scholarly journals Prostate-Specific Antigen Density: A Measurement to Differentiate Benign Hypertrophy of Prostate from Prostate Carcinoma

2020 ◽  
Vol 12 (01) ◽  
pp. 44-48
Author(s):  
Chandan Kumar Nath ◽  
Bhupen Barman ◽  
Pranjal Phukan ◽  
Stephen L. Sailo ◽  
Biswajit Dey ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Sensitivity And Specificity ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Prostate Specific Antigen Density ◽  
Significant Difference ◽  
The Mean ◽  
Set Up ◽  
The Individual

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.

scholarly journals The Initial Application of MRI Based Prostate Volume-Adjusted Prostate-Specific Antigen In The Diagonosis of MRI-Positive Prostate Cancer Patients

2021 ◽  
Author(s):  
Jiemin Si ◽  
Mingzhuo Li ◽  
Nailong Cao ◽  
Baojun Gu
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Transition Zone ◽  
Sensitivity And Specificity ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Receiver Operating Curve ◽  
Pathological Stage ◽  
Prostate Biopsies ◽  
Prostate Specific Antigen Density

Abstract Purpose: To identify the value of prostate-specific antigen density (PSAD) and prostate-specific antigen density of the transition zone (PSADTZ) in improving the sensitivity and specificity of the prostate multiparameter magnetic resonance imaging (mp-MRI), for the purpose of predicting prostate cancer (PCa) and grade reclassification in men with prostate-specific antigen (PSA) between 4 and 20 ng/mL to reduce unnecessary prostate biopsies. Patients and Methods: Between 2018 and 2020, we retrospectively identified 283 consecutive men in Shanghai Jiao Tong University Affiliated Sixth People’s Hospital who had mp-MRI and PSA test within 3 months before prostate biopsies. Total prostate volume (TPV) and transition zone volume (TZV) were measured on mp-MRI. PSA, PSAD, and PSADTZ were compared to improve the sensitivity and specificity of positive biopsy cores and pathological stage by univariate analyses and through the receiver operating curve (ROC). We were focused primarily on the MRI-positive patients with PSA levels of 4-20ng/ml who were most likely subjected to unnecessary repeated prostate biopsies. Results: Of the 283 patients, 138 (48.8%) had PCa and in 145 (51.2%) a benign prostate disease was diagnosed. PSA, PSAD, and PSADTZ were significantly related to biopsy, and equally able to predict higher pathological stage. The receiver operating curve (AUC) for predicting the presence of PCa in all patients was 58.06 for PSA, 72.13 for PSAD and 78.28 for PSADTZ. In addition, the AUC for predicting higher pathological stage in PCa patients was 65.71 for PSA, 65.46 for PSAD and 69.81 for PSADTZ. For 228 MRI-positive patients, the AUC for predicting the presence of PCa was 61.31 for PSA, 74.00 for PSAD and 80.13 for PSADTZ. No difference among the PSA, PSAD, and PSADTZ was found in 55 MRI-negative patients. Conclusion: The determination of PSADTZ had higher diagnostic accuracy for PCa than that based on PSA or PSAD. For MRI-positive patients, PSADTZ promote a more effective and simple method for PCa detection, and may be useful for decreasing the burden of surveillance prostate biopsies.

Can the PSAD (Prostate Specific Antigen Density) be Useful in the Diagnosis of Prostate Carcinoma?

1993 ◽  
Vol 60 (4) ◽  
pp. 307-308
Author(s):  
E. Gastaldi ◽  
S. Benvenuti ◽  
B. Mennini ◽  
M. Iacoviello ◽  
M. Caviglione ◽  
...  
Keyword(s):  
Prostate Specific Antigen ◽  
Sensitivity And Specificity ◽  
Prostate Carcinoma ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Prostate Specific Antigen Density

PSA (prostate specific antigen) has not demonstrated sufficient sensitivity and specificity to be useful in the evaluation of prostate carcinoma. To enhance the accuracy of serum PSA the Authors have used a quotient of serum PSA (ng/ml) and prostate volume (calculated by transrectal ultrasound) which is named PSAD (prostate specific antigen density).

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.

