Clinical value of PSA:
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
Bremen
UNI-MED
2005
|
| Edition: | 1. ed. |
| Series: | UNI-MED science
|
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | 123 S. graph. Darst. |
| ISBN: | 3895998893 |
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Record in the Search Index
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| adam_text | Contents
^| Important facts on PSA 14
1.1. History 14
1.2. Diagnostic value 15
1.2.1. Upper limit of normal Indication for biopsy 15
1.2.2. Changes in biopsy technique 16
1.2.3. PSA to determine response to primary therapy 16
1.2.4. PSA for early detection of recurrent PCa 17
1.2.5. PSA to monitor responses to hormonal therapy 17
1.2.6. PSA to assess response to therapy in androgen independent PCa 17
1.2.7. PSA as a screening tool 17
1.2.8. PSA isoforms 18
1.3. Subsequent developments to improve specificity of PSA screening 18
1.3.1. Relation to age and ethnicity 18
1.3.2. Relation to the size of the prostate 19
1.3.3. Relation to tumor mass 19
1.3.4. Natural course (velocity) 20
1.3.4.1. Correlation of pretreatment PSA DT to outcome 20
1.3.4.2. Correlation of posttreatment PSA DT to outcome 20
1.3.4.3. PSA DT in watchful waiting 21
1.4. Conclusions 22
m Quality assurance of PSA testing 28
2.1. Introduction 28
2.2. Pre analytical factors 28
2.2.1. Effect of clinical or diagnostic interventions on measured PSA 28
2.2.2. Effect of clinical conditions on interpretation of PSA measurements 28
2.2.2.1. Medication for benign prostatic hypertrophy 28
2.2.2.2. Urinary tract infection 29
2.2.2.3. Prostatitis and urinary retention 31
2.2.2.4. Renal failure 31
2.2.2.5. Ejaculation 32
2.2.2.6. Bicycling and other strenuous exercise 32
2.2.2.7. Non prostatic disease 32
2.2.3. Stability of PSA and PSA isoforms in blood, serum and plasma 32
2.3. Analytical requirements 36
2.3.1. Calibration of PSA assays 37
2.3.2. Differences in antibody specificity and reaction kinetics 37
2.3.3. Vulnerability to clinically relevant interferences 37
2.3.3.1. Human anti mouse and heterophilic antibody interference 38
2.3.3.2. High dose hooking 38
2.4. Post analytical factors 38
2.5. Conclusion 39
U Kinetics of PSA and interpretation of results 44
3.1. Introduction 44
3.2. Analytical variation 44
3.3. Biological variation 44
3.4. Interpretation of single and replicate measurements during screening and diagnosis 45
3.5. Interpretation of serial measurements during monitoring 47
3.6. Other factors influencing PSA results 49
3.7. Conclusions 50
H Screening for prostate cancer with prostate specific antigen 54
4.1. Does the natural history of prostate cancer suggest a need for a screening test? 54
4.2. Can testing for PSA identify the men destined to die from prostate cancer? 56
4.3. Does early detection of prostate cancer lower prostate cancer mortality rates? 57
4.4. How has testing for PSA altered prostate cancer outcomes? 57
4.5. Does screening do more harm than good? 58
4.6. How to advise the patient 58
^| Overdetection and overtreatment with PSA driven screening for prostate
cancer 62
^| Nomograms and artificial neural networks in the diagnosis of prostate cancer
and for the prediction of pathological parameters 68
6.1. Nomograms and ANNs in the diagnosis of prostate cancer 69
6.2. Nomograms and ANNs for prediction of pathological parameters of prostate cancer 73
6.2.1. Prediction of insignificant prostate cancer 73
6.2.2. Nomograms for prediction of pathological stage 73
6.2.3. Nomograms for prediction of pelvic lymph node metastasis 77
11 Free PSA in the early detection of prostate cancer 82
7.1. PSA in peripheral blood, free and complexed PSA 82
7.2. Clinical application of free PSA (fPSA) 82
7.3. Molecular isoforms of free PSA for early diagnosis of prostate cancer 84
7.3.1. BPH related isoforms of free PSA (BPSA and nicked PSA ) 84
7.3.2. Clinical application of BPH related isoforms of free PSA 85
7.3.3. Cancer related free PSA isoforms, pro PSA, intact PSA (fPSA l) 86
7.3.4. Clinical application of cancer associated isoforms of free PSA 86
H Interpretation of ultrasensitive prostate specific antigen (PSA) test
results: How low do we want to measure? 92
8.1. Definition of ultrasensitive t PSA assays 92
8.2. Determination of the lower limit of detection 92
8.3. Interference by t PSA of extraprostatic origin in ultrasensitive assays 92
