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Query: UMLS:C0376358 (prostate cancer)
 59,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Prostatic acid phosphatase (PAP) and prostatic specific antigen (PSA) were measured by immunochemical methods using test preparations from two different companies. In 66 patients with benign hyperplasia of the prostate a good correlation was found only between PSA levels (orthogonal regression analysis: y = 1.77 x -0.68; r = 0.995). Discrimination analysis between benign hyperplasia and new prostatic cancer (28 patients), using ROC curves, revealed a sensitivity for prostatic cancer of about 30 percent using both PAP methods and of about 58 percent using both PSA methods at the 95-percentile of benign hyperplasia. The PSA methods were both more sensitive in detecting prostatic cancer than the PAP methods.
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PMID:The contribution of prostatic acid phosphatase and prostatic specific antigen in the diagnosis of prostatic cancer. 246 22

The average radiologist will never compute a probability by using Bayes theorem or carry out a logistic regression, ROC, or cost-effectiveness analysis. Why, then, do we think that radiologists should be familiar with these techniques? Radiologists base many decisions on information gleaned from the published literature. In the past decade, the techniques discussed here have begun to appear in medical (including radiologic) publications. A radiologist with no comprehension of ROC analysis, for example, would be unable to critically assess a study that used this technique to compare MR imaging and CT in the detection of liver metastases and would have to accept or reject its conclusions blindly. A knowledgeable radiologist, on the other hand, could judge whether the study employed proper methodology, and could accept or reject its conclusions on that basis. The four cases presented here are specific examples of generic problems facing the radiologist: predicting the likelihood of disease on the basis of a test result, using several pieces of information provided by a single test to arrive at a diagnosis, comparing the efficacy of radiologic tests or interpretive techniques, and choosing among available tests or procedures on the basis of their relative cost-effectiveness. It is likely, therefore, that the techniques of medical decision making discussed here will appear with increasing frequency in the radiology literature. The list of potential applications is long. Some of the questions that can be addressed by the techniques presented here are: How predictive of IUGR are the various proposed Doppler criteria? How can they be used in conjunction with conventional sonographic criteria to diagnose IUGR? Which technique is best for detecting prostate cancer or for staging known cancer--sonography or MR imaging? Which MR pulse sequence is best for a variety of organ systems and clinical indications? Is routine screening obstetric sonography cost-effective? Applications of statistical decision-making techniques to these and related questions will improve the quality of health care provided by radiologists, if the statistical techniques are done properly and understood by the intended audience.
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PMID:Statistical techniques for medical decision making: applications to diagnostic radiology. 312 27

The value of preoperative bone scans in patients with primary breast and prostate cancer was evaluated prospectively. Of 414 patients with breast cancer, clinical stage I is 14, II is 219, IIIA is 59, IIIB is 39 and IV is 14. Of 88 patients with prostate cancer, clinical stage I is 14, II is 15, III is 18 and IV is 41. 11 percent of patients with breast cancer and 54 percent of patients with prostate cancer had bone metastases. Clavicle, ribs, thoracic spine, lumbar spine and pelvis metastasized most frequently. The incidences of bone metastases were 18.4% with Scirrhous carcinoma, 15.4% with Medullary tubular carcinoma and 3.8% with Papillotubular carcinoma. The methodology and results of ROC analysis were described in our other papers. Some results of data analysis were described in this paper.
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PMID:[Prospective study to assess the clinical efficacy of bone scintigraphy--some analyses of clinical data]. 338 1

The value of preoperative bone scans in patients with primaly breast and prostate cancer was evaluated prospectively. The methodology and some clinical results were described previously. The clinical efficacy of the bone scan was assessed by using ROC analysis and we obtained the following results. 1) Preoperative bone scan of carcinomas of the breast is effective for patients with clinical stage IIIA, IIIB and IV. It is not so effective for patients with clinical stage I and II, but there is no denying the importance of it, because it provides a base-line scan for comparison to subsequent scans obtained in the postoperative period. 2) Preoperative bone scan of prostate carcinomas is effective, especially for clavicle, the ribs and the cervical spine, when compared with bone X-ray. 3) Bone scan is effective means for patients who were diagnosed uncertainly to have bone metastasis.
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PMID:[Prospective study to assess the clinical efficacy of bone scintigraphy--ROC analysis]. 338 2

