Skip to main content
Erschienen in: Medical Oncology 4/2014

01.04.2014 | Original Paper

Percent free prostate-specific antigen does not improve the effectiveness of prostate cancer detection in Chinese men with a prostate-specific antigen of 2.5–20.0 ng/ml: a multicenter study

verfasst von: Maping Huang, Yurong Lin, Abai Xu, Matthew Uhlman, Xiangrong Deng, Xuanting Lin, Sifeng Wu, Pengfei Diao, Keji Xie, Ping Tang

Erschienen in: Medical Oncology | Ausgabe 4/2014

Einloggen, um Zugang zu erhalten

Abstract

The prostate-specific antigen (PSA) “gray zone” in Chinese men is likely higher than the traditional value (2.5–10.0 ng/ml) since the incidence of prostate cancer in Chinese men is relative low. The utility of percent free PSA in predicting prostate cancer is based on Western populations and may introduce sizable bias when applied to a Chinese cohort. We assessed the efficacy of percent free PSA in predicting prostate cancer in Chinese men with a PSA of 2.5–10.0 and 10.1–20.0 ng/ml. A total of 558 men with a PSA of 2.5–20.0 ng/ml who had undergone prostatic biopsy to detect prostate cancer from two Chinese centers were included. The rates of prostate cancer in different percent free PSA ranges were evaluated. Receiver operating characteristic curve (ROC) was used to evaluate and compare the efficiency of PSA and percent free PSA in the diagnosis of prostate cancer. The areas under ROC (AUCs) for percent free PSA for predicting prostate cancer were not higher than those for PSA, although prostate cancer detection rates increased with decreased percent free PSA in men with a PSA of 2.5–10.0, 10.1–20.0, and 2.5–20.0 ng/ml. Similarly, for men aged <70 and ≥70 years and with prostate volume <40 and ≥40 ml, AUCs showed percent free PSA was not better than PSA in predicting prostate cancer. By analyzing multicenter data, we first found that percent free PSA does not improve detection of prostate cancer in Chinese men with a PSA of 2.5–10.0 or 10.1–20.0 ng/ml.
Literatur
1.
2.
Zurück zum Zitat Yoshida K, Honda M, Sumi S, Arai K, Suzuki S, Kitahara S. Levels of free prostate-specific antigen (PSA) can be selectively measured by heat treatment of serum: free/total-PSA ratios improve detection of prostate carcinoma. Clin Chim Acta. 1999;280:195–203.PubMedCrossRef Yoshida K, Honda M, Sumi S, Arai K, Suzuki S, Kitahara S. Levels of free prostate-specific antigen (PSA) can be selectively measured by heat treatment of serum: free/total-PSA ratios improve detection of prostate carcinoma. Clin Chim Acta. 1999;280:195–203.PubMedCrossRef
3.
Zurück zum Zitat Greene KL, Albertsen PC, Babaian RJ, Carter HB, Gann PH, Han M, et al. Prostate specific antigen best practice statement: 2009 update. J Urol. 2013;189(1 Suppl):S2–11.PubMedCrossRef Greene KL, Albertsen PC, Babaian RJ, Carter HB, Gann PH, Han M, et al. Prostate specific antigen best practice statement: 2009 update. J Urol. 2013;189(1 Suppl):S2–11.PubMedCrossRef
4.
Zurück zum Zitat Catalona WJ, Smith DS, Wolfert RL, Wang TJ, Rittenhouse HG, Ratliff TL, et al. Evaluation of percentage of free serum prostate-specific antigen to improve specificity of prostate cancer screening. JAMA. 1995;274:1214–20.PubMedCrossRef Catalona WJ, Smith DS, Wolfert RL, Wang TJ, Rittenhouse HG, Ratliff TL, et al. Evaluation of percentage of free serum prostate-specific antigen to improve specificity of prostate cancer screening. JAMA. 1995;274:1214–20.PubMedCrossRef
5.
Zurück zum Zitat Matsuda T, Saika K. Comparison of time trends in prostate cancer incidence (1973–2002) in Asia, from cancer incidence in five continents, Vols. IV–IX. Jpn J Clin Oncol. 2009;39:468–9. Matsuda T, Saika K. Comparison of time trends in prostate cancer incidence (1973–2002) in Asia, from cancer incidence in five continents, Vols. IV–IX. Jpn J Clin Oncol. 2009;39:468–9.
6.
