Advantages of replacing the total PSA assay with the assay for PSA-α1-antichymotrypsin complex for the screening and management of prostate cancer

被引:0
|
作者
Wu, JT
Liu, GH
机构
[1] Univ Utah, Dept Pathol, Salt Lake City, UT 84112 USA
[2] Univ Utah, Dept Associated Reg Univ Pathologists, ARUP, Salt Lake City, UT USA
关键词
benign prostate hyperplasia; free PSA; percent-free PSA;
D O I
10.1002/(SICI)1098-2825(1998)12:1<32::AID-JCLA6>3.0.CO;2-L
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
Several advantages become immediately apparent when the prostate specific antigen (PSA, or tPSA) assay is replaced by the assay specific for the serum PSA-alpha 1-antichymotrypsin (PSA-ACT) complex. For instance, random contributions to the tPSA value by various serum minor PSA isoforms can be avoided, making possible the determination of a more accurate relation of the PSA-ACT concentration to the tumor activity. Discrepancies in percent free PSA (% fPSA) values from the same specimens due to the use of different commercial kits also can be eliminated, mainly because the PSA-ACT assay does not have the problems in antibody selection and calibrator preparation usually associated with the tPSA assay. We found that at the present time different cutoffs of % fPSA for the differentiation of BPH from prostate cancer must be established for each individual tPSA assay. Cutoffs established using values from one tPSA assay should not be used for making clinical decisions when their tPSA values are determined by a different kit. Moreover, when we monitored the patients during treatment with serum tPSA, specific fPSA, and specific PSA-ACT complex assays simultaneously, it was clear that any interpretation of the patient's clinical status based on tPSA values alone could be misleading. Because there is less PSA-ACT complex in BPH specimens relative to that found in cancer serum samples, expressing fPSA as "fPSA/ PSA-ACT x 100" and measuring PSA-ACT complex concentrations instead of tPSA during screening improve the measurable contrast between BPH and prostate cancer. Although individually modest, collectively these advantages can add up to considerable improvements. (C) 1998 Wiley-Liss, Inc.
引用
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页码:32 / 40
页数:9
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