The ratio of prostate‐specific antigen (PSA) to prostate volume (PSA density) as a parameter to improve the detection of prostate carcinoma in PSA values in the range of &lt; 4 ng/mL

Stephan, Carsten; Stroebel, Greta; Heinau, Marc; Lenz, André; Roemer, Andreas; Lein, Michael; Schnorr, Dietmar; Loening, Stefan A.; Jung, Klaus

doi:10.1002/cncr.21267

Cited by 60 publications

(35 citation statements)

References 72 publications

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“…The strength of our study relative to the previous studies relates to the consideration of very low tPSA values (2.5 ng/mL), as others were restricted to tPSA values higher than 2.0 ng/mL. [5][6][7]9,23,24 Therefore, our findings can be viewed as an extension of the previous reports, which extends the proof of %free PSA usefulness across virtually the entire range of tPSA values.…”

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confidence: 53%

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Percent free prostate‐specific antigen (PSA) is an accurate predictor of prostate cancer risk in men with serum PSA 2.5 ng/mL and lower

Walz

Haese

Scattoni

et al. 2008

Cancer

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BACKGROUND.Up to 17% of men with a prostate‐specific antigen (PSA) level below the accepted prostate biopsy cutoff of 2.5 ng/mL may have prostate cancer. Because identification of these patients represents a difficult task, we assessed the ability of percent free PSA to discriminate between benign and malignant prostate biopsy outcomes in men with PSA ≤2.5 ng/mL.METHODS.Between 1999 and 2006, 543 men with a PSA ≤2.5 ng/mL were referred for initial prostate biopsy. Age, total PSA, percent free PSA, and digital rectal examination findings represented predictors of prostate cancer at biopsy in logistic regression models. The area under the receiver operating characteristics curve (AUC) quantified the discriminative ability of the predictors. The pathological characteristics of the detected cancers were assessed in individuals treated with radical prostatectomy.RESULTS.Of all, 23% had prostate cancer on biopsy, 16.5% of patients treated with radical prostatectomy had pT3 stage, and 35.6% had a pathological Gleason score of 3 + 4 or higher. The most accurate predictor of prostate cancer on biopsy was percent free PSA (0.68) versus age (0.50), total PSA (0.57), or rectal examination findings (0.58). Of patients with percent free PSA below 14%, 59% had prostate cancer. In multivariate models, percent free PSA (P < .001) and rectal examination findings (P = .001) were the only independent predictors of prostate cancer. The combined AUC of all predictors (0.69) was not significantly (P = .7) higher than that of percentage of free PSA alone (0.68).CONCLUSIONS.The risk of prostate cancer is clearly non‐negligible in patients with PSA ≤2.5 ng/mL. The percent free PSA can accurately predict the prevalence of prostate cancer at prostate biopsy in these individuals. Cancer 2008. © 2008 American Cancer Society.

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Section: Figure 2 (A)mentioning

confidence: 53%

“…[6][7][8][9] Therefore, we investigated the value of %free PSA in predicting prostate cancer at prostate biopsy in men with a tPSA 2.5 ng/mL and compared it to other common prostate cancer predictors. Our analyses addressed potential %free PSA cutoffs that could help to identify men at an elevated risk of prostate cancer, despite tPSA 2.5 ng/mL.…”

mentioning

confidence: 99%

Percent free prostate‐specific antigen (PSA) is an accurate predictor of prostate cancer risk in men with serum PSA 2.5 ng/mL and lower

Walz

Haese

Scattoni

et al. 2008

Cancer

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“…Al-Azab, et al18 also reported that a smaller prostate size was associated with PCa patients with PSA of 2.0-9.0 ng/mL. Other studies also demonstrated significant differences in the prostate volume between the patients with and without PCa 19-21. High PSA levels are positively related to PCa at biopsy, but a large prostate volume has a negative relationship.…”

Section: Discussionmentioning

confidence: 94%

Role of Prostate Volume in the Early Detection of Prostate Cancer in a Cohort with Slowly Increasing Prostate Specific Antigen

et al. 2013

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PurposeTo investigate the relationship between prostate volume and the increased risk for being diagnosed with prostate cancer (PCa) in men with slowly increasing prostate specific antigen (PSA).Materials and MethodsA cohort of 1035 men who visited our hospital's health promotion center and were checked for serum PSA levels more than two times between January 2001 and November 2011 were included. Among them, 116 patients had a change in PSA levels from less than 4 ng/mL to more than 4 ng/mL and underwent transrectal ultrasound guided prostate biopsy. Median age was 55.9 years and 26 (22.4%) had PCa. We compared the initial PSA level, the last PSA level, age, prostate volume, PSA density (PSAD), PSA velocity, and follow-up period between men with and without PCa. The mean follow-up period was 83.7 months.ResultsSignificant predictive factors for the detection of prostate cancer identified by univariate analysis were prostate volume, follow-up period and PSAD. In the multivariate analysis, prostate volume (p<0.001, odds ratio: 0.890) was the most significant factor for the detection of prostate cancer. In the receiver operator characteristic curve of prostate volume, area under curve was 0.724. At the cut-off value of 28.8 mL for prostate volume, the sensitivity and specificity were 61.1% and 73.1% respectively.ConclusionIn men with PSA values more than 4 ng/mL during the follow-up period, a small prostate volume was the most important factor in early detection of prostate cancer.