Zurück zum Zitat Roddam AW, Duffy MJ, Hamdy FC, Ward AM, Patnick J, Price CP, et al. 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. Eur Urol. 2005;48:386–399; discussion 398–9. Roddam AW, Duffy MJ, Hamdy FC, Ward AM, Patnick J, Price CP, et al. 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. Eur Urol. 2005;48:386–399; discussion 398–9.
7.
Zurück zum Zitat Jeong IG, Lee KH. Percent free prostate specific antigen does not enhance the specificity of total prostate specific antigen for the detection of prostate cancer in Korean men 50–65 years old: a prospective multicenter study. J Urol. 2008;179:111–6.PubMedCrossRef Jeong IG, Lee KH. Percent free prostate specific antigen does not enhance the specificity of total prostate specific antigen for the detection of prostate cancer in Korean men 50–65 years old: a prospective multicenter study. J Urol. 2008;179:111–6.PubMedCrossRef
8.
Zurück zum Zitat Wang JX, Wang Y, Liu BX, Zhou LP. Clinical significance of combined detection of serum PSA, free-to-total PSA and ACP in diagnosis of prostate carcinoma. Mod Oncol. 2012;20:999–1001. Wang JX, Wang Y, Liu BX, Zhou LP. Clinical significance of combined detection of serum PSA, free-to-total PSA and ACP in diagnosis of prostate carcinoma. Mod Oncol. 2012;20:999–1001.
9.
Zurück zum Zitat Lin Y, Li LM, Qiang WN, Yu ST, Yan H, Zhang G, et al. The percentage of free to total prostate specific antigen used in detecting prostate cancer. Zhongguo zhong liu linchuang. 2003;30:252–4. Lin Y, Li LM, Qiang WN, Yu ST, Yan H, Zhang G, et al. The percentage of free to total prostate specific antigen used in detecting prostate cancer. Zhongguo zhong liu linchuang. 2003;30:252–4.
10.
Zurück zum Zitat Li M, Na YQ. The detection rate of prostate cancer in different prostate-specific antigen (PSA) levels in Chinese men. Zhonghua Yi Xue Za Zhi. 2008;88:16–8.PubMed Li M, Na YQ. The detection rate of prostate cancer in different prostate-specific antigen (PSA) levels in Chinese men. Zhonghua Yi Xue Za Zhi. 2008;88:16–8.PubMed
11.
Zurück zum Zitat Catalona WJ, Smith DS, Ornstein DK. Prostate cancer detection in men with serum PSA concentrations of 2.6–4.0 ng/mL and benign prostate examination. Enhancement of specificity with free PSA measurements. JAMA. 1997;277:1452–5.PubMedCrossRef Catalona WJ, Smith DS, Ornstein DK. Prostate cancer detection in men with serum PSA concentrations of 2.6–4.0 ng/mL and benign prostate examination. Enhancement of specificity with free PSA measurements. JAMA. 1997;277:1452–5.PubMedCrossRef
12.
Zurück zum Zitat Morote J, Trilla E, Esquena S, Serrallach F, Abascal JM, Muñoz A, et al. The percentage of free prostatic-specific antigen is also useful in men with normal digital rectal examination and serum prostatic-specific antigen between 10.1 and 20 ng/ml. Eur Urol. 2002;42:333–7.PubMedCrossRef Morote J, Trilla E, Esquena S, Serrallach F, Abascal JM, Muñoz A, et al. The percentage of free prostatic-specific antigen is also useful in men with normal digital rectal examination and serum prostatic-specific antigen between 10.1 and 20 ng/ml. Eur Urol. 2002;42:333–7.PubMedCrossRef
13.
Zurück zum Zitat Stephan C, Lein M, Jung K, Schnorr D, Loening SA. The influence of prostate volume on the ratio of free to total prostate specific antigen in serum of patients with prostate carcinoma and benign prostate hyperplasia. Cancer. 1997;79:104–9.PubMedCrossRef Stephan C, Lein M, Jung K, Schnorr D, Loening SA. The influence of prostate volume on the ratio of free to total prostate specific antigen in serum of patients with prostate carcinoma and benign prostate hyperplasia. Cancer. 1997;79:104–9.PubMedCrossRef
14.
