguez¹,

Polo²,

Roop³

et al. 2020

Biomark�Insights

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Current screening methods for prostate cancer (PCa) result in a large number of false positives making it difficult for clinicians to assess disease status, thus warranting advancements in screening and early detection methods. The goal of this study was to design a liquid biopsy test that uses flow cytometry–based immunophenotyping and artificial neural network (ANN) analysis to detect PCa. Numerous myeloid and lymphoid cell populations, including myeloid-derived suppressor cells, were measured from 156 patients with PCa, 123 with benign prostatic hyperplasia (BPH), and 99 male healthy donor (HD) controls. Using pattern recognition neural network (PRNN) analysis, a type of ANN, PCa detection compared against HD resulted in 96.6% sensitivity, 87.5% specificity, and an area under the curve (AUC) value of 0.97. Detecting patients with higher risk disease (⩾Gleason 7) against lower risk disease (BPH/Gleason 6) resulted in 92.0% sensitivity, 42.7% specificity, and an AUC of 0.72. This study suggests that analyzing flow cytometry immunophenotyping data with PRNNs may prove to be a useful tool to improve PCa detection and reduce the number of unnecessary prostate biopsies performed each year.

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“…In addition, for a screening test such as PSA, the sensitivity and specificity can be significantly biased because the presence/absence of cancer is not verified in every subject and the likelihood of biopsy depends on the test result itself [3]. Even PSA derivatives or trends (eg, PSA velocity, PSA doubling time, PSA density, free/total PSA) are not highly sensitive in predicting positive biopsy [4,5].…”

Section: Evolution Of the Diagnosis Of Prostate Cancermentioning

confidence: 98%

Extended and saturation needle biopsy for the diagnosis of prostate cancer

Chrouser

Lieber

2004

Curr Urol Rep

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The diagnosis of prostate cancer hinges on the use of systematic ultrasound-guided transrectal needle biopsy. The choice of technique is important, especially for patients with a history of a negative biopsy. Saturation biopsy can be considered for patients at risk of cancer who are willing to accept the side effects and who understand that clinically insignificant cancers can be detected. For patients with previous negative sextant biopsies, expanding the zones sampled and increasing the number of biopsy cores can help detect significant cancers while they are still confined. However, as extended biopsy becomes more commonly performed for initial diagnosis, there likely will be less need for saturation biopsy protocols.

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Improving the utility of prostate specific antigen (PSA) in the diagnosis of prostate cancer: the use of PSA derivatives and novel markers

Cited by 22 publications

References 49 publications

Presence of PSA auto-antibodies in men with prostate abnormalities (prostate cancer/benign prostatic hyperplasia/prostatitis)

Presence of PSA auto-antibodies in men with prostate abnormalities (prostate cancer/benign prostatic hyperplasia/prostatitis)

Detecting Prostate Cancer Using Pattern Recognition Neural Networks With Flow Cytometry-Based Immunophenotyping in At-Risk Men

Extended and saturation needle biopsy for the diagnosis of prostate cancer

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