The Clinical Utility of PSA Density for Early Detection of Prostate Cancer in Japanese Patients with Intermediate Total PSA Levels

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Background: We carried out to examine whether specific markers such as total PSA, gamma-seminoprotein (γ-Sm), γ-Sm density (γ-SmD), PSA density (PSAD), and the γ-Sm/total PSA ratio could be useful or not to predict prostate cancer in patients with intermediate total PSA levels in terms of reducing unnecessary biopsies. Patients and Methods: Between January 1998 and December 2002, 408 patients with suspected PCa underwent prostate biopsies in Aichi Medical University Hospital. Of these, 166 who had PSA levels ranged from 4.1 to 10ng/ml enrolled this study. Results: Histological analysis showed that 29 (17.5%) were positive for PCa. Average age was significantly higher for subjects with PCa than for those with benign prostate hyperplasia (BPH) (p<0.005). Prostate volume was significantly larger in patients with BPH than in patients with PCa (p<0.01). Values of γ-Sm and γ-Sm/total PSA were significantly lower (p<0.05, p<0.005) and PSAD was significantly higher (p<0.001) in PCa than in BPH. The areas under the receiver operating characteristic curve of γ-Sm, γ-Sm/total PSA and PSAD were 0.639, 0.665, and 0.699, and in multivariate logistic regression analysis revealed that PSAD was significantly different, with R^2=0.196 and p=0.0074. When the cutoff level for PSAD was set at 0.18, sensitivity and specificity were 89.7% and 39.7%, respectively. Conclusion: In subjects with a total PSA of 4.1-10ng/ml, PSAD was the most useful predictive factor for the diagnosis of Japanese patients with PCa and its optimum cutoff level was suggested to be 0.18.
愛知医科大学の論文
2005-12-15

The Clinical Utility of PSA Density for Early Detection of Prostate Cancer in Japanese Patients with Intermediate Total PSA Levels

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