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The use of prostate specific antigen (PSA) density in detecting prostate cancer in Chinese men with PSA levels of 4–10 ng/mL

Journal of Cancer Research and Clinical Oncology volume 134, pages 1207–1210 (2008)Cite this article

Abstract

Aim

To investigate the utility of prostate specific antigen density for detecting prostate cancer in men with serum PSA levels of 4–10 ng/mL.

Methods

Between January 2003 and November 2007, 237 men (aged 48–84 years, median 71) with total PSA levels of 4–10 ng/mL participated in a protocol for prostate cancer screening. Eligible patients were recommended for transrectal ultrasonography (TRUS)-guided prostate biopsies after measuring prostate volumes transrectally. The diagnostic value of PSA levels and the free-to-total PSA ratio (f/tPSA), PSA densities (PSAD) were compared using receiver operating characteristic analysis.

Results

Prostate cancer was diagnosed in 44 (18.6%) of the 237 men who had biopsies. There were significant differences between the groups in the prostate volumes determined by TRUS, PSAD, PSA levels and f/tPSA, whereas there was no significant difference in patient age. The area under the curve (AUC) of PSA (0.6786) and PSAD (0.717) was similar and significantly greater than that of f/tPSA (AUC 0.329). PSAD was a significantly better indicator of prostate cancer than f/tPSA. The sensitivity and specificity of PSA density at a cutoff of 0.134 ng/mL2 was 90 and 33.7%, respectively.

Conclusion

PSAD was a better predictor of prostate cancer in Chinese men with PSA levels of 4–10 ng/mL, especially those who have had prior ultrasound-determined measurements of prostate volume. Our data suggest that different PSAD cutoffs may need to be defined for Chinese.

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Acknowledgments

We would like to thank Dr. Long-Cheng Li from the University of California San Francisco for critical reading of this manuscript and Drs. Xian-Hong Huang from the Department of Social Medicine and Health Service Management, Zhejiang University School of Medicine for assistance with statistical analysis.

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Affiliations

  1. Department of Urology, First Affiliated Hospital, Zhejiang University School of Medicine, 310003, Hangzhou, China

    Xiang-Yi Zheng, Li-Ping Xie, Yu-Yong Wang, Kai Yang, Hua-Feng Shen, Jie Qin, Yu Bai & Zhao-Dian Chen

  2. Department of Pathology, First Affiliated Hospital, Zhejiang University School of Medicine, 310003, Hangzhou, China

    Wei Ding

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  1. Xiang-Yi Zheng
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  2. Li-Ping Xie
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  5. Kai Yang
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  7. Jie Qin
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  8. Yu Bai
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  9. Zhao-Dian Chen
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Correspondence to Li-Ping Xie.

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Zheng, XY., Xie, LP., Wang, YY. et al. The use of prostate specific antigen (PSA) density in detecting prostate cancer in Chinese men with PSA levels of 4–10 ng/mL. J Cancer Res Clin Oncol 134, 1207–1210 (2008). https://doi.org/10.1007/s00432-008-0400-8

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  • DOI: https://doi.org/10.1007/s00432-008-0400-8

Keywords

  • Prostate specific antigen
  • Prostate specific antigen density
  • Transrectal biopsy
  • Prostate cancer