Discordant performance of assays for free and total prostate‐specific antigen in relation to the early detection of prostate cancer

Objective To assess the value of applying rigid threshold values in interpreting prostate specific antigen (PSA) results, by selecting and comparing five current methods for measuring free and total PSA. Materials and methods Samples taken from an ongoing screening study for prostate cancer (total P...

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Veröffentlicht in:BJU international 2001-10, Vol.88 (6), p.545-550
Hauptverfasser: Blijenberg, B.G., Yurdakul, G., Van Zelst, B.D., Bangma, C.H., Wildhagen, M.F., Schröder, F.H.
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container_end_page 550
container_issue 6
container_start_page 545
container_title BJU international
container_volume 88
creator Blijenberg, B.G.
Yurdakul, G.
Van Zelst, B.D.
Bangma, C.H.
Wildhagen, M.F.
Schröder, F.H.
description Objective To assess the value of applying rigid threshold values in interpreting prostate specific antigen (PSA) results, by selecting and comparing five current methods for measuring free and total PSA. Materials and methods Samples taken from an ongoing screening study for prostate cancer (total PSA by Tandem‐E assay, 17 334 participants; biopsy criterion a PSA of 3.0 µg/L, 4 464 men) from men with a total PSA of 1.0–6.0 µg/L were measured for free and total PSA using the Access, Immulite, Elecsys and Prostatus analysis kits, in two patient groups, i.e. with prostate cancer or no evidence of disease. Results Both patient groups had equal means for total PSA but not for free PSA. In all, 360 samples from men with cancer and 96 from men with no evidence of disease were analysed. All methods applied to both groups deviated statistically significantly from the Tandem‐E result for total PSA, except for the Access kit. There was a close correlation among all the methods (correlation coefficients of 0.89–0.97). There were very discordant results for the combination of the Tandem‐E vs Prostatus (8% difference), representing 315 participants at a threshold of 3.0 µg/L. For free PSA (free/total PSA) the situation was worse, with extreme differences of 32% and 36% for both patient groups (Elecsys vs Access). Conclusions Depending on the threshold value applied as an indication for biopsy, when using the total PSA alone or combined with the free/total PSA, care is needed in interpreting patient groups because of the discordance among PSA assays.
doi_str_mv 10.1046/j.1464-410X.2001.02374.x
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Materials and methods Samples taken from an ongoing screening study for prostate cancer (total PSA by Tandem‐E assay, 17 334 participants; biopsy criterion a PSA of 3.0 µg/L, 4 464 men) from men with a total PSA of 1.0–6.0 µg/L were measured for free and total PSA using the Access, Immulite, Elecsys and Prostatus analysis kits, in two patient groups, i.e. with prostate cancer or no evidence of disease. Results Both patient groups had equal means for total PSA but not for free PSA. In all, 360 samples from men with cancer and 96 from men with no evidence of disease were analysed. All methods applied to both groups deviated statistically significantly from the Tandem‐E result for total PSA, except for the Access kit. There was a close correlation among all the methods (correlation coefficients of 0.89–0.97). There were very discordant results for the combination of the Tandem‐E vs Prostatus (8% difference), representing 315 participants at a threshold of 3.0 µg/L. For free PSA (free/total PSA) the situation was worse, with extreme differences of 32% and 36% for both patient groups (Elecsys vs Access). Conclusions Depending on the threshold value applied as an indication for biopsy, when using the total PSA alone or combined with the free/total PSA, care is needed in interpreting patient groups because of the discordance among PSA assays.</description><identifier>ISSN: 1464-4096</identifier><identifier>EISSN: 1464-410X</identifier><identifier>DOI: 10.1046/j.1464-410X.2001.02374.x</identifier><identifier>PMID: 11678748</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Biological and medical sciences ; Biopsy - methods ; biopsy thresholds ; clinical decision‐making ; Decision Making ; free PSA ; Humans ; Male ; Medical sciences ; Nephrology. Urinary tract diseases ; Prostate-Specific Antigen - metabolism ; Prostatic Neoplasms - diagnosis ; PSA assays ; Sensitivity and Specificity ; total PSA ; Tumors of the urinary system ; Urinary tract. 