MP63-17 EARLY DETECTION OF CLINICALLY SIGNIFICANT PROSTATE CANCER: LOW FREE PROSTATE-SPECIFIC ANTIGEN LEVELS AS A CRITERION FOR PROSTATE BIOPSY IN PATIENTS WITH LOW TOTAL PROSTATE-SPECIFIC ANTIGEN LEVELS

2014 ◽  
Vol 191 (4S) ◽  
Author(s):  
Mitsuharu Sasaki ◽  
Shigeto Ishidoya ◽  
Akihiro Ito ◽  
Kenji Numahata ◽  
Daisuke Shibuya ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Early Detection ◽  
Prostate Specific Antigen ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Total Prostate Specific Antigen ◽  
Clinically Significant

scholarly journals CAN PROSTATE-SPECIFIC ANTIGEN DENSITY AND FREE / TOTAL PROSTATE-SPECIFIC ANTIGEN RATIO PREDICT CLINICALLY SIGNIFICANT PROSTATE CANCER (GLEASON ≥ 7) IN PATİENTS DIAGNOSED PROSTATE CANCER ON BIOPSY WITH A PROSTATE-SPECIFIC ANTIGEN LEVEL OF 2.5 -10 NG/ML?

2021 ◽  
Author(s):  
Fatih Bicaklioglu ◽  
Hasan Aydin ◽  
Ahmet Özgür Güçtaş ◽  
Hamit Zafer Aksoy
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Sensitivity And Specificity ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Free Psa ◽  
Total Prostate Specific Antigen ◽  
Prostate Specific Antigen Density ◽  
Clinically Significant ◽  
Total Psa

Introduction Many men with non-clinically significant PCa (N-CSPCa) will not progress to become symptomatic within their lifetime. If we can predict clinically significant PCa (CSPCa), we can prevent patients from unnecessary biopsies, overdiagnoses, and overtreatment. The purpose of this study was to determine whether PSAD and f/t PSA can predict CSPCa (Gleason ≥ 7) in patients diagnosed with prostate cancer on biopsy with a PSA level of 2.5-10 ng/ml or not. Materials and Methods 78 patients who underwent TRUSG-guided prostate biopsy with PSA 2.5-10.0 in our clinic between March 2017 - August 2020 and whose pathology result was reported as prostate adenocarcinoma, were retrospectively evaluated. In addition to the demographic content of the patients, PSA, free PSA, prostate size (with TRUSG), rectal examination findings and prostate biopsy pathology results were recorded. Clinically significant prostate cancer was defined as a Gleason score 7. Results The mean age of the patients was 66.9 ± 8.4, PSA value was 6.9 ± 1.8, free / total PSA ratio was 18 ± 8.1%, and PSA density was 0.150 ± 0.078. The P values of PSA, free PSA, PSAD, f/t PSA, and prostate volume between CSPCa and N- CSPCa groups were 0.010, 0.780, 0.001, 0.084, and 0.030, respectively. The area under the ROC curve (AUC) of the PSAD for predicting CSPCa was 0.719 with a 95% Cl (0.604–0.835), and the standard errors were 0.062 and 0.059, respectively. When PSAD cutoff was 0.130 for predicting CSPCa, sensitivity and specificity were 75% and 63%, respectively. Conclusion PSAD can be used for predicting CSPCa, but f/t PSA can not. PSAD is not a strong stand-alone tool with its sensitivity and specificity, but we suggest that PSAD can be a part of future nomograms for predicting CSPCa and future protocols for active surveillance. Key words:prostate-specific antigen; clinically significant prostate cancer

scholarly journals The use of prostate specific antigen density to predict clinically significant prostate cancer

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Igor Yusim ◽  
Muhammad Krenawi ◽  
Elad Mazor ◽  
Victor Novack ◽  
Nicola J. Mabjeesh
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Prostate Biopsy ◽  
Prostate Volume ◽  
Characteristic Curve ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Prostate Adenocarcinoma ◽  
Prostate Specific Antigen Density ◽  
Clinically Significant

AbstractThe purpose of this study was to assess the predictive value of prostate specific antigen density (PSAD) for detection of clinically significant prostate cancer in men undergoing systematic transrectal ultrasound (TRUS)-guided prostate biopsy. We retrospectively analyzed data of men who underwent TRUS-guided prostate biopsy because of elevated PSA (≤ 20 ng/ml) or abnormal digital rectal examination. Receiver operating characteristic curve analysis to compare PSA and PSAD performance and chi-square automatic interaction detector methodologies were used to identify predictors of clinically significant cancer (Gleason score ≥ 7 or international society of urological pathology grade group ≥ 2). Nine-hundred and ninety-two consecutive men with a median age of 66 years (IQR 61–71) were included in the study. Median PSAD was 0.10 ng/ml2 (IQR 0.10–0.22). Prostate adenocarcinoma was diagnosed in 338 men (34%). Clinically significant prostate adenocarcinoma was diagnosed in 167 patients (50% of all cancers and 17% of the whole cohort). The AUC to predict clinically significant prostate cancer was 0.64 for PSA and 0.78 for PSAD (P < 0.001). The highest Youden's index for PSAD was at 0.20 ng/ml2 with 70% sensitivity and 79% specificity for the diagnosis of clinically significant cancer. Men with PSAD < 0.09 ng/ml2 had only 4% chance of having clinically significant disease. The detection rate of clinically significant prostate cancer in patients with PSAD between 0.09 and 0.19 ng/ml2 was significantly higher when prostate volume was less than 33 ml. In conclusion, PSAD was a better predictor than PSA alone of clinically significant prostate cancer in patients undergoing TRUS-guided biopsy. Patients with PSAD below 0.09 ng/ml2 were unlikely to harbor clinically significant prostate cancer. Combining PSAD in the gray zone (0.09–0.19) with prostate volume below 33 ml adds diagnostic value of clinically significant prostate cancer.

