A New Kinetic Interpretation of PSA for Diagnosis and Treatment-Response Assessment of Prostate Cancer
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PO-GePV-M-318 (Sunday, 7/10/2022) [Eastern Time (GMT-4)]
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Purpose: Prostate specific antigen (PSA) is commonly used for diagnosis and treatment-response assessment of the prostate cancer (PC). Indication of PSA dynamics, PSA velocity (PSAV) or doubling time (DT), is controversial. A new kinetic interpretation of PSA changes with time may provide a theoretical explanation.
Methods: According to pretreatment PSA changes of 20 patients plus some follow-up PSA curves, the epithelial cells in the prostate and seminal vesicles were divided into an exponentially growth or activate population and an exponentially decay or deactivate population, mathematically as PSA(t) = C₁exp(λ₁t)+C₂exp(-λ₂t) with the coefficients from cell groups to PSA, Cᵢ, and the growth or decay constants, λᵢ = 0.693/DTᵢ, to be determined by fitting the patient PSA curve.
Results: Over half of pre- and post-treatment PSA curves were well fitted with mono-exponential curves (straight lines in semilog plot) but other over 40% PSA curves with fluctuated values were better fitted with the new two population model. For instance, two recurrent PCs with arising PSA curves post radical prostatectomy had C₂ = 0, C₁ = PSA(0) and λ₁ = 0.693/PSA DT. PSA curves post a course of radiotherapy with or without androgen deprivation therapy (ADT), reasonably fitted with C₁ = 0, C₂ = PSA(0) and λ₂ = 0.693/PSA DT for R²>0.85, could be further improved for R²>0.95 by including a small population of C₁<
Conclusion: Our preliminary results of a new kinetic interpretation of PSA dynamics associated with activate and deactivate cell populations within an intact or treated PC are promising to predict cell developments for more accurate diagnosis and treatment-response assessment.
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