Value of PSA Density, PSA Velocity and Percent Free PSA for Detection of Prostate Cancer in Patients with Serum PSA 4-10ng/ml Patients.
- Author:
Seung Chan LEE
1
;
Sang Cheol LEE
;
Wun Jae KIM
Author Information
1. Department of Urology, Chungbuk National University College of Medicine, Cheongju, Korea. wjkim@chungbuk.ac.kr
- Publication Type:Original Article
- Keywords:
Prostate cancer;
Prostate-specific antigen
- MeSH:
Biopsy;
Humans;
Male;
Prostate*;
Prostate-Specific Antigen;
Prostatic Neoplasms*;
ROC Curve;
Sensitivity and Specificity;
Ultrasonography
- From:Korean Journal of Urology
2004;45(8):747-752
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Purpose: This study investigated whether the PSA density (PSAD), PSA velocity (PSAV) and percent free PSA (F/T PSA) might be valuable in predicting prostate cancer in men with serum PSA levels of 4-10ng/ml. Materials and Methods: Prostate biopsy data were obtained from 1,020 patients out of 1,165 men with serum PSA levels of 4-10ng/ml. The prostate volume was estimated by transrectal ultrasonography, and the levels of total PSA and free PSA determined by a radioimmune assay. The PSAD, PSAV and percent free PSA were calculated from these data. A receiver operating characteristic curve (ROC) was generated and utilized to evaluate the cut-off values of PSAD, PSAV and percent free PSA. Results: Of the 1,020 patients, 119 (11.7%) had prostate cancer and 901 (88.3%) had various benign conditions, mainly BPH, on pathological examination. The mean values of PSAD and PSAV were significantly higher in the prostate cancer patients than the non-prostate cancer cases (p<0.001). However, the F/T PSA in each group were not different, which was in contrast to western data (p=0.09). The area under the PSAV ROC curve was significantly larger than that of the total PSA ROC curve in the PSA range between 4-10ng/ml. The PSAD (based on a cut-off value of 0.15) had a sensitivity and specificity of 83.7 and 39.9%, respectively, for diagnosing prostate cancer, while the results for PSAV (based on a cut-off value of 0.75) were 64.9 and 78.4%, respectively. In men with serum PSA levels of 4-10ng/ml, the analysis of the sensitivity and specificity showed that the PSAD and PSAV had higher sensitivities and specificities. Conclusions: These results suggest that the PSAD and PSAV might be useful parameters for the detection of prostate cancer in men with serum PSA levels of 4-10ng/ml.
