Korean J Urol.  2006 Nov;47(11):1161-1165. 10.4111/kju.2006.47.11.1161.

Clinical Significance of Prostate-Specific Antigen Density in Patients with Serum Prostate Specific Antigen between 4 and 10ng/ml

• Kim BK
• Chang HS
• Kim CI

• KMID: 2294273
• DOI: http://doi.org/10.4111/kju.2006.47.11.1161

Abstract

Purpose
To examine the usefulness of the prostate-specific antigen (PSA) density for selection of biopsy candidates with serum PSA levels between 4-10ng/ml, and determine the optimal PSA density (PSAD) cut off value for use in clinical practice.
Materials and Methods
We retrospectively enrolled 705 patients with serum PSA levels between 4-10ng/ml. The patients were divided into the prostate cancer and the non-prostate cancer groups. The PSA level and PSAD in predicting prostate cancer were compared. A receiver operating characteristic (ROC) curve was generated, and utilized to evaluate the optimal PSAD cut off value.
Results
One hundred and nineteen and five hundred and eighty six patients had prostate and non-prostate cancers, respectively, on pathological examination. The mean PSA values were not significantly different; 6.9 and 7.0ng/ml, respectively (p>0.05). However, the mean PSAD values were 0.168 and 0.213ng/ml/cc; significantly higher in the prostate cancer group than the BPH group (p<0.05). The ROC curves for the PSA level and PSAD demonstrated superior benefit for the PSAD. The sensitivity, specificity and positive predictive values of a PSAD cut off of 0.15ng/ml/ cc were 73.1, 45.9 and 21.5%, respectively. A PSAD cut off of 0.17ng/ml/cc showed the highest sensitivity and specificity, with sensitivity, specificity and positive predictive values of 63.9, 59.2 and 24.1%, respectively.
Conclusions
The PSAD seems to be useful in the selection of biopsy candidates with serum PSA levels between 4-10ng/ml, and a PSAD cut off of 0.17ng/ml/cc would seem to be preferable to 0.15ng/ml/cc.

Keyword

Prostate cancer; Prostate-specific antigen

MeSH Terms

Biopsy
Humans
Prostate*
Prostate-Specific Antigen*
Prostatic Neoplasms
Retrospective Studies
ROC Curve
Sensitivity and Specificity
Prostate-Specific Antigen

Figure

• 

  Fig. 1 Receiver operating characteristic curves of the prostate-specific antigen density (PSAD) and level of prostate-specific antigen (PSA).

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