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Irish Journal of Medical Science (1971 -)

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Open Access 06-07-2023 | Prostate Cancer | Original Article

Value of serum free prostate-specific antigen density in the diagnosis of prostate cancer

Authors: Bing-Zi Zou, Hong Wen, Huan-Jia Luo, Wan-Chao Luo, Qi-Tong Xie, Meng-Ting Zhou

Published in: Irish Journal of Medical Science (1971 -) | Issue 6/2023

Abstract

Purpose

To investigate the value of serum free prostate-specific antigen density (fPSAD) in the diagnosis of prostate cancer (PCa).

Methods

The data of 558 patients who underwent transrectal ultrasound-guided prostate biopsy were retrospectively analyzed. According to the pathological results, the patients were divided into a PCa group and a benign prostatic hyperplasia (BPH) group. Receiver operating characteristic curves were plotted, based on which the sensitivity, specificity, Youden index, concordance, and kappa values of free prostate-specific antigen (fPSA), the free-to-total f/tPSA, prostate-specific antigen density (PSAD), the free-to-total (f/t)/PSAD ratio, and fPSAD were compared. The patients were divided into three groups by PSA levels (PSA < 4 ng/mL, PSA = 4–10 ng/mL, and PSA > 10 ng/mL), into three groups by age (age < 60 year, age = 60–80y, and age > 80 years), and into two groups by prostate volume (PV) (PV ≤ 80 mL and PV > 80 mL) to compare the sensitivity, specificity, and concordance of indicators.

Results

tPSA, PSAD, (f/t)/PSAD, and fPSAD had high accuracy in predicting PCa with AUC values of 0.820, 0.900, 0.846, and 0.867. fPSAD showed lower diagnostic sensitivity but significantly higher specificity and concordance for PCa than tPSA, f/tPSA, (f/t)/PSAD, or PSAD. Thus, fPSAD had the highest accuracy in the diagnosis of PCa. In the groups with different PSA, age, and PV stratification, the concordance of fPSAD was significantly higher (88.61%, 90.74%, and 90.38%) than that of other indicators.

Conclusion

With the optimal cutoff value of 0.062, fPSAD has a higher diagnostic value for PCa than tPSA, f/tPSA, (f/t)/PSAD, and PSAD, and can well predict the risk of PCa, significantly improve the clinical diagnostic rate of PCa, and reduce unnecessary biopsy.

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Title: Value of serum free prostate-specific antigen density in the diagnosis of prostate cancer
Authors: Bing-Zi Zou
Hong Wen
Huan-Jia Luo
Wan-Chao Luo
Qi-Tong Xie
Meng-Ting Zhou
Publication date: 06-07-2023
Publisher: Springer International Publishing
Keywords: Prostate Cancer
Prostate Cancer
Benign Prostatic Hypertrophy
Benign Prostatic Hypertrophy
Published in: Irish Journal of Medical Science (1971 -) / Issue 6/2023
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI: https://doi.org/10.1007/s11845-023-03448-w

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