Zurück zum Zitat Tanaka N, Fujimoto K, Hirayama A, Yoneda T, Yoshida K, Hirao Y. Trends of the primary therapy for patients with prostate cancer in Nara uro-oncological research group (NUORG): a comparison between the CaPSURE data and the NUORG data. Jpn J Clin Oncol. 2010;40:588–92.PubMedCrossRef Tanaka N, Fujimoto K, Hirayama A, Yoneda T, Yoshida K, Hirao Y. Trends of the primary therapy for patients with prostate cancer in Nara uro-oncological research group (NUORG): a comparison between the CaPSURE data and the NUORG data. Jpn J Clin Oncol. 2010;40:588–92.PubMedCrossRef
15.
Zurück zum Zitat Tang P, Du W, Xie K, Fu J, Chen H, Yang W, et al. Characteristics of baseline PSA and PSA velocity in young men without prostate cancer: racial differences. Prostate. 2012;72:173–80.PubMedCrossRef Tang P, Du W, Xie K, Fu J, Chen H, Yang W, et al. Characteristics of baseline PSA and PSA velocity in young men without prostate cancer: racial differences. Prostate. 2012;72:173–80.PubMedCrossRef
16.
Zurück zum Zitat Tang P, Du W, Xie K, Deng X, Fu J, Chen H, et al. Transition zone PSA density improves the prostate cancer detection rate both in PSA 4.0–10.0 and 10.1–20.0 ng/ml in Chinese men. Urol Oncol. 2013;31:744–8.PubMedCrossRef Tang P, Du W, Xie K, Deng X, Fu J, Chen H, et al. Transition zone PSA density improves the prostate cancer detection rate both in PSA 4.0–10.0 and 10.1–20.0 ng/ml in Chinese men. Urol Oncol. 2013;31:744–8.PubMedCrossRef
17.
Zurück zum Zitat Yu W, Pattar A, He Q, Shan GZ, Jin J. Impact of prostate volume on the diagnostic value of prostate cancer with different biopsy strategies. Beijing Da Xue Xue Bao. 2010;42:400–3.PubMed Yu W, Pattar A, He Q, Shan GZ, Jin J. Impact of prostate volume on the diagnostic value of prostate cancer with different biopsy strategies. Beijing Da Xue Xue Bao. 2010;42:400–3.PubMed
18.
Zurück zum Zitat Ornstein DK, Smith DS, Humphrey PA, Catalona WJ. The effect of prostate volume, age, total prostate specific antigen level and acute inflammation on the percentage of free serum prostate specific antigen levels in men without clinically detectable prostate cancer. J Urol. 1998;159:1234–7.PubMedCrossRef Ornstein DK, Smith DS, Humphrey PA, Catalona WJ. The effect of prostate volume, age, total prostate specific antigen level and acute inflammation on the percentage of free serum prostate specific antigen levels in men without clinically detectable prostate cancer. J Urol. 1998;159:1234–7.PubMedCrossRef
19.
Zurück zum Zitat Chun FK, Epstein JI, Ficarra V, Freed land SJ, Montironi R, Montorsi F, et al. Optimizing performance and interpretation of prostate biopsy: a critical analysis of the literature. Eur Urol. 2010;58:851–64.PubMedCrossRef Chun FK, Epstein JI, Ficarra V, Freed land SJ, Montironi R, Montorsi F, et al. Optimizing performance and interpretation of prostate biopsy: a critical analysis of the literature. Eur Urol. 2010;58:851–64.PubMedCrossRef
20.
Zurück zum Zitat Lee R, Localio AR, Armstrong K, Malkowicz SB, Schwartz JS. A meta-analysis of the performance characteristics of the free prostate-specific antigen test. Urology. 2006;67:762–8.PubMedCrossRef Lee R, Localio AR, Armstrong K, Malkowicz SB, Schwartz JS. A meta-analysis of the performance characteristics of the free prostate-specific antigen test. Urology. 2006;67:762–8.PubMedCrossRef
Metadaten
Titel
Percent free prostate-specific antigen does not improve the effectiveness of prostate cancer detection in Chinese men with a prostate-specific antigen of 2.5–20.0 ng/ml: a multicenter study
verfasst von
Maping Huang
Yurong Lin
Abai Xu
Matthew Uhlman
Xiangrong Deng
Xuanting Lin
Sifeng Wu
Pengfei Diao
Keji Xie
Ping Tang
Publikationsdatum
01.04.2014
Verlag
Springer US
Erschienen in
Medical Oncology / Ausgabe 4/2014
Print ISSN: 1357-0560
Elektronische ISSN: 1559-131X
DOI
https://doi.org/10.1007/s12032-014-0925-4

Weitere Artikel der Ausgabe 4/2014

Medical Oncology 4/2014 Zur Ausgabe

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.