PMID- 18312936
OWN - NLM
STAT- MEDLINE
DCOM- 20080801
LR  - 20080303
IS  - 1078-1439 (Print)
IS  - 1078-1439 (Linking)
VI  - 26
IP  - 2
DP  - 2008 Mar-Apr
TI  - PSA-related markers in the detection of prostate cancer and high-grade disease in 
      the contemporary era with extended biopsy.
PG  - 166-70
LID - 10.1016/j.urolonc.2007.05.030 [doi]
AB  - OBJECTIVE: To determine the relationship of total PSA (tPSA), percent free PSA 
      (%fPSA), and complexed PSA (cPSA) with prostate cancer detection and the 
      diagnosis of poorly-differentiated cancers in the contemporary era. METHODS: We 
      retrospectively reviewed the clinical and pathological records of 292 men who met 
      the following inclusion criteria: (1) tPSA 2.5 to 10 ng/ml; (2) initial biopsy 
      only; (3) extended biopsy scheme (>or=10 peripheral zone cores); (4) no previous 
      prostate surgeries. The ability of PSA-related markers to detect cancer was 
      determined by area under the receiver operating characteristics curve analysis 
      (AUC-ROC). Various clinically relevant % fPSA cutoffs and cPSA ranges were 
      analyzed to determine the association with poorly-differentiated cancers. 
      RESULTS: Cancer was detected in 126 (43%) men, with mean Gleason score of 7. The 
      cancer detection rates for various cutoffs of tPSA, cPSA and % fPSA were very 
      similar. On ROC analysis for cancer diagnosis, the AUCs for tPSA, % fPSA, and 
      cPSA were 0.53, 0.54, and 0.52, respectively. Men with % fPSA <15 were more 
      likely to have poorly-differentiated cancer than those with % fPSA >or=15 (66% 
      vs. 41%, P < 0.005). Similarly, cPSA ranges (2-4, 4.1-6, and >6) were associated 
      with the detection of poorly-differentiated cancers (37%, 57%, and 80% P < 
      0.003). CONCLUSIONS: With the use of extended prostate sampling in the 
      contemporary screening population, the addition of cPSA and % fPSA does not 
      enhance the diagnostic performance of tPSA. However, the significant association 
      between cPSA and poorly-differentiated cancers suggests that this may be a more 
      useful initial test for prostate cancer screening.
FAU - Bratslavsky, Gennady
AU  - Bratslavsky G
AD  - Division of Urology, Albany Medical College and Stratton VA Medical Center, 
      Albany, NY 12208, USA.
FAU - Fisher, Hugh A G
AU  - Fisher HA
FAU - Kaufman, Ronald P Jr
AU  - Kaufman RP Jr
FAU - Voskoboynik, Diana
AU  - Voskoboynik D
FAU - Nazeer, Tipu
AU  - Nazeer T
FAU - Mian, Badar M
AU  - Mian BM
LA  - eng
PT  - Journal Article
DEP - 20071126
PL  - United States
TA  - Urol Oncol
JT  - Urologic oncology
JID - 9805460
RN  - EC 3.4.21.77 (Prostate-Specific Antigen)
SB  - IM
MH  - Biopsy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prostate-Specific Antigen/*blood
MH  - Prostatic Neoplasms/*blood/*diagnosis/pathology
MH  - Retrospective Studies
EDAT- 2008/03/04 09:00
MHDA- 2008/08/02 09:00
CRDT- 2008/03/04 09:00
PHST- 2006/12/08 00:00 [received]
PHST- 2007/05/29 00:00 [revised]
PHST- 2007/05/31 00:00 [accepted]
PHST- 2008/03/04 09:00 [pubmed]
PHST- 2008/08/02 09:00 [medline]
PHST- 2008/03/04 09:00 [entrez]
AID - S1078-1439(07)00163-9 [pii]
AID - 10.1016/j.urolonc.2007.05.030 [doi]
PST - ppublish
SO  - Urol Oncol. 2008 Mar-Apr;26(2):166-70. doi: 10.1016/j.urolonc.2007.05.030. Epub 
      2007 Nov 26.