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The Value of Adjusted PSAD in Prostate Cancer Detection in the Chinese Population

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Journal Front Oncol
Specialty Oncology
Date 2024 Oct 17
PMID 39416462
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Abstract

Objective: To investigate the value of adjusted prostate-specific antigen density (PSAD) in the diagnosis of prostate cancer (PCa).

Methods: Data from 410 patients who underwent transrectal ultrasound-guided prostate biopsy were retrospectively analyzed in Beijing Tsinghua Changgung Hospital between November 2014 and March 2024. All patients were divided into PCa and benign prostatic hyperplasia (BPH) groups according to pathological results. Multivariate logistic regression analyses were performed to evaluate the odd ratios (ORs) of predictors for PCa occurrence. Receiver operating characteristic curves were plotted, and the area under the curve (AUC) values were used to assess and compare the diagnostic accuracies of total PSA (tPSA), free-to-total (f/t) PSA, free PSA (fPSA), PSAD, and PSAD (PSAD×weight).

Results: There were 166 patients in the PCa group and 244 in the BPH group. Multivariate analyses demonstrated that PSAD was positively correlated with the presence of PCa, with the highest OR value among all PSA-related parameters (OR = 19.075, <0.001). tPSA, fPSAD, PSAD, and PSAD had high accuracy in predicting PCa, with AUC values of 0.633, 0.730, 0.778, and 0.780. Of note, PSAD had the highest AUC with a sensitivity of 63.3% and specificity of 81.6%. Similarly, in patients with a PSA level in the gray zone, the diagnostic accuracy of PSAD in predicting PCa (AUC, 0.709; 95% CI, 0.616-0.802) remained better than other PSA-related markers.

Conclusion: PSAD has an advantage over other PSA-related markers in detecting PCa and could be used for making biopsy decisions.

References
1.
Cornford P, van den Bergh R, Briers E, Van den Broeck T, Brunckhorst O, Darraugh J . EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on Prostate Cancer-2024 Update. Part I: Screening, Diagnosis, and Local Treatment with Curative Intent. Eur Urol. 2024; 86(2):148-163. DOI: 10.1016/j.eururo.2024.03.027. View

2.
Liu J, Wang Z, Li M, Zhou M, Yu Y, Zhan W . Establishment of two new predictive models for prostate cancer to determine whether to require prostate biopsy when the PSA level is in the diagnostic gray zone (4-10 ng ml). Asian J Androl. 2019; 22(2):213-216. PMC: 7155794. DOI: 10.4103/aja.aja_46_19. View

3.
Lin Y, Wei X, Uhlman M, Lin X, Wu S, Diao P . PSA density improves the rate of prostate cancer detection in Chinese men with a PSA between 2.5-10.0 ng ml (-1) and 10.1-20.0 ng ml (-1) : a multicenter study. Asian J Androl. 2014; 17(3):503-7. PMC: 4430959. DOI: 10.4103/1008-682X.142129. View

4.
Nordstrom T, Akre O, Aly M, Gronberg H, Eklund M . Prostate-specific antigen (PSA) density in the diagnostic algorithm of prostate cancer. Prostate Cancer Prostatic Dis. 2017; 21(1):57-63. DOI: 10.1038/s41391-017-0024-7. View

5.
Stevens E, Truong M, Bullen J, Ward R, Purysko A, Klein E . Clinical utility of PSAD combined with PI-RADS category for the detection of clinically significant prostate cancer. Urol Oncol. 2020; 38(11):846.e9-846.e16. DOI: 10.1016/j.urolonc.2020.05.024. View