Fundamental and clinical studies of serum prostatic acid phosphatase (PAP) detected by a Delfia PAP kit were performed. The system is a time-resolved fluoroimmunoassay using europium as a tracer. The lower limit of detection was 0.2 ng/ml. Sera from 54 patients with prostate cancer, 20 with benign prostatic hypertrophy, 20 with urological malignancies other than prostate cancer and 140 adult males over 46 years old were determined. From the mean + 2 S.D. of serum PAP values obtained on the adult males, 1.5 ng/ml was considered as the upper normal level of adult males. By calculating the efficiency and ROC curve using the PAP values of prostate cancer and benign prostatic cancer, 2.5 ng/ml was decided as a cut-off value of this kit. The positive rates of adult males, prostate cancer, benign prostatic cancer and urological malignancies other than prostate cancer were 0.7%, 65%, 20% and 10%, respectively. The sensitivity of stage A2, B2, C and D1 + D2 was, 0%, 0%, 64% and 83%, respectively. The efficiency of the Delfia PAP kit was 52% and that of the Markit M PA kit was 71%. The correlation between the values assayed with the Delfia PAP kit and the Dinabot PAP kit was very high; the value obtained with the Delfia PAP kit was about 80% of that obtained with the Dinabot PAP kit.
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PMID:[Measurement of serum prostatic acid phosphatase (PAP) by Delfia PAP Kit using europium and clinical evaluation in patients with prostate cancer]. 753 Apr 4

Diagnostic utility of serum markers and their relative values to prostatic volume were evaluated using Receiver Operator Characteristics Analysis (ROC analysis) in 173 patients who underwent ultrasound guided biopsy of the prostate gland. Seventy cases (40.5%) of prostate cancer were detected. As a whole, prostate specific antigen density (PSAD) and prostate specific antigen (PSA) were more useful than gammaseminoprotein density (GSMD), gammaseminoprotein (GSM) and prostatic acid phosphatase in diagnosing cancer judged by the area under the ROC curve denoting a test's diagnostic accuracy (p < 0.05). No significant difference was noted, however, between PSAD and PSA (p > 0.05). Prostate specific antigen density was more predictive for prostate cancer than PSA in a subgroup of patients with PSA levels of 2.0-10.0 ng/ml (p < 0.05). No advantage of PSAD was obtained in patients with intermediate PSA levels of 2.0-5.0 ng/ml or benign-feeling glands (p > 0.05). Higher sensitivity could be achieved by using Eiken PSA 2.0 ng/ml as a cutoff rather than the recommended value of 3.0 ng/ml. This helped to diagnose 5 more cases of prostate cancer who otherwise might have been missed if PSA cutoff of 3.0 ng/ml had been used. A PSAD cutoff of 0.15 has a sensitivity of 81.4%, a specificity of 87.4% and an accuracy of 85.0%. However, use of this cutoff for biopsy could result in unacceptable numbers of undiagnosed cases, including many potentially curable cancers. Though PSAD may enhance sensitivity and specificity in a certain group of patients, this gain is not sufficient to reliably define the group at highest risk of prostate cancer. Indication of biopsy should still be determined based upon PSA concentration rather than PSAD value.
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PMID:[Comparison of tumor markers versus their relative values to prostatic volume in detecting prostate cancer]. 799 Mar 3

Serum tissue polypeptide antigen (TPA) was measured using a newly developed Prolifigen TPA-M "Daiichi" kit in 1,236 healthy subjects, 2,867 patients with malignant tumors, and 901 with benign diseases. Because 94.0% of healthy subjects had serum TPA under 70 U/l, the cut-off value was set at 70 U/l. Serum TPA was elevated in more than 50% of patients with head and neck cancer, lung cancer, liver cancer, gallbladder or bile duct cancer, pancreatic cancer, colorectal cancer, ovarian cancer, and prostate cancer. The overall positive rate in malignant tumors was 55.5%. Serum TPA was higher in advanced cancer than in earlier stage cancer, and decreased after the resection of the tumor. The false positive rate in benign diseases was 31.3%. ROC analysis revealed the usefulness of TPA as a tumor marker in many cancers. The correlation coefficient between TPA and CYFRA 21-1, and between TPA and TPSA, was 0.747 and 0.694, respectively. In conclusion, measurement of serum TPA using the new kit is useful in the management of patients with various malignant tumors.
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PMID:[Measurement of serum tissue polypeptide antigen (TPA) in patients with malignant tumor using prolifigen TPA-M "Daiichi" kit]. 864 25

