UP-02.219 Modified Cut-off Point of Total Prostate-Specific Antigen and Free-to-Total Prostate-Specific Antigen Ratio for Detecting Prostate Cancer: Sensitivity and Specificity Evaluation

Urology ◽  
2011 ◽  
Vol 78 (3) ◽  
pp. S337
Author(s):  
G. Pourmand ◽  
R. Ramezani ◽  
B. Sabahgoulian ◽  
F. Nadeali ◽  
A. Mehrsai ◽  
...  
Author(s):  
Fatih Bicaklioglu ◽  
Hasan Aydin ◽  
Ahmet Özgür Güçtaş ◽  
Hamit Zafer Aksoy

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


2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Nelson C. Okpua ◽  
Simon I. Okekpa ◽  
Stanley Njaka ◽  
Augusta N. Emeh

Abstract Background Being diagnosed with cancer, irrespective of type initiates a serious psychological concern. The increasing rate of detection of indolent prostate cancers is a source of worry to public health. Digital rectal examination and prostate-specific antigen tests are the commonly used prostate cancer screening tests. Understanding the diagnostic accuracies of these tests may provide clearer pictures of their characteristics and values in prostate cancer diagnosis. This review compared the sensitivities and specificities of digital rectal examination and prostate-specific antigen test in detection of clinically important prostate cancers using studies from wider population. Main body We conducted literature search in PubMed, Medline, Science Direct, Wiley Online, CINAHL, Scopus, AJOL and Google Scholar, using key words and Boolean operators. Studies comparing the sensitivity and specificity of digital rectal examination and prostate-specific antigen tests in men 40 years and above, using biopsy as reference standard were retrieved. Data were extracted and analysed using Review manager (RevMan 5.3) statistical software. The overall quality of the studies was good, and heterogeneity was observed across the studies. The result comparatively shows that prostate-specific antigen test has higher sensitivity (P < 0.00001, RR 0.74, CI 0.67–0.83) and specificity (P < 0.00001, RR 1.81, CI 1.54–2.12) in the detection of prostate cancers than digital rectal examination. Conclusion Prostate-specific antigen test has higher sensitivity and specificity in detecting prostate cancers from men of multiple ethnic origins. However, combination of prostate-specific antigen test and standardized digital rectal examination procedure, along with patients history, may improve the accuracy and minimize over-diagnoses of indolent prostate cancers.


2004 ◽  
Vol 45 (2) ◽  
pp. 160-165 ◽  
Author(s):  
Gunnar Aus ◽  
Charlotte Becker ◽  
Stefan Franzén ◽  
Hans Lilja ◽  
Pär Lodding ◽  
...  

2021 ◽  
Author(s):  
Lu Ma ◽  
Dong Cheng ◽  
Qinghua Li ◽  
Jingbo Zhu ◽  
Yu Wang ◽  
...  

Abstract Objective: To explore the predictive value of white blood cell (WBC), monocyte (M), neutrophil-to-lymphocyte ratio (NLR), fibrinogen (FIB), free prostate-specific antigen (fPSA) and free prostate-specific antigen/prostate-specific antigen (f/tPSA) in prostate cancer (PCa).Materials and methods: Retrospective analysis of 200 cases of prostate biopsy and collection of patients' systemic inflammation indicators, biochemical indicators, PSA and fPSA. First, the dimensionality of the clinical feature parameters is reduced by the Lass0 algorithm. Then, the logistic regression prediction model was constructed using the reduced parameters. The cut-off value, sensitivity and specificity of PCa are predicted by the ROC curve analysis and calculation model. Finally, based on Logistic regression analysis, a Nomogram for predicting PCa is obtained.Results: The six clinical indicators of WBC, M, NLR, FIB, fPSA, and f/tPSA were obtained after dimensionality reduction by Lass0 algorithm to improve the accuracy of model prediction. According to the regression coefficient value of each influencing factor, a logistic regression prediction model of PCa was established: logit P=-0.018-0.010×WBC+2.759×M-0.095×NLR-0.160×FIB-0.306×fPSA-2.910×f/tPSA. The area under the ROC curve is 0.816. When the logit P intercept value is -0.784, the sensitivity and specificity are 72.5% and 77.8%, respectively.Conclusion: The establishment of a predictive model through Logistic regression analysis can provide more adequate indications for the diagnosis of PCa. When the logit P cut-off value of the model is greater than -0.784, the model will be predicted to be PCa.


2020 ◽  
Vol 12 (01) ◽  
pp. 44-48
Author(s):  
Chandan Kumar Nath ◽  
Bhupen Barman ◽  
Pranjal Phukan ◽  
Stephen L. Sailo ◽  
Biswajit Dey ◽  
...  

Abstract Background Determination of isolated prostate-specific antigen (PSA) in asymptomatic individuals has not demonstrated sufficient sensitivity and specificity to be useful in the routine evaluation of prostate disease. To enhance the accuracy of serum PSA we have used a proportion of serum PSA and prostate volume, which we refer to as prostate-specific antigen density (PSAD). Prostate volume in this study was calculated using transrectal ultrasonography (TRUS). Materials and Methods A total of 106 patients with prostatic disease clinically confined to the prostate glands were evaluated. Results and Observation The mean PSAD for prostate cancer was 0.15 ± 0.01 while that for benign hypertrophy of the prostate (BPH) was 0.11 ± 0.02 (p < 0.05). Significant difference (p < 0.05) was noted in the prostate volume in these two groups with the mean prostate volume measured by TRUS in the BPH to be 53.85 ± 9.71 mL compared with 58.14 ± 7.48 mL in the carcinoma. PSA density of 0.13 ng/mL can be used as a cutoff for the individual in our set-up who should go for prostate biopsy with sensitivity and specificity of over 90%. Conclusion These results suggest that PSAD may be useful in distinguishing BPH and prostate cancer.


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