The Usefulness of PSA Adjusted for the Transition Zone Volume

Kim, Hyun Hag; Kwon, Dong Deuk; Oh, Bong Ryoul; Park, Kwang sung; Ryu, Soo Bang; Park, Yang Il

Abstract

This study is to assess the usefulness of prostate specific antigen adjusted for the transition zone volume (PSAT) in diagnosing prostate cancer in men with normal digital rectal examination and intermediate PSA levels of 4.1 to 10.0ng/ml. PSAT was obtained from 58 patients who had a PSA of 4.1-10.0ng/ml and underwent transrectal ultrasound-guided biopsy of prostate. During the period between July 1998 and December 2000. All had prostates that gave no suspicion of carcinoma on digital rectal examination. Of 58 patients, 6 (10.3%) had prostate cancer and 52 (89.7%) had benign prostatic hyperplasia on pathologic examination. Mean PSA, F/T ratio, PSAD and PSAT were 6.21+/-1.19ng/ml 0.19+/-0.09, 0.23+/-0.07ng/ml/cc and 0.68+/-0.37ng/ml/cc in patients with prostate cancer, and 6.40+/-1.69ng/ml, 0.22+/-0.10, 0.15+/-0.06ng/ml/cc and 0.26+/-0.16ng/ml/cc in patients with benign prostatic hyperplasia, respectively. Receiver operating characteristic curve analysis demonstrated that PSAD and PSAT predicted the biopsy outcome significantly better than PSA (p<0.05), and PSAT predicted better than PSAD (p<0.05). These results suggest that PSAT is more accurate than PSA and PSAD in distinguishing benign prostatic disease from prostatic cancer in men with intermediate PSA levels of 4.1 to 10ng/ml. But large prospective studies are needed to assess the precise role of PSAT in early prostate cancer detection.