Utilidad de la fracción libre del antígeno prostático específico en el diagnóstico diferencial entre hiperplasia prostática benigna y cáncer de próstata
Usefulness of percentage of free prosthatic specific antigen in the differential diagnosis between benign prostatic hyperplasia and prostate cancer
M.ª Jesús Gaspar
, Ignacio Arribas, Carmen Coca
Autor para correspondencia
mgaspar@hupa.insalud.es
Correspondencia: Servicio de Análisis Clínicos. Hospital Príncipe de Asturias. Ctra. Alcalá-Meco, s/n. 28805 Alcalá de Henares. Madrid.
Correspondencia: Servicio de Análisis Clínicos. Hospital Príncipe de Asturias. Ctra. Alcalá-Meco, s/n. 28805 Alcalá de Henares. Madrid.
Análisis Clínicos Departamento de Ciencias Morfológicas y Cirugía. Hospital Universitario Príncipe de Asturias. Alcalá de Henares. Madrid.
a Servicio de Urología.Departamento de Ciencias Morfológicas y Cirugía. Hospital Universitario Príncipe de Asturias. Alcalá de Henares. Madrid.
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Hospital Universitario Príncipe de Asturias. Alcalá de Henares. Madrid." ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Servicio de Análisis Clínicos. Hospital Príncipe de Asturias. Ctra. Alcalá-Meco, s/n. 28805 Alcalá de Henares. Madrid." ] ] ] 1 => array:3 [ "autoresLista" => "José. Manuel Hontoria, Paloma Bokobo, C. Javier Angulo" "autores" => array:3 [ 0 => array:3 [ "nombre" => "José." "apellidos" => "Manuel Hontoria" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Paloma" "apellidos" => "Bokobo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "C." "apellidos" => "Javier Angulo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Servicio de Urología.Departamento de Ciencias Morfológicas y Cirugía. Hospital Universitario Príncipe de Asturias. Alcalá de Henares. Madrid." "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Usefulness of percentage of free prosthatic specific antigen in the differential diagnosis between benign prostatic hyperplasia and prostate cancer" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-02-29" "fechaAceptado" => "2000-07-06" "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec222511" "palabras" => array:3 [ 0 => "Antígeno prostático específico" 1 => "Cáncer de próstata" 2 => "Hiperplasia prostática benigna" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El antígeno prostático específico (PSA) es el marcador tumoral más utilizado en la monitorización del cáncer de próstata. Es un test aceptablemente sensible. Las formas moleculares del PSA representan una oportunidad de mejorar su especificidad. Deseamos evaluar la utilidad del porcentaje PSA libre/PSA total (%PSA-L/PSA-T) en el diagnóstico de cáncer de próstata en el intervalo entre 4 y 20 ng/ml, en el que en nuestro medio existe un solapamiento de valores para pacientes con cáncer de próstata e hiperplasia benigna de próstata.</p> <span class="elsevierStyleSectionTitle">Pacientes y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio prospectivo de 269 pacientes, 73 con cáncer de próstata y 196 con hiperplasia benigna de próstata. Se determinaron el PSA-T y el PSA-L en el analizador AXSYM (Abbott) por un enzimoinmunoanálisis de micropartículas (MEIA).