The ability of free to total prostate-specific antigen and prostate-specific antigen density to detect clinically significant prostate cancer in men undergoing transperineal template biopsy

2017 ◽  
Vol 10 (6) ◽  
pp. 529-534 ◽  
Author(s):  
Surayne V Segaran ◽  
Amr M Emara ◽  
Tharani Mahesan ◽  
Joshua Silverman ◽  
Hashim U Ahmed ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Operating Characteristic ◽  
Receiver Operating Characteristic Analysis ◽  
Specific Antigen ◽  
Area Under The Curve ◽  
Characteristic Analysis ◽  
Total Prostate Specific Antigen ◽  
Prostate Specific Antigen Density ◽  
Clinically Significant

Objective: The purpose of this study was to determine the ability of the ratio of free to total prostate-specific antigen and prostate-specific antigen density to predict the presence of clinically significant prostate cancer on template biopsies. The value of these tests may be underestimated as they were previously validated against sextant transrectal biopsy of the prostate, which has been proved to miss a large proportion of significant prostate cancers. The ability of these tests to specifically detect clinically significant cancers has not previously been studied. Patients and methods: A retrospective analysis was performed of patients undergoing transperineal template biopsy who also had free to total prostate-specific antigen and prostate-specific antigen density. Receiver-operating characteristic analysis was performed to determine the comparative utility of each test in the detection of all cancers as well as clinically significant cancers, by means of the area under the curve. Results: Data from 293 patients were analysed. Prostate cancer was detected in 72% of patients, of which 62% of this group had clinically significant disease. Receiver-operating characteristic analysis demonstrated the superiority of prostate-specific antigen density and free to total prostate-specific antigen over standard prostate-specific antigen in the overall detection of cancer (area under the curve 0.662 and 0.674 vs 0.534, p=0.003 and 0.02 respectively). Both tests were even more effective in the detection of clinically significant cancers (area under the curve 0.755 and 0.715 vs 0.572, p<0.0001 and 0.009 respectively). Conclusion: The free to total prostate-specific antigen and prostate-specific antigen density both appear to perform well at detecting clinically significant prostate cancer in our population of men undergoing template biopsy. The potential role of these inexpensive tests should not be overlooked as they may be of value when deciding which patients require biopsy following an initial magnetic resonance imaging scan and also for those on surveillance protocols.

scholarly journals Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Alone or Combined with Prostate-Specific Antigen for the Diagnosis of Clinically Significant Prostate Cancer

2020 ◽  
Author(s):  
Sat Prasad Nepal ◽  
Takehiko Nakasato ◽  
Yoshio Ogawa ◽  
Yoshihiro Nakagami ◽  
Takeshi Shichijo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Gleason Score ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Diagnose Prostate Cancer ◽  
Clinically Significant ◽  
Insignificant Prostate Cancer

Abstract Background: Many patients undergo unwanted prostate biopsy due to unreliability of prostate-specific antigen (PSA). PSA density (PSAD), free PSA, free-to-total PSA ratio, prebiopsy MRI are used to diagnose prostate cancer (PCa). Since 1863, correlations between inflammation and cancer have been identified and explored; thus, the role of various blood parameters in detecting cancer has been studied, especially neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). Here, we evaluated whether these parameters before prostate biopsy can diagnose prostate cancer in our hospital.Methods: We conducted a retrospective study from January 2014 to January 2018. Prostate cancer patients were divided into significant cancer (Gleason Score ≥ 7) and insignificant cancer (Gleason Score < 7). NLR, PLR, and other clinical parameters were taken before the prostate biopsy. We then analyzed the associations of NLR and PLR alone or with PSA, with significant prostate cancer. Results: We included 463 patients, of whom 60.3% (279) had prostate cancer and 75.6 % (211) had a Gleason score (GS) of ≥ 7. PSA and PSAD in the clinically significant prostate cancer patient group were around two times more than those in the insignificant prostate cancer group. PV, NLR, PLR, and combined markers were more in the GS ≥ 7 population group. PSA combined with PLR (PPLR) and PSA with NLR (PNLR) had better area under a curve (AUC) (0.732 and 0.730, resp.), with statistical significance, than PSA, NLR, and PLR alone (0.723, 0.585, and 0.590). In the multivariate analysis using separate models with PSA and NLR or PLR compared to age, DRE-positive lesions, PV, PSAD; PNLR, and PPLR were statistically significant in finding aggressive prostate cancer. When combined markers were used together, despite the high correlations, PSA and NLR were nearly significant (p = 0.062) in detecting the GS ≥ 7 population.Conclusion: The combined use of PSA with PLR and PSA with NLR helps detect the differences between clinically significant and insignificant prostate cancer.

Discordant performance of assays for free and total prostate-specific antigen in relation to the early detection of prostate cancer

2001 ◽  
Vol 88 (6) ◽  
pp. 545-550 ◽  
Author(s):  
B.G. Blijenberg ◽  
G. Yurdakul ◽  
B.D. Van Zelst ◽  
C.H. Bangma ◽  
M.F. Wildhagen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Early Detection ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Total Prostate Specific Antigen
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