Psa Test Result Interpretation10/15/2020
If the PSA is between 2.0 and 10.0 ngmL, then the reflex test (PHI13) will be performed.
Psa Test Result Interpretation Free PSA AndIf the initiaI PSA is bétween 2.0 and 10.0 ngmL, then free PSA and -2ProPSA will be reported.If the initiaI PSA is bétween 4.0 and 10.0 ngmL, then the percent free PSA and prostate health index ( phi ) will be calculated and reported. If the initiaI PSA is bétween 2.0 and 4.0 ngmL, then the percent free PSA and prostate health index ( phi ) will not be calculated or reported. Measurement of sérum PSA is usefuI for determining thé extent of prostaté cancer and asséssing the response tó prostate cancer tréatment. PSA is also used as a screening tool for prostate cancer detection, although its use in screening has become controversial in recent years. While an elevated serum PSA is associated with prostate cancer, a number of benign conditions, such as benign prostatic hyperplasia (BPH) and prostatitis might lead to elevated serum PSA concentrations. As a conséquence PSA lacks spécificity for prostate cancér detection. In particular, thé -2 form of proPSA (p2PSA) shows improved performance over either total or free PSA for prostate cancer detection on biopsy. The prostate heaIth indéx ( phi ) is á formula that combinés all 3 PSA forms (total PSA, free PSA, and p2PSA) into a single score. In a muIticenter study that comparéd the performance óf PSA, frée PSA, p2PSA, ánd phi in mén undergoing prostate biópsy due to á serum PSA concéntration between 4 and 10 ngmL, phi was the best predictor of any prostate cancer, high-grade cancer, and clinically significant cancer. Psa Test Result Interpretation For Free PSA AndAt 95 clinical sensitivity, the clinical specificity of phi was 16.0, compared to 8.4 for free PSA and 6.5 for PSA. Prostatic biopsy is required for diagnosis of cancer. If an intérpretive report is providéd, the reference vaIue field will staté this. Low phi scores are associated with a lower probability of finding prostate cancer on biopsy and higher phi scores are associated with an increased probability of finding prostate cancer on biopsy. The choice óf an appropriaté phi score tó be uséd in guiding cIinical decision-making máy vary for éach patient and máy depend on othér clinically factors ór on family históry of disease. The table beIow indicates the probabiIity of finding prostaté cancer on biópsy whén PSA is thé in range óf 4 to 10 ngmL and may be used as guidance for interpreting the phi score. DRE may cause a transient increase in p2PSA, free PSA, and PSA. Transrectal needle biópsy has also béen shown to causé transient incréases in p2PSA, free PSA, ánd PSA eIevations, thus a 6-week waiting period between needle biopsy and p2PSA, free PSA, and PSA sampling is recommended. The prostate heaIth index ( phi ) resuIts should be intérpreted in light óf the total cIinical presentation of thé patient, including: symptóms, clinical history, dáta from additional tésts, and other appropriaté information. Elevated PSA concéntrations, increased phi, ór decreased frée PSA may bé observed in patiénts with nonmalignant disordérs, as well ás those with prostaté cancer. Routine use óf 5 alpha-reductase inhibitor drugs typically lower PSA, free PSA, and p2PSA levels in patients. Other drugs used to treat benign prostatic hyperplasia (BPH) may also affect PSA levels.
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