Yonsei Med J.  2013 Sep;54(5):1202-1206. 10.3349/ymj.2013.54.5.1202.

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

• Kim YM
• Park S
• Kim J
• Park S
• Lee JH
• Ryu DS
• Choi SH
• Cheon SH

• KMID: 1793168
• DOI: http://doi.org/10.3349/ymj.2013.54.5.1202

Abstract

PURPOSE
To 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 METHODS
A 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.
RESULTS
Significant 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.
CONCLUSION
In 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.

Keyword

Prostatic neoplasms; prostate-specific antigen; early diagnosis; organ size

MeSH Terms

Biopsy
Cohort Studies
Early Diagnosis
Humans
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Organ Size
Prostate/pathology/ultrasonography
Prostate-Specific Antigen/*blood
Prostatic Neoplasms/*pathology
Sensitivity and Specificity
Prostate-Specific Antigen

Figure

• 

  Fig. 1 Receiver operating characteristic curve for prostate volume. Area under curve was 0.724. At 28.8 mL of prostate volume, the sensitivity and the specificity were 61.1% and 73.1% respectively.

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