| 1. |
- Abrahamsson, P. A., et al.
(författare)
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Molecular forms of serum prostate-specific antigen : The clinical value of percent free prostate-specific antigen
- 1997
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Ingår i: Urologic Clinics of North America. - 0094-0143. ; 24:2, s. 353-365
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Tidskriftsartikel (refereegranskat)abstract
- The concept of measuring the proportions of various forms of PSA in serum, particularly the proportion of free to total PSA, represents a new and exciting method of detecting early curable prostate cancers and avoiding unnecessary prostate biopsies in men who have BPH only. Compared with other methods of improving diagnostic specificity, it does not require transrectal ultrasound for determination of prostate volume, as does the use of PSA density, and it does not require multiple blood sampling over a sufficiently long period, as does PSA velocity. Recent findings suggest determination of the proportion of free to total PSA, rather than that of complexed to total PSA, to be the optimal discriminator between patients with prostate cancer and those with BPH in the PSA reflex range of 2.5 or 3 ng/mL to 10 ng/mL, and to improve the clinical accuracy of the PSA test substantially. If the total PSA value is normal, percent free PSA improves the sensitivity (increases cancer detection) of the PSA test; if the total PSA value is slightly elevated, percent free PSA enhances the specificity (eliminates unnecessary negative prostate biopsies) of the PSA test. Both of these outcomes are clinically desirable in attempting to diagnose early, curable prostate cancers in a cost-effective manner among men who also have varying degrees of BPH. Figure 5 contains a diagnostic algorithm for the detection of clinically significant prostate cancers at a curable stage, employing the concept of percent free PSA. As more is learned about percent free PSA, however, it may be necessary to make modifications in how this concept is used clinically.
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| 2. |
- Huland, H, et al.
(författare)
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Prediction of tumor heterogeneity in localized prostate cancer
- 2002
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Ingår i: Urologic Clinics of North America. - 0094-0143. ; 29:1, s. 213-213
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Tidskriftsartikel (refereegranskat)abstract
- The clinical T1-T2 prostatic carcinoma is a heterogeneous tumor in respect to pathologic stage and outcome. Tumor heterogeneity can be fairly good predicted by the use of classification and regression tree analysis with preoperative parameters, especially a quantitative analysis of Gleason grade 4-5 cancer in six systematic biopsies and a determination of preoperative prostate-specific antigen levels, to predict lymph node status, capsular penetration, and outcome.
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| 3. |
- Lilja, H.
(författare)
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Significance of different molecular forms of serum PSA : The free, noncomplexed form of PSA versus that complexed to α1-antichymotrypsin
- 1993
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Ingår i: Urologic Clinics of North America. - 0094-0143. ; 20:4, s. 681-686
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Forskningsöversikt (refereegranskat)abstract
- Prostate specific antigen is an abundant prostate-derived serine protease in the seminal fluid. Low concentrations of the protein are normally released into blood, but above normal concentrations are frequently detected in prostate disease. The PSA-ACT complex is the predominant molecular form of serum PSA (up to ≃95%) although complex formation is slow between the purified proteins in vitro. A free, noncomplexed form of PSA constitutes a minor fraction of the serum PSA, although serum ACT occurs in large molar excess. The free, noncomplexed form of serum PSA is reported to constitute a significantly smaller proportion of the PSA in untreated prostate cancer than in BPH. The molecular basis for this finding is unclear, but measurements of the proportion of the free form of serum PSA or the proportion of serum PSA- ACT may facilitate discrimination between prostate cancer and BPH.
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