The prostate specific antigen (PSA) level represents all of the immunoreactive serum PSA, either free or bound to alpha-1-anti-chymotrypsin. Isolated assay of free PSA has demonstrated a higher free PSA/total PSA ratio in cases of benign prostatic hyperplasia (BPH) than in cases of cancer, suggesting the possible use of this ratio in the detection of prostatic cancer when the PSA level is between 4 and 10 ng/mL. We retrospectively assayed free PSA in 64 cases of localized prostate cancer, 90 cases of BPH before transurethral resection and 59 healthy controls. By comparing the mean values of the 3 populations and the ROC curves, we confirmed the superiority of the free PSA/total PSA ratio over total PSA in the detection of prostatic cancer, but these results, established in a retrospectively constituted population, need to be confirmed by prospective epidemiological studies. Nevertheless, in routine urological practice, we propose that free PSA assay be performed in all men with a PSA level between 4 and 10 ng/mL and a normal prostate on digital rectal examination.
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PMID:[Clinical assessment of free serum prostate specific antigen (PSA)]. 876 91

We compared prostate-specific antigen (PSA) assay systems [i.e., free PSA (f-PSA) and the corresponding total PSA (t-PSA) assay] from four different manufacturers as well as the f-PSA/t-PSA ratios with regard to their ability to discriminate between benign prostate hyperplasia (BPH) and prostate cancer (PCA). ROC analysis showed similar areas under the curves (AUCs) with different assay systems. For the entire patient population the AUCs of the f-PSA/t-PSA ratio were not or slightly increased compared with the sole measurement of t-PSA (t-PSA, 0.792-0.820; f-PSA/t-PSA ratio, 0.685-0.859). In contrast, for only those patients who showed t-PSA concentrations within the diagnostic gray area of 4-25 micrograms/L t-PSA, the AUCs were greater for the f-PSA/ t-PSA ratio than for measurement of t-PSA alone (t-PSA, 0.608-0.647; f-PSA/t-PSA ratio, 0.690-0.806). These results were confirmed by the predictive values of the negative results (NPVs) of the t-PSA assays and the f-PSA/t-PSA ratios (assay thresholds corresponding to a 95% detection limit). Compared with the sole t-PSA measurement there was no mentionable increase in the NPVs due to the f-PSA/t-PSA ratio for the entire patient population, but an increase up to 49% when limited to t-PSA concentrations within 4-25 micrograms/L. We therefore conclude that the f-PSA/t-PSA ratio may be helpful for differential diagnosis of BPH and PCA within the diagnostic gray area of 4-25 micrograms/L t-PSA.
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PMID:Comparison of prostate-specific antigen (PSA) measured by four combinations of free PSA and total PSA assays. 929 33

Although general consensus exists that percent free prostate-specific antigen (PSA) is superior to total immunoreactive PSA for prostate cancer (CaP) detection, its diagnostic performance is not yet well established. Analytical problems may account for difficulties in evaluating percent free PSA because the free PSA concentration is substantially lower than that of total PSA. The aim of the present study was to establish the diagnostic performances of the IMMULITE percent free PSA assay from Diagnostics Products Corp. under experimental conditions optimized to minimize analytical variability. Eighty-five patients with untreated primary CaP and 261 with untreated benign prostate hypertrophy (BPH) were prospectively enrolled. The Diagnostics Products IMMULITE total (Third Generation) and free PSA were measured by the same technician, using the same instrument and the same reagent batch. We calculated the post-test probability to express how the likelihood of the diagnosis of CaP changed after the percent free PSA was determined. Areas under the ROC curves of percent free PSA were better than those of total PSA in every evaluated range of total PSA. The percent free PSA could have reduced the rate of unnecessary biopsies by 47% in patients with total PSA >/=4 microg/L with only 3.8% false-negative results. The post-test probability of percent free PSA was, however, <50% in men 50-70 years of age, using cutoff points providing sensitivity from 99% to 80%. Percent free PSA is superior to total PSA in distinguishing primary CaP from BPH in patients with total PSA between 2 and 30 microg/L. In men with low total PSA, the diagnostic performance of the percent free PSA assay may be optimized by controlling methodological variability. The percent free PSA assay is effective in reducing the rate of unnecessary biopsies in men with total PSA >4 microg/L. However, the post-test probability provided by percent free PSA is relatively low in asymptomatic patients 50-70 years of age.
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PMID:Percent free prostate-specific antigen in assessing the probability of prostate cancer under optimal analytical conditions. 983 13


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