Transition zone prostate specific antigen density improves prostate cancer detection in Iranian men

doi:10.5812/numonthly.26752

. 2015 Mar 20;7(2):e26752.

doi: 10.5812/numonthly.26752. eCollection 2015 Mar.

Transition zone prostate specific antigen density improves prostate cancer detection in Iranian men

Mohammadreza Nowroozi¹, Mohsen Ayati¹, Hassan Jamshidian¹, Amir Arbab¹, Hamidreza Ghorbani¹, Erfan Amini¹, Hassan Hakima², Sohrab Salehi³, Alireza Ghadian⁴

Affiliations

¹ Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.
² Farhangian University, Qazvin, IR Iran.
³ Department of Urology, Qazvin University of Medical Sciences, Qazvin, IR Iran.
⁴ Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.

PMID: 25821749
PMCID: PMC4360524
DOI: 10.5812/numonthly.26752

Transition zone prostate specific antigen density improves prostate cancer detection in Iranian men

Mohammadreza Nowroozi et al. Nephrourol Mon. 2015.

. 2015 Mar 20;7(2):e26752.

doi: 10.5812/numonthly.26752. eCollection 2015 Mar.

Authors

Mohammadreza Nowroozi¹, Mohsen Ayati¹, Hassan Jamshidian¹, Amir Arbab¹, Hamidreza Ghorbani¹, Erfan Amini¹, Hassan Hakima², Sohrab Salehi³, Alireza Ghadian⁴

Affiliations

¹ Uro-Oncology Research Center, Tehran University of Medical Sciences, Tehran, IR Iran.
² Farhangian University, Qazvin, IR Iran.
³ Department of Urology, Qazvin University of Medical Sciences, Qazvin, IR Iran.
⁴ Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.

PMID: 25821749
PMCID: PMC4360524
DOI: 10.5812/numonthly.26752

Abstract

Background: Prostate specific antigen (PSA) as a tumor marker has extensively changed the diagnosis of prostate cancer (PCa). With the advent of PSA, the majority of patients are diagnosed with nonpalpable early stage PCa. However, PSA lacks specificity and many patients undergo unnecessary biopsies due to an elevated serum PSA level.

Objectives: This study aimed to assess the sensitivity and specificity of transition zone PSA density (TZPSAD) in detection of PCa.

Patients and methods: This study was performed on 1712 men underwent trans-rectal ultrasound guided prostate biopsy in our institution between March 2008 and March 2013. A total of 1120 men with PSA < 20 ng/mL and normal digital rectal exam were selected for evaluation. Transition zone PSA density was calculated in all patients and the receiver operating characteristic (ROC) curve was used to analyze the accuracy of TZPSAD for the diagnosis of PCa.

Results: Among 1120 men who were eligible for enrolment, prostate cancer was detected in 265 patients. Mean serum PSA levels were 9.7 ± 4.3 ng/mL and 8.5 ± 3.7 ng/mL in patients with and without PCa, respectively (P < 0.001). Mean value for TZPSAD was 1.18 ± 1.19 ng/mL/mL in patients with PCa, whereas it was 0.55 ± 0.84 ng/mL in men without cancer (P < 0.001). Optimal cut-off value for TZPSAD was 0.32 ng/mL. At this cut-off value, the sensitivity and specificity values for TZPSAD were 85% and 45%, respectively. Applying the TZPSAD for PCa screening decreased 50% of unnecessary biopsies.

Conclusions: Using TZPSAD as an adjunct to PSA may improve the specificity of PSA in the diagnosis of PCa and decrease the number of unnecessary prostatic biopsies in Iranian men with serum PSA level < 20 ng/mL.

Keywords: Prostate-Specific Antigen; Prostatic Neoplasms; ROC Curve; Sensitivity and Specificity.

PubMed Disclaimer

Figures

**Figure 1.. ROC Curve Analysis for Total PSA and PSA Transition Zone Density in the Diagnosis of Prostate Cancer**

See this image and copyright information in PMC

Cited by

Zonal adjusted PSA density improves prostate cancer detection rates compared with PSA in Taiwanese males with PSA < 20 ng/ml.
Chang TH, Lin WR, Tsai WK, Chiang PK, Chen M, Tseng JS, Chiu AW. Chang TH, et al. BMC Urol. 2020 Oct 7;20(1):151. doi: 10.1186/s12894-020-00717-z. BMC Urol. 2020. PMID: 33028274 Free PMC article.
The roles of MRI-based prostate volume and associated zone-adjusted prostate-specific antigen concentrations in predicting prostate cancer and high-risk prostate cancer.
Zheng S, Jiang S, Chen Z, Huang Z, Shi W, Liu B, Xu Y, Guo Y, Yang H, Li M. Zheng S, et al. PLoS One. 2019 Nov 19;14(11):e0218645. doi: 10.1371/journal.pone.0218645. eCollection 2019. PLoS One. 2019. PMID: 31743339 Free PMC article.
Peripheral zone volume ratio (PZ-ratio) is relevant with biopsy results and can increase the accuracy of current diagnostic modality.
Chang Y, Chen R, Yang Q, Gao X, Xu C, Lu J, Sun Y. Chang Y, et al. Oncotarget. 2017 May 23;8(21):34836-34843. doi: 10.18632/oncotarget.16753. Oncotarget. 2017. PMID: 28422738 Free PMC article.

