Contemporary use of complexed PSA and calculated percent free PSA for early detection of prostate cancer: impact of changing disease demographics.

摘要: Abstract Objectives. To assess the diagnostic performance of complexed prostate-specific antigen (cPSA), total PSA (tPSA), and calculated free/total (f/t PSA) ratios in differentiation benign disease from prostate cancer (CaP) using a contemporary patient cohort. Methods. The cPSA, tPSA, fPSA values were determined Bayer Immuno-1 system. validate our f/t ratio, we also retrospectively measured Abbott AxSYM immunoassay system archival pretreatment sera obtained between 1990 1997 362 men with clinically biopsy-confirmed prostatic hyperplasia (n = 179) or CaP 183). utility ratio was assessed test population consisting prospectively collected June 1999 2000 3006 who had recently undergone systematic biopsy by urologists clinical practices throughout United States. This sample diagnoses either no evidence malignancy 1857) 1149). All serum samples tPSA 2.0 20.0 ng/mL. Results. versus Pearson’s correlation coefficient 0.9130 studied men. areas under receiver operating characteristic curves (ROC-AUCs) for indistinguishable (69.6% 69.2%, respectively). In 3006), ROC-AUC 52.2%, 53.9%, 58.4%, respectively. We compared published cutoffs (greater than 4.0 ng/mL), cPSA 3.8 15% greater 25%) reflex ranges 2 to 20 ng/mL 10 found that both 25% cutoff) outperformed yielded similar results terms biopsies spared cancers missed. Conclusions. perform equally well improvement specificity discrimination CaP. provide benefits over use alone, such as an increased sparing unnecessary performed manageable degree risk delayed detection.