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

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