PMID- 10367846
OWN - NLM
STAT- MEDLINE
DCOM- 19990708
LR  - 20190714
IS  - 1527-9995 (Electronic)
IS  - 0090-4295 (Linking)
VI  - 53
IP  - 6
DP  - 1999 Jun
TI  - Determination of alpha1-antichymotrypsin-PSA complex in serum does not improve 
      the differentiation between benign prostatic hyperplasia and prostate cancer 
      compared with total PSA and percent free PSA.
PG  - 1160-7; discussion 1167-8
AB  - OBJECTIVES: To evaluate the analytical performance and diagnostic utility of 
      alpha1-antichymotrypsin (ACT)-prostate-specific antigen (PSA) complex in serum to 
      improve the differentiation between benign prostatic hyperplasia (BPH) and 
      prostate cancer (PCa). METHODS: Serum concentrations of total PSA (tPSA), free 
      PSA (fPSA), and ACT-PSA were measured in 112 untreated patients with PCa (median 
      age 65 years), 34 patients with BPH (median age 66 years) with histologic 
      confirmation, and 33 men without prostate disease and with a normal digital 
      rectal examination considered as controls (median age 54 years). Sera were frozen 
      at -80 degrees C within 2 hours after collection and then analyzed during a 
      12-week period. Determinations were made with the Enzymun-Test for tPSA and fPSA 
      and with a prototype assay for ACT-PSA on the ES system (Roche Diagnostics, 
      Boehringer Mannheim). RESULTS: The new ACT-PSA assay showed reliable data of 
      analytical performance. The lower detection limit amounted to 0.068 microg/L. The 
      assay was linear to 50 microg/L. Spiking experiments showed a mean recovery rate 
      of 98.2%. No interferences of the assay were observed in patients with acute 
      inflammation and highly increased ACT concentrations. The values of intra- and 
      interassay imprecision ranged from 1.51% to 3.48% and 2.1% to 6.3%, respectively. 
      The median value of ACT-PSA concentrations were significantly different (P 
      <0.001) between controls and patients with BPH and PCa (0.40, 3.86, 5.26 
      microg/L, respectively). The median fPSA/tPSA and fPSA/ACT-PSA ratios were 
      significantly different between BPH and PCa (24.3% versus 12.2%, P <0.001 and 
      32.9% versus 15.0%, P <0.001, respectively), but no difference of the 
      ACT-PSA/tPSA ratio was observed (78.2% versus 78.7%, P = 0.696). Receiver 
      operating characteristics of ACT-PSA (area under the curve = 0.630) and all the 
      derivative ratios of fPSA/ACT-PSA (area = 0.737) and ACT-PSA/tPSA (area = 0.528) 
      were not different from that of tPSA (area = 0.619), but showed a lower 
      discrimination power between BPH and PCa than the fPSA/tPSA ratio (area = 0.790). 
      CONCLUSIONS: Using this prototype assay to quantify ACT-PSA in serum, we have 
      demonstrated that ACT-PSA and the calculated derivatives are not superior in the 
      differentiation between BPH and PCa compared with tPSA and the ratio of fPSA to 
      tPSA.
FAU - Jung, K
AU  - Jung K
AD  - Department of Urology, University Hospital Charite, Humboldt University Berlin, 
      Germany.
FAU - Brux, B
AU  - Brux B
FAU - Lein, M
AU  - Lein M
FAU - Knabich, A
AU  - Knabich A
FAU - Sinha, P
AU  - Sinha P
FAU - Rudolph, B
AU  - Rudolph B
FAU - Schnorr, D
AU  - Schnorr D
FAU - Loening, S A
AU  - Loening SA
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Urology
JT  - Urology
JID - 0366151
RN  - 0 (alpha 1-Antichymotrypsin)
RN  - EC 3.4.21.77 (Prostate-Specific Antigen)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Diagnosis, Differential
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prostate-Specific Antigen/*blood
MH  - Prostatic Hyperplasia/*blood/*diagnosis
MH  - Prostatic Neoplasms/*blood/*diagnosis
MH  - Reproducibility of Results
MH  - alpha 1-Antichymotrypsin/*blood
EDAT- 1999/06/15 00:00
MHDA- 1999/06/15 00:01
CRDT- 1999/06/15 00:00
PHST- 1999/06/15 00:00 [pubmed]
PHST- 1999/06/15 00:01 [medline]
PHST- 1999/06/15 00:00 [entrez]
AID - S0090429599000801 [pii]
AID - 10.1016/s0090-4295(99)00080-1 [doi]
PST - ppublish
SO  - Urology. 1999 Jun;53(6):1160-7; discussion 1167-8. doi: 
      10.1016/s0090-4295(99)00080-1.