Influence of Prostatic Disease and Prostatic Manipulations on the Concentration of Prostate-Specific Antigen

Walz, P.; Schoppmann, Th.; Büscher, C.; Ennen, Jochen C; Schriewer, H

doi:10.1159/000474716

Cited by 15 publications

(7 citation statements)

References 21 publications

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“…Several authors have shown that standard digital rectal examination produces a small, clinically insigni®cant rise in the serum PSA. 8 Benign prostatic hyperplasia Whilst BPH is one of the most common ailments affecting ageing men, with more than 60% in their sixties having histologically proven disease, only two-thirds will develop symptoms. Stromal nodules enlarge and coalesce, producing urethral compression.…”

Section: In¯ammation Of the Prostatementioning

confidence: 99%

Prostate specific antigen: biology, biochemistry and available commercial assays

Ward

Catto²,

Hamdy³

2001

Ann Clin Biochem

133

108

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Prostate speci®c antigen (PSA) is the marker of choice in the management of prostate cancer. However, PSA is not a simple molecule, existing in the serum in ®ve isoforms and a number of molecular con®gurations and complexes. The elucidation of the biochemistry of PSA has increased the potential use of the marker in the diagnosis of prostate malignancy.This review summarizes the clinical use of PSA in the management of prostate disease and the assays available in the UK. Assay calibration in relation to the World Health Organization 1st International Standard for Prostate Speci®c Antigen (90:10) has increased conformity between the various commercial assay kits, and the nonequimolar kits have largely been superseded or withdrawn. Special reference is made to evaluations performed on behalf of the Medical Devices Agency of the Department of Health.

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Section: In¯ammation Of the Prostatementioning

confidence: 99%

Prostate specific antigen: biology, biochemistry and available commercial assays

Ward

Catto²,

Hamdy³

2001

Ann Clin Biochem

133

108

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“…prostate conditions such as benign prostatic hyperplasia and prostatitis can also lead to elevated PSA levels. 24,25 When PSA values fall within the diagnostic gray zone (4 ng/mL to 10 ng/mL), the biopsy-based detection rate of csPCa only ranges between 4.1% and 25%. 26,27 In the existing literature, median PSA levels in men with negative or equivocal MRI results (PI-RADS 1-3) predominantly fall within the diagnostic gray zone, [28][29][30] which is consistent with the findings in our current study (9.8 ng/mL).…”

Section: Discussionmentioning

confidence: 99%

The PRIMARY Score

Guo,

Kang,

et al. 2023

Clin Nucl Med

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Purpose Multiparametric MRI is the current standard for detecting clinically significant prostate cancer (csPCa). However, men with negative or equivocal MRI often undergo unnecessary biopsies due to concerns about false-negative results. The recently proposed 68Ga-PSMA PET/CT-based PRIMARY score exhibited good diagnostic performance for csPCa. This study aimed to externally validate the performance of the PRIMARY score and evaluate its added diagnostic value to MRI triage in detecting csPCa. Patients and Methods This retrospective cohort study included 431 men who underwent both 68Ga-PSMA PET/CT and MRI before biopsy. Performance was assessed using the area under the receiver operating characteristic curve and the decision curve analysis. The PRIMARY score + MRI was considered positive for either PRIMARY score 3–5 or Prostate Imaging Reporting and Data System (PI-RADS) 4/5. Results The prevalence of csPCa was 51.7% (223/431). The area under the receiver operating characteristic curve of the 5-level PRIMARY score for csPCa was significantly higher than that of MRI (0.873 vs 0.786, P < 0.001). For the entire group, sensitivity, specificity, positive predictive value, and negative predictive value of the PRIMARY score were 90.6%, 61.1%, 71.4%, and 85.8%, respectively, which outperformed 87.9%, 49.0%, 64.9%, and 79.1% of PI-RADS on MRI. The PRIAMRY score + MRI improved sensitivity (96.0% vs 87.9%, P < 0.001) and negative predictive value (91.5% vs 79.1%, P < 0.001) without compromising specificity and positive predictive value compared with MRI alone. This combined approach avoided 24.6% (106/431) of unnecessary biopsies, while missing 4.0% (9/223) of csPCa cases. The addition of the PRIMARY score in men with PI-RADS 1–3 showed a net benefit, but not in men with PI-RADS 4/5. Conclusions The PRIMARY score was superior to MRI in detecting csPCa, and its added diagnostic value was in men with negative or equivocal MRI results. The PRIMARY score + MRI improved negative predictive value and sensitivity for csPCa compared with MRI alone. Further prospective trials will validate whether men with clinical suspicion of csPCa but negative PRIMARY score + MRI can safely avoid unnecessary biopsies.

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“…Conversely, the rate of cancer detection by surgery in our study was only 4.76%. This could be explained by the fact that AUR and indwelling catheter, rather than cancer are responsible for PSA elevation in these patients [14,15].…”

Section: Discussionmentioning

confidence: 99%

Patients with Elevated Serum PSA and Indwelling Catheter after Acute Urinary Retention: Prospective Study of 63 Patients with 7-Year Follow-Up

Kravchick

Bunkin

Peled

et al. 2007

Journal of Endourology

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The detection rate of clinically significant cancer on preoperative biopsies postoperative pathologic exam in patients with AUR and indwelling catheter is low. These patients could be safely operated on without any delay. However, in order to detect clinically important cancer in the peripheral zone a postoperative monitoring period of should be recommended: starting 6 months after operation and continuing subsequently for at least 4 years. Postoperative PSA level is the strongest predictor of cancer detection and could be usefully employed in these patients. AUR and in the patients with large prostate cause elevated PSA. Cancer detection rate on preoperative biopsies is low in these patients. Long postoperative monitoring period should be strongly recommended.

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Influence of Prostatic Disease and Prostatic Manipulations on the Concentration of Prostate-Specific Antigen

Cited by 15 publications

References 21 publications

Prostate specific antigen: biology, biochemistry and available commercial assays

Prostate specific antigen: biology, biochemistry and available commercial assays

The PRIMARY Score

Patients with Elevated Serum PSA and Indwelling Catheter after Acute Urinary Retention: Prospective Study of 63 Patients with 7-Year Follow-Up

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