Free, complexed, and total serum prostate-specific antigen concentrations and their proportions in predicting stage, grade, and deoxyribonucleic acid ploidy in patients with adenocarcinoma of the prostate

Seth E. Lerner, Steven J. Jacobsen, Hans Lilja, Erik J. Bergstralh, Jeanine Ransom, George G. Klee, Timo Piironen, Michael L. Blute, Michael M. Lieber, Horst Zincke, Kim Pettersson, Diane Peterson, Joseph E. Oesterllng

Research output: Contribution to journalArticle

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Abstract

Objectives. Nearly half of men with clinically localized prostate cancer are understaged. We evaluated whether knowledge of preoperative free prostate-specific antigen (f-PSA), complexed (c-PSA), and total (t-PSA) concentrations or the ratios thereof (f-PSA/t-PSA, c-PSA/t PSA, and f PSA/c- PSA) could improve upon the staging of prostate cancer when compared with standard PSA testing (t-PSA). In addition, we examined their associations with tumor grade and deoxyribonucleic acid (DNA) ploidy. Methods. Two hundred ninety patients with prostate cancer, 178 (61%) of whom were treated with radical prostatectomy, formed the study group. Results. Although there were significant differences in the f-PSA concentrations with respect to clinical stage, considerable overlap in PSA levels among the clinical substages was observed. Statistically significant differences but weak correlations were observed between the individual f-PSA, c-PSA, and t-PSA concentrations with regard to pathologic stage (organ-confined versus extraprostatic) and grade. No significant relationship, however, was observed with the three ratios. Higher PSA values were not always associated with a pathologic stage of pT3 or greater, and lower levels did not ensure that a tumor was organ-confined. Only a slight association was observed between c-PSA and t-PSA levels and DNA ploidy. No significant relationship was observed between the f-PSA levels as well as the three ratios with regard to DNA ploidy. A statistically significant improvement in predicting pathologic stage was observed when combining knowledge of preoperative t-PSA concentration with the c-PSA/t-PSA ratio. However, the area under the receiver operator characteristic curves was only slightly increased; as such this combination was of limited clinical utility. Conclusions. Statistically significant but weak correlations were observed between the molecular forms of PSA and stage, grade, and DNA ploidy. The significant overlap in f-PSA and c-PSA values among all stages grades, and ploidy values precluded any useful predictive information for the individual patient. As such preoperative knowledge of f-PSA and c-PSA values and the three ratios provided no additional diagnostic information over standard PSA (t-PSA) values alone.

Original languageEnglish (US)
Pages (from-to)240-248
Number of pages9
JournalUrology
Volume48
Issue number2
DOIs
StatePublished - Aug 1996
Externally publishedYes

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Ploidies
Prostate-Specific Antigen
Prostate
Adenocarcinoma
DNA
Serum
Prostatic Neoplasms
Prostatectomy
Neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Free, complexed, and total serum prostate-specific antigen concentrations and their proportions in predicting stage, grade, and deoxyribonucleic acid ploidy in patients with adenocarcinoma of the prostate. / Lerner, Seth E.; Jacobsen, Steven J.; Lilja, Hans; Bergstralh, Erik J.; Ransom, Jeanine; Klee, George G.; Piironen, Timo; Blute, Michael L.; Lieber, Michael M.; Zincke, Horst; Pettersson, Kim; Peterson, Diane; Oesterllng, Joseph E.

In: Urology, Vol. 48, No. 2, 08.1996, p. 240-248.