References

1. Matsuda T, Saika K. Comparison of time trends in prostate cancer incidence (1973-2002) in Asia, from cancer incidence in five continents, Vols IV-IX. Jpn J Clin Oncol. 2009;39(7):468–9. doi: 10.1093/jjco/hyp077. - DOI - PubMed
1. Chen CS, Wang SS, Li JR, Cheng CL, Yang CR, Chen WM, et al. PSA density as a better predictor of prostate cancer than percent-free PSA in a repeat biopsy. J Chin Med Assoc. 2011;74(12):552–5. doi: 10.1016/j.jcma.2011.10.004. - DOI - PubMed
1. Matsuda T, Saika K. Comparison of time trends in prostate cancer incidence (1973 1997) in East Asia, Europe and USA, from Cancer Incidence in Five Continents Vols IV VIII. Jpn J Clin Oncol. 2007;37(7):556–7. doi: 10.1093/jjco/hym100. - DOI - PubMed
1. Oesterling JE. Prostate specific antigen: a critical assessment of the most useful tumor marker for adenocarcinoma of the prostate. J Urol. 1991;145(5):907–23. - PubMed
1. Benson MC, Whang IS, Olsson CA, McMahon DJ, Cooner WH. The use of prostate specific antigen density to enhance the predictive value of intermediate levels of serum prostate specific antigen. J Urol. 1992;147(3 Pt 2):817–21. - PubMed

LinkOut - more resources

Full Text Sources
- Europe PubMed Central
- PubMed Central
Other Literature Sources
- scite Smart Citations
Research Materials
- NCI CPTC Antibody Characterization Program
Miscellaneous
- NCI CPTAC Assay Portal

[1] Matsuda T, Saika K. Comparison of time trends in prostate cancer incidence (1973-2002) in Asia, from cancer incidence in five continents, Vols IV-IX. Jpn J Clin Oncol. 2009;39(7):468–9. doi: 10.1093/jjco/hyp077. - DOI - PubMed

[2] Matsuda T, Saika K. Comparison of time trends in prostate cancer incidence (1973-2002) in Asia, from cancer incidence in five continents, Vols IV-IX. Jpn J Clin Oncol. 2009;39(7):468–9. doi: 10.1093/jjco/hyp077. - DOI - PubMed

[3] Chen CS, Wang SS, Li JR, Cheng CL, Yang CR, Chen WM, et al. PSA density as a better predictor of prostate cancer than percent-free PSA in a repeat biopsy. J Chin Med Assoc. 2011;74(12):552–5. doi: 10.1016/j.jcma.2011.10.004. - DOI - PubMed

[4] Chen CS, Wang SS, Li JR, Cheng CL, Yang CR, Chen WM, et al. PSA density as a better predictor of prostate cancer than percent-free PSA in a repeat biopsy. J Chin Med Assoc. 2011;74(12):552–5. doi: 10.1016/j.jcma.2011.10.004. - DOI - PubMed

[5] Matsuda T, Saika K. Comparison of time trends in prostate cancer incidence (1973 1997) in East Asia, Europe and USA, from Cancer Incidence in Five Continents Vols IV VIII. Jpn J Clin Oncol. 2007;37(7):556–7. doi: 10.1093/jjco/hym100. - DOI - PubMed

[6] Matsuda T, Saika K. Comparison of time trends in prostate cancer incidence (1973 1997) in East Asia, Europe and USA, from Cancer Incidence in Five Continents Vols IV VIII. Jpn J Clin Oncol. 2007;37(7):556–7. doi: 10.1093/jjco/hym100. - DOI - PubMed

[7] Oesterling JE. Prostate specific antigen: a critical assessment of the most useful tumor marker for adenocarcinoma of the prostate. J Urol. 1991;145(5):907–23. - PubMed

[8] Oesterling JE. Prostate specific antigen: a critical assessment of the most useful tumor marker for adenocarcinoma of the prostate. J Urol. 1991;145(5):907–23. - PubMed

[9] Benson MC, Whang IS, Olsson CA, McMahon DJ, Cooner WH. The use of prostate specific antigen density to enhance the predictive value of intermediate levels of serum prostate specific antigen. J Urol. 1992;147(3 Pt 2):817–21. - PubMed

[10] Benson MC, Whang IS, Olsson CA, McMahon DJ, Cooner WH. The use of prostate specific antigen density to enhance the predictive value of intermediate levels of serum prostate specific antigen. J Urol. 1992;147(3 Pt 2):817–21. - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Transition zone prostate specific antigen density improves prostate cancer detection in Iranian men

Affiliations

Transition zone prostate specific antigen density improves prostate cancer detection in Iranian men

Authors

Affiliations

Abstract

Figures

Similar articles

Cited by

References

LinkOut - more resources

Full Text Sources

Other Literature Sources

Research Materials

Miscellaneous