8.4. Earlier detection of residual cancer with ultrasensitive assays 93
8.5. PSA fluctuations in the very low concentration range 93
8.6. Clinical consequences of very low t PSA concentrations after radical prostatectomy? 94
U Markers for adenocarcinoma of the prostate an overview on established
and potential future markers 98
9.1. Introduction 98
9.2. Prostate specific antigen (PSA) 98
9.2.1. PSA ranges in the early detection of prostate cancer 98
9.2.2. PSA derivates in the detection of prostate cancer 99
9.2.3. Complex PSA in the early detection of prostate cancer 100
9.3. Prostate Specific Membrane Antigen (PSMA) 101
9.3.1. Clinical applications of PSMA 101
9.4. Androgen Receptor and Carcinoma of the Prostate 102
9.4.1. Androgen receptor polymorphisms 102
9.4.2. Androgen receptor gene mutations 103
9.4.3. Androgen receptor amplification 103
9.5. Insulin Like Growth Factors and their binding proteins 103
9.6. Putative future markers for prostate cancer 104
^| Rising PSA following definitive local treatment of prostate cancer 112
10.1. Introduction 112
10.2. Definition 112
10.3. PSA recurrence after radical prostatectomy 112
10.4. PSA recurrence following radiotherapy 113
10.5. The natural history of PSA recurrence 113
10.6. Diagnostic evaluation of PSA recurrence 114
10.7. Therapeutic options 115
^| Therapeutic consequences in several common clinical dilemmas 118
11.1. PSA rise in patients with prostatitis, value of antibiotic therapy 118
11.1.1. PSA rise in clinical acute or chronic prostatitis 118
11.1.2. PSA rise in asymptomatic prostatitis 118
11.2. Rising PSA without proof of cancer despite prostate biopsy 119
11.3. Elevated PSA in patients with BPH, effect of medical therapy 120
^ Index 122
|
| adam_txt |
Contents
^| Important facts on PSA 14
1.1. History 14
1.2. Diagnostic value 15
1.2.1. "Upper limit of normal" Indication for biopsy 15
1.2.2. Changes in biopsy technique 16
1.2.3. PSA to determine response to primary therapy 16
1.2.4. PSA for early detection of recurrent PCa 17
1.2.5. PSA to monitor responses to hormonal therapy 17
1.2.6. PSA to assess response to therapy in androgen independent PCa 17
1.2.7. PSA as a screening tool 17
1.2.8. PSA isoforms 18
1.3. Subsequent developments to improve specificity of PSA screening 18
1.3.1. Relation to age and ethnicity 18
1.3.2. Relation to the size of the prostate 19
1.3.3. Relation to tumor mass 19
1.3.4. Natural course (velocity) 20
1.3.4.1. Correlation of pretreatment PSA DT to outcome 20
1.3.4.2. Correlation of posttreatment PSA DT to outcome 20
1.3.4.3. PSA DT in watchful waiting 21
1.4. Conclusions 22
m Quality assurance of PSA testing 28
2.1. Introduction 28
2.2. Pre analytical factors 28
2.2.1. Effect of clinical or diagnostic interventions on measured PSA 28
2.2.2. Effect of clinical conditions on interpretation of PSA measurements 28
2.2.2.1. Medication for benign prostatic hypertrophy 28
2.2.2.2. Urinary tract infection 29
2.2.2.3. Prostatitis and urinary retention 31
2.2.2.4. Renal failure 31
2.2.2.5. Ejaculation 32
2.2.2.6. Bicycling and other strenuous exercise 32
2.2.2.7. Non prostatic disease 32
2.2.3. Stability of PSA and PSA isoforms in blood, serum and plasma 32
2.3. Analytical requirements 36
2.3.1. Calibration of PSA assays 37
2.3.2. Differences in antibody specificity and reaction kinetics 37
2.3.3. Vulnerability to clinically relevant interferences 37
2.3.3.1. Human anti mouse and heterophilic antibody interference 38
2.3.3.2. High dose "hooking" 38
2.4. Post analytical factors 38
2.5. Conclusion 39
U Kinetics of PSA and interpretation of results 44
3.1. Introduction 44
3.2. Analytical variation 44
3.3. Biological variation 44
3.4. Interpretation of single and replicate measurements during screening and diagnosis 45
3.5. Interpretation of serial measurements during monitoring 47
3.6. Other factors influencing PSA results 49
3.7. Conclusions 50
H Screening for prostate cancer with prostate specific antigen 54
4.1. Does the natural history of prostate cancer suggest a need for a screening test? 54
4.2. Can testing for PSA identify the men destined to die from prostate cancer? 56
4.3. Does early detection of prostate cancer lower prostate cancer mortality rates? 57
4.4. How has testing for PSA altered prostate cancer outcomes? 57
4.5. Does screening do more harm than good? 58
4.6. How to advise the patient 58
^| Overdetection and overtreatment with PSA driven screening for prostate
cancer 62
^| Nomograms and artificial neural networks in the diagnosis of prostate cancer
and for the prediction of pathological parameters 68
6.1. Nomograms and ANNs in the diagnosis of prostate cancer 69
6.2. Nomograms and ANNs for prediction of pathological parameters of prostate cancer 73
6.2.1. Prediction of insignificant prostate cancer 73
6.2.2. Nomograms for prediction of pathological stage 73
6.2.3. Nomograms for prediction of pelvic lymph node metastasis 77
11 Free PSA in the early detection of prostate cancer 82
7.1. PSA in peripheral blood, free and complexed PSA 82
7.2. Clinical application of free PSA (fPSA) 82
7.3. Molecular isoforms of free PSA for early diagnosis of prostate cancer 84
7.3.1. BPH related isoforms of free PSA (BPSA and "nicked PSA") 84
7.3.2. Clinical application of BPH related isoforms of free PSA 85
7.3.3. Cancer related free PSA isoforms, pro PSA, "intact" PSA (fPSA l) 86
7.3.4. Clinical application of cancer associated isoforms of free PSA 86
H Interpretation of "ultrasensitive" prostate specific antigen (PSA) test
results: How low do we want to measure? 92
8.1. Definition of "ultrasensitive" t PSA assays 92
8.2. Determination of the lower limit of detection 92
8.3. Interference by t PSA of extraprostatic origin in "ultrasensitive" assays 92
8.4. Earlier detection of residual cancer with ultrasensitive assays 93
8.5. PSA fluctuations in the very low concentration range 93
8.6. Clinical consequences of very low t PSA concentrations after radical prostatectomy? 94
U Markers for adenocarcinoma of the prostate an overview on established
and potential future markers 98
9.1. Introduction 98
9.2. Prostate specific antigen (PSA) 98
9.2.1. PSA ranges in the early detection of prostate cancer 98
9.2.2. PSA derivates in the detection of prostate cancer 99
9.2.3. Complex PSA in the early detection of prostate cancer 100
9.3. Prostate Specific Membrane Antigen (PSMA) 101
9.3.1. Clinical applications of PSMA 101
9.4. Androgen Receptor and Carcinoma of the Prostate 102
9.4.1. Androgen receptor polymorphisms 102
9.4.2. Androgen receptor gene mutations 103
9.4.3. Androgen receptor amplification 103
9.5. Insulin Like Growth Factors and their binding proteins 103
9.6. Putative future markers for prostate cancer 104
^| Rising PSA following definitive local treatment of prostate cancer 112
10.1. Introduction 112
10.2. Definition 112
10.3. PSA recurrence after radical prostatectomy 112
10.4. PSA recurrence following radiotherapy 113
10.5. The natural history of PSA recurrence 113
10.6. Diagnostic evaluation of PSA recurrence 114
10.7. Therapeutic options 115
^| Therapeutic consequences in several common clinical dilemmas 118
11.1. PSA rise in patients with prostatitis, value of antibiotic therapy 118
11.1.1. PSA rise in clinical acute or chronic prostatitis 118
11.1.2. PSA rise in asymptomatic prostatitis 118
11.2. Rising PSA without proof of cancer despite prostate biopsy 119
11.3. Elevated PSA in patients with BPH, effect of medical therapy 120
^ Index 122 |
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| isbn | 3895998893 |
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| spelling | Clinical value of PSA Nikolaus Schmeller ... 1. ed. Bremen UNI-MED 2005 123 S. graph. Darst. txt rdacontent n rdamedia nc rdacarrier UNI-MED science Prostata-spezifisches Antigen (DE-588)4385529-5 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Prostata-spezifisches Antigen (DE-588)4385529-5 s DE-604 Schmeller, Nikolaus 1952- Sonstige (DE-588)141758457 oth HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=014620235&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
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| subject_GND | (DE-588)4385529-5 (DE-588)4143413-4 |
| title | Clinical value of PSA |
| title_auth | Clinical value of PSA |
| title_exact_search | Clinical value of PSA |
| title_exact_search_txtP | Clinical value of PSA |
| title_full | Clinical value of PSA Nikolaus Schmeller ... |
| title_fullStr | Clinical value of PSA Nikolaus Schmeller ... |
| title_full_unstemmed | Clinical value of PSA Nikolaus Schmeller ... |
| title_short | Clinical value of PSA |
| title_sort | clinical value of psa |
| topic | Prostata-spezifisches Antigen (DE-588)4385529-5 gnd |
| topic_facet | Prostata-spezifisches Antigen Aufsatzsammlung |
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