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. 2020 Oct 26;35(41):e342.
doi: 10.3346/jkms.2020.35.e342.

Strategy for Prostate Cancer Patients with Low Prostate Specific Antigen Level (2.5 to 4.0 ng/mL)

Jae Hoon Chung  1 , Jiwoong Yu  1 , Wan Song  1 , Minyong Kang  1 , Hyun Hwan Sung  1 , Hwang Gyun Jeon  1 , Byong Chang Jeong  1 , Seong Il Seo  1 , Hyun Moo Lee  1 , Seong Soo Jeon  2
Affiliations

Strategy for Prostate Cancer Patients with Low Prostate Specific Antigen Level (2.5 to 4.0 ng/mL)

Jae Hoon Chung et al. J Korean Med Sci. .

Abstract

Background: To evaluate the strategy for detection of prostate cancer (PCa) with low prostate specific antigen (PSA) level (2.5-4.0 ng/mL), prostate biopsy patients with low PSA were assessed. We evaluated the risk of low PSA PCa and the strategy for screening low-PSA patients.

Methods: We retrospectively analyzed the patients who underwent prostate biopsy with low PSA level. Baseline characteristics, PSA level before prostate biopsy, prostate volume, prostate specific antigen density (PSAD), and pathological data were assessed.

Results: Among the 1986 patients, 24.97% were diagnosed with PCa. The PSAD was 0.12 ± 0.04 ng/mL² in the PCa-diagnosed group and 0.10 ± 0.04 ng/mL² in non-cancer-diagnosed group (P < 0.001). Of the 496 patients diagnosed with PCa, 302 (60.89%) were in the intermediate- or high-risk group. PSAD was 0.13 ± 0.04 ng/mL² in the intermediate- or high-risk group and 0.11 ± 0.03 ng/mL² in the very low- and low-risk group (P < 0.001). Of 330 patients who underwent radical prostatectomy, 85.15% were diagnosed as having significant cancer. There was significant correlation between PSAD and PCa (r = 0.294, P < 0.001). PSAD with a specificity of 80.00% of a clinically significant cancer diagnosis was assessed at 0.1226 ng/mL².

Conclusion: The PCa detection rate in the low-PSA group was not lower than that of previous studies of patients with PSA from 4.0 to 10.0 ng/mL. Further, it may be helpful to define a strategy for PCa detection using PSAD in the low-PSA group.

Keywords: Biopsy; Diagnosis; Prostate-Specific Antigen; Prostatic Neoplasms.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Flowchart of patients who underwent prostate biopsy (2.5 ≤ PSA< 4.0 ng/mL).
PSA = prostate specific antigen.
Fig. 2
Fig. 2. Risk classification according to the National Comprehensive Cancer Network classification.
Fig. 3
Fig. 3. Correlation between prostate specific antigen density and prostate cancer.
Fig. 4
Fig. 4. Receiver operating characteristic curve for prostate specific antigen density and clinically significant prostate cancer.
AUC = area under the curve.
See this image and copyright information in PMC

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