NEW YORK (Reuters Health) Dec 12 - Among men with a serum prostate-specific antigen (PSA) level of 2.5 ng/mL or lower, the percent free PSA is an accurate predictor of prostate cancer at prostate biopsy, according to findings published in the November 15th issue of the journal Cancer.
"Recently, urological and oncological associations lowered the recommended total serum PSA (tPSA) cutoff for prostate biopsy from 4 to 2.5 ng/mL," Dr. Jochen Walz, of Institut Paoli-Calmettes, Marseille, France, and colleagues write. "Up to 17% of men with a PSA level below the accepted prostate biopsy cutoff of 2.5 ng/mL may have prostate cancer."
The researchers examined the ability of percent free PSA to identify men at an increased risk of prostate cancer, despite tPSA levels no higher than 2.5 ng/mL. They also assessed the pathological characteristics of the cancers detected in this population.
A total of 543 men with a PSA of 2.5 ng/mL or less were referred for initial prostate biopsy between 1999 and 2006. Overall, 125 (23.0%) men in the entire group and 77 (19.3%) of those with unremarkable digital rectal examination findings had prostate cancer on biopsy.
Seventy-nine of the patients with prostate cancer at biopsy underwent radical prostatectomy. Of these 79 patients, 13 (16.5%) had pathological stage pT3 and 24 (35.6%) had Gleason score of 3 + 4 or higher.
Among patients with percent free PSA below 14%, 59% of the overall group and 49% of those with unremarkable digital rectal examination had prostate cancer.
Results of multivariate analysis showed that percent free PSA (p < p =" 0.001)">
"The routine use of percent free PSA should be strongly recommended in prostate cancer screening or early detection efforts to better risk stratify the probability of prostate cancer at biopsy," Dr. Walz and colleagues conclude.
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου