2016, Number 2
Correlation between increase in prostate-specific antigen and metastatic lesions identified by imaging
Hernández-Salazar JJ, Onofre-Castillo JJ, García-Pacheco LE, Dávila-Cavazos DA, Torres-Gómez E, Santana-Vela IA
Full text
Language: Spanish
References: 13
Page: 88-93
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ABSTRACT
Prostatic adenocarcinoma is the most common form of cancer in men over 40 in the western population. Imaging methods have substantial value in detecting foci of lesions suggestive of metastatic disease in patients with prostate cancer. Recurrence or persistence following treatment is first detected by an increase in prostate-specific antigen. Between 30 and 70% of such patients have lesions which are visible by imaging methods.Objetive: show association between increase in prostate-specific antigen and metastasis by means of different imaging methods: magnetic resonance, computed axial tomography, and ultrasound.
Materials and Methods: all patients with known diagnosis of prostate cancer who visited our hospital from January 2014 through September of the same year were included. Forty-nine patients were included, with known diagnosis of prostate cancer, with mean age of 67 years (range 53-87). Patients with lesions suggestive of metastasis were included in the group of cases, whereas individuals who presented a negative image study for metastatic disease were included in a control group.
Results: the mean value of prostate-specific antigen in the group of cases was 53 ng/mL (median 73) whereas in the control group it was 2.1 ng/mL (range 0.01-7.3). An equation of crossed products was made, finding that there is an odds ratio 34.5 times greater in the probability of suffering metastatic disease with prostate-specific antigen above its normal value [OR 34.5, 95% CI (33-36)]. It was complemented with a contrast hypothesis test, documenting a value of 21.21, with 1 degree of liberty, to obtain a p ‹ 0.025, which concludes that it is statistically significant.
Conclusion: our study showed a significant association between increase in prostate-specific antigen and the presence of disease disseminated to other organs. It documented that an increase in antigenemia above 10 ng/mL is highly suggestive of metastatic disease. We suggest that image study be mandatory in all patients with antigenemia above 10 ng/mL.
REFERENCES
van der Cruijsen-Koeter IW, Vis AN, Roobol MJ, Wildhagen MF, de Koning HJ, van der Kwast TH, Schroder FH. Comparison of screen detected and clinically diagnosed prostate cancer in the European randomized study of screening for prostate cancer, section rotterdam. Urol. 2005 jul;174(1):121-5. Cuadro 1. Antígeno prostático específico en el grupo de casos Antígeno prostático específico Menor de 4 ng/mL 4-10 ng/mL Mayor de 10 ng/mL Porcentaje 18 26 56 Cuadro 2. Comparación entre metástasis óseas y no óseas en el grupo de casos Metástasis ósea Metástasis no ósea 88% 12%