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June 26, 1981

Prostatic Acid Phosphatase by Radioimmunoassay

Author Affiliations

Harvard Medical School Boston

JAMA. 1981;245(24):2493. doi:10.1001/jama.1981.03310490011005

To the Editor.—  Lindholm et al (1980;244:2071) conclude that the radioimmunoassay for acid phosphatase "should not be used for screening but as an adjunct for staging known prostatic carcinoma." Although I agree with this conclusion (based on independent observations), I do not believe the data substantiate their assay as a worthy "adjunct for staging" prostatic cancer. The goal of staging prostate cancer should be to differentiate "curable" from "noncurable" cases and thus to guide the choice of appropriate forms of treatment. Urologists generally agree that stage A and B lesions are curable, while stage D and probably C are not. The data presented by Lindholm et al show that 22% and 29% of the curable stage lesions would be recorded as positive, while 13% and 48% of the incurable cases would be recorded as negative based on the results of this assay; both groups would be subjected to the