title: Prostate-specific antigen as a marker of bone metastasis in patients with prostate cancer.
abstract: OBJECTIVE
  Staging in patients with newly diagnosed untreated cancer of the prostate has significant ramifications on the management of the disease. Currently measurement of the serum prostate-specific antigen (PSA) concentration and radionuclide bone scan are two important procedures in the metastatic workup of these patients. We retrospectively evaluated the efficacy of PSA as a staging marker to discriminate prostate cancer patients with bone metastases from those without bone metastases.
  
  
  METHODS
  In a retrospective study 158 prostate cancer patients with (n = 21) and without (n = 137) bone metastases were analyzed. In all patients the initial PSA measurement as well as the radionuclide bone scan were evaluated.
  
  
  RESULTS
  Patients with bone metastases demonstrated a median serum PSA concentration of 151 ng/ml and only 1 patient revealed a serum PSA concentration of <10 ng/ml. This resulted in a negative predictive value of 98%. In addition 67% of these patients demonstrated a serum PSA concentration of >100 ng/ml, which resulted in a positive predictive value of 74% and an overall accuracy of 92%.
  
  
  CONCLUSIONS
  The serum PSA concentration seems to provide useful information with regard to the presence of bone metastasis in patients with newly diagnosed cancer of the prostate. A serum PSA value of <10 ng/ml nearly excludes bone metastases, whereas a serum PSA value of> 100 ng/ml is highly predictive of bone metastases.
authors.affiliation: Departments of Urology, Aachen University of Technology, Aachen, Germany.
authors.forename: J M
authors.initials: JM
authors.lastname: Wolff
authors.forename: R
authors.initials: R
authors.lastname: Bares
authors.forename: P K
authors.initials: PK
authors.lastname: Jung
authors.forename: U
authors.initials: U
authors.lastname: Buell
authors.forename: G
authors.initials: G
authors.lastname: Jakse
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000276:immunology / Q000473:pathology*; D012372:ROC Curve; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D017430:Prostate-Specific Antigen