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Discrimination of Benign From Malignant Prostatic Disease by Selective Measurements of Single Chain, Intact Free Prostate Specific Antigen

2002; Lippincott Williams & Wilkins; Volume: 168; Issue: 5 Linguagem: Inglês

10.1016/s0022-5347(05)64263-2

1527-3792

Thomas Steuber, Pauliina Nurmikko, Alexander Haese, Kim Pettersson, Markus Graefen, Peter Hammerer, Hartwig Huland, Hans Lilja,

Urologic and reproductive health conditions

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Nov 2002Discrimination of Benign From Malignant Prostatic Disease by Selective Measurements of Single Chain, Intact Free Prostate Specific Antigenis corrected byErrata THOMAS STEUBER, PAULIINA NURMIKKO, ALEXANDER HAESE, KIM PETTERSSON, MARKUS GRAEFEN, PETER HAMMERER, HARTWIG HULAND, and HANS LILJA THOMAS STEUBERTHOMAS STEUBER , PAULIINA NURMIKKOPAULIINA NURMIKKO , ALEXANDER HAESEALEXANDER HAESE , KIM PETTERSSONKIM PETTERSSON , MARKUS GRAEFENMARKUS GRAEFEN , PETER HAMMERERPETER HAMMERER , HARTWIG HULANDHARTWIG HULAND , and HANS LILJAHANS LILJA View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64263-2AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Free prostate specific antigen (PSA) in serum consists of heterogeneous molecular subforms. Recently we developed an immunoassay for selective measurement of a subfraction of free PSA called intact PSA, which has been shown to be closely associated with prostate cancer. We assessed the ability of serum intact PSA to discriminate between benign and malignant prostatic disease. Materials and Methods: In serum of 178 men with benign disease and 255 men with prostate cancer we measured total PSA and free PSA using a commercially available immunoassay. Intact PSA levels were analyzed by a newly developed assay specific for noncleaved, that is single chain forms of free PSA. Internally cleaved “nicked” PSA was calculated by subtracting intact from free PSA. We also calculated ratios of intact PSA-to-free PSA (intact-to-free PSA) and nicked PSA-to-total PSA (nicked-to-total PSA). We compared means, medians and ranges of all analytes and ratios in patients with and without cancer for the entire total PSA range and in a subset with total PSA ranging from 2 to 10 ng./ml. Furthermore, various combinations of PSA forms were tested for their predictive ability. For statistical comparison we used the Mann-Whitney U test and ROC analysis. Results: The ratio intact-to-free PSA was significantly higher in cancer (median 48.5%) compared to noncancer cases (median 41.8%, p <0.0001). Conversely, the ratio nicked-to-total PSA was significantly higher in men without compared to those with prostate cancer (median 11.0% and 6.0%, respectively, p <0.0001). Highest discriminative ability was observed for a combination of intact, total and free PSA (log [intact, free, total], AUC = 0.773) followed by nicked-to-total PSA (AUC 0.755). In the subgroup of patients with total PSA levels from 2 to 10 ng./ml. only the AUC of log intact, free, total (AUC 0.706, p = 0.0017) and nicked-to-total PSA (AUC 0.704,p = 0.0019) were significantly larger compared to the AUC of total PSA (AUC 0.602). 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Related articlesJournal of Urology9 Nov 2018Errata Volume 168Issue 5November 2002Page: 1917-1922 Advertisement Copyright & Permissions© 2002 by American Urological Association, Inc.Keywordsprostatic neoplasmsdiagnosisprostate-specific antigenMetricsAuthor Information THOMAS STEUBER More articles by this author PAULIINA NURMIKKO More articles by this author ALEXANDER HAESE More articles by this author KIM PETTERSSON More articles by this author MARKUS GRAEFEN More articles by this author PETER HAMMERER More articles by this author HARTWIG HULAND More articles by this author HANS LILJA More articles by this author Expand All Advertisement PDF downloadLoading ...