Ghafoori Mahyar, Varedi Peyman, Hosseini Seyed Jalil, Asgari Mojgan, Shakiba Madjid
Department of Radiology, Hazrat Rasoul Akram University Hospital, Iran University of Medical Sciences, Tehran, Iran.
Urol J. 2009 Summer;6(3):182-8.
The objective of this study was to evaluate the value of serum prostate-specific antigen (PSA) and prostate-specific antigen density (PSAD) in the diagnosis of prostate cancer.
A total of 330 consecutive patients suspected of having prostate cancer due to either abnormal digital rectal examination or elevated serum PSA levels underwent transrectal ultrasonography-guided sextant biopsy of the prostate. The PSA and PSAD values were assessed based on the biopsy results.
One hundred and twenty-one patients (36.7%) had prostate cancer. In this group, the mean PSA was 31.60 +/- 30.85 ng/mL (range, 1.9 ng/mL to 166.0 ng/mL) and the mean PSAD was 0.83 +/- 1.01 (range, 0.04 ng/mL/cm3 to 6.38 ng/mL/cm3). In those without prostate cancer the mean PSA and PSAD levels were 13.80 +/- 18.72 ng/mL (range, 0.4 ng/mL to 130.0 ng/mL; P < .001) and 0.24 +/- 0.32 (range of 0.01 ng/mL/cm3 to 2.29 ng/mL/cm3; P < .001). The receiver operating characteristic curve analysis revealed that the discriminating power of serum PSA for detecting prostate cancer, as estimated by the area under the curve, was 0.74 while that for PSAD was 0.81 (P < .001). For the PSA range of 3.5 ng/mL to 41 ng/mL (gray zone) the areas under the curve was 0.68 for PSA, while it was 0.78 for PSAD (P < .001).
The use of PSAD instead of PSA in the diagnosis of prostatic cancer improves the diagnostic accuracy.
本研究的目的是评估血清前列腺特异性抗原（PSA）和前列腺特异性抗原密度（PSAD）在前列腺癌诊断中的价值。
共有330例因直肠指检异常或血清PSA水平升高而疑似患有前列腺癌的连续患者接受了经直肠超声引导下的前列腺六分区活检。根据活检结果评估PSA和PSAD值。
121例患者（36.7%）患有前列腺癌。在该组中，平均PSA为31.60±30.85 ng/mL（范围为1.9 ng/mL至166.0 ng/mL），平均PSAD为0.83±1.01（范围为0.04 ng/mL/cm³至6.38 ng/mL/cm³）。在无前列腺癌的患者中，平均PSA和PSAD水平分别为13.80±18.72 ng/mL（范围为0.4 ng/mL至130.0 ng/mL；P<.001）和0.24±0.32（范围为0.01 ng/mL/cm³至2.29 ng/mL/cm³；P<.001）。受试者工作特征曲线分析显示，血清PSA检测前列腺癌的鉴别能力，以曲线下面积估计为0.74，而PSAD为0.81（P<.001）。对于3.5 ng/mL至41 ng/mL（灰色区域）的PSA范围，PSA的曲线下面积为0.68，而PSAD为0.78（P<.001）。
在前列腺癌诊断中使用PSAD而非PSA可提高诊断准确性。
