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Articles |
Departments of
1
Urology,
2
Laboratory Medicine and Pathobiochemistry, and
3
Pathology, University Hospital Charité, Humboldt University, Schumannstrasse 20/21, D-10098 Berlin, Germany.
a Author for correspondence. Fax 49-30-2802-1402; e-mail klaus.jung{at}charite.de
Background: The aim of this study was to compare the diagnostic
utility of a new assay that measures all forms of prostate-specific
antigen complexed (cPSA) to serum proteins except
2-macroglobulin with the assay of free PSA (fPSA) and
the corresponding ratios to total PSA (tPSA) to improve the
differentiation between benign prostatic hyperplasia (BPH) and prostate
cancer (PCa).
Methods: Serum samples were collected from 91 men without prostate disease and with normal digital rectal examination (controls), 144 untreated patients with PCa, and 89 patients with BPH. tPSA and cPSA were measured using the Bayer Immuno 1 system; fPSA and the additional tPSA were measured with the Roche Elecsys system.
Results: The median cPSA/tPSA, fPSA/tPSA, and fPSA/cPSA ratios were significantly different between patients with BPH and PCa (78.7% vs 90.7%, 25.5% vs 12.1%, and 36.8% vs 14.3%, respectively; P <0.001). No correlations of cPSA and its ratios to tumor stage and grade were found. ROC analysis showed that cPSA was not different from tPSA (areas under the curve, 0.632 vs 0.568), whereas the cPSA/tPSA ratio was similar to the fPSA/tPSA ratio in increasing discrimination between BPH and PCa patients with tPSA concentrations in the tPSA gray zone between 2 and 10 µg/L (areas under the curve, 0.851 vs 0.838).
Conclusions: Compared with tPSA, the fPSA/tPSA and cPSA/tPSA ratios both improve the differentiation between BPH and PCa comparably and are similarly effective in reducing the rate of unnecessary biopsies, whereas cPSA alone does not have any effect.
The following articles in journals at HighWire Press have cited this article:
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  M. R. Cooperberg, J. W. Moul, and P. R. Carroll The Changing Face of Prostate Cancer J. Clin. Oncol., November 10, 2005; 23(32): 8146 - 8151. [Abstract] [Full Text] [PDF]
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 T. Keller, H. Butz, M. Lein, M. Kwiatkowski, A. Semjonow, H.-J. Luboldt, P. Hammerer, C. Stephan, and K. Jung Discordance Analysis Characteristics as a New Method to Compare the Diagnostic Accuracy of Tests: Example of Complexed Versus Total Prostate-Specific Antigen Clin. Chem., March 1, 2005; 51(3): 532 - 539. [Abstract] [Full Text] [PDF]
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 T. Nakamura, A. Scorilas, C. Stephan, K. Jung, A. R. Soosaipillai, and E. P. Diamandis The Usefulness of Serum Human Kallikrein 11 for Discriminating between Prostate Cancer and Benign Prostatic Hyperplasia Cancer Res., October 1, 2003; 63(19): 6543 - 6546. [Abstract] [Full Text] [PDF]
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L. Zhu, J. Leinonen, W.-M. Zhang, P. Finne, and U.-H. Stenman Dual-Label Immunoassay for Simultaneous Measurement of Prostate-specific Antigen (PSA)-{alpha}1-Antichymotrypsin Complex Together with Free or Total PSA Clin. Chem., January 1, 2003; 49(1): 97 - 103. [Abstract] [Full Text] [PDF]
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 M. A. Serdar, O. Oguz, A. Olgun, B. Seckin, S. Ilgan, A. Hasimi, M. Salih, F. Peker, and T. Kutluay Diagnostic Approach to Prostate Cancer using Total Prostate Specific Antigen-Based Parameters Together Ann. Clin. Lab. Sci., January 1, 2002; 32(1): 22 - 30. [Abstract] [Full Text] [PDF]
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R. Wiese, Y. Belosludtsev, T. Powdrill, P. Thompson, and M. Hogan Simultaneous Multianalyte ELISA Performed on a Microarray Platform Clin. Chem., August 1, 2001; 47(8): 1451 - 1457. [Abstract] [Full Text] [PDF]
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 C. Stephan, K. Jung, M. Lein, P. Sinha, D. Schnorr, and S. A. Loening Molecular Forms of Prostate-specific Antigen and Human Kallikrein 2 as Promising Tools for Early Diagnosis of Prostate Cancer Cancer Epidemiol. Biomarkers Prev., November 1, 2000; 9(11): 1133 - 1147. [Abstract] [Full Text]
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