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“…PSAD, PSA seviyesinin prostat hacmi ile olan korelasyonunu ifade eder. Literatürde prostat kanseri taramasında kullanılması üzerine farklı sonuç bildiren çalışmalar vardır [17][18][19]. Prostat epitel/stroma oranının değişken olması, prostat hacminin ölçümünün deneyim gerektirmesi PSAD'nin kullanılmasında sıkıntı oluşturmaktadır.…”

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Our Prostate Biopsy Results in The Patients with Prostate Specific Antigen Levels Below 4 ng/ml

Aydemi̇r¹

2015

Ann Clin Anal Med

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ÖzetAmaç: Bu çalışmada kliniğimizde prostat spesifik antijen (PSA) 4 ng/ml ve altında değerlere sahip hastaların transrektal ultrasonografi (TRUS) eşliğinde yapılmış olan prostat biyopsilerinin histopatolojik sonuçlarının değerlendiril-mesi amaçlandı. Gereç ve Yöntem: Kliniğimizde Ocak 2010-Şubat 2013 tarihleri arasında prostat kanseri şüphesi nedeniyle prostat biyopsisi yapılan 524 hastadan PSA değerleri 4 ng/ml ve altında olan 43 olgu histopatolojik sonuç-ları ile retrospektif olarak değerlendirildi. Bulgular: Hastaların yaş ortalaması 64.63 ±7.42 olup ortalama PSA değeri 2.89 ±0.88 ng/ml idi. Hastaların 41 (%95.34) 'inde parmakla rektal muayenede (PRM) şüpheli bulgu vardı. Hastaların biyopsi sonucunda 13 (%30.23) hastada prostat adenokarsinom tespit edildi. Bu hastaların ortalama PSA değerleri 2.52 ±1.21 ng/ml olup ortalama gleason skorları ise 6.41 ±0.87 idi. Ortalama prostat volümleri 41.46 ±11.95 cm3 olarak tespit edildi. Tartışma: Çalışmamızda PSA 4 ng/ml'nin altında %30.3 oranında prostat kanseri saptanmıştır. PRM, prostat değerlendi-rilmesinde halen önemini korumaktadır. Sonuçlarımız PSA 4 ng/ml'nin altında anlamlı sayıda kanser tespit edildiğini göstermektedir. Anahtar KelimelerProstat Kanseri; Prostat Spesifik Antijen; Prostat Biyopsi Abstract Aim: The aim of this study is to evaluate the re¬sults of prostate biopsy of patients who had the prostate-specific antigen (PSA) levels below 4 ng/ml. Material and Method: The medical records of 524 pa¬tients who underwent transrectal prostate biopsy be¬tween January 2010 and February 2013 in our clinic, due to suspi¬cion of prostate cancer were evaluated and histopathologic results of 43 patients whose PSA levels under 4 ng/ml were retrospectively revieved. Results: The mean age of patients was 64.63 ±7:42 and the mean level of PSA was 2.89 ±0.88ng /ml. A digital rectal examination (DRE) had suspicious findings in 41(95.34%) patients. Prostate adenocarcinoma was determined in 13 of (30.23%) patients according to the biopsy result. The mean PSA value of these patients was 2.89 ±0.88 ng/ml and the mean gleason score of these patients was 6.41 ±0.87. The mean prostate volume of these patients was 41.46 ±11.95 cm3. Discussion: In our study, prostate cancer was identified in 30.3% of patients whose PSA levels were below 4 ng/ml. DRE, is still important for the evaluation of the prostate. According to our results, significant number of cancers can be detected in PSA below 4 ng/ml levels.

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The ratio of prostate‐specific antigen (PSA) to prostate volume (PSA density) as a parameter to improve the detection of prostate carcinoma in PSA values in the range of < 4 ng/mL

Cited by 60 publications

References 72 publications

Percent free prostate‐specific antigen (PSA) is an accurate predictor of prostate cancer risk in men with serum PSA 2.5 ng/mL and lower

Percent free prostate‐specific antigen (PSA) is an accurate predictor of prostate cancer risk in men with serum PSA 2.5 ng/mL and lower

Role of Prostate Volume in the Early Detection of Prostate Cancer in a Cohort with Slowly Increasing Prostate Specific Antigen

Our Prostate Biopsy Results in The Patients with Prostate Specific Antigen Levels Below 4 ng/ml

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