Editorial comment to “The value of percentage free prostate-specific antigen (PSA) in the detection of prostate cancer among patients with intermediate levels of total PSA (4.0–10.0 ng/mL) in Nigeria” and Reply by authors
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[12] Oesterling JE, Jacobsen SJ, Klee GG, Pettersson K, Piironen T, Abrahamsson PA, et al. Free, complexed and total serum prostate-specific antigen: the establishment of appropriate reference ranges for their concentrations and ratios. J Urol 1995;154:1090–5. [13] Tanaka H, Murakami S, Igarashi T, Abe T, Suzuki K, Sekita N, et al. Free/total PSA ratio of prostate-specific antigen (PSA) for prostate cancer detection in patients with gray zone PSA level. Hinyokika Kiyo 1997;43:855–60. [14] Arcangeli CG, Shepherd DL, Smith DS, Humphrey PA, Keetch WJ, Catalona WJ. Correlation of percent free PSA and pathologic features of prostatic carcinomas. J Urol 1996;155(Suppl.):415. [15] Carter HB, Partin AW, Luderer AA, Metter EJ, Landis P, Chan DW, et al. Percentage of free prostate-specific antigen in sera predicts aggressiveness of prostate cancer a decade before diagnosis. Urology 1997;49:379–84. [16] Pannek J, Rittenhouse HG, Chan DW, Epstein JI, Walsh PC, Partin AW. The use of percent free PSA for staging of men with clinically localized prostate cancer. J Urol 1998;159: 1238–42. [17] Matsuyama H, Baba Y, Yamakawa G, Yamamoto N, Naito K. Diagnostic value of prostate-specific antigen-related parameters in discriminating prostate cancer. Int J Urol 2000;7:409–14. [18] Kuriyama M, Kawada Y, Arai Y, Maeda H, Egawa S, Koshiba K, et al. Significance of free to total PSA ratio in men with slightly elevated serum PSA Levels: a Cooperative Study. J Clin Oncol 1998;28:661–5. [19] Morgan TO, Jacobsen SJ, McCarthy WF, Jacobson DG, McLeod DG, Moul JW. Age-specific reference ranges for serum prostate-specific antigen in black men. N Engl J Med 1996;335:304–10. [20] Catalona WJ, Partin AW, Slawin KM, Naughton CK, Brawer RC, Flanigan RC, et al. Percentage of free PSA in black versus white men for detection and staging of prostate cancer: a prospective multicenter clinical trial. Urology 2000;55:372–6. [21] Fowler Jr JE, Sanders J, Bigler SA, Rigdon J, Kilambi NK, Land SA. Percent free prostate specific antigen and cancer detection in black and white men with total prostate specific antigen 2.5-9.9 ng./ml. J Urol 2000;163:1467–70. [22] Catalona WJ, Smith DS, Ratliff TL, Dodds KM, Coplen DE, Yuan JJ, et al. Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med 1991;324:1156–61. [23] Laguna Pes MP, Guinda Sevillano C, Zazo Romojaro A, Domı́nguez J, Garcı́a Luzón A, Borrego Hernando J, et al. Clinical usefulness of free PSA/total PSA ratio in the early diagnosis of prostatic cancer. Arch Esp Urol 2000;53:333–41. [24] Sawyer R, Berman JJ, Borkowski A, Moore GW. Prostatespecific antigen in black men. Lancet 1996;347:1329. [25] Abbiyesuku FM, Shittu OB, Oduwole OO, Osotimehin BO. Prostate specific antigen in the Nigerian African. Afr J Med Med Sci 2000;29:97–100. (4.0–10 ng/mL) for detecting prostate cancer. The prostate biopsy was taken using a digitally directed six-core technique and correlated with the % fPSA level. Prostate cancer was detected in 14 patients (13%) and all of them had a % fPSA of <40%. However, six of the patients with a % fPSA level of <40% had no cancer. The authors concluded that the best threshold for % fPSA in the studied population was <40%, with a sensitivity of 100%, specificity of 93.4% and a positive predictive value of 70%. This is different from the value reported previously of a threshold of 625% fPSA for patients with PSA levels of 4.0–10.0 ng/mL and where a TRUS biopsy was used, and more extended biopsy protocols adopted. Digitally directed transrectal biopsies are no longer the standard, as the exact path of the needle, the exact site of the biopsy and the depth of penetration cannot be guaranteed except under TRUS guidance. In addition, suspicious areas on ultrasonography should be biopsied separately, and these sites increase the detection rate of cancer. No data were provided about prostate size, which might affect the cancer detection rate as long as the number of biopsies is similar in all cases. All these factors might be responsible for the lower cancer detection rate and the higher % fPSA indicated. However, data from this report might be helpful for urologists practising in such regions where the facility for TRUS biopsy is not available.
منابع مشابه
What is the most appropriate test in detecting prostate cancer in patients with intermediate prostate specific antigen levels?
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متن کاملThe value of percentage free prostate specific antigen (PSA) in the detection of prostate cancer among patients with intermediate levels of total PSA (4.0–10.0 ng/mL) in Nigeria
OBJECTIVES To assess the value of percentage free prostate-specific antigen (%fPSA) in the detection of prostate cancer among Nigerian men with an intermediate total PSA level (4-10 ng/mL), and to show if the optimum threshold for biopsy is different from Caucasian values when the widely used (six-core, digitally directed) prostate biopsy protocol in Nigerians is applied. PATIENTS AND METHODS...
متن کاملAssessing the Diagnostic Value of Plasma-Free DNA in Prostate Cancer Screening
Background: Prostate cancer is the second form of cancer among men worldwide. For early cancer detection, we should identify tumors in initial stages before the physical signs become visible. The present study aims to evaluate the diagnostic value of cell-free DNA (cfDNA), its comparison with prostate-specific antigen (PSA) level in prostate cancer screening and also in patients with localized ...
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عنوان ژورنال:
دوره 10 شماره
صفحات -
تاریخ انتشار 2012