Contribution of prostate-specific antigen density in the prediction of prostate cancer: does prostate volume matter?

2018 ◽  
Vol 60 (1) ◽  
pp. 14
Author(s):  
Murat Zor ◽  
Engin Kaya ◽  
Selahattin Bedir
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Prostate Specific Antigen Density

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 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.

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.

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.

scholarly journals Addition of Prostate Volume and Prostate-specific Antigen Density to Memorial Sloan Kettering Cancer Center Prostate Cancer Nomograms

2021 ◽  
Vol 30 ◽  
pp. 13-15
Author(s):  
Michael Tzeng ◽  
Emily Vertosick ◽  
Spyridon P. Basourakos ◽  
James A. Eastham ◽  
Behfar Ehdaie ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Prostate Volume ◽  
Specific Antigen ◽  
Cancer Center ◽  
Prostate Specific Antigen Density
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