Delta Prostate Specific Antigen (PSA) Helps to Predict Prostate Cancer in Men with Serum PSA Level above 4 ng/ml / 대한남성과학회지
Korean Journal of Andrology
;
: 123-128, 2007.
Artigo
em Coreano
| WPRIM
| ID: wpr-26499
ABSTRACT
PURPOSE:
Prostate biopsies have typically been performed on all patients with prostate specific antigen (PSA) levels above 4 ng/ml, however, the cancer detection rate is low. We would like to predict cancerous conditions of the prostate by developing a new PSA formula. MATERIALS ANDMETHODS:
Between July 2004 and July 2006, 93 patients with serum PSA levels above 4 ng/ml received extended prostate biopsies. The medical records of all patients - age, total/free PSA after/before prostate massage, final diagnoses of prostate biopsies - were reviewed retrospectively. We developed a new formula to calculate the delta PSA (total/free PSA after prostate massage - total/free PSA before prostate massage) / total/free PSA before prostate massage.RESULTS:
The patients were divided into two groups, the prostate cancer group (39 patients) and the benign disease group (54 patients). Mean total/free PSA for the benign disease group were 9.35/1.49 ng/ml (before) and 16.66/5.06 ng/ml (after), while values for the data of prostate cancer group were 21.02/2.43 ng/ml (before) and 24.61/4.40 ng/ml (after). The positive predictive value of the patients with PSA levels between 4 and 10 ng/ml was 32%; the positive predictive value of the patients with PSA levels above 10 ng/ml was 75%. The mean delta total/free PSA values for the benign disease and prostate cancer groups were 0.92/2.42 and 0.28/1.14, respectively. The cut off value of delta total/free PSA was below 0.5/2.0. Sensitivity, specificity, and positive predictive values for delta total PSA were 90% (95% confidence interval (CI), 80.2~99.3), 54% (95% CI, 41.4~67.7) and 58% (95% CI, 45.9~70.8), respectively. Sensitivity, specificity, and positive predictive values based on delta free PSA were 87% (95% CI, 76.7~97.7), 48% (95% CI, 36.7~63.3), and 56% (95% CI, 43.3~68.2), respectively.CONCLUSIONS:
We suggest that the use of delta total/free PSA in patients with serum PSA levels above 4 ng/ml may be helpful, not only to better detect prostate cancer, but also to reduce unnecessary prostate biopsies.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Próstata
/
Neoplasias da Próstata
/
Biópsia
/
Prontuários Médicos
/
Estudos Retrospectivos
/
Sensibilidade e Especificidade
/
Antígeno Prostático Específico
/
Diagnóstico
/
Massagem
Tipo de estudo:
Estudo diagnóstico
/
Estudo observacional
/
Estudo prognóstico
Limite:
Humanos
/
Masculino
Idioma:
Coreano
Revista:
Korean Journal of Andrology
Ano de publicação:
2007
Tipo de documento:
Artigo
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