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Free, complexed, and total serum prostate-specific antigen concentrations and their proportions in predicting stage, grade, and deoxyribonucleic acid ploidy in patients with adenocarcinoma of the prostate

Lerner, Seth E. ; Jacobsen, Steven J. ; Lilja, Hans LU orcid ; Bergstralh, Erik J. ; Ransom, Jeanine ; Klee, George G. ; Piironen, Timo ; Blute, Michael L. ; Lieber, Michael M. and Zincke, Horst , et al. (1996) In Urology 48(2). p.240-248
Abstract

Objectives. Nearly half of men with clinically localized prostate cancer are understaged. We evaluated whether knowledge of preoperative free prostate-specific antigen (f-PSA), complexed (c-PSA), and total (t-PSA) concentrations or the ratios thereof (f-PSA/t-PSA, c-PSA/t PSA, and f PSA/c- PSA) could improve upon the staging of prostate cancer when compared with standard PSA testing (t-PSA). In addition, we examined their associations with tumor grade and deoxyribonucleic acid (DNA) ploidy. Methods. Two hundred ninety patients with prostate cancer, 178 (61%) of whom were treated with radical prostatectomy, formed the study group. Results. Although there were significant differences in the f-PSA concentrations with respect to clinical... (More)

Objectives. Nearly half of men with clinically localized prostate cancer are understaged. We evaluated whether knowledge of preoperative free prostate-specific antigen (f-PSA), complexed (c-PSA), and total (t-PSA) concentrations or the ratios thereof (f-PSA/t-PSA, c-PSA/t PSA, and f PSA/c- PSA) could improve upon the staging of prostate cancer when compared with standard PSA testing (t-PSA). In addition, we examined their associations with tumor grade and deoxyribonucleic acid (DNA) ploidy. Methods. Two hundred ninety patients with prostate cancer, 178 (61%) of whom were treated with radical prostatectomy, formed the study group. Results. Although there were significant differences in the f-PSA concentrations with respect to clinical stage, considerable overlap in PSA levels among the clinical substages was observed. Statistically significant differences but weak correlations were observed between the individual f-PSA, c-PSA, and t-PSA concentrations with regard to pathologic stage (organ-confined versus extraprostatic) and grade. No significant relationship, however, was observed with the three ratios. Higher PSA values were not always associated with a pathologic stage of pT3 or greater, and lower levels did not ensure that a tumor was organ-confined. Only a slight association was observed between c-PSA and t-PSA levels and DNA ploidy. No significant relationship was observed between the f-PSA levels as well as the three ratios with regard to DNA ploidy. A statistically significant improvement in predicting pathologic stage was observed when combining knowledge of preoperative t-PSA concentration with the c-PSA/t-PSA ratio. However, the area under the receiver operator characteristic curves was only slightly increased; as such this combination was of limited clinical utility. Conclusions. Statistically significant but weak correlations were observed between the molecular forms of PSA and stage, grade, and DNA ploidy. The significant overlap in f-PSA and c-PSA values among all stages grades, and ploidy values precluded any useful predictive information for the individual patient. As such preoperative knowledge of f-PSA and c-PSA values and the three ratios provided no additional diagnostic information over standard PSA (t-PSA) values alone.

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publishing date
type
Contribution to journal
publication status
published
in
Urology
volume
48
issue
2
pages
9 pages
publisher
Elsevier
external identifiers
  • scopus:0038193994
  • pmid:8753736
ISSN
0090-4295
DOI
10.1016/S0090-4295(96)00159-8
language
English
LU publication?
no
id
1bddae63-dac4-40e6-86f5-eb1f558ab333
date added to LUP
2022-12-06 17:51:22
date last changed
2024-06-09 10:21:01
@article{1bddae63-dac4-40e6-86f5-eb1f558ab333,
  abstract     = {{<p>Objectives. Nearly half of men with clinically localized prostate cancer are understaged. We evaluated whether knowledge of preoperative free prostate-specific antigen (f-PSA), complexed (c-PSA), and total (t-PSA) concentrations or the ratios thereof (f-PSA/t-PSA, c-PSA/t PSA, and f PSA/c- PSA) could improve upon the staging of prostate cancer when compared with standard PSA testing (t-PSA). In addition, we examined their associations with tumor grade and deoxyribonucleic acid (DNA) ploidy. Methods. Two hundred ninety patients with prostate cancer, 178 (61%) of whom were treated with radical prostatectomy, formed the study group. Results. Although there were significant differences in the f-PSA concentrations with respect to clinical stage, considerable overlap in PSA levels among the clinical substages was observed. Statistically significant differences but weak correlations were observed between the individual f-PSA, c-PSA, and t-PSA concentrations with regard to pathologic stage (organ-confined versus extraprostatic) and grade. No significant relationship, however, was observed with the three ratios. Higher PSA values were not always associated with a pathologic stage of pT3 or greater, and lower levels did not ensure that a tumor was organ-confined. Only a slight association was observed between c-PSA and t-PSA levels and DNA ploidy. No significant relationship was observed between the f-PSA levels as well as the three ratios with regard to DNA ploidy. A statistically significant improvement in predicting pathologic stage was observed when combining knowledge of preoperative t-PSA concentration with the c-PSA/t-PSA ratio. However, the area under the receiver operator characteristic curves was only slightly increased; as such this combination was of limited clinical utility. Conclusions. Statistically significant but weak correlations were observed between the molecular forms of PSA and stage, grade, and DNA ploidy. The significant overlap in f-PSA and c-PSA values among all stages grades, and ploidy values precluded any useful predictive information for the individual patient. As such preoperative knowledge of f-PSA and c-PSA values and the three ratios provided no additional diagnostic information over standard PSA (t-PSA) values alone.</p>}},
  author       = {{Lerner, Seth E. and Jacobsen, Steven J. and Lilja, Hans and Bergstralh, Erik J. and Ransom, Jeanine and Klee, George G. and Piironen, Timo and Blute, Michael L. and Lieber, Michael M. and Zincke, Horst and Pettersson, Kim and Peterson, Diane and Oesterllng, Joseph E.}},
  issn         = {{0090-4295}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{240--248}},
  publisher    = {{Elsevier}},
  series       = {{Urology}},
  title        = {{Free, complexed, and total serum prostate-specific antigen concentrations and their proportions in predicting stage, grade, and deoxyribonucleic acid ploidy in patients with adenocarcinoma of the prostate}},
  url          = {{http://dx.doi.org/10.1016/S0090-4295(96)00159-8}},
  doi          = {{10.1016/S0090-4295(96)00159-8}},
  volume       = {{48}},
  year         = {{1996}},
}