PMID- 15982797
OWN - NLM
STAT- MEDLINE
DCOM- 20051213
LR  - 20181201
IS  - 0302-2838 (Print)
IS  - 0302-2838 (Linking)
VI  - 48
IP  - 3
DP  - 2005 Sep
TI  - Use of prostate-specific antigen (PSA) isoforms for the detection of prostate 
      cancer in men with a PSA level of 2-10 ng/ml: systematic review and 
      meta-analysis.
PG  - 386-99; discussion 398-9
AB  - OBJECTIVE: Measurement of serum prostate-specific antigen (PSA) for the detection 
      of prostate cancer has poor specificity in men with PSA levels between 2 and 10 
      ng/ml. It has been suggested that measurement of the ratio of free to total PSA 
      (f/tPSA) or complexed PSA (cPSA) might offer an improvement. We performed a 
      systematic review and meta-analysis to evaluate the diagnostic performance of 
      these tests among men with PSA levels between 2 and 10 ng/ml. METHODS: Data on 
      sensitivity and specificity were extracted from 66 eligible studies. Likelihood 
      ratios and summary receiver operating characteristic curves were estimated and 
      possible sources of heterogeneity between studies examined. RESULTS: Use of the 
      f/tPSA or the cPSA test improved diagnostic performance among men with a total 
      PSA (tPSA) of 2-4 or 4-10 ng/ml compared to tPSA alone. The diagnostic 
      performance of the f/tPSA test was significantly higher in the tPSA range of 4-10 
      ng/ml compared to a tPSA range of 2-4 ng/ml (p < 0.01); at a sensitivity of 95%, 
      the specificity was 18% in the 4-10 ng/ml tPSA range and 6% in the 2-4 ng/ml tPSA 
      range. Among studies that measured both isoforms, the diagnostic performance of 
      the f/tPSA test and the cPSA was equivalent in both PSA ranges. CONCLUSIONS: The 
      use of the f/tPSA or cPSA test among men with PSA levels between 2 and 10 ng/ml 
      can reduce the number of unnecessary biopsies whilst maintaining a high cancer 
      detection rate.
FAU - Roddam, Andrew W
AU  - Roddam AW
AD  - Cancer Research UK Epidemiology Unit, University of Oxford, UK. 
      andrew.roddam@ceu.ox.ac.uk
FAU - Duffy, Michael J
AU  - Duffy MJ
FAU - Hamdy, Freddie C
AU  - Hamdy FC
FAU - Ward, Anthony Milford
AU  - Ward AM
FAU - Patnick, Julietta
AU  - Patnick J
FAU - Price, Christopher P
AU  - Price CP
FAU - Rimmer, Janet
AU  - Rimmer J
FAU - Sturgeon, Cathie
AU  - Sturgeon C
FAU - White, Peter
AU  - White P
FAU - Allen, Naomi E
AU  - Allen NE
CN  - NHS Prostate Cancer Risk Management Programme
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
PL  - Switzerland
TA  - Eur Urol
JT  - European urology
JID - 7512719
RN  - EC 3.4.21.77 (Prostate-Specific Antigen)
SB  - IM
CIN - Eur Urol. 2005 Dec;48(6):1059-60; author reply 1060-1. PMID: 16260082
MH  - Humans
MH  - Likelihood Functions
MH  - Male
MH  - Prostate-Specific Antigen/*blood
MH  - Prostatic Neoplasms/*blood/*diagnosis
MH  - ROC Curve
MH  - Sensitivity and Specificity
RF  - 96
EDAT- 2005/06/29 09:00
MHDA- 2005/12/15 09:00
CRDT- 2005/06/29 09:00
PHST- 2005/01/11 00:00 [received]
PHST- 2005/04/20 00:00 [accepted]
PHST- 2005/06/29 09:00 [pubmed]
PHST- 2005/12/15 09:00 [medline]
PHST- 2005/06/29 09:00 [entrez]
AID - S0302-2838(05)00260-5 [pii]
AID - 10.1016/j.eururo.2005.04.015 [doi]
PST - ppublish
SO  - Eur Urol. 2005 Sep;48(3):386-99; discussion 398-9. doi: 
      10.1016/j.eururo.2005.04.015.