Predictive Factors for Prostate Cancer in Biopsy of Patients with Prostate-Specific Antigen Levels Equal to or Less Than 4 ng/ml
- PMID: 21461279
- PMCID: PMC3065127
- DOI: 10.4111/kju.2011.52.3.166
Predictive Factors for Prostate Cancer in Biopsy of Patients with Prostate-Specific Antigen Levels Equal to or Less Than 4 ng/ml
Abstract
Purpose: This study was conducted to identify the predictive factors for prostate cancer in patients with prostate-specific antigen (PSA) levels equal to or less than 4 ng/ml.
Materials and methods: A retrospective study of medical records was conducted on 292 patients with initial serum PSA ≤4 ng/ml among 2,305 patients who underwent prostate biopsy from January 2003 to December 2008. Prostate biopsy was performed on patients with PSA ≤4 ng/ml in the case of abnormal findings in the digital rectal examination (DRE) or transrectal ultrasonography (TRUS) or in those with a PSA level higher than the age-adjusted PSA levels. The patients were divided into the group diagnosed with prostate cancer and the non-prostate-cancer group. Subsequently, the variables of the two groups were compared.
Results: The patients' mean age was significantly higher in the prostate cancer group (n=28) than in the non-prostate-cancer group (n=264; p=0.033). In addition, for the patients with a PSA range of 2.0-2.9 ng/ml, their age (p=0.049) and PSA density (PSAD; p=0.042) were significantly higher and the prostate volume (p=0.028) was significantly smaller in the prostate cancer group than in the non-prostate-cancer group.
Conclusions: Of the patients with PSA ≤4 ng/ml, the age of the patients who showed abnormal findings in the DRE or TRUS or who had a PSA level higher than the age-adjusted PSA level was a significant predictive factor for prostate cancer. In particular, for the PSA range of 2.0-2.9 ng/ml, a thorough screening test for prostate cancer was required if the patients had conditions such as higher age, smaller prostate, and higher PSAD.
Keywords: Prostate-specific antigen; Prostatic neoplasms.
Conflict of interest statement
The authors have nothing to disclose.
Figures
Similar articles
-
Detection of prostatic carcinoma: the role of TRUS, TRUS guided biopsy, digital rectal examination, PSA and PSA density.J Exp Clin Cancer Res. 2001 Dec;20(4):473-80. J Exp Clin Cancer Res. 2001. PMID: 11876539
-
Cost-effective prostate cancer detection. Reduction of low-yield biopsies. Investigators of the American Cancer Society National Prostate Cancer Detection Project.Cancer. 1994 Dec 15;74(12):3146-58. doi: 10.1002/1097-0142(19941215)74:12<3146::aid-cncr2820741214>3.0.co;2-z. Cancer. 1994. PMID: 7526969
-
[Examination for indication of systematic biopsy for diagnosis of prostate cancer].Nihon Hinyokika Gakkai Zasshi. 1999 Jul;90(7):657-62. doi: 10.5980/jpnjurol1989.90.657. Nihon Hinyokika Gakkai Zasshi. 1999. PMID: 10481471 Japanese.
-
Evaluation of prostate specific antigen density and transrectal ultrasonography-guided biopsies in 100 consecutive patients with a negative digital rectal examination and intermediate serum prostate specific antigen levels.Int J Urol. 1997 Jul;4(4):362-7. doi: 10.1111/j.1442-2042.1997.tb00209.x. Int J Urol. 1997. PMID: 9256325 Review.
-
The role of digital rectal examination, transrectal ultrasound, and prostate specific antigen for the detection of confined and clinically relevant prostate cancer.J Cell Biochem Suppl. 1992;16H:69-73. doi: 10.1002/jcb.240501216. J Cell Biochem Suppl. 1992. PMID: 1283897 Review.
Cited by
-
Prostate Cancer Can Be Detected Even in Patients with Decreased PSA Less than 2.5 ng/ml after Treatment of Chronic Prostatitis.Korean J Urol. 2011 Jul;52(7):457-60. doi: 10.4111/kju.2011.52.7.457. Epub 2011 Jul 24. Korean J Urol. 2011. PMID: 21860765 Free PMC article.
-
DNA methylation of GSTP1 in human prostate tissues: pyrosequencing analysis.Korean J Urol. 2012 Mar;53(3):200-5. doi: 10.4111/kju.2012.53.3.200. Epub 2012 Mar 19. Korean J Urol. 2012. PMID: 22468217 Free PMC article.
-
Is prostate biopsy essential to diagnose prostate cancer in the older patient with extremely high prostate-specific antigen?Korean J Urol. 2012 Feb;53(2):82-6. doi: 10.4111/kju.2012.53.2.82. Epub 2012 Feb 20. Korean J Urol. 2012. PMID: 22379585 Free PMC article.
-
Prostate-specific antigen and prostate-specific antigen density cutoff points among Indonesian population suspected for prostate cancer.Prostate Int. 2013;1(1):23-30. doi: 10.12954/PI.12003. Epub 2013 Jan 31. Prostate Int. 2013. PMID: 24223398 Free PMC article.
-
Prostate-Specific Antigen fluctuation: what does it mean in diagnosis of prostate cancer?Int Braz J Urol. 2015 Mar-Apr;41(2):258-64. doi: 10.1590/S1677-5538.IBJU.2015.02.11. Int Braz J Urol. 2015. PMID: 26005966 Free PMC article.
References
-
- Jemal A, Siegel R, Ward E, Hao Y, Xu J, Thun MJ. Cancer statistics, 2009. CA Cancer J Clin. 2009;59:225–249. - PubMed
-
- Park SK, Sakoda LC, Kang D, Chokkalingam AP, Lee E, Shin HR, et al. Rising prostate cancer rates in South Korea. Prostate. 2006;66:1285–1291. - PubMed
-
- Brawer MK. Screening for prostate cancer. Semin Surg Oncol. 2000;18:29–36. - PubMed
-
- Pelzer AE, Tewari A, Bektic J, Berger AP, Frauscher F, Bartsch G, et al. Detection rates and biologic significance of prostate cancer with PSA less than 4.0 ng/mL: observation and clinical implications from Tyrol screening project. Urology. 2005;66:1029–1033. - PubMed
-
- Bunting PS. Screening for prostate cancer with prostate-specific antigen: beware the biases. Clin Chim Acta. 2002;315:71–97. - PubMed
LinkOut - more resources
Full Text Sources
Research Materials
Miscellaneous