The value of serum PSA subgroups and biopsy Gleason score in the prediction of pathologic stage of prostate cancer / 肿瘤

ABSTRACT

Objective: To evaluate the role of serum prostate specific antigen (PSA) subgroups and biopsy Gleason score in the prediction of pathologic stage of prostate cancer. Methods: Ninety two patients with prostate adenocarcinoma pathologically confirmed were retrospectively analyzed in the study. All the patients underwent radical prostatectomy and had preoperative tPSA, free PSA,free PSA/total PSA (fPSA/tPSA), PSA density (PSAD) and biopsy Gleason score. Each of the above parameters in patients with organ-confined disease were compared with that in patients with extraprostatic extension. The receiver operating characteristics (ROC) curve was used to analyze the performance of each of the above parameters to predict the pathologic stage;multivariate logistic regression analysis was used to select the main influencing factors of organ-confined disease. Results: PSAD, tPSA, fPSA/tPSA and biopsy Gleason score levels were higher in patients with extraprostatic extension than that in patients with organ-confined disease (P 0.7, P < 0.05]. Multivariate analysis revealed that only PSAD and biopsy Gleason score were the main influencing factors of organ-confined disease (P < 0.05), and multivariate model of AUC reached 0.80 (P = 0.000). Conclusion: PSAD was better than PSA in predicting pathological stage of organ-confined disease. Predictive models could consider using PSAD instead of tPSA. PSAD in combination with other factors was able to improve the predictive accuracy.