</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se encontraron diferencias estadísticamente significativas entre %PSA-L/PSA-T para los pacientes con cáncer de próstata frente a hiperplasia benigna de próstata, lo que no sucedió para los valores de PSA-T. Se establecieron los valores de sensibilidad y especificidad para diferentes puntos de corte. El análisis de curva ROC comprobó mejor eficacia diagnóstica para el %PSA-L/PSA-T que para el PSA-T.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El %PSA-L/PSA-T es un elemento útil en el diagnóstico diferencial entre cáncer de próstata e hiperplasia benigna de próstata. Un cociente inferior al 12% selecciona una población con alto riesgo de cáncer. Un porcentaje superior al 18% resulta útil para evitar o posponer la indicación de biopsia.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">PSA (prostatic specific antigen) is the most used tumor marker to monitor prostate cancer (PC). It is an acceptably sensitive test. Molecular forms of PSA give a chance to improve its specificity. We have evaluated the usefulness of the ratio free PSA/total PSA (f-PSA/t-PSA%) to diagnose prostate cancer, in the range between 4 and 20 ng/ml; i.e. the interval in which values overlap for patients with PC and benign prostatic hyperplasia (BPH) in our environment.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Prospective study on 269 patients, 73 with PC and 196 with BPH. Both t-PSA and f-PSA were determined using microparticles enzyme immune assay (MEIA) with AXSYM (Abbott) analyzer.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Statistically significant differences were evidenced in f-PSA/t-PSA% for patients with PC vs. BPH; but that did not happen for t-PSA values. Sensitivity and specificity values were established for different cut-off points. ROC curve analysis proved diagnostic efficacy was better for f-PSA/t-PSA% than for t-PSA.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">f-PSA/t-PSA percentage is a useful tool for the differential diagnosis between PC and BPH. A ratio lower than 12% selects a population with high risk of cancer. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 0 | 6 | 6 |
| 2024 Octubre | 3 | 43 | 46 |
| 2024 Septiembre | 5 | 55 | 60 |
| 2024 Agosto | 3 | 49 | 52 |
| 2024 Julio | 0 | 44 | 44 |
| 2024 Junio | 2 | 59 | 61 |
| 2024 Mayo | 0 | 69 | 69 |
| 2024 Abril | 4 | 58 | 62 |
| 2024 Marzo | 9 | 84 | 93 |
| 2024 Febrero | 2 | 68 | 70 |
| 2024 Enero | 7 | 105 | 112 |
| 2023 Diciembre | 1 | 77 | 78 |
| 2023 Noviembre | 4 | 102 | 106 |
| 2023 Octubre | 8 | 112 | 120 |
| 2023 Septiembre | 2 | 49 | 51 |
| 2023 Agosto | 5 | 40 | 45 |
| 2023 Julio | 3 | 75 | 78 |
| 2023 Junio | 7 | 57 | 64 |
| 2023 Mayo | 0 | 63 | 63 |
| 2023 Abril | 0 | 36 | 36 |
| 2023 Marzo | 75 | 58 | 133 |
| 2023 Febrero | 2 | 59 | 61 |
| 2023 Enero | 16 | 51 | 67 |
| 2022 Diciembre | 0 | 38 | 38 |
| 2022 Noviembre | 1 | 32 | 33 |
| 2022 Octubre | 1 | 31 | 32 |
| 2022 Septiembre | 1 | 40 | 41 |