Lack of Effect of a Low-Fat, High-Fruit, -Vegetable, and -Fiber Diet on Serum Prostate-Specific Antigen of Men Without Prostate Cancer: Results From a Randomized Trial

2002 ◽  
Vol 20 (17) ◽  
pp. 3592-3598 ◽  
Author(s):  
Moshe Shike ◽  
Lianne Latkany ◽  
Elyn Riedel ◽  
Martin Fleisher ◽  
Arthur Schatzkin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Fruits And Vegetables ◽  
Dietary Intervention ◽  
Specific Antigen ◽  
Intervention Group ◽  
Control Group ◽  
Serum Prostate Specific Antigen ◽  
Significant Difference ◽  
The Individual

PURPOSE: To determine whether a diet low in fat and high in fruits, vegetables, and fiber may be protective against prostate cancer by having an impact on serial levels of serum prostate-specific antigen (PSA). METHODS: Six hundred eighty-nine men were randomized to the intervention arm and 661 to the control arm. The intervention group received intensive counseling to consume a diet low in fat and high in fiber, fruits, and vegetables. The control group received a standard brochure on a healthy diet. PSA in serum was measured at baseline and annually thereafter for 4 years, and newly diagnosed prostate cancers were recorded. RESULTS: The individual PSA slope for each participant was calculated, and the distributions of slopes were compared between the two groups. There was no significant difference in distributions of the slopes (P = .99). The two groups were identical in the proportions of participants with elevated PSA at each time point. There was no difference in the PSA slopes between the two groups (P = .34) and in the frequencies of elevated PSA values for those with elevated PSA at baseline. Incidence of prostate cancer during the 4 years was similar in the two groups (19 and 22 in the control and intervention arms, respectively). CONCLUSION: Dietary intervention over a 4-year period with reduced fat and increased consumption of fruits, vegetables, and fiber has no impact on serum PSA levels in men. The study also offers no evidence that this dietary intervention over a 4-year period affects the incidence of prostate cancer during the 4 years.

scholarly journals Can we expand the borders in active surveillance for low-risk prostate cancer?

2018 ◽  
Vol 12 (1) ◽  
pp. 54-59
Author(s):  
Ekrem Islamoglu ◽  
Erdem Kisa ◽  
Cem Yucel ◽  
Orcun Celik ◽  
Ozgur Cakmak ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Active Surveillance ◽  
Specific Antigen ◽  
Low Risk ◽  
Significant Difference ◽  
Risk Prostate Cancer ◽  
Low Risk Prostate Cancer ◽  
The Mean

Purpose: We assessed the outcomes of men with low-risk prostate cancer enrolled in active surveillance. Methods: From January 2008, patients in our clinic who were classified as having low-risk prostate cancer according to the D’Amico classification were included in the protocol. Follow-up consisted of regular prostate-specific antigen tests, digital rectal examinations and biopsies. Outcomes were compared between men who progressed and those who did not, and survival analysis was obtained. Results: The mean follow-up period was 46 months. A total of six patients received curative treatment during follow-up as a result of meeting progression criteria. The mean follow-up time from the beginning of active surveillance until curative therapy was 27.1 months. Four of our 64 patients lost their lives due to diseases other than prostate cancer, none of the patients were lost due to prostate cancer. When patients who showed progression and those who did not were compared in terms of positive core numbers and the core tumour percentage we found no significant difference between the two groups ( P>0.05) Conclusion: Active surveillance seems to be a safe and feasible practice in men with low-risk prostate cancer. Gleason score, clinical stage and initial prostate-specific antigen seem to be the most definite criteria for the selection of patients, while it is thought that the number of positive cores is a matter that can be dealt with more flexibility. Level of evidence: Not applicable for this multicentre audit.

Clinical Usefulness of Prostate Specific Antigen and Prostate Specific Antigen Density to Distinguish Benign from Malignant Prostate Diseases

1994 ◽  
Vol 61 (4) ◽  
pp. 289-293
Author(s):  
C. Terrone ◽  
E. Vestita ◽  
A. Formigoni ◽  
S. Rocca Rossetti ◽  
G. Aimo
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Three Dimensions ◽  
Surgical Specimen ◽  
Prostate Specific Antigen Density ◽  
Prostate Diseases ◽  
Malignant Prostate

The possibility of distinguishing prostate cancer from BPH with the prostate specific antigen (PSA) determination is particularly poor when PSA levels are between 4.1 and 10 ng/ml. In these cases the quotient of serum PSA and prostate volume, defined as prostate specific antigen density (PSAD), seems to enhance the accuracy of PSA alone. In this study we evaluated retrospectively the preoperative PSA levels in 139 patients with BPH and in 26 patients with prostate cancer who underwent surgical treatment at our Department. We calculated the prostate volume with the following formula: length x width x depth x 0.52. The three dimensions were obtained from the surgical specimen in the patients with prostate cancer and using transrectal ultrasound in the cases of BPH. In patients with a serum PSA level of 4.1 to 10 ng/ml, PSA alone was not able to distinguish benign from malignant prostate disease; the PSAD values, on the contrary, provided a statistically significant (p < 0.003) stratification between BPH and prostate cancer (mean PSAD of 0.0088 and 0.191 respectively). Only 6% of patients with BPH had a PSAD greater than 0.15 compared to 76% of patients with prostate cancer. These results suggest the usefulness of PSAD in predicting the presence of prostate cancer in patients with intermediate levels of serum PSA.

Sign in / Sign up

Export Citation Format

Share Document