OBJECTIVETo evaluate the roles of total prostate specific antigen (tPSA), PSA density (PSAD) and biopsy Gleason score in predicting the pathologic stage of prostate cancer.

METHODSWe retrospectively analyzed the clinical data of 124 cases of pathologically confirmed prostate adenocarcinoma, and divided them into Groups A (n=48) and B (n=76) based on the results of bone scanning, CT, MRI, tPSA, PSAD and postoperative biopsy Gleason score, the former with extraprostatic infiltration or distant metastasis, while the latter without. We compared the above parameters between the two groups, screened the main factors that influenced the pathologic staging of prostate cancer by multivariate logistic regression analysis, and appraised the value of each of the parameters in predicting the pathologic stage of prostate cancer with a relative operating characteristic (ROC) curve.

RESULTSThe tPSA level and biopsy Gleason score were significantly higher in Group A than in B (P < 0.05). Multivariate logistic regression analysis showed that only tPSA could predict the pathologic stage of localized prostate cancer. The ROC curve exhibited that the combined use of tPSA and Gleason score had a better predicting value than other parameters (Gleason score + tPSA > tPSA > PSAD + tPSA + Gleason score).

CONCLUSIONTotal PSA remains a valuable predictor of the pathologic stage of prostate cancer, and its combination with Gleason score can further improve the predictive accuracy and contribute much to the treatment and prognosis of the disease.