The Value of Prostate Specific Antigen Density in the Diagnosis of Prostate Adenocarcinoma.
- Author:
Jung Yun JUNG
1
;
Kyu Seon CHO
;
Seok Soo BYEON
;
Kwang Myung KIM
;
Jae Seung PAICK
;
Sang Eun LEE
Author Information
1. Department of Urology, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Prostate adenocarcinoma;
Benign prostatic hyperplasia;
Prostate specific antigen density
- MeSH:
Adenocarcinoma*;
Biopsy;
Diagnosis*;
Humans;
Prostate*;
Prostate-Specific Antigen*;
Prostatic Hyperplasia;
Prostatic Neoplasms;
Retrospective Studies;
Sensitivity and Specificity
- From:Korean Journal of Urology
1998;39(4):355-360
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Most studies have shown considerable overlap between benign prostatic hyperplasia(BPH) and cancer, using a prostate specific antigen(PSA) cut-off point of 4.0ng/ml. Because of lack of sensitivity and specificity, the value of PSA measurement in the diagnosis of prostate cancer has been questioned. The concept of PSA density(PSAD) was introduced to enhance the specificity of serum PSA. To determine the value of PSAD in the diagnosis of prostate cancer, we investigated whether PSAD-based clinical guidelines could help in the diagnosis of prostate cancer and assist in avoiding a significant number of biopsies. MATERIALS AND METHODS: Retrospective data were analysed from a selected population of 130 patients(mean age 66 years, range 42-86), 54 with histopathologically diagnosed prostate cancer and 76 with BPH. DRE(digital rectal examination) and TRUS(transrectal ultrasonography) were performed and PSA and PSAD were determined for each patient. RESULTS: The median PSA level was 7.0ng/ml(range 0.6-87ng/m1) in the patients with a benign diagnosis and 25.5ng/ml(range 2.2-736ng/m1) in those with malignancies. Also, the median PSAD was 0.18ng/m1/cm3(range 0.02-2.56ng/ml/cm3) in the benign group and 0.75ng/m1/cm3(range 0.06-22.3ng/m1/cm3) in the malignant group. Both PSA and PSAD discriminated BPH from cancer in a whole range of PSA level and were statistically significant. Of the 130 patients, 49(377 %) had a PSA level in the intermediate range(4.0-10.0ng/ml). In these patients, the median PSA was 6.5ng/ml(range 4.2-10ng/m1) In the benign group and 5.2ng/ml(range 4.1-9.8ng/ml) in the malignant group. Also, the median PSAD was 0.16ng/m1/cm3(range 0.07-0.39ng/m1/cm3) in the benign group and 0.17ng/m1/cm3 (range 0.08-0.27ng/m1/cm3) in the malignant group Both PSA and PSAD had no discriminating ability between BPH arid cancer in the Intermediate PSA range(4.0-10.0ng/ml). CONCLUSIONS: PSAD was of no additional value over serum PSA measurement in discriminating BPH from cancer for the population with intermediate PSA levels.
