Usefulness of alpha1-antichymotrypsin-PSA complex for predicting bone metastases of prostate cancer

Eiji Kikuchi, Jun Nakashima, Midori Ishibashi, Takashi Ohigashi, Mototsugu Oya, Ken Nakagawa, Akira Miyajima, Masaru Murai

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives: To determine the usefulness of alpha1-antichymotrypsin-prostate-specific antigen (PSA) complex (PSA-ACT)-based parameters in predicting bone metastasis in patients with prostate cancer. Methods: PSA-ACT, total PSA, free PSA, their volume-adjusted values, and alkaline phosphatase were evaluated in 220 consecutive patients with newly diagnosed prostate cancer. Results: Bone metastases were detected by bone scan in 27 (12.3%) of the 220 patients. The serum levels of PSA-ACT, total PSA, free PSA, PSA density, PSA adjusted for transition zone volume, PSA-ACT density, PSA-ACT adjusted for transition zone volume, alkaline phosphatase, PSA-ACT/PSA ratio, and Gleason score in patients with bone metastases were each significantly greater than in those without bone metastases. On receiver operating characteristic analyses, PSA-ACT had the greatest area under the curve (0.88), but the receiver operating characteristic curve demonstrated that the sensitivity and specificity of PSA-ACT were marginally better than those of total PSA at only a few selected cutoff points. At a sensitivity of 93% (2 patients with bone metastasis missed), unnecessary bone scans would have been avoided in 107 and 102 patients using a PSA-ACT cutoff value of 10 ng/mL and total PSA cutoff value of 11.5 ng/mL, respectively. Multivariate logistic regression analysis demonstrated that PSA-ACT and Gleason score were significant independent predictors of bone metastasis. Conclusions: PSA-ACT is as useful as total PSA for identifying patients with a low probability of having bone metastasis. PSA-ACT could replace PSA for predicting negative bone scans in a clinical setting in which PSA-ACT is used for monitoring and screening patients for prostate cancer.

Original languageEnglish
Pages (from-to)371-375
Number of pages5
JournalUrology
Volume68
Issue number2
DOIs
Publication statusPublished - 2006 Aug

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Prostate-Specific Antigen
Prostatic Neoplasms
Neoplasm Metastasis
Bone and Bones
Neoplasm Grading
ROC Curve
Alkaline Phosphatase

ASJC Scopus subject areas

  • Urology

Cite this

Kikuchi, E., Nakashima, J., Ishibashi, M., Ohigashi, T., Oya, M., Nakagawa, K., ... Murai, M. (2006). Usefulness of alpha1-antichymotrypsin-PSA complex for predicting bone metastases of prostate cancer. Urology, 68(2), 371-375. https://doi.org/10.1016/j.urology.2006.02.031

Usefulness of alpha1-antichymotrypsin-PSA complex for predicting bone metastases of prostate cancer. / Kikuchi, Eiji; Nakashima, Jun; Ishibashi, Midori; Ohigashi, Takashi; Oya, Mototsugu; Nakagawa, Ken; Miyajima, Akira; Murai, Masaru.

In: Urology, Vol. 68, No. 2, 08.2006, p. 371-375.

Research output: Contribution to journalArticle

Kikuchi, E, Nakashima, J, Ishibashi, M, Ohigashi, T, Oya, M, Nakagawa, K, Miyajima, A & Murai, M 2006, 'Usefulness of alpha1-antichymotrypsin-PSA complex for predicting bone metastases of prostate cancer', Urology, vol. 68, no. 2, pp. 371-375. https://doi.org/10.1016/j.urology.2006.02.031
Kikuchi, Eiji ; Nakashima, Jun ; Ishibashi, Midori ; Ohigashi, Takashi ; Oya, Mototsugu ; Nakagawa, Ken ; Miyajima, Akira ; Murai, Masaru. / Usefulness of alpha1-antichymotrypsin-PSA complex for predicting bone metastases of prostate cancer. In: Urology. 2006 ; Vol. 68, No. 2. pp. 371-375.
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AU - Nakashima, Jun

AU - Ishibashi, Midori

AU - Ohigashi, Takashi

AU - Oya, Mototsugu

AU - Nakagawa, Ken

AU - Miyajima, Akira

AU - Murai, Masaru

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AB - Objectives: To determine the usefulness of alpha1-antichymotrypsin-prostate-specific antigen (PSA) complex (PSA-ACT)-based parameters in predicting bone metastasis in patients with prostate cancer. Methods: PSA-ACT, total PSA, free PSA, their volume-adjusted values, and alkaline phosphatase were evaluated in 220 consecutive patients with newly diagnosed prostate cancer. Results: Bone metastases were detected by bone scan in 27 (12.3%) of the 220 patients. The serum levels of PSA-ACT, total PSA, free PSA, PSA density, PSA adjusted for transition zone volume, PSA-ACT density, PSA-ACT adjusted for transition zone volume, alkaline phosphatase, PSA-ACT/PSA ratio, and Gleason score in patients with bone metastases were each significantly greater than in those without bone metastases. On receiver operating characteristic analyses, PSA-ACT had the greatest area under the curve (0.88), but the receiver operating characteristic curve demonstrated that the sensitivity and specificity of PSA-ACT were marginally better than those of total PSA at only a few selected cutoff points. At a sensitivity of 93% (2 patients with bone metastasis missed), unnecessary bone scans would have been avoided in 107 and 102 patients using a PSA-ACT cutoff value of 10 ng/mL and total PSA cutoff value of 11.5 ng/mL, respectively. Multivariate logistic regression analysis demonstrated that PSA-ACT and Gleason score were significant independent predictors of bone metastasis. Conclusions: PSA-ACT is as useful as total PSA for identifying patients with a low probability of having bone metastasis. PSA-ACT could replace PSA for predicting negative bone scans in a clinical setting in which PSA-ACT is used for monitoring and screening patients for prostate cancer.

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