Managing the impact of inter-method bias of prostate specific antigen assays on biopsy referral: the key to move towards precision health in prostate cancer management

Author:

Ferraro Simona12,Biganzoli Giacomo3,Bussetti Marco4,Castaldi Silvana56,Biganzoli Elia Mario3,Plebani Mario7ORCID

Affiliation:

1. Endocrinology Laboratory Unit , “Luigi Sacco” University Hospital, Università degli Studi di Milano , Milan , Italy

2. Newborn Screening and Genetic Metabolic Diseases Unit, “V. Buzzi” Children’s Hospital , Milan , Italy

3. Medical Statistics Unit, Department of Biomedical and Clinical Sciences , “Luigi Sacco” University Hospital, Università degli Studi di Milano , Milan , Italy

4. Immunoematologia e Medicina trasfusionale Ospedale Castelli , Verbania , Italy

5. Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico , Milan , Italy

6. Department of Biomedical Sciences for Health , Università degli Studi di Milano , Milan , Italy

7. Department of Medicine-DIMED , University of Padova , Padova , Italy

Abstract

Abstract Objectives We assessed the inter-method bias of total (tPSA) and free (fPSA) prostate-specific antigen (PSA) immunoassays to establish if tPSA-based risk thresholds for advanced prostate cancer (PCa), obtained from one method (Roche) can be converted into the corresponding concentrations assayed by other methods. Then we evaluated the impact of the bias of tPSA and fPSA on the estimation of the %f/tPSA ratio and performed a re-calibration of the proposed thresholds for the %f/tPSA ratio according to the assay used. Methods tPSA and fPSA were measured in 135 and 137 serum samples, respectively by Abbott Alinity i, Beckman Access Dxl, Roche Cobas e801, and Siemens Atellica IM analytical platforms. Scatterplots, Bland-Altman diagrams, Passing-Bablok (PB) were used to inspect and estimate the systematic and proportional bias between the methods. The linear equations with confidence intervals of the parameter estimates were used to transform the tPSA risk thresholds for advanced PCa into the corresponding concentrations measurable by the other analytical methods. To construct a correction coefficient for converting the %f/tPSA ratio from one method to the other, PB and non-parametric boostrapping were used. Results The inter-method bias is not constant but strictly linear allowing the conversion of PSA results obtained from Roche into the other assays, which underestimate tPSA vs. Roche. Siemens and Abbott vs. Roche and Beckman assays, being characterized by a positive and a negative proportional bias for tPSA and fPSA measurements, tend to overestimate the %f/tPSA ratio. Conclusions There is a consistent risk to miss advanced PCa, if appropriate conversion factors are not applied.

Publisher

Walter de Gruyter GmbH

Subject

Biochemistry (medical),Clinical Biochemistry,General Medicine

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3