Free/total serum prostate‐specific antigen ratio: how helpful is it in detecting prostate cancer?
Objective To determine whether the use of free/total (f/t) serum prostate specific antigen (PSA) ratio would help reduce the number of prostate biopsies performed without compromising the detection of prostate cancer, in the setting of a transrectal ultrasonography (TRUS) clinic. Patients and metho...
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| Veröffentlicht in: | British Journal of Urology 1998-03, Vol.81 (3), p.419-423 |
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| container_title | British Journal of Urology |
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| creator | MASTERS, J. G KEEGAN, P. E HILDRETH, A. J GREENE, D. R. J |
| description | Objective
To determine whether the use of free/total (f/t) serum prostate specific antigen (PSA) ratio would help reduce the number of prostate biopsies performed without compromising the detection of prostate cancer, in the setting of a transrectal ultrasonography (TRUS) clinic.
Patients and methods
The study included 93 consecutive patients referred to the clinic for TRUS and biopsy. Serum samples were assessed for total PSA and free PSA, and the f/t PSA ratio calculated; 70 biopsies were taken. Patients over the age of 70 years with TRUS findings consistent with benign prostatic hyperplasia and with PSA levels |
| doi_str_mv | 10.1046/j.1464-410x.1998.00566.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_79752081</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>79752081</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3926-cd51ad91bdafd272886bb47103737ea4b95ceb4b21662592b4f1e37bd3551b703</originalsourceid><addsrcrecordid>eNqNkMtq3DAUhkVpSSZpH6GgRejOjm6WrBAoacilJdBNA90JST5ONHjsqSSTyS6P0Gfsk8TuTGfd1Tnwf-fChxCmpKREyNNlSYUUhaBkU1Kt65KQSspy8wYt_gU_36IFIUQVlHN6iI5SWhIyhVIcoANdMS4lXyB_HQFO85BthxPEcYXXcUjZZvjz8jutwYc2eGz7HB6gx9HmMJzhx-EJP0K3bscOh4RDxqHHDWTwOfQP-w3Y295D_PwevWttl-DDrh6j--urH5e3xd33m6-XF3eF55rJwjcVtY2mrrFtwxSra-mcUJRwxRVY4XTlwQnHqJSs0syJlgJXruFVRZ0i_Bh92u6dHvg1QspmFZKHrrM9DGMySquKkZpOYL0F_fRpitCadQwrG58NJWb2a5Zm1mhmv2b2a_76NZtp9OPuxuhW0OwHd0Kn_GSX2-Rt18ZJQUh7jFGtqJix8y32FDp4_u_z5su3-6nhrwcRmFY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>79752081</pqid></control><display><type>article</type><title>Free/total serum prostate‐specific antigen ratio: how helpful is it in detecting prostate cancer?</title><source>MEDLINE</source><source>Wiley Journals</source><creator>MASTERS, J. G ; KEEGAN, P. E ; HILDRETH, A. J ; GREENE, D. R. J</creator><creatorcontrib>MASTERS, J. G ; KEEGAN, P. E ; HILDRETH, A. J ; GREENE, D. R. J</creatorcontrib><description>Objective
To determine whether the use of free/total (f/t) serum prostate specific antigen (PSA) ratio would help reduce the number of prostate biopsies performed without compromising the detection of prostate cancer, in the setting of a transrectal ultrasonography (TRUS) clinic.
Patients and methods
The study included 93 consecutive patients referred to the clinic for TRUS and biopsy. Serum samples were assessed for total PSA and free PSA, and the f/t PSA ratio calculated; 70 biopsies were taken. Patients over the age of 70 years with TRUS findings consistent with benign prostatic hyperplasia and with PSA levels <10 ng/mL were not biopsied.
Results
Tumour was detected in 23 patients; receiver operating characteristic curves showed no advantage for the f/t PSA ratio when compared with total PSA in detecting prostate cancer. If a f/t PSA ratio of <0.15 had been used to determine the necessity for biopsy in the group with a total PSA of 4–10 ng/mL, then two‐thirds of all tumours would have been undetected.
