Wang Xin, Sun Jinxiao, Xu Dandan, Zhu Hao
Department of Ultrasound, Wuxi Second Hospital of Traditional Chinese Medicine, Wuxi, Jiangsu, China.
Department of Ultrasound, Guangzhou 11th People's Hospital, Guangzhou, Guangdong, China.
Discov Oncol. 2025 Aug 19;16(1):1583. doi: 10.1007/s12672-025-03402-5.
This study aimed to enhance prostate cancer (PCa) detection in patients with prostate-specific antigen (PSA) levels within the "gray zone" (4-10 ng/mL) by comparing PSA density (PSAD) calculations derived from the traditional ellipsoid formula (TEF) and the biproximate ellipsoid formula (BPEF).
A total of 99 patients were enrolled. All participants underwent transrectal ultrasound (TRUS) for prostate volume estimation, followed by PSAD calculation using both the BPEF and TEF methods. The BPEF method, which incorporates well-defined anatomical landmarks, was assessed for its accuracy in prostate volume measurement and diagnostic performance for PCa compared to TEF. Inter- and intra-observer consistency were also evaluated for both approaches.
Both BPEF and TEF reliably measured prostate volume, however, BPEF demonstrated superior accuracy and higher consistency in inter- and intra-observer assessments. PSAD calculated using BPEF (BPEF-PSAD) exhibited significantly greater diagnostic performance than TEF-PSAD, with an area under the curve (AUC) of 0.84. At the optimal diagnostic threshold of 0.15 ng/mL/cm³, BPEF-PSAD achieved a sensitivity of 88.89% and a specificity of 74.60%, enhancing the discrimination between PCa and benign prostatic hyperplasia (BPH). Multivariate logistic regression analysis identified BPEF-PSAD as an independent predictor of PCa.
The study concluded that the BPEF method, when combined with TRUS, improves the accuracy of PSA density measurements, potentially reducing unnecessary biopsies in patients with intermediate PSA levels, particularly in cases where MRI is unavailable or contraindicated.
本研究旨在通过比较传统椭球体公式（TEF）和双近似椭球体公式（BPEF）得出的前列腺特异抗原（PSA）密度（PSAD）计算结果，提高前列腺特异抗原水平处于“灰色区域”（4 - 10 ng/mL）的患者的前列腺癌（PCa）检测率。
共纳入99例患者。所有参与者均接受经直肠超声（TRUS）以估计前列腺体积，随后使用BPEF和TEF方法计算PSAD。与TEF相比，评估了纳入明确解剖标志的BPEF方法在前列腺体积测量中的准确性以及对PCa的诊断性能。还评估了两种方法在观察者间和观察者内的一致性。
BPEF和TEF均能可靠地测量前列腺体积，然而，BPEF在观察者间和观察者内评估中显示出更高的准确性和一致性。使用BPEF计算的PSAD（BPEF - PSAD）的诊断性能显著高于TEF - PSAD，曲线下面积（AUC）为0.84。在最佳诊断阈值0.15 ng/mL/cm³时，BPEF - PSAD的灵敏度为88.89%，特异度为74.60%，增强了对PCa和良性前列腺增生（BPH）的鉴别能力。多因素逻辑回归分析确定BPEF - PSAD为PCa的独立预测因子。
该研究得出结论，BPEF方法与TRUS结合使用时，可提高PSA密度测量的准确性，有可能减少PSA水平处于中等范围的患者不必要的活检，特别是在无法进行或禁忌进行MRI检查的情况下。
