Re: Prognosis of prostate cancer and prostate - specific antigen levels

Joob, Beuy; Wiwanitkit, Viroj

doi:10.1590/S1677-5538.IBJU.2018.0867

To the editor,

We read the publication on “Prognosis of patients with prostate cancer and middle range prostate - specific antigen (PSA) levels of 20 – 100 ng / mL” with a great interest (¹). Iwamoto et al. noted that “PSA is a useful biomarker for predicting prognosis at levels between 20 and 70 ng / mL (1)” and “When the PSA level reaches approximately 70 ng / mL, prognosis might bottom and reach a plateau (1)”. We would like to share ideas on this report. We agree that there might be a plateau phenomenon in case of high PSA level. Nevertheless, we should also be aware on the possible false negative result in patients with low PSA level (²). As an immunological test, the prozone effect is possible and this might lead to aberrant low PSA level (³). In that case, the prognosing might be affected.

REFERENCES

¹ Iwamoto H, Izumi K, Kadono Y, Mizokami A. Prognosis of patients with prostate cancer and middle range prostate -specific antigen levels of 20 – 100 ng / mL. Int Braz J Urol. 2019;45:61-7.
² Basuyau JP, Leroy M, Brunelle P. Determination of tumor markers in serum. Pitfalls and good practice. Clin Chem Lab Med. 2001;39:1227-33.
³ Akamatsu S, Tsukazaki H, Inoue K, Nishio Y. Advanced prostate cancer with extremely low prostate-specific antigen value at diagnosis: an example of high dose hook effect. Int J Urol. 2006;13:1025-7.

Publication Dates

Publication in this collection
27 June 2019
Date of issue
May-Jun 2019

History

Received
21 Dec 2018
Accepted
24 Dec 2018
Published
20 Mar 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

[1] ¹ Iwamoto H, Izumi K, Kadono Y, Mizokami A. Prognosis of patients with prostate cancer and middle range prostate -specific antigen levels of 20 – 100 ng / mL. Int Braz J Urol. 2019;45:61-7.

[2] ² Basuyau JP, Leroy M, Brunelle P. Determination of tumor markers in serum. Pitfalls and good practice. Clin Chem Lab Med. 2001;39:1227-33.

[3] ³ Akamatsu S, Tsukazaki H, Inoue K, Nishio Y. Advanced prostate cancer with extremely low prostate-specific antigen value at diagnosis: an example of high dose hook effect. Int J Urol. 2006;13:1025-7.