Conclusion
The f/t PSA ratio had no advantage over total PSA in improving specificity at a given sensitivity for detecting prostate cancer. Therefore, it cannot be recommended as a means of decreasing unnecessary biopsies in patients with a raised PSA level and/or an abnormal digital rectal examination. This applied particularly to the group of patients with a total PSA of 4–10 ng/mL.</description><identifier>ISSN: 0007-1331</identifier><identifier>EISSN: 1464-410X</identifier><identifier>DOI: 10.1046/j.1464-410x.1998.00566.x</identifier><identifier>PMID: 9523663</identifier><identifier>CODEN: BJURAN</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science Ltd</publisher><subject>Age Distribution ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Biopsy - methods ; False Positive Reactions ; Humans ; Male ; Medical sciences ; Middle Aged ; Nephrology. Urinary tract diseases ; prostate cancer ; Prostate-Specific Antigen - blood ; Prostatic Neoplasms - blood ; Prostatic Neoplasms - diagnosis ; Prostatic Neoplasms - pathology ; PSA ratio ; Sensitivity and Specificity ; Total prostate specific antigen level ; Tumors of the urinary system ; Urinary tract. Prostate gland</subject><ispartof>British Journal of Urology, 1998-03, Vol.81 (3), p.419-423</ispartof><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3926-cd51ad91bdafd272886bb47103737ea4b95ceb4b21662592b4f1e37bd3551b703</citedby><cites>FETCH-LOGICAL-c3926-cd51ad91bdafd272886bb47103737ea4b95ceb4b21662592b4f1e37bd3551b703</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1046%2Fj.1464-410x.1998.00566.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1046%2Fj.1464-410x.1998.00566.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2197143$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9523663$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MASTERS, J. G</creatorcontrib><creatorcontrib>KEEGAN, P. E</creatorcontrib><creatorcontrib>HILDRETH, A. J</creatorcontrib><creatorcontrib>GREENE, D. R. J</creatorcontrib><title>Free/total serum prostate‐specific antigen ratio: how helpful is it in detecting prostate cancer?</title><title>British Journal of Urology</title><addtitle>Br J Urol</addtitle><description>Objective
To determine whether the use of free/total (f/t) serum prostate specific antigen (PSA) ratio would help reduce the number of prostate biopsies performed without compromising the detection of prostate cancer, in the setting of a transrectal ultrasonography (TRUS) clinic.
Patients and methods
The study included 93 consecutive patients referred to the clinic for TRUS and biopsy. Serum samples were assessed for total PSA and free PSA, and the f/t PSA ratio calculated; 70 biopsies were taken. Patients over the age of 70 years with TRUS findings consistent with benign prostatic hyperplasia and with PSA levels <10 ng/mL were not biopsied.
Results
Tumour was detected in 23 patients; receiver operating characteristic curves showed no advantage for the f/t PSA ratio when compared with total PSA in detecting prostate cancer. If a f/t PSA ratio of <0.15 had been used to determine the necessity for biopsy in the group with a total PSA of 4–10 ng/mL, then two‐thirds of all tumours would have been undetected.
Conclusion
The f/t PSA ratio had no advantage over total PSA in improving specificity at a given sensitivity for detecting prostate cancer. Therefore, it cannot be recommended as a means of decreasing unnecessary biopsies in patients with a raised PSA level and/or an abnormal digital rectal examination. This applied particularly to the group of patients with a total PSA of 4–10 ng/mL.</description><subject>Age Distribution</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Biopsy - methods</subject><subject>False Positive Reactions</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nephrology. Urinary tract diseases</subject><subject>prostate cancer</subject><subject>Prostate-Specific Antigen - blood</subject><subject>Prostatic Neoplasms - blood</subject><subject>Prostatic Neoplasms - diagnosis</subject><subject>Prostatic Neoplasms - pathology</subject><subject>PSA ratio</subject><subject>Sensitivity and Specificity</subject><subject>Total prostate specific antigen level</subject><subject>Tumors of the urinary system</subject><subject>Urinary tract. Prostate gland</subject><issn>0007-1331</issn><issn>1464-410X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkMtq3DAUhkVpSSZpH6GgRejOjm6WrBAoacilJdBNA90JST5ONHjsqSSTyS6P0Gfsk8TuTGfd1Tnwf-fChxCmpKREyNNlSYUUhaBkU1Kt65KQSspy8wYt_gU_36IFIUQVlHN6iI5SWhIyhVIcoANdMS4lXyB_HQFO85BthxPEcYXXcUjZZvjz8jutwYc2eGz7HB6gx9HmMJzhx-EJP0K3bscOh4RDxqHHDWTwOfQP-w3Y295D_PwevWttl-DDrh6j--urH5e3xd33m6-XF3eF55rJwjcVtY2mrrFtwxSra-mcUJRwxRVY4XTlwQnHqJSs0syJlgJXruFVRZ0i_Bh92u6dHvg1QspmFZKHrrM9DGMySquKkZpOYL0F_fRpitCadQwrG58NJWb2a5Zm1mhmv2b2a_76NZtp9OPuxuhW0OwHd0Kn_GSX2-Rt18ZJQUh7jFGtqJix8y32FDp4_u_z5su3-6nhrwcRmFY</recordid><startdate>199803</startdate><enddate>199803</enddate><creator>MASTERS, J. G</creator><creator>KEEGAN, P. E</creator><creator>HILDRETH, A. J</creator><creator>GREENE, D. R. J</creator><general>Blackwell Science Ltd</general><general>Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>199803</creationdate><title>Free/total serum prostate‐specific antigen ratio: how helpful is it in detecting prostate cancer?