Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

PSA velocity and PSA slope

Prostate Cancer and Prostatic Diseases volume 9, pages 169–172 (2006)Cite this article

Abstract

The aim of this study is to compare different tools for evaluating prostate-specific antigen (PSA) increase or decrease, such as PSA velocity and PSA slope. This study was conducted on 312 male patients evaluated with transrectal ultrasound-guided biopsy of prostate with six or more cores. Patients with at least three consecutive PSA measurements in at least 18 months entered the study. Prostate-specific antigen slope was estimated by the slope of the least-square regression line fit to PSA versus time in years; PSA velocity was calculated with 3 or more PSA arrays. Median age was 66 years (range 45–86). Overall 67 patients were affected by primary prostate cancer, 245 were controls without prostate cancer. Prostate-specific antigen slope and PSA velocity were significantly higher in patients with prostate cancer than in controls. At the ROC analysis, PSA slope evidenced better results than PSA velocity (area under the curve (AUC) 0.743 for PSA slope; AUC 0.663 for PSA velocity; P=0.037). At PSA slope (calculated with the least-square fit) equal to zero, the sensitivity resulted as being 94% with a specificity of 38.8%. In conclusion prostate-specific antigen slope calculated with three or more PSA assays permits longitudinal evaluation of PSA for prostate diagnosis. Prostate-specific antigen slope improves both sensitivity and specificity in prostate cancer diagnosis, compared with PSA velocity.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Kirbly SR, Christmas TJ, Brawer MK . Prostate Cancer (2nd edition). Mosby (London, England), 2001, 59–71.

    Google Scholar 

  2. Young J (Ed). Cancer Incidence in Five Continents. Lyon, France, International Agency for Research on Cancer, vol VII 1997.

  3. Catalona WJ, Smith DS, Ratliff TL . Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med 1991; 324: 1156–1161.

    Article  CAS  PubMed  Google Scholar 

  4. Woolf SH . Screening for prostate cancer with prostate-specific antigen. An examination of evidence. N Engl J Med 1995; 1333: 1401–1405.

    Article  Google Scholar 

  5. Karazanashvili G, Abrahamsson PA . Prostate specific antigen and human glandular kallikrein 2 in early detection of prostate cancer. J Urol 2003; 169: 445–457.

    Article  CAS  PubMed  Google Scholar 

  6. Benecchi L, Pieri AM . Utilizzo pratico di una semplice rete neurale nella diagnosi dell'adenocarcinoma prostatico. Urologia 2005; 72: 78–84.

    Article  Google Scholar 

  7. Carter HB, Pearson JD, Metter EJ, Brant LJ, Chan DW, Andres R et al. Longitudinal evaluation of prostate specific antigen levels in men with and without prostate disease. JAMA 1992; 267: 2215–2220.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Roobol MJ, Kranse R, De Koning HJ, Schroder FH . Prostate-specific antigen velocity at low prostate-specific antigens levels as screening tool for prostate cancer: results of second screening round of ERSPC (Rotterdam). Urology 2004; 63: 309–315.

    Article  CAS  PubMed  Google Scholar 

  9. D'Amico AV, Ming-Hui C, Roehl KA, Catalona WJ . Preoperative PSA velocity and the risk of death from postate cancer after radical prostatectomy. N Eng J Med 2004; 351: 125–135.

    Article  CAS  Google Scholar 

  10. Khan MA, Carter HB, Epstein JI, Miller MC, Landis P, Walsh PW et al. Can prostate specific antigen derivatives and pathological parameters predict significant change in expectant management criteria for prostate cancer? J Urol 2003; 170: 2274–2278.

    Article  PubMed  Google Scholar 

  11. Carter HB, Pearson JD, Waclawiw Z, Metter EJ, Chan DW, Guess HA et al. Prostate-specific antigen variability in men without prostate cancer: effect of sampling interval on prostate-specific antigen velocity. Urology 1995; 45: 591–596.

    Article  CAS  PubMed  Google Scholar 

  12. Hanley JA, McNeil BJ . A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology 1983; 148: 839.

    Article  CAS  PubMed  Google Scholar 

  13. Hanley JA, McNeil BJ . The meaning and use of the area under a receiver operating characteristic (ROC) curve. Radiology 1982; 143: 29.

    Article  CAS  PubMed  Google Scholar 

  14. Catalona WL, Smith DS, Ratliff TL, Basler JW . Detection of organ-confined prostate cancer is increased through prostate-specific antigen-based screening. JAMA 1993; 270: 948–954.

    Article  CAS  PubMed  Google Scholar 

  15. Catalona WJ, Richie P, Ahmann FR, Hudson MA, Scardino PT, Flanigan RC et al. Comparison of digital rectal examination and serum prostate specific antigen in the early detection of prostate cancer: results of a multicenter clinical trial of 6,630 men. J Urol 1994; 151: 1283–1290.

    Article  PubMed  Google Scholar 

  16. Reissigl A, Klocker H, Pointner J, Fink K, Horninger W, Ennemoser O et al. Usefulness of the ratio free/total prostate-specific antigen in addition to total PSA levels in prostate cancer screening. Urology 1996; 48: 62–66.

    Article  CAS  PubMed  Google Scholar 

  17. Carter H, Morrell CH, Pearson JD, Brant LJ, Plato CC, Metter EJ et al. Estimation of prostatic growth using serial PSA measurements in men with and without prostate disease. Cancer Res 1992; 52: 3323–3328.

    CAS  PubMed  Google Scholar 

  18. Brawer M, Beatie J, Wener M, Vessella R, Preston S, Lange P . for prostatic carcinoma with PSA : results of the second year. J Urol 1993; 150: 106–109.

    Article  CAS  PubMed  Google Scholar 

  19. Porter JR, Hayward R, Brawer MK . The significance of short term PSA change in men undergoing ultrasound guided prostate biopsy. J Urol 1994; 164: 293A.

    Google Scholar 

  20. Smith DS, Catalona WJ . Rate of change in serum prostate specific antigen levels as a method for prostate cancer detection. J Urol 1994; 152: 1168–1169.

    Article  Google Scholar 

  21. Raaijmakers R, Wildhagen MF, Ito K, Paez A, De Vries SH, Roobol MJ et al. Prostate specific antigen in the European randomized study of screening for prostate cancer, Section Rotterdam. Urology 2004; 63: 316–320.

    Article  PubMed  Google Scholar 

  22. Takamiya R, Weinberg V, Young D, Sandler H, McLaughlin P, Roach M . A zero PSA slope in posttreatment prostate-specific antigen supports cure of patients with long-term follow-up after external beam radiotherapy for localized prostate cancer. Int J Radiat Oncol Biol Phys 2003; 56: 1073–1078.

    Article  PubMed  Google Scholar 

  23. Komatsu K, Wehner N, Prestigiacomo AF . Physiologic (intraindividual) variation of serum prostate-specific antigen in 814 men from a screening population. Urology 1996; 47: 343–346.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

Paolo Vitolo and Marina Di Capua provided assistance with the statistics.

Author information

Authors and Affiliations

  1. Department of Urology, Fidenza Hospital, Parma, Italy

    L Benecchi

Authors
  1. L Benecchi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to L Benecchi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Benecchi, L. PSA velocity and PSA slope. Prostate Cancer Prostatic Dis 9, 169–172 (2006). https://doi.org/10.1038/sj.pcan.4500866

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.pcan.4500866

Keywords

This article is cited by

Search

Advanced search

Quick links