Prostate-Specific Antigen: Concepts for Staging Prostate Cancer and Monitoring Response to Therapy  HERBERT C. RUCKLE, M.D., GEORGE G. KLEE, M.D., PH.D., JOSEPH E. OESTERLING, M.D.  Mayo Clinic Proceedings  Volume 69, Issue 1, Pages 69-79 (January 1994) DOI: 10.1016/S0025-6196(12)61615-2 Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 1 Serum prostate-specific antigen (PSA) value and clinical stage. Note considerable overlap among stages. BPH = benign prostatic hyperplasia. (From Hudson and associates.2 By permission of the American Urological Association.) Mayo Clinic Proceedings 1994 69, 69-79DOI: (10.1016/S0025-6196(12)61615-2) Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 2 Prediction of pathologic stage of prostate cancer as function of preoperative serum prostate-specific antigen (PSA) concentration, local clinical stage, and tumor grade. A, Probability of organ-confined (OC) disease (stage A or B). B, Probability of extracapsular disease (ECD) without lymph node (LN) involvement (stage C). C, Probability of positive pelvic LNs (stage D1). (From Kleer and associates.4 By permission of Cahners Publishing.) Mayo Clinic Proceedings 1994 69, 69-79DOI: (10.1016/S0025-6196(12)61615-2) Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 3 Predicted percentage of patients with newly diagnosed, untreated prostate cancer who had positive results on bone scan (solid line), on basis of logistic regression model using natural logarithm of serum prostate-specific antigen (PSA) concentration. Confidence limits (95%) for predicted percentages also are shown (shaded area). Circles denote observed percentages based on PSA groupings determined by cutoff points of 5, 10, 20, 40, 80, 160, 320, and 640 ng/mL in 521 patients. (From Chybowski and associates.6 By permission of the American Urological Association.) Mayo Clinic Proceedings 1994 69, 69-79DOI: (10.1016/S0025-6196(12)61615-2) Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 4 Classification of prostate-specific antigen (PSA) assays on basis of precision profiles. First-generation assays can measure concentrations as low as 0.5 ng/mL, with coefficients of variation (CV) of less than 20%. Subsequent generations can measure 10-fold lower concentrations. Mayo Clinic Proceedings 1994 69, 69-79DOI: (10.1016/S0025-6196(12)61615-2) Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions

Fig. 5 Prostate-specific antigen (PSA) production as function of time for LNCaP prostate cancer cells. A, Dihydrotestosterone (DHT) is potent androgen. B, Mibolerone (MIS) is potent androgen. Note that stimulatory effect of DHT and MIB on PSA production can be inhibited by antiandrogen hydroxyflutamide (HF). Mayo Clinic Proceedings 1994 69, 69-79DOI: (10.1016/S0025-6196(12)61615-2) Copyright © 1994 Mayo Foundation for Medical Education and Research Terms and Conditions