Response by Chang et al to Letter Regarding Article, “Prostate-Specific Antigen Within the Reference Range, Subclinical Coronary Atherosclerosis, and Cardiovascular Mortality”

Background: Total prostate-specific antigen (PSA) levels increase with advancing age. Its age-specific ranges are being advocated to increase its sensitivity and specificity. This study was aimed to examine the relationship between total PSA levels and age, and to determine the age-specific ranges among healthy men without prostatic diseases in our environment.Methods: In this retrospective hospital-based study, records of men without prostatic diseases who had visited University of Port Harcourt Teaching Hospital for routine screening for prostate cancer using serum total PSA between 1st January 2012 and 31st December 2016 were retrieved and analyzed using descriptive statistics and Spearman’s correlation test. A p-value < 0.05 was considered significant.Results: Records of 476 men aged 38 to 86 years were recruited for the study. The age-specific total PSA reference range using the 95th percentile total PSA concentration values in each 10year groups were 0-1.60, 0-4.93, 0-6.93, 0-7.80, 0-9.65, and 0-13.30 for the age groups 30-39, 40-49, 50-59, 60-69, 70-79 and >80years respectively. There was a positive correlation between serum PSA concentration and age (rs = 0.395; p<0.001).Conclusions: Total PSA increases with advancing age and its age-specific reference range in this study are similar to findings in our environment but higher than the values found in other parts of the world. We suggest serum PSA normal reference values should be characterized by age and race in our environment.

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Prostate Specific Antigen (PSA): Normal Reference Value in Bangladeshi Male, a Retrospective PSA Analysis of 765 Male

Anwer Khan Modern Medical College Journal ◽

10.3329/akmmcj.v5i1.18766 ◽

2014 ◽

Vol 5 (1) ◽

pp. 19-22

Author(s):

Md Tahminur Rahman ◽

Tabassum Tahmin Sajani ◽

Rosy Sultana ◽

Sohel Reza Choudhury ◽

Md Mahmudur Rahman Siddiqui

Keyword(s):

Prostate Specific Antigen ◽

Reference Range ◽

Specific Antigen ◽

Reference Value ◽

Developed Countries ◽

Male Population ◽

Noninvasive Test ◽

Normal Reference Range ◽

Normal Reference ◽

Normal Reference Value

Prostate specific antigen (PSA) is an important tool for the diagnosis, prognosis and follow up of prostatic cancer, the most common malignancy of the male throughout the world. It is safe, reliable, specific, noninvasive test if done properly. However there are many benign, inflammatory and other prostatic conditions which can also give rise to elevated PSA value and thus limits its use. Different methods of estimation may also give rise to variable PSA level. More over the normal reference range may be variable depending on the age, geographic situation, environmental conditions and other factors. The normal reference range mentioned in the texts is based on findings in the developed countries. No effort was made before to see the normal reference PSA value among Bangladeshi male population. With this background the present study was undertaken to determine the normal reference value of PSA in Bangladeshi population. It is evident form the present study that the normal reference PSA value for Bangladeshi male in different age groups are lower in comparison to that of upper limit of normal reference value mentioned in the text. DOI: http://dx.doi.org/10.3329/akmmcj.v5i1.18766 Anwer Khan Modern Medical College Journal Vol. 5, No. 1: January 2014, Pages 19-22

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Efficiency of prostate-specific antigen and digital rectal examination in screening, using 4.0 ng/ml and age-specific reference range as a cutoff for abnormal values

The Prostate ◽

10.1002/(sici)1097-0045(19990301)38:4<296::aid-pros5>3.0.co;2-p ◽

1999 ◽

Vol 38 (4) ◽

pp. 296-302 ◽

Cited By ~ 50

Author(s):

E. David Crawford ◽

Sunai Leewansangtong ◽

Serdar Goktas ◽

Kerri Holthaus ◽

Monika Baier

Keyword(s):

Prostate Specific Antigen ◽

Reference Range ◽

Specific Antigen ◽

Digital Rectal Examination ◽

Specific Reference ◽

Rectal Examination

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New onset of heterophilic antibody interference in prostate-specific antigen measurement occurring during the period of post-prostatectomy prostate-specific antigen monitoring

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1258/acb.2009.008159 ◽

2009 ◽

Vol 46 (3) ◽

pp. 253-256 ◽

Cited By ~ 10

Author(s):

B E Fritz ◽

R J Hauke ◽

D F Stickle

Keyword(s):

Prostate Specific Antigen ◽

Time Course ◽

Reference Range ◽

Specific Antigen ◽

Progressive Increase ◽

Antibody Assay ◽

Heterophilic Antibody ◽

Time Point ◽

Assay Interference ◽

New Onset

Laboratories evaluated whether an interference was causing a false-positive PSA for the Immulite 2000 immunoassay after a time course of increasing prostate-specific antigen (PSA) in a post-prostatectomy patient led to salvage therapy, which had no effect on the elevated PSA. Serial dilutions of PSA for the patient sample (6.1 ng/mL; post-prostatectomy reference range: <0.1 ng/mL [undetectable]) were linear ( r > 0.99). However, the PSA measurement was reduced to 0.1 ng/mL after pretreatment of the sample with heterophilic antibody blocking reagent. PSA was undetectable (<0.1 ng/mL) when measured using two alternative immunoassays. These results were consistent with the presence of heterophilic antibody interference for the Immulite 2000 assay. In this case, heterophilic antibody interference with PSA measurement must have originated during the period of post-prostatectomy monitoring, and the apparent progressive increases in PSA may have been due solely to the progressive increase of this heterophilic antibody assay interference. In the absence of clinical correlation, positive PSA monitoring results should always be assessed for heterophilic antibody interference for at least one time point.

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