Prostate-specific antigen density — a reliable parameter for the detection of prostate cancer?
We compared the prostate-specific antigen density (PSAD) in clinically and surgically staged patients with specimen-confined prostate cancer (n=57) and in patients with benign hyperplasia (n=69), who underwent transvesical adenomectomy. The PSAD was calculated from the preoperative PSA level and the specimen volume. The prostate volume was determined by dividing the prostate weight by the specific gravity of the tissue. The mean tissue values used for PSAD calculation were 51.9 g in men with prostate cancer (PCA) and 62.9 g in men with benign prostatic hyperplasia (BPH). The PSAD values showed significant differences (BPH 0.19 versus PCA 0.37,P=0.029). Receiver operator characteristic (ROC) curves demonstrated the best cutoff value to be 0.15, with the sensitivity being 58%; the specificity, 51% and the positive predictive value of PCA, 49%. At a serum PSA level below 10 ng/ml, the best cutoff value was 0.1 and the positive predictive value was 51%. The PSAD results we calculated from an accurate prostate volume (surgical estimate) show that PSAD is not a significant predictor of prostate cancer.
KeywordsPublic Health Prostate Cancer Receiver Operator Characteristic Benign Prostatic Hyperplasia Specific Gravity
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- 2.Armitage P, Berry G (1987) Statistical methods in medical research, 2nd edn. Blackwell, OxfordGoogle Scholar
- 3.Aumüller G (1979) Prostate gland and seminal vesicles. Springer, New York Berlin Heidelberg, p 51Google Scholar
- 6.Bernard R (1990) Fundamentals of biostatistics. PWS, Boston, pp 442–450Google Scholar
- 15.Coffey DS (1992) The molecular biology, endocrinology, and physiology of the prostate and seminal vesicles. In: Walsh PC, Retik AB, Stamey TA, Vaughan ED Jr (eds) Campell's urology, 6th en. Vol 1, ch 6. Saunders, Philadelphia, p 225Google Scholar
- 21.Hosmer DW Jr, Lemeshow S (1989) Applied logistic regression. Wiley and Sons, New York, pp 1–7Google Scholar
- 23.Labrie F, Dupont A, Suburu R, Cusan L, Tremblay J, Gomez J-L, Emond J (1991) Serum prostate specific antigen as a prescreening test for prostate cancer. J Urol 147:846–852Google Scholar
- 35.Schmid HP, McNeal JE, Stamey TA (1992) Observation on the doubling time of prostate cancer: the use of serial prostate-specific antigen in patients with untreated disease as a measure of increasing cancer volume. Cancer 71:2031–2040Google Scholar
- 38.Stamey TA, Yang N, Hay AR, McNeal JE, Freiha F, Redwine E (1987) Prostate-specific antigen as a serum marker for adenocarcinoma of the prostate. N Engl J Med 317-909-916Google Scholar