TY - JOUR
T1 - Analysis of percent free prostate-specific antigen (PSA) for prostate cancer detection
T2 - Influence of total PSA, prostate volume, and age
AU - Partin, Alan W.
AU - Catalona, William J.
AU - Southwick, Paula C.
AU - Subong, Eric N P
AU - Gasior, Gail H.
AU - Chan, Daniel W.
N1 - Funding Information:
From the Department of Urology (A.W.P., E.N.P.S.) and Department of Pathology (D.W.C.), The Johns Hopkins Hospital, Baltimore, Maryland; Division of Urologic Surgery [W.J.C.), Washington University School of Medicine, St. Louis, Missouri; Research and Development (P.C.S., G.H.G.), Hybritech Inc., San Diego, Cal$ornia This study was funded by Hybritech Inc., San Diego, California.
PY - 1996/12
Y1 - 1996/12
N2 - Objectives. To determine whether the use of the free-to-total PSA ratio (percent free PSA) could increase the specificity of PSA testing for prostate cancer detection in men with serum PSA concentrations between 4.0 and 10.0 ng/mL, and to assess the influence of total PSA, prostate volume, and age on percent free PSA. Methods. Sera were obtained from 217 men with histologically confirmed diagnoses (139 prostate cancer, 78 benign). Free and total PSA concentrations were determined using Hybritech Tandem® assays. Results. Use of percent free PSA increased PSA specificity: 29% of negative biopsies would be spared while retaining 95% sensitivity. Percent free PSA increased with increasing age and prostate volume. Percent free PSA decreased as total PSA increased. A significant relation exists between percent free PSA and the probability of a positive biopsy; in this cohort, a patient with a low percent free PSA (≤10%) had a higher probability of cancer (63 ± 9%) than a patient with a high percent free PSA (≤26%) (probability 2 ± 3%). Conclusions. Percent free PSA may be used as an aid in distinguishing prostate cancer from benign disease in men with a total PSA between 4.0 and 10.0 ng/mL. Large prospective multicenter trials are required to develop consistent recommendations and determine the appropriate cutpoints and risk probabilities, controlling for total PSA, prostate volume, age, and biopsy history.
AB - Objectives. To determine whether the use of the free-to-total PSA ratio (percent free PSA) could increase the specificity of PSA testing for prostate cancer detection in men with serum PSA concentrations between 4.0 and 10.0 ng/mL, and to assess the influence of total PSA, prostate volume, and age on percent free PSA. Methods. Sera were obtained from 217 men with histologically confirmed diagnoses (139 prostate cancer, 78 benign). Free and total PSA concentrations were determined using Hybritech Tandem® assays. Results. Use of percent free PSA increased PSA specificity: 29% of negative biopsies would be spared while retaining 95% sensitivity. Percent free PSA increased with increasing age and prostate volume. Percent free PSA decreased as total PSA increased. A significant relation exists between percent free PSA and the probability of a positive biopsy; in this cohort, a patient with a low percent free PSA (≤10%) had a higher probability of cancer (63 ± 9%) than a patient with a high percent free PSA (≤26%) (probability 2 ± 3%). Conclusions. Percent free PSA may be used as an aid in distinguishing prostate cancer from benign disease in men with a total PSA between 4.0 and 10.0 ng/mL. Large prospective multicenter trials are required to develop consistent recommendations and determine the appropriate cutpoints and risk probabilities, controlling for total PSA, prostate volume, age, and biopsy history.
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U2 - 10.1016/S0090-4295(96)00611-5
DO - 10.1016/S0090-4295(96)00611-5
M3 - Article
C2 - 8973701
AN - SCOPUS:0030447621
SN - 0090-4295
VL - 48
SP - 55
EP - 61
JO - Urology
JF - Urology
IS - 6 SUPPL.
ER -
