We have located links that may give you full text access.
Journal Article
Research Support, Non-U.S. Gov't
Prostate carcinoma staging. Clinical utility of bone alkaline phosphatase in addition to prostate specific antigen.
Cancer 1996 December 2
BACKGROUND: Biochemical markers of bone disease have been of interest as part of the investigation of prostate carcinoma and the monitoring of skeletal involvement. Bone isoenzyme of the alkaline phosphatase (BAP) is an indicator of the metabolism of the osteoblasts. An immunoradioanalyses with two monoclonal antibodies in sandwich was developed, allowing an accurate measurement of BAP concentration. The goal of the current study was to compare the clinical performance of BAP and prostate specific antigen (PSA) in patients with untreated prostate carcinoma and to determine whether or not BAP can provide valuable additional information to PSA regarding the degree of skeletal extension in patients with prostate carcinoma.
METHODS: BAP and PSA serum concentrations were determined in 140 newly diagnosed prostate carcinoma patients (72 M0 and 68 M1-4). The efficiency of both markers in the prediction of positive bone scans was studied as well as the relationship observed between the concentrations of the two markers and the degree of skeletal involvement. To investigate the potential utility of BAP and PSA in eliminating the need for a bone scan, the negative predictive values for different cutoff points for both markers were calculated.
RESULTS: BAP was more efficient than PSA in the prediction of positive bone scans and its level was significantly related to the magnitude of skeletal involvement whereas PSA was only able to distinguish between M0 and M1-4 groups of patients. The highest predictive value for a bone scan result was found for BAP cutoff values between 20 and 30 ng/mL, leading to negative and positive predictive values of 92.6% and 98.2%, respectively. The combination of BAP and PSA both set at a 20 ng/ mL cutoff value yielded a negative predictive value of 100% and the combination of BAP and PSA at 30 ng/mL and 20 ng/mL cutoff values, respectively, increased the positive predictive value to 98.5%.
CONCLUSIONS: This study suggests that BAP could be a complementary marker to PSA in the diagnosis of bone disease in patients with prostate carcinoma. Its clinical utility could result in important cost saving implications, eliminating bone scan when PSA ranges from 10 to 20 ng/mL because the predictive negative value of PSA < 20 ng/mL and BAP < 20 ng/mL is 100% in this series. In addition, it could provide useful clinical information regarding the degree of skeletal involvement.
METHODS: BAP and PSA serum concentrations were determined in 140 newly diagnosed prostate carcinoma patients (72 M0 and 68 M1-4). The efficiency of both markers in the prediction of positive bone scans was studied as well as the relationship observed between the concentrations of the two markers and the degree of skeletal involvement. To investigate the potential utility of BAP and PSA in eliminating the need for a bone scan, the negative predictive values for different cutoff points for both markers were calculated.
RESULTS: BAP was more efficient than PSA in the prediction of positive bone scans and its level was significantly related to the magnitude of skeletal involvement whereas PSA was only able to distinguish between M0 and M1-4 groups of patients. The highest predictive value for a bone scan result was found for BAP cutoff values between 20 and 30 ng/mL, leading to negative and positive predictive values of 92.6% and 98.2%, respectively. The combination of BAP and PSA both set at a 20 ng/ mL cutoff value yielded a negative predictive value of 100% and the combination of BAP and PSA at 30 ng/mL and 20 ng/mL cutoff values, respectively, increased the positive predictive value to 98.5%.
CONCLUSIONS: This study suggests that BAP could be a complementary marker to PSA in the diagnosis of bone disease in patients with prostate carcinoma. Its clinical utility could result in important cost saving implications, eliminating bone scan when PSA ranges from 10 to 20 ng/mL because the predictive negative value of PSA < 20 ng/mL and BAP < 20 ng/mL is 100% in this series. In addition, it could provide useful clinical information regarding the degree of skeletal involvement.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app