Research output: Contribution to journalArticle

Lerner, SE, Jacobsen, SJ, Lilja, H, Bergstralh, EJ, Ransom, J, Klee, GG, Piironen, T, Blute, ML, Lieber, MM, Zincke, H, Pettersson, K, Peterson, D & Oesterllng, JE 1996, 'Free, complexed, and total serum prostate-specific antigen concentrations and their proportions in predicting stage, grade, and deoxyribonucleic acid ploidy in patients with adenocarcinoma of the prostate', Urology, vol. 48, no. 2, pp. 240-248. https://doi.org/10.1016/S0090-4295(96)00159-8
Lerner, Seth E. ; Jacobsen, Steven J. ; Lilja, Hans ; Bergstralh, Erik J. ; Ransom, Jeanine ; Klee, George G. ; Piironen, Timo ; Blute, Michael L. ; Lieber, Michael M. ; Zincke, Horst ; Pettersson, Kim ; Peterson, Diane ; Oesterllng, Joseph E. / Free, complexed, and total serum prostate-specific antigen concentrations and their proportions in predicting stage, grade, and deoxyribonucleic acid ploidy in patients with adenocarcinoma of the prostate. In: Urology. 1996 ; Vol. 48, No. 2. pp. 240-248.
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title = "Free, complexed, and total serum prostate-specific antigen concentrations and their proportions in predicting stage, grade, and deoxyribonucleic acid ploidy in patients with adenocarcinoma of the prostate",
abstract = "Objectives. Nearly half of men with clinically localized prostate cancer are understaged. We evaluated whether knowledge of preoperative free prostate-specific antigen (f-PSA), complexed (c-PSA), and total (t-PSA) concentrations or the ratios thereof (f-PSA/t-PSA, c-PSA/t PSA, and f PSA/c- PSA) could improve upon the staging of prostate cancer when compared with standard PSA testing (t-PSA). In addition, we examined their associations with tumor grade and deoxyribonucleic acid (DNA) ploidy. Methods. Two hundred ninety patients with prostate cancer, 178 (61{\%}) of whom were treated with radical prostatectomy, formed the study group. Results. Although there were significant differences in the f-PSA concentrations with respect to clinical stage, considerable overlap in PSA levels among the clinical substages was observed. Statistically significant differences but weak correlations were observed between the individual f-PSA, c-PSA, and t-PSA concentrations with regard to pathologic stage (organ-confined versus extraprostatic) and grade. No significant relationship, however, was observed with the three ratios. Higher PSA values were not always associated with a pathologic stage of pT3 or greater, and lower levels did not ensure that a tumor was organ-confined. Only a slight association was observed between c-PSA and t-PSA levels and DNA ploidy. No significant relationship was observed between the f-PSA levels as well as the three ratios with regard to DNA ploidy. A statistically significant improvement in predicting pathologic stage was observed when combining knowledge of preoperative t-PSA concentration with the c-PSA/t-PSA ratio. However, the area under the receiver operator characteristic curves was only slightly increased; as such this combination was of limited clinical utility. Conclusions. Statistically significant but weak correlations were observed between the molecular forms of PSA and stage, grade, and DNA ploidy. The significant overlap in f-PSA and c-PSA values among all stages grades, and ploidy values precluded any useful predictive information for the individual patient. As such preoperative knowledge of f-PSA and c-PSA values and the three ratios provided no additional diagnostic information over standard PSA (t-PSA) values alone.",
author = "Lerner, {Seth E.} and Jacobsen, {Steven J.} and Hans Lilja and Bergstralh, {Erik J.} and Jeanine Ransom and Klee, {George G.} and Timo Piironen and Blute, {Michael L.} and Lieber, {Michael M.} and Horst Zincke and Kim Pettersson and Diane Peterson and Oesterllng, {Joseph E.}",
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T1 - Free, complexed, and total serum prostate-specific antigen concentrations and their proportions in predicting stage, grade, and deoxyribonucleic acid ploidy in patients with adenocarcinoma of the prostate

AU - Lerner, Seth E.

AU - Jacobsen, Steven J.

AU - Lilja, Hans

AU - Bergstralh, Erik J.

AU - Ransom, Jeanine

AU - Klee, George G.

AU - Piironen, Timo

AU - Blute, Michael L.

AU - Lieber, Michael M.

AU - Zincke, Horst

AU - Pettersson, Kim

AU - Peterson, Diane

AU - Oesterllng, Joseph E.

