The Value of Prostate-Specific Antigen-Related Indexes and Imaging Screening in the Diagnosis of Prostate Cancer.
benign prostatic hyperplasia
free prostate-specific antigen
prostate cancer
prostate-specific antigen density
total prostate-specific antigen
Journal
Cancer management and research
ISSN: 1179-1322
Titre abrégé: Cancer Manag Res
Pays: New Zealand
ID NLM: 101512700
Informations de publication
Date de publication:
2020
2020
Historique:
received:
10
04
2020
accepted:
07
07
2020
entrez:
18
8
2020
pubmed:
18
8
2020
medline:
18
8
2020
Statut:
epublish
Résumé
The aim of this study was to explore the value of the prostate-specific antigen (PSA) levels, the ratio of free PSA to total PSA (fPSA/TPSA), the PSA density (PSAD), digital rectal examination (DRE), transrectal prostate ultrasound (TRUS), and multiparameter MRI (MP-MRI) in the differential diagnosis of benign prostatic hyperplasia (BPH) and prostate cancer (PCa). From February 2016 to September 2019, data from 620 patients who underwent systematic transrectal ultrasound-guided prostate biopsy (STURS-PB) in our hospital were retrospectively collected, including the PSA levels, the fPSA/TPSA ratio, the PSAD, DRE, TRUS, MP-MRI, prostate volume, and other clinical data. Among the 620 patients, 249 patients were in the PCa group, and 371 patients in the BPH group. The positive puncture rate was 40.16%. The positive predictive values of DRE, TRUS, mpMRI, and TPSA levels for PCa were 39.91%, 39.38%, 64.14%, and 41.57%, respectively; the sensitivity of these parameters was 37.35%, 51.41%, 74.69%, and 57.43%, respectively; and the specificity of these parameters was 62.26%, 46.90%, 71.97%, and 45.82%, respectively. When the TPSA concentration was in the range of 4-20 ng/mL, the positive puncture rate of STURS-PB was 23.18%, with a high rate of misdiagnosis. When the TPSA concentration was in the range of 4-20 ng/mL, the fPSA/TPSA ratio was 0.15, the PSAD was 0.16, the comprehensive evaluation of PCa was optimal (the sensitivity of these parameters was 88.85% and 84.09%, respectively; the specificity was 80.17% and 67.29%, respectively; the positive predictive value was 57.41% and 51.39%, respectively). When the TPSA concentration >4 ng/mL, the fPSA/TPSA ratio ≤0.15 and the PSAD ≥0.16, the sensitivity, specificity, and correctness index of the PCa and BPH diagnosis were 80.54%, 82.75%, and 67.07%, respectively. When using DRE, TRUS, and MP-MRI to screen for PCa, MP-MRI has a relatively high sensitivity and specificity. Using these three thresholds (TPSA >4 ng/mL combined with an fPSA/TPSA ratio ≤0.15 and a PSAD ≥0.16) is significantly better than using TPSA levels alone for the differential diagnosis of PCa and BPH.
Identifiants
pubmed: 32801907
doi: 10.2147/CMAR.S257769
pii: 257769
pmc: PMC7414922
doi:
Types de publication
Journal Article
Langues
eng
Pagination
6821-6826Informations de copyright
© 2020 Bai et al.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest in this work.
Références
Biomed Res Int. 2014;2014:341324
pubmed: 25243131
Ann Intern Med. 2012 Apr 3;156(7):539; author reply 540
pubmed: 22473441
Nat Rev Clin Oncol. 2014 Jun;11(6):308-23
pubmed: 24840073
J Urol. 1988 Dec;140(6):1445-7
pubmed: 3193513
Eur Urol. 2017 Mar;71(3):353-365
pubmed: 27543165
J Urol. 2017 Feb;197(2S):S208-S209
pubmed: 28010975
Urol Clin North Am. 1993 Nov;20(4):653-63
pubmed: 7505973
AJR Am J Roentgenol. 2000 Mar;174(3):623-7
pubmed: 10701599
JAMA. 2017 Jun 27;317(24):2532-2542
pubmed: 28655021
Biosens Bioelectron. 2018 Jan 15;99:458-463
pubmed: 28820987
Prostate. 2000 Dec 1;45(4):315-9
pubmed: 11102956
Eur Urol. 2015 Sep;68(3):438-50
pubmed: 25480312
AJR Am J Roentgenol. 2007 Aug;189(2):323-8
pubmed: 17646457
AJR Am J Roentgenol. 2007 Jan;188(1):84-90
pubmed: 17179349
J Urol. 2017 Feb;197(2S):S200-S207
pubmed: 28012755
Asian Pac J Cancer Prev. 2018 Mar 27;19(3):699-702
pubmed: 29580043
Urology. 2009 Jul;74(1):177-83
pubmed: 19428074
Biosens Bioelectron. 2018 Apr 15;102:276-281
pubmed: 29153949
J Urol. 1999 Mar;161(3):835-9
pubmed: 10022696
Eur Urol. 1994;25(4):281-7
pubmed: 7519989
World J Mens Health. 2015 Apr;33(1):14-9
pubmed: 25927058
BMJ. 2015 Jan 27;350:h472
pubmed: 25630373
Infect Drug Resist. 2018 Sep 17;11:1491-1497
pubmed: 30271182
Urol Int. 2006;76(1):27-30
pubmed: 16401917
Contemp Clin Trials. 2015 May;42:26-40
pubmed: 25749312
Int J Urol. 2006 Jul;13(7):910-4
pubmed: 16882054
Lancet. 2017 Feb 25;389(10071):767-768
pubmed: 28126331
Am Fam Physician. 2015 May 1;91(9):Online
pubmed: 25955746
Eur Urol. 2016 Jan;69(1):149-56
pubmed: 25862143
Can J Urol. 2014 Jun;21(3):7312-21
pubmed: 24978363
Eur Urol. 2017 Jun;71(6):896-903
pubmed: 28063613
Eur Urol. 2012 Jun;61(6):1079-92
pubmed: 22424666
J Urol. 2012 Dec;188(6):2404-9
pubmed: 23088974
Urology. 1999 Aug;54(2):220-4
pubmed: 10443714
Nat Rev Urol. 2018 Apr;15(4):207-208
pubmed: 29335526