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Materials and methods Samples taken from an ongoing screening study for prostate cancer (total PSA by Tandem‐E assay, 17 334 participants; biopsy criterion a PSA of 3.0 µg/L, 4 464 men) from men with a total PSA of 1.0–6.0 µg/L were measured for free and total PSA using the Access, Immulite, Elecsys and Prostatus analysis kits, in two patient groups, i.e. with prostate cancer or no evidence of disease. Results Both patient groups had equal means for total PSA but not for free PSA. In all, 360 samples from men with cancer and 96 from men with no evidence of disease were analysed. All methods applied to both groups deviated statistically significantly from the Tandem‐E result for total PSA, except for the Access kit. There was a close correlation among all the methods (correlation coefficients of 0.89–0.97). There were very discordant results for the combination of the Tandem‐E vs Prostatus (8% difference), representing 315 participants at a threshold of 3.0 µg/L. For free PSA (free/total PSA) the situation was worse, with extreme differences of 32% and 36% for both patient groups (Elecsys vs Access). Conclusions Depending on the threshold value applied as an indication for biopsy, when using the total PSA alone or combined with the free/total PSA, care is needed in interpreting patient groups because of the discordance among PSA assays.</description><subject>Biological and medical sciences</subject><subject>Biopsy - methods</subject><subject>biopsy thresholds</subject><subject>clinical decision‐making</subject><subject>Decision Making</subject><subject>free PSA</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Prostate-Specific Antigen - metabolism</subject><subject>Prostatic Neoplasms - diagnosis</subject><subject>PSA assays</subject><subject>Sensitivity and Specificity</subject><subject>total PSA</subject><subject>Tumors of the urinary system</subject><subject>Urinary tract. 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Urinary tract diseases</topic><topic>Prostate-Specific Antigen - metabolism</topic><topic>Prostatic Neoplasms - diagnosis</topic><topic>PSA assays</topic><topic>Sensitivity and Specificity</topic><topic>total PSA</topic><topic>Tumors of the urinary system</topic><topic>Urinary tract. Prostate gland</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Blijenberg, B.G.</creatorcontrib><creatorcontrib>Yurdakul, G.</creatorcontrib><creatorcontrib>Van Zelst, B.D.</creatorcontrib><creatorcontrib>Bangma, C.H.</creatorcontrib><creatorcontrib>Wildhagen, M.F.</creatorcontrib><creatorcontrib>Schröder, F.H.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>BJU international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Blijenberg, B.G.</au><au>Yurdakul, G.</au><au>Van Zelst, B.D.</au><au>Bangma, C.H.</au><au>Wildhagen, M.F.</au><au>Schröder, F.H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Discordant performance of assays for free and total prostate‐specific antigen in relation to the early detection of prostate cancer</atitle><jtitle>BJU international</jtitle><addtitle>BJU Int</addtitle><date>2001-10</date><risdate>2001</risdate><volume>88</volume><issue>6</issue><spage>545</spage><epage>550</epage><pages>545-550</pages><issn>1464-4096</issn><eissn>1464-410X</eissn><abstract>Objective To assess the value of applying rigid threshold values in interpreting prostate specific antigen (PSA) results, by selecting and comparing five current methods for measuring free and total PSA. Materials and methods Samples taken from an ongoing screening study for prostate cancer (total PSA by Tandem‐E assay, 17 334 participants; biopsy criterion a PSA of 3.0 µg/L, 4 464 men) from men with a total PSA of 1.0–6.0 µg/L were measured for free and total PSA using the Access, Immulite, Elecsys and Prostatus analysis kits, in two patient groups, i.e. with prostate cancer or no evidence of disease. Results Both patient groups had equal means for total PSA but not for free PSA. In all, 360 samples from men with cancer and 96 from men with no evidence of disease were analysed. All methods applied to both groups deviated statistically significantly from the Tandem‐E result for total PSA, except for the Access kit. There was a close correlation among all the methods (correlation coefficients of 0.89–0.97). There were very discordant results for the combination of the Tandem‐E vs Prostatus (8% difference), representing 315 participants at a threshold of 3.0 µg/L. 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subjects Biological and medical sciences
Biopsy - methods
biopsy thresholds
clinical decision‐making
Decision Making
free PSA
Humans
Male
Medical sciences
Nephrology. Urinary tract diseases
Prostate-Specific Antigen - metabolism
Prostatic Neoplasms - diagnosis
PSA assays
Sensitivity and Specificity
total PSA
Tumors of the urinary system
Urinary tract. Prostate gland
title Discordant performance of assays for free and total prostate‐specific antigen in relation to the early detection of prostate cancer
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