PY - 1996/8

Y1 - 1996/8

N2 - Objectives. Nearly half of men with clinically localized prostate cancer are understaged. We evaluated whether knowledge of preoperative free prostate-specific antigen (f-PSA), complexed (c-PSA), and total (t-PSA) concentrations or the ratios thereof (f-PSA/t-PSA, c-PSA/t PSA, and f PSA/c- PSA) could improve upon the staging of prostate cancer when compared with standard PSA testing (t-PSA). In addition, we examined their associations with tumor grade and deoxyribonucleic acid (DNA) ploidy. Methods. Two hundred ninety patients with prostate cancer, 178 (61%) of whom were treated with radical prostatectomy, formed the study group. Results. Although there were significant differences in the f-PSA concentrations with respect to clinical stage, considerable overlap in PSA levels among the clinical substages was observed. Statistically significant differences but weak correlations were observed between the individual f-PSA, c-PSA, and t-PSA concentrations with regard to pathologic stage (organ-confined versus extraprostatic) and grade. No significant relationship, however, was observed with the three ratios. Higher PSA values were not always associated with a pathologic stage of pT3 or greater, and lower levels did not ensure that a tumor was organ-confined. Only a slight association was observed between c-PSA and t-PSA levels and DNA ploidy. No significant relationship was observed between the f-PSA levels as well as the three ratios with regard to DNA ploidy. A statistically significant improvement in predicting pathologic stage was observed when combining knowledge of preoperative t-PSA concentration with the c-PSA/t-PSA ratio. However, the area under the receiver operator characteristic curves was only slightly increased; as such this combination was of limited clinical utility. Conclusions. Statistically significant but weak correlations were observed between the molecular forms of PSA and stage, grade, and DNA ploidy. The significant overlap in f-PSA and c-PSA values among all stages grades, and ploidy values precluded any useful predictive information for the individual patient. As such preoperative knowledge of f-PSA and c-PSA values and the three ratios provided no additional diagnostic information over standard PSA (t-PSA) values alone.

AB - Objectives. Nearly half of men with clinically localized prostate cancer are understaged. We evaluated whether knowledge of preoperative free prostate-specific antigen (f-PSA), complexed (c-PSA), and total (t-PSA) concentrations or the ratios thereof (f-PSA/t-PSA, c-PSA/t PSA, and f PSA/c- PSA) could improve upon the staging of prostate cancer when compared with standard PSA testing (t-PSA). In addition, we examined their associations with tumor grade and deoxyribonucleic acid (DNA) ploidy. Methods. Two hundred ninety patients with prostate cancer, 178 (61%) of whom were treated with radical prostatectomy, formed the study group. Results. Although there were significant differences in the f-PSA concentrations with respect to clinical stage, considerable overlap in PSA levels among the clinical substages was observed. Statistically significant differences but weak correlations were observed between the individual f-PSA, c-PSA, and t-PSA concentrations with regard to pathologic stage (organ-confined versus extraprostatic) and grade. No significant relationship, however, was observed with the three ratios. Higher PSA values were not always associated with a pathologic stage of pT3 or greater, and lower levels did not ensure that a tumor was organ-confined. Only a slight association was observed between c-PSA and t-PSA levels and DNA ploidy. No significant relationship was observed between the f-PSA levels as well as the three ratios with regard to DNA ploidy. A statistically significant improvement in predicting pathologic stage was observed when combining knowledge of preoperative t-PSA concentration with the c-PSA/t-PSA ratio. However, the area under the receiver operator characteristic curves was only slightly increased; as such this combination was of limited clinical utility. Conclusions. Statistically significant but weak correlations were observed between the molecular forms of PSA and stage, grade, and DNA ploidy. The significant overlap in f-PSA and c-PSA values among all stages grades, and ploidy values precluded any useful predictive information for the individual patient. As such preoperative knowledge of f-PSA and c-PSA values and the three ratios provided no additional diagnostic information over standard PSA (t-PSA) values alone.

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