✦ LIBER ✦

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

✍ Scribed by Carsten Stephan; Greta Stroebel; Marc Heinau; Andre Lenz; Andreas Roemer; Michael Lein; Dietmar Schnorr; Stefan A. Loening; Klaus Jung

Publisher: John Wiley and Sons
Year: 2005
Tongue: English
Weight: 236 KB
Volume: 104
Category: Article
ISSN: 0008-543X
DOI: 10.1002/cncr.21267

No coin nor oath required. For personal study only.

✦ Synopsis

Abstract

BACKGROUND

The objective of this study was to evaluate the prostate specific antigen (PSA) density (PSAD) (the quotient of PSA and prostate volume) compared with the percent free PSA (%fPSA) in different total PSA (tPSA) ranges from 2 ng/mL to 20 ng/mL. Possible cut‐off levels depending on the tPSA should be established.

METHODS

In total, 1809 men with no pretreatment of the prostate were enrolled between 1996 and 2004. Total and free PSA were measured with the IMMULITE PSA and Free PSA kits (Diagnostic Products, Los Angeles, CA). Prostate volume was determined by transrectal ultrasound. The diagnostic validity of tPSA, %fPSA, and PSAD was evaluated by receiver operation characteristic (ROC) curve analysis.

RESULTS

The PSAD differed significantly (P < 0.0001) between patients with prostate carcinoma and patients with benign prostatic hyperplasia in all analyzed ranges of tPSA and prostate volume. At the 90% and 95% sensitivity levels and regarding the area under the ROC curve (AUC) within the tPSA range of 2–4 ng/mL, The PSAD was significantly better than tPSA and %fPSA. Within the tPSA range of 4–10 ng/mL, the PSAD did not perform better than %fPSA.

CONCLUSIONS

PSAD showed a better performance than %fPSA at tPSA concentrations < 4 ng/mL for detecting prostate carcinoma, with a significantly larger AUC for PSAD (0.739) compared with %fPSA (0.667). PSAD did not perform better than %fPSA when the tPSA range of 4–10 ng/mL was analyzed. Different PSAD cut‐off values of 0.05 at tPSA 2–4 ng/mL, 0.1 at tPSA 4–10 ng/mL, and 0.19 at 10–20 ng/mL were necessary to reach 95% sensitivity. Cancer 2005. © 2005 American Cancer Society.

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