Ratio Of Prostate Specific Antigen Minor Molecular Forms-To-Total Prostate Specific Antigen Is Constant Regardless Of The Pathological Condition Of The Prostate

Kobayashi, Takashi; Kamato, Toshiyuki; Isogawa, Yoshiaki; Kinoshita, Hidefumi; Terai, Akito; Habuchi, Tomonori; Ogawa, Osamu

doi:10.1016/s0022-5347(05)64050-5

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…Thus using only PSA-ACT was better than using the free-to-total ratio; the specificity of PSA-ACT was better than that of the free-to-total ratio both at 95% (36% vs 18%) and 90% (40% vs 37%) sensitivity. PSA-ACT density had the greatest AUC on ROC analysis (0.852, Table 2), similar to results in previous reports [9,10].…”

Section: Discussionsupporting

confidence: 90%

“…Whether PSA-ACT is more useful for the early detection of cancer than variables associated with total PSA combined with free PSA or prostate volume remains controversial [9][10][11][14][15][16]. In the present ROC analysis (Fig.…”

Section: Discussionmentioning

confidence: 87%

“…Indeed, the cancer detection rate in men with PSA levels of 2.0-2.4 ng/mL was only 8% (two of 25). For PSA-ACT, although we determined the threshold of 1.5 ng/mL to be equivalent to that of total PSA based on a previous study [10], the present regression analysis predicted a PSA-ACT of 1.3 ng/mL at a total PSA of 2.0 ng/mL. As one of the aims of the study was to determine appropriate thresholds for biopsy, provisional values had to be a little lower, and the thresholds should be corrected appropriately as a result of the present study.…”

Section: Discussionmentioning

confidence: 99%

“…an unbound free form and complexed forms bound to a 1-antichymotrypsin (PSA-ACT), a 2-macroglobulin, protein C inhibitor, a 1-antitrypsin, and intera -trypsin inhibitor [3,4]. Recent reports show that measuring some molecular forms, including PSA complexed to a 1-protease inhibitor [5], complex PSA [6][7][8] and PSA-ACT [9,10], improve the discrimination of cancer from BPH in men with PSA levels of < 10.0 ng/mL. There have been a few studies on the utility of PSA-ACT for detecting prostate cancer in men with PSA levels of < 4.0 ng/mL [11] but the utility of PSA-ACT in screening in Japanese men with total PSA levels of 2.0-4.0 ng/mL has yet to be elucidated.…”

Section: Introductionmentioning

confidence: 99%

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Prostate‐specific antigen (PSA) complexed to α1‐antichymotrypsin improves prostate cancer detection using total PSA in Japanese patients with total PSA levels of 2.0–4.0 ng/mL

Kobayashi¹,

Nishizawa²,

Mitsumori³

et al. 2005

BJU International

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prostate volume-adjusted density were evaluated by receiver operating characteristic (ROC) analysis. RESULTSOf 1003 men enrolled, 547 met the biopsy criteria and a biopsy was taken in 315 (57.6%) patients. The area under the ROC curve for PSA-ACT (0.679) was significantly greater than that for total PSA (0.601, P = 0.04) and equivalent to that for the free-to-total ratio (0.686, P = 0.911) in 116 men, including 27 with cancer with total PSA levels of 2.0-4.0 ng/mL. PSA-ACT was more specific than the free-to-total ratio at a sensitivity of 95% (36% vs 18%, P < 0.05). The best variable for discriminating between cancer and benign disease in men with PSA levels of 2.0-4.0 ng/mL was PSA-ACT density (area under the curve 0.852) which provided 66% specificity at a sensitivity of 90%. CONCLUSIONSPSA-ACT is better than total PSA and equivalent to the free-to-total ratio for detecting prostate cancer in men with PSA levels of 2.0-4.0 ng/mL, and is thus useful for reducing the number of unnecessary biopsies.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prostate‐specific antigen (PSA) complexed to α1‐antichymotrypsin improves prostate cancer detection using total PSA in Japanese patients with total PSA levels of 2.0–4.0 ng/mL

Kobayashi¹,

Nishizawa²,

Mitsumori³

et al. 2005

BJU International

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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

et al. 2005

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Age‐associated increase of prostate‐specific antigen in a high level of men visiting urological clinics

et al. 2005

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Objectives : To evaluate the distribution of serum prostate-specific antigen (PSA) levels as a function of age in men with no evidence of prostate cancer who visited urological clinics. Methods : Simultaneous measurements of total PSA and PSA-a -1-antichymotrypsin (PSA-ACT) were performed on patients who presented at urological clinics in Japan. After excluding 490 patients because of follow-up biopsy findings indicating prostate cancer, patients' history of prostatic surgery and medication affecting the serum PSA level, 1520 patients with PSA levels of less than 20.0 ng/ mL were available for the study.Results : Medians (95th percentile) of the total PSA levels were 0.9 (4.7), 1.2 (5.6), 1.7 (11.0), 2.1 (9.8) and 2.8 (11.0) ng/mL in men in their 40s ( n = 37), 50s ( n = 211), 60s ( n = 488), 70s ( n = 609) and 80s ( n = 175), respectively, whereas those of PSA-ACT were 0.5 (2.9), 0.7 (3.7), 1.1 (7.4), 1.2 (5.9) and 1.6 (6.4) ng/mL, respectively. Both total PSA and PSA-ACT increase with aging, although comparison between the 10-year age groups showed a significant difference in the two molecular forms only between men in their 50s and 60s. Conclusions : The PSA ranges of men who visited urological clinics were higher than those of men participating in prostate cancer screening programs reported in other published studies. An ageassociated increase in PSA similar to screening populations was also observed in urological outpatients. The results of the present study indicate that age-adjusted PSA cut-off levels can be used in outpatient settings, although the PSA reference value derived from the screening population should be carefully applied to symptomatic men of clinical practices.

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Ratio Of Prostate Specific Antigen Minor Molecular Forms-To-Total Prostate Specific Antigen Is Constant Regardless Of The Pathological Condition Of The Prostate

Cited by 4 publications

References 17 publications

Prostate‐specific antigen (PSA) complexed to α1‐antichymotrypsin improves prostate cancer detection using total PSA in Japanese patients with total PSA levels of 2.0–4.0 ng/mL

Prostate‐specific antigen (PSA) complexed to α1‐antichymotrypsin improves prostate cancer detection using total PSA in Japanese patients with total PSA levels of 2.0–4.0 ng/mL

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

Age‐associated increase of prostate‐specific antigen in a high level of men visiting urological clinics

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