</title><author>MASTERS, J. G ; KEEGAN, P. E ; HILDRETH, A. J ; GREENE, D. R. J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3926-cd51ad91bdafd272886bb47103737ea4b95ceb4b21662592b4f1e37bd3551b703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Age Distribution</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Biopsy - methods</topic><topic>False Positive Reactions</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nephrology. Urinary tract diseases</topic><topic>prostate cancer</topic><topic>Prostate-Specific Antigen - blood</topic><topic>Prostatic Neoplasms - blood</topic><topic>Prostatic Neoplasms - diagnosis</topic><topic>Prostatic Neoplasms - pathology</topic><topic>PSA ratio</topic><topic>Sensitivity and Specificity</topic><topic>Total prostate specific antigen level</topic><topic>Tumors of the urinary system</topic><topic>Urinary tract. Prostate gland</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>MASTERS, J. G</creatorcontrib><creatorcontrib>KEEGAN, P. E</creatorcontrib><creatorcontrib>HILDRETH, A. J</creatorcontrib><creatorcontrib>GREENE, D. R. J</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>British Journal of Urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>MASTERS, J. G</au><au>KEEGAN, P. E</au><au>HILDRETH, A. J</au><au>GREENE, D. R. J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Free/total serum prostate‐specific antigen ratio: how helpful is it in detecting prostate cancer?</atitle><jtitle>British Journal of Urology</jtitle><addtitle>Br J Urol</addtitle><date>1998-03</date><risdate>1998</risdate><volume>81</volume><issue>3</issue><spage>419</spage><epage>423</epage><pages>419-423</pages><issn>0007-1331</issn><eissn>1464-410X</eissn><coden>BJURAN</coden><abstract>Objective
To determine whether the use of free/total (f/t) serum prostate specific antigen (PSA) ratio would help reduce the number of prostate biopsies performed without compromising the detection of prostate cancer, in the setting of a transrectal ultrasonography (TRUS) clinic.
Patients and methods
The study included 93 consecutive patients referred to the clinic for TRUS and biopsy. Serum samples were assessed for total PSA and free PSA, and the f/t PSA ratio calculated; 70 biopsies were taken. Patients over the age of 70 years with TRUS findings consistent with benign prostatic hyperplasia and with PSA levels <10 ng/mL were not biopsied.
Results
Tumour was detected in 23 patients; receiver operating characteristic curves showed no advantage for the f/t PSA ratio when compared with total PSA in detecting prostate cancer. If a f/t PSA ratio of <0.15 had been used to determine the necessity for biopsy in the group with a total PSA of 4–10 ng/mL, then two‐thirds of all tumours would have been undetected.
Conclusion
The f/t PSA ratio had no advantage over total PSA in improving specificity at a given sensitivity for detecting prostate cancer. Therefore, it cannot be recommended as a means of decreasing unnecessary biopsies in patients with a raised PSA level and/or an abnormal digital rectal examination. This applied particularly to the group of patients with a total PSA of 4–10 ng/mL.</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Ltd</pub><pmid>9523663</pmid><doi>10.1046/j.1464-410x.1998.00566.x</doi><tpages>5</tpages></addata></record> |
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| ispartof | British Journal of Urology, 1998-03, Vol.81 (3), p.419-423 |
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| subjects | Age Distribution Aged Aged, 80 and over Biological and medical sciences Biopsy - methods False Positive Reactions Humans Male Medical sciences Middle Aged Nephrology. Urinary tract diseases prostate cancer Prostate-Specific Antigen - blood Prostatic Neoplasms - blood Prostatic Neoplasms - diagnosis Prostatic Neoplasms - pathology PSA ratio Sensitivity and Specificity Total prostate specific antigen level Tumors of the urinary system Urinary tract. Prostate gland |
| title | Free/total serum prostate‐specific antigen ratio: how helpful is it in detecting prostate cancer? |
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