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• W4320801426 abstract "No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Dec 2000USE OF THE COMPLEX BETWEEN PROSTATE SPECIFIC ANTIGEN AND α1-PROTEASE INHIBITOR FOR SCREENING PROSTATE CANCER PATRIK FINNE, WAN-MING ZHANG, ANSSI AUVINEN, JARI LEINONEN, LIISA MÄÄTTÄNEN, SAKARI RANNIKKO, TEUVO L.J. TAMMELA, and ULF-HÅKAN STENMAN PATRIK FINNEPATRIK FINNE More articles by this author , WAN-MING ZHANGWAN-MING ZHANG More articles by this author , ANSSI AUVINENANSSI AUVINEN More articles by this author , JARI LEINONENJARI LEINONEN More articles by this author , LIISA MÄÄTTÄNENLIISA MÄÄTTÄNEN More articles by this author , SAKARI RANNIKKOSAKARI RANNIKKO More articles by this author , TEUVO L.J. TAMMELATEUVO L.J. TAMMELA More articles by this author , and ULF-HÅKAN STENMANULF-HÅKAN STENMAN More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)66927-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We assess whether the complex between prostate specific antigen (PSA) and α1-protease inhibitor in serum can be used to reduce further the number of false-positive PSA screen results independent of total and free PSA. Materials and Methods: Sera from 304 consecutive screen positive subjects, including 78 with and 226 without prostate cancer, and serum PSA of 4 to 10 μg./l. or higher in the Finnish, randomized, population based prostate cancer screening trial were analyzed for PSA-α-protease inhibitor, and total and free PSA. Main outcome measures were specificity, sensitivity and area under receiver operating characteristics curve for proportions of free PSA and PSA-α1-protease inhibitor, and for a combination of these among screen positive cases. Results: The proportion of serum PSA-α1-protease inhibitor of total PSA was lower in cancer cases than in controls (0.9% versus 1.6%, p <0.001). Logistic regression analysis of total PSA, free PSA and PSA-α1-protease inhibitor showed that PSA-α1-protease inhibitor in serum was an independent variable for discrimination between subjects with and without prostate cancer (p = 0.006) in the PSA range of 4 to 10 μg./l. The proportion of PSA-α1-protease inhibitor alone improved specificity less than the proportion of free PSA but when these were combined by logistic regression they performed better than the proportion of free PSA alone at sensitivities of 85% to 95% (p <0.001). Conclusions: Serum PSA-α1-protease inhibitor improves the specificity of total and free PSA in a screening population with total PSA 4 to 10 μg./l. References 1 : Cancer incidence in five continents. Lyon: International Agency for Research of Cancer1997. Google Scholar 2 : Optimized strategy for detection of early stage, curable prostate cancer: role of prescreening with prostate-specific antigen. Clin Invest Med1993; 16: 425. Google Scholar 3 : The European Randomized Study of Screening for Prostate Cancer (ERSPC). Br J Urol1997; 79: 68. Google Scholar 4 : Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med1991; 324: 1156. Google Scholar 5 : European randomized study of prostate cancer screening: first-year results of the Finnish trial. Br J Cancer1999; 79: 1210. 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J Urol1993; 150: 100. Abstract, Google Scholar 12 : Use of the percentage of free prostate-specific antigen to enhance differentiation of prostate cancer from benign prostatic disease: a prospective multicenter clinical trial. JAMA1998; 279: 1542. Google Scholar 13 : Evaluation of percentage of free serum prostate-specific antigen to improve specificity of prostate cancer screening. JAMA1995; 274: 1214. Google Scholar 14 : Usefulness of the ratio free/total prostate-specific antigen in addition to total PSA levels in prostate cancer screening. Urology1996; 48: 62. Google Scholar 15 : Time-resolved immunofluorometric assays for trypsinogen-1 and 2 in serum reveal preferential elevation of trypsinogen-2 in pancreatitis. J Lab Clin Med1990; 115: 712. Google Scholar 16 : Applied Logistic Regression. New York: John Wiley & Sons1989. Google Scholar 17 : The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology1982; 143: 29. Google Scholar 18 : Estimation of prostate cancer probability by logistic regression: free and total prostate-specific antigen, digital rectal examination, and heredity are significant variables. Clin Chem1999; 45: 987. Google Scholar 19 : Predicting the outcome of prostate biopsy in screen-positive men by a multilayer perceptron network. Urology2000; 56: 418. Google Scholar From the Departments of Clinical Chemistry and Urology, Helsinki University Central Hospital, STUK-Radiation and Nuclear Safety Authority, Helsinki, School of Public Health, University of Tampere Finnish Cancer Registry and Division of Urology, Tampere University Hospital, Tampere, Finland© 2000 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byKOBAYASHI T, KAMATO T, ISOGAWA Y, KINOSHITA H, TERAI A, HABUCHI T and OGAWA O (2018) Ratio Of Prostate Specific Antigen Minor Molecular Forms-To-Total Prostate Specific Antigen Is Constant Regardless Of The Pathological Condition Of The ProstateJournal of Urology, VOL. 169, NO. 1, (121-124), Online publication date: 1-Jan-2003. Volume 164Issue 6December 2000Page: 1956-1960 Advertisement Copyright & Permissions© 2000 by American Urological Association, Inc.Keywordsmass screeningalpha 1-antitrypsinprostatic neoplasmsprostate-specific antigenMetricsAuthor Information PATRIK FINNE More articles by this author WAN-MING ZHANG More articles by this author ANSSI AUVINEN More articles by this author JARI LEINONEN More articles by this author LIISA MÄÄTTÄNEN More articles by this author SAKARI RANNIKKO More articles by this author TEUVO L.J. TAMMELA More articles by this author ULF-HÅKAN STENMAN More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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