The impact of diurnal variation of PSA on timing of measurement in prostate biopsy
Autor: | Hakkı Uzun, Medeni Arpa |
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Rok vydání: | 2019 |
Předmět: |
Male
0301 basic medicine medicine.medical_specialty Time Factors Prostate biopsy Biopsy Urology 03 medical and health sciences Prostate cancer 0302 clinical medicine Lower Urinary Tract Symptoms Lower urinary tract symptoms Prostate medicine Humans Testosterone Aged Morning Aged 80 and over medicine.diagnostic_test business.industry Diurnal temperature variation Prostatic Neoplasms Middle Aged Prostate-Specific Antigen medicine.disease Confidence interval Circadian Rhythm 030104 developmental biology medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis business |
Zdroj: | The Prostate. 79:1666-1672 |
ISSN: | 1097-0045 0270-4137 |
DOI: | 10.1002/pros.23891 |
Popis: | Background Prostate-specific antigen (PSA) synthesis is related to testosterone, which has a diurnal rhythm. PSA might have a diurnal variation and the timing of measurement could change the clinical practice for prostate biopsy. Methods Male patients complaining of lower urinary tract symptoms (group 1) and diagnosed with prostate cancer (group 2) were recruited into the study. Morning fasting blood samples were withdrawn between 9.00 and 11.00 am for the determination of biochemical parameters, PSA (PSA1), total testosterone (T1), and estradiol (E1) levels. In the afternoon, between 15.00 and 15.30 pm, blood samples were again obtained from the same participants at the same day and the serum concentration of PSA (PSA2), total testosterone (T2), and estradiol (E2) were measured. Results A total of 160 and 30 patients were enrolled in groups 1 and 2, respectively. One hundred forty (87.5%) and 26 (86.6%) patients had a decrease in the PSA levels when measured in the afternoon. The Wilcoxon signed-rank test determined a statistically significant difference between the PSA levels measured in the morning and in the afternoon in each group. An analysis of covariance test revealed no statistically significant difference in PSA concentration between the groups after adjustment for baseline concentration (F(1.187) = 0.203, P = .653). There was a weak positive correlation between PSA1/PSA2 and T1/T2, rs (160) = 0.163, P = .034. An extra unit increase in PSA1 concentration leads to a 0.805 (95% confidence interval [CI], 0.781-0.830) and 0.828 (95% CI, 0.807-0.849) ng/mL increase in PSA2 concentration in groups 1 and 2, respectively, that is, patients with and without prostate cancer had a similar decrease in the PSA levels. When measured in the afternoon, 66.6% and 50% patients with a morning PSA level over 3 or 4 ng/mL had a PSA drop below these levels, respectively. Conclusions PSA has a diurnal variation and the timing of measurement may alter the decision of the clinician for transrectal ultrasound prostate biopsy. |
Databáze: | OpenAIRE |
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