Complexed prostate-specific antigen for early detection of prostate cancer in men with serum prostate-specific antigen levels of 2 to 4 nanograms per milliliter

Wolfgang Horninger, Carol D. Cheli, Richard J. Babaian, Herbert A. Fritsche, Herbert Lepor, Samir S. Taneja, Stacy Childs, Thomas A. Stamey, Lori J Sokoll, Daniel Wan-Yui Chan, Michael K. Brawer, Alan Wayne Partin, Georg Bartsch

Research output: Contribution to journalArticle

Abstract

Complexed PSA (cPSA) has been shown to improve specificity in the detection of prostate cancer over that of total PSA (tPSA) testing in men with tPSA values greater than the cutoff value of 4.0 ng/mL. However, recent studies have reported a 25% incidence of prostate cancer in men with tPSA values in the 2.5- to 4.0-ng/mL range. We performed a multicenter study of cPSA in a population of men who underwent prostate biopsies because of elevated PSA levels or abnormal digital rectal examination (DRE). As part of this study, we sought to assess the clinical value of cPSA in comparison to tPSA, the free/tPSA ratio (f/tPSA) and the complexed/tPSA ratio (c/tPSA) in early detection of prostate cancer in men with tPSA values in the range of 2 to 4 ng/mL. The study was performed at 7 centers. Sera were drawn from men who underwent biopsy procedures consisting of >10 prostate tissue cores. Receiver operating characteristic (ROC) analysis was performed from the results of patients with tPSA values in the range of 2 to 4 ng/mL, including men with suspicious as well as unremarkable findings on DRE. Sera were collected and tested with the Bayer tPSA and cPSA assay and the Beckman free PSA and tPSA assays. ROC analysis was performed for all samples in the 2- to 4-ng/mL PSA range. At biopsy, 158 men had no evidence of malignancy and 57 (26.5%) were diagnosed with prostate cancer. ROC analysis indicated that the area under the curve (AUC) for cPSA was 0.64, which was statistically significantly greater than that achieved for tPSA (AUC, 0.57; P 92% of the cancers treated with radical prostatectomy were organ confined, and the histologic grading of the tumors ranged from moderately to poorly differentiated with Gleason scores from 5 to 9. These data confirm that there is a high incidence of clinically significant prostate cancer in men with tPSA levels

Original languageEnglish (US)
Pages (from-to)31-35
Number of pages5
JournalUrology
Volume60
Issue number4 SUPPL.
DOIs
StatePublished - Oct 1 2002

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Prostate-Specific Antigen
Early Detection of Cancer
Prostatic Neoplasms
Serum
ROC Curve
Digital Rectal Examination
Neoplasm Grading
Biopsy
Area Under Curve
Prostate
Incidence
Prostatectomy
Multicenter Studies
Neoplasms
Population

ASJC Scopus subject areas

  • Urology

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Complexed prostate-specific antigen for early detection of prostate cancer in men with serum prostate-specific antigen levels of 2 to 4 nanograms per milliliter. / Horninger, Wolfgang; Cheli, Carol D.; Babaian, Richard J.; Fritsche, Herbert A.; Lepor, Herbert; Taneja, Samir S.; Childs, Stacy; Stamey, Thomas A.; Sokoll, Lori J; Chan, Daniel Wan-Yui; Brawer, Michael K.; Partin, Alan Wayne; Bartsch, Georg.

In: Urology, Vol. 60, No. 4 SUPPL., 01.10.2002, p. 31-35.

Research output: Contribution to journalArticle

Horninger, W, Cheli, CD, Babaian, RJ, Fritsche, HA, Lepor, H, Taneja, SS, Childs, S, Stamey, TA, Sokoll, LJ, Chan, DW-Y, Brawer, MK, Partin, AW & Bartsch, G 2002, 'Complexed prostate-specific antigen for early detection of prostate cancer in men with serum prostate-specific antigen levels of 2 to 4 nanograms per milliliter', Urology, vol. 60, no. 4 SUPPL., pp. 31-35. https://doi.org/10.1016/S0090-4295(02)01693-X
Horninger, Wolfgang ; Cheli, Carol D. ; Babaian, Richard J. ; Fritsche, Herbert A. ; Lepor, Herbert ; Taneja, Samir S. ; Childs, Stacy ; Stamey, Thomas A. ; Sokoll, Lori J ; Chan, Daniel Wan-Yui ; Brawer, Michael K. ; Partin, Alan Wayne ; Bartsch, Georg. / Complexed prostate-specific antigen for early detection of prostate cancer in men with serum prostate-specific antigen levels of 2 to 4 nanograms per milliliter. In: Urology. 2002 ; Vol. 60, No. 4 SUPPL. pp. 31-35.
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T1 - Complexed prostate-specific antigen for early detection of prostate cancer in men with serum prostate-specific antigen levels of 2 to 4 nanograms per milliliter

AU - Horninger, Wolfgang

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AU - Babaian, Richard J.

AU - Fritsche, Herbert A.

AU - Lepor, Herbert

AU - Taneja, Samir S.

AU - Childs, Stacy

AU - Stamey, Thomas A.

AU - Sokoll, Lori J

AU - Chan, Daniel Wan-Yui

AU - Brawer, Michael K.

AU - Partin, Alan Wayne

AU - Bartsch, Georg

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N2 - Complexed PSA (cPSA) has been shown to improve specificity in the detection of prostate cancer over that of total PSA (tPSA) testing in men with tPSA values greater than the cutoff value of 4.0 ng/mL. However, recent studies have reported a 25% incidence of prostate cancer in men with tPSA values in the 2.5- to 4.0-ng/mL range. We performed a multicenter study of cPSA in a population of men who underwent prostate biopsies because of elevated PSA levels or abnormal digital rectal examination (DRE). As part of this study, we sought to assess the clinical value of cPSA in comparison to tPSA, the free/tPSA ratio (f/tPSA) and the complexed/tPSA ratio (c/tPSA) in early detection of prostate cancer in men with tPSA values in the range of 2 to 4 ng/mL. The study was performed at 7 centers. Sera were drawn from men who underwent biopsy procedures consisting of >10 prostate tissue cores. Receiver operating characteristic (ROC) analysis was performed from the results of patients with tPSA values in the range of 2 to 4 ng/mL, including men with suspicious as well as unremarkable findings on DRE. Sera were collected and tested with the Bayer tPSA and cPSA assay and the Beckman free PSA and tPSA assays. ROC analysis was performed for all samples in the 2- to 4-ng/mL PSA range. At biopsy, 158 men had no evidence of malignancy and 57 (26.5%) were diagnosed with prostate cancer. ROC analysis indicated that the area under the curve (AUC) for cPSA was 0.64, which was statistically significantly greater than that achieved for tPSA (AUC, 0.57; P 92% of the cancers treated with radical prostatectomy were organ confined, and the histologic grading of the tumors ranged from moderately to poorly differentiated with Gleason scores from 5 to 9. These data confirm that there is a high incidence of clinically significant prostate cancer in men with tPSA levels

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