Prostate cancer detection by prostate-specific antigen-related parameters

Area of Science:

• Urology
• Oncology
• Diagnostic Imaging

Background:

• Prostate-specific antigen (PSA) is a key biomarker for prostate cancer (CaP).
• Intermediate PSA levels (4-10 ng/ml) present diagnostic challenges.
• Differentiating between CaP and benign conditions is crucial.

Purpose of the Study:

• To compare the diagnostic utility of PSA density (PSAD), free-to-total PSA ratio (F/T ratio), and total PSA.
• To evaluate these parameters in patients with intermediate PSA concentrations.
• To determine the most effective biomarker for CaP diagnosis in this group.

Main Methods:

• Retrospective analysis of 43 patients with intermediate PSA levels (4-10 ng/ml).
• Ultrasound-guided systematic sextant biopsies were performed.
• Receiver operating characteristic (ROC) curve analysis compared PSAD, F/T ratio, and total PSA.

Main Results:

• PSA density (PSAD) significantly outperformed F/T ratio and total PSA in predicting biopsy outcomes (p < 0.05).
• A PSAD cutoff of 0.16 ng/ml/cm³ achieved 83.3% sensitivity and 71.0% specificity for CaP detection.
• Mean PSAD was higher in CaP patients (0.271 ng/ml/cm³) compared to non-CaP patients (0.178 ng/ml/cm³).

Conclusions:

• PSA density (PSAD) is a superior diagnostic marker for prostate cancer in men with intermediate PSA levels.
• PSAD aids in distinguishing CaP from non-CaP, improving diagnostic accuracy.
• This study highlights the clinical significance of PSAD in Japanese men.