Wang Fangming, Fu Meng, Tang Yuzhe, Li Jianxing
Department of Urology, Tsinghua University Affiliated Beijing Tsinghua Changgung Hospital, Tsinghua University Clinical Institute, Beijing, China.
Front Oncol. 2024 Oct 2;14:1462997. doi: 10.3389/fonc.2024.1462997. eCollection 2024.
To investigate the value of adjusted prostate-specific antigen density (PSAD) in the diagnosis of prostate cancer (PCa).
Data from 410 patients who underwent transrectal ultrasound-guided prostate biopsy were retrospectively analyzed in Beijing Tsinghua Changgung Hospital between November 2014 and March 2024. All patients were divided into PCa and benign prostatic hyperplasia (BPH) groups according to pathological results. Multivariate logistic regression analyses were performed to evaluate the odd ratios (ORs) of predictors for PCa occurrence. Receiver operating characteristic curves were plotted, and the area under the curve (AUC) values were used to assess and compare the diagnostic accuracies of total PSA (tPSA), free-to-total (f/t) PSA, free PSA (fPSA), PSAD, and PSAD (PSAD×weight).
There were 166 patients in the PCa group and 244 in the BPH group. Multivariate analyses demonstrated that PSAD was positively correlated with the presence of PCa, with the highest OR value among all PSA-related parameters (OR = 19.075, <0.001). tPSA, fPSAD, PSAD, and PSAD had high accuracy in predicting PCa, with AUC values of 0.633, 0.730, 0.778, and 0.780. Of note, PSAD had the highest AUC with a sensitivity of 63.3% and specificity of 81.6%. Similarly, in patients with a PSA level in the gray zone, the diagnostic accuracy of PSAD in predicting PCa (AUC, 0.709; 95% CI, 0.616-0.802) remained better than other PSA-related markers.
PSAD has an advantage over other PSA-related markers in detecting PCa and could be used for making biopsy decisions.
探讨校正前列腺特异性抗原密度（PSAD）在前列腺癌（PCa）诊断中的价值。
回顾性分析2014年11月至2024年3月在北京清华长庚医院接受经直肠超声引导下前列腺穿刺活检的410例患者的数据。所有患者根据病理结果分为PCa组和良性前列腺增生（BPH）组。进行多因素逻辑回归分析以评估PCa发生预测指标的比值比（OR）。绘制受试者工作特征曲线，并使用曲线下面积（AUC）值评估和比较总前列腺特异性抗原（tPSA）、游离与总前列腺特异性抗原比值（f/t）PSA、游离前列腺特异性抗原（fPSA）、PSAD以及PSAD（PSAD×体重）的诊断准确性。
PCa组有166例患者，BPH组有244例患者。多因素分析表明，PSAD与PCa的存在呈正相关，在所有与PSA相关的参数中OR值最高（OR = 19.075，<0.00）。tPSA、fPSAD、PSAD以及PSAD在预测PCa方面具有较高的准确性，AUC值分别为0.633、0.730、0.778和0.780。值得注意的是，PSAD的AUC最高，敏感性为63.3%，特异性为81.6%。同样，在PSA水平处于灰色区域的患者中，PSAD预测PCa的诊断准确性（AUC，0.709；95%CI，0.616 - 0.802）仍然优于其他与PSA相关的标志物。
PSAD在检测PCa方面优于其他与PSA相关的标志物，可用于指导活检决策。
