Journal List > Korean J Urol > v.47(12) > 1069804

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Kim, Cho, Kwon, Jang, Park, Chung, and Kang: Biological Variation of Serum Prostate Specific Antigen Levels in Men Aged 50 or Older without Prostate Cancer
Original Article
Korean Journal of Urology

Korean Journal of Urology 2006; 47(12): 1284-1288.

Published online: 31 December 2006

DOI: https://doi.org/10.4111/kju.2006.47.12.1284

Biological Variation of Serum Prostate Specific Antigen Levels in Men Aged 50 or Older without Prostate Cancer

Jung-Yub Kim, Jin Seon Cho, Moon Sic Kwon, Won Seok Jang, Sung Yul Park, Byung Soo Chung, Hee Jung Kang1

Department of Urology, Hallym University College of Medicine, Chuncheon, Korea.

1Department of Laboratory Medicine, Hallym University College of Medicine, Chuncheon, Korea.

Corresponding author (js315@hallym.or.kr)

Received 15 May 2006       Accepted 18 October 2006

Copyright © 2006 The Korean Urological Association

Abstract

Purpose

To evaluated the effect of the intra-individual variation in the serum prostate specific antigen (PSA) level in men without prostate cancer to decide on the requirement of a prostate biopsy.

Materials and Methods

Patients, aged between 50 and 80 years, were screened for prostate cancer or lower urinary tract symptoms at least 2 times within 3 months using PSA or free PSA measurements. Patients with an initial PSA level between 2.0 and 10.0ng/ml were included. Those with prostate cancer, urinary tract infection or 5-alpha reductase inhibitor medication were excluded. The coefficient of variation (CV) was evaluated in each PSA range.

Results

The analysis included 139 patients, with a mean age 62.1 years. The level of free PSA was measured in 56 patients. The mean interval between the two PSA measurements was 36.6 days. The mean CVs for the total PSA and % free PSA were 21.5 and 22.2%, respectively. 20% of patients show a CV of more than 30%, implying a large variation. In our study, the 95% confidence interval of initial PSA levels between 3.0 and 4.9ng/ml included the PSA cut-off point (4.0ng/ml) in the visit results.

Conclusions

The variation the PSA level was relatively small, but some patients showed a CV greater than 30%. Therefore, the intra-individual PSA variation should become part of interpreting the PSA test results, especially for men with a PSA value near the cut-off point.

Keywords: Prostate-specific antigen, Antigen variation, Prostate

Figures and Tables

Fig. 1
The relationship between the initial and next visit prostate-specific antigen (PSA) results. The solid line is obtained from a linear regression analysis.
kju-47-1284-g001
Fig. 2
Distribution of the coefficient of variation for the total prostate-specific antigen serum concentration.
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Table 1
Coefficient of variation of PSA, as stratified by the initial serum PSA
kju-47-1284-i001

PSA: prostate-specific antigen, CV: coefficient of variation, SE: standard error, CI: confidence interval

Table 2
Coefficients of variation of total, free and percentage free PSA, as stratified by the initial serum PSA
kju-47-1284-i002

PSA: prostate-specific antigen, CV: coefficient of variation, SE: standard error, CI: confidence interval

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