ISSN: 0970-938X (Print) | 0976-1683 (Electronic)

Biomedical Research

An International Journal of Medical Sciences


Free prostate specific antigen density predicts prostate cancer with high accuracy

Although serum Prostate Specific Antigen (PSA) has greatly improved the detection of human prostate cancer (PCa), one limitation of the test is that increased serum PSA is also associated with other benign prostate conditions. Biopsy specimens and clinical data from patients at risk for PCa (n=303) were retrospectively analysed by PSA density (PSAD) and fPSAD. Receiver Operating Characteristic (ROC) curves were used to calculate the areas under the ROC curves (AUCs) and to determine sensitivity and specificity of the various PSA parameters in the detection of PCa. The cohort included cases of PCa (n=112; 37.0%) and benign prostatic hyperplasia (BPH; n=191; 63.0%). The mean age, total prostate volume, tPSA, PSA (%), PSAD and fPSAD of patients diagnosed with PCa were significantly higher than in patients with BPH (P<0.05). The AUCs for tPSA, PSA (%), PSAD and fPSAD were 85.6%, 33.1%, 89.6% and 84.9%, respectively. The threshold value of 0.033 for fPSAD had a maximum Youden’s index of 0.675, a sensitivity of 75.9% and a specificity of 91.6%. The agreement of fPSAD with histological diagnosis at 85.8% was the highest compared to tPSA, PSA (%) or PSAD. In conclusion, the results demonstrated fPSAD as having discriminative predictive power for diagnosis of PCa.

Author(s): Fu-Xiang Lin, Liang Zhao, Jiu-Min Liu, Jian-Xin Lai, Ke-Lin Lai, Lin-Sun Lin, Huan-Zhang Kang, Hui Cao, Yun Yu, Hai-Ping You, Kunpeng Wu, Wei-Zhong Yang
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