Prostate Specific Antigen Density as a Predictor of Clinically Significant Prostate Cancer When the Prostate Specific Antigen is in the Diagnostic Gray Zone: Defining the Optimum Cutoff Point Stratified by Race and Body Mass Index

2018 ◽  
Vol 200 (4) ◽  
pp. 758-766 ◽  
Author(s):  
Alireza Aminsharifi ◽  
Lauren Howard ◽  
Yuan Wu ◽  
Amanda De Hoedt ◽  
Charlotte Bailey ◽  
...  
Author(s):  
Eyam Sunday Eyam ◽  
Ima-Abasi E. Bassey ◽  
Edoise M. Isiwele ◽  
Eyam Lilian Eberechukwu

Background: Prostate-specific antigen density (PSAD) is one of the means of improving PSA sensitivity as a marker of a prostate cancer diagnosis. However, this ability is perceived to be obscured by certain factors such as high body mass index and age in Caucasian and western populations, which tends to reduce its sensitivity and lead to misclassification of at-risk patients for prostate cancer. Aim: We studied the correlation of body mass index (BMI) and age with prostate-specific antigen density (PSAD) as indicators of prostate cancer risk in a screened male population(40 years and above) in the University of Calabar, Nigeria. Study Design: A cross-sectional analytical study with consecutive participant recruitment. Place and Duration of Study: The study was carried out in the University of Calabar Medical centre during a medical outreach. Materials and Methods: The study involved sixty-one (61) healthy male participants. BMI was mathematically determined from the weight and height and was categorized as underweight, normal weight, overweight and obesity based on the WHO classification with values of <18.5, 18.5-24.9, 25.0-29.9, and ≥30 (Kg/m2) respectively. Blood samples were collected and analyzed for PSA and transrectal ultrasound scan was done to estimate the prostate volume and was used to calculate the prostate-specific antigen density. Results: Over 67% of participants had PSA values below 4.0 ng/ml, 14.8% between 4.0-10.0 ng/ml, and 18% above 10.0 ng/ml. Body mass index (BMI) assessment revealed that 1.6% of the sampled population had BMI <18.5 Kg/m2, 32.8% had BMI between 18.5 Kg/m2 and 24.9 Kg/m2, while 50.8% were noticed to have a BMI of between 25.0 Kg/m2 and 29.9 Kg/m2, and 14.8% had BMI of 30 Kg/m2 and above. Conclusion: There was an inverse correlation of BMI with prostate-specific antigen density (PSAD) and a direct correlation of age with PSAD in this study of Nigerian men.


2012 ◽  
Vol 35 (5) ◽  
pp. 490-492 ◽  
Author(s):  
Luke E. Pater ◽  
Kimberly W. Hart ◽  
Brian J. Blonigen ◽  
Christopher J. Lindsell ◽  
William L. Barrett

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Igor Yusim ◽  
Muhammad Krenawi ◽  
Elad Mazor ◽  
Victor Novack ◽  
Nicola J. Mabjeesh

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.


2006 ◽  
Vol 175 (4S) ◽  
pp. 486-487
Author(s):  
Maxwell V. Meng ◽  
Natalia Sadetsky ◽  
David M. Latini ◽  
Janeen Duchane ◽  
June M. Chan ◽  
...  

Cancer ◽  
2007 ◽  
Vol 109 (8) ◽  
pp. 1493-1498 ◽  
Author(s):  
Jason A. Efstathiou ◽  
Ming-Hui Chen ◽  
Andrew A. Renshaw ◽  
Marian J. Loffredo ◽  
Anthony V. D'Amico

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