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- Title
Value of prostate-specific antigen (PSA) mass ratio in the detection of prostate cancer in men with PSA levels of ≤10 ng/mL.
- Authors
Hong, Sung Kyu; Oh, Jong Jin; Byun, Seok-Soo; Hwang, Sung Il; Choo, Min Soo; Lee, Sang Eun
- Abstract
Study Type - Diagnostic (exploratory cohort) Level of Evidence 2b What's known on the subject? and What does the study add? A group of researchers introduced a parameter named PSA mass ratio, which is defined as total circulating PSA protein (PSA [ng/mL] x plasma volume [L]) per prostate volume, as a prostate cancer screening tool. They suggested that PSA mass ratio may be representative of a PSA value adjusted for potentially influencing factors, such as haemodilution and prostate volume. By adjusting for the combined effects of plasma volume and prostate volume, it can be hypothesized that PSA mass ratio would enhance the predictive value of the PSA test. Although PSA mass ratio appears to be an attractive alternative to serum PSA level, PSA mass ratio may not significantly enhance the currently available method to predict prostate cancer detection among men with PSA level of ≤10 ng/mL who are undergoing prostate biopsy. OBJECTIVE To investigate the value of prostate-specific antigen (PSA) mass ratio, defined as total PSA in circulation per prostate volume (PV), in the prediction of prostate cancer detection among men with PSA levels of ≤10 ng/mL who are undergoing prostate biopsy., PATIENTS AND METHODS We reviewed records of 2431 men aged 56-80 years who presented with PSA levels of ≤10 ng/mL and underwent multi (≥12)-core transrectal ultrasound-guided prostate biopsy at our institution., Predictive accuracies of relevant variables and multivariate models in the prostate cancer detection via biopsy were assessed with receiver operating characteristics-derived area under the curve and compared., RESULTS When compared one-on-one, PSA mass ratio had a significantly higher accuracy than PSA in the prediction of prostate cancer among our subjects (0.638 vs 0.565, P < 0.001)., Meanwhile, when multivariable model for the prediction of prostate cancer detection via prostate biopsy was devised incorporating patient age, body mass index, digital rectal examination findings, PV, number of biopsy cores, and PSA level, the replacement of PSA level with PSA mass ratio ( P= 0.102) or the addition of PSA mass ratio ( P= 0.164) in the model was not associated with significantly increased accuracy of model for predicting prostate cancer detection via biopsy., CONCLUSION Although PSA mass ratio appears to be an attractive alternative to PSA level, PSA mass ratio may not significantly enhance the currently available method to predict prostate cancer detection among men with PSA levels of ≤10 ng/mL who are undergoing prostate biopsy.
- Subjects
PROSTATE cancer; DIAGNOSIS; PROSTATE-specific antigen; CANCER patients; HEMODILUTION; BIOPSY; MULTIVARIATE analysis
- Publication
BJU International, 2012, Vol 110, Issue 2b, pE81
- ISSN
1464-4096
- Publication type
Article
- DOI
10.1111/j.1464-410X.2011.10764.x