| 2022 Agosto | 77 | 49 | 126 |
| 2022 Julio | 0 | 20 | 20 |
| 2022 Junio | 2 | 26 | 28 |
| 2022 Mayo | 2 | 29 | 31 |
| 2022 Abril | 0 | 24 | 24 |
| 2022 Marzo | 1 | 47 | 48 |
| 2022 Febrero | 1 | 27 | 28 |
| 2022 Enero | 1 | 50 | 51 |
| 2021 Diciembre | 0 | 35 | 35 |
| 2021 Noviembre | 0 | 34 | 34 |
| 2021 Octubre | 1 | 46 | 47 |
| 2021 Septiembre | 0 | 38 | 38 |
| 2021 Agosto | 0 | 53 | 53 |
| 2021 Julio | 1 | 38 | 39 |
| 2021 Junio | 0 | 25 | 25 |
| 2021 Mayo | 8 | 36 | 44 |
| 2021 Abril | 0 | 58 | 58 |
| 2021 Marzo | 1 | 71 | 72 |
| 2021 Febrero | 1 | 52 | 53 |
| 2021 Enero | 0 | 27 | 27 |
| 2020 Diciembre | 0 | 25 | 25 |
| 2020 Noviembre | 4 | 22 | 26 |
| 2020 Octubre | 0 | 25 | 25 |
| 2020 Septiembre | 0 | 21 | 21 |
| 2020 Agosto | 0 | 24 | 24 |
| 2020 Julio | 2 | 8 | 10 |
| 2020 Junio | 2 | 19 | 21 |
| 2020 Mayo | 2 | 27 | 29 |
| 2020 Abril | 0 | 21 | 21 |
| 2020 Marzo | 0 | 66 | 66 |
| 2020 Febrero | 2 | 27 | 29 |
| 2020 Enero | 0 | 26 | 26 |
| 2019 Diciembre | 25 | 20 | 45 |
| 2019 Noviembre | 0 | 19 | 19 |
| 2019 Octubre | 1 | 32 | 33 |
| 2019 Septiembre | 0 | 30 | 30 |
| 2019 Agosto | 2 | 15 | 17 |
| 2019 Julio | 5 | 24 | 29 |
| 2019 Junio | 21 | 13 | 34 |
| 2019 Mayo | 9 | 42 | 51 |
| 2019 Abril | 5 | 0 | 5 |
| 2019 Marzo | 4 | 0 | 4 |
| 2018 Diciembre | 5 | 0 | 5 |
| 2018 Noviembre | 1 | 0 | 1 |
| 2018 Febrero | 1 | 0 | 1 |
| 2017 Noviembre | 0 | 1 | 1 |
| 2017 Octubre | 294 | 7 | 301 |
| 2017 Septiembre | 400 | 13 | 413 |
| 2017 Agosto | 401 | 19 | 420 |
| 2017 Julio | 464 | 14 | 478 |
| 2017 Junio | 499 | 26 | 525 |
| 2017 Mayo | 500 | 19 | 519 |
| 2017 Abril | 472 | 17 | 489 |
| 2017 Marzo | 484 | 38 | 522 |
| 2017 Febrero | 541 | 17 | 558 |
| 2017 Enero | 357 | 10 | 367 |
| 2016 Diciembre | 386 | 17 | 403 |
| 2016 Noviembre | 448 | 19 | 467 |
| 2016 Octubre | 428 | 14 | 442 |
| 2016 Septiembre | 481 | 22 | 503 |
| 2016 Agosto | 241 | 45 | 286 |
| 2016 Julio | 219 | 9 | 228 |
| 2016 Junio | 303 | 1 | 304 |
| 2016 Mayo | 305 | 1 | 306 |
| 2016 Abril | 317 | 1 | 318 |
| 2016 Marzo | 264 | 0 | 264 |
| 2016 Febrero | 171 | 1 | 172 |
| 2016 Enero | 177 | 0 | 177 |
| 2015 Diciembre | 150 | 0 | 150 |
| 2015 Noviembre | 187 | 0 | 187 |
| 2015 Octubre | 115 | 0 | 115 |
| 2015 Septiembre | 66 | 0 | 66 |
| 2015 Agosto | 75 | 0 | 75 |
| 2015 Julio | 71 | 0 | 71 |
| 2015 Junio | 36 | 0 | 36 |
| 2015 Mayo | 37 | 0 | 37 |
| 2015 Abril | 62 | 0 | 62 |
| 2015 Marzo | 33 | 0 | 33 |
| 2015 Febrero | 37 | 0 | 37 |
| 2015 Enero | 21 | 0 | 21 |
| 2014 Diciembre | 21 | 0 | 21 |
| 2014 Noviembre | 9 | 0 | 9 |
| 2014 Octubre | 9 | 0 | 9 |
| 2014 Septiembre | 10 | 0 | 10 |
| 2014 Agosto | 11 | 0 | 11 |
| 2014 Julio | 16 | 0 | 16 |
| 2014 Junio | 9 | 0 | 9 |
| 2014 Mayo | 7 | 0 | 7 |
| 2014 Abril | 6 | 0 | 6 |
| 2014 Marzo | 13 | 0 | 13 |
| 2014 Febrero | 6 | 0 | 6 |
| 2014 Enero | 6 | 0 | 6 |
| 2013 Diciembre | 2 | 0 | 2 |
| 2013 Noviembre | 15 | 0 | 15 |
| 2013 Octubre | 36 | 0 | 36 |
| 2013 Septiembre | 17 | 0 | 17 |
| 2013 Agosto | 16 | 0 | 16 |
| 2013 Julio | 1 | 0 | 1 |
| 2000 Septiembre | 5365 | 0 | 5365 |
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