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CHARACTERIZATION AND COMPARISON OF THE VALUE OF TOTAL PROSTATE-SPECIFIC ANTIGEN (PSAT) WITH PROSTATE-SPECIFIC ANTIGEN (PSAD) IN THE DIAGNOSIS OF PROSTATE TRANSITION ZONE CANCER
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Abstract
Purpose: Describe and compare the value of total prostate specific antigen (PSAt) with prostate specific density specific antigen (PSAd) in the diagnosis of prostate cancer in transition zone (TZ). Material and method: Descriptive study on 67 patients with suspected prostate cancer (by clinical or PSA test), with TZ nodule on MRI of the prostate, who had transrectal ultrasound guided prostate biopsy at Hanoi Medical University Hospitals from February 2019 to May 2022. Describe and compare the mean value of PSAt and PSAd between the group of TZ cancer and non-cancer, plot the ROC and calculated the sensitivity, specificity, negative diagnostic value, negative diagnostic value and diagnostic value of PSAt and PSAd in the diagnosis of TZ cancer with cut-off threshold of 10 ng/ml for PSAt and 0.15 ng/ml2 for PSAd. Result: The mean age of patients was 66.6±8.3. The average prostate volume was 56.9±40.2 cm3. The mean value of PSAt was 32.2±28.7 ng/ml, that of PSAd was 0.73±0.67 ng/ml2. There are 32 patients with TZ cancer and 35 patients without cancer. There was a statistically significant difference between the TZ cancer and the non-cancer groups in PSAt (p=0.005) and PSAd (p<0.001). With cut-off thresholds of ≥10 ng/ml for PSAt and ≥0.15 ng/ml2 for PSAd, the sensitivity, specificity, negative predictive value, positive predictive value, and diagnostic value for TZ cancer diagnosis was 93.8%; 25.7%; 81.8%; 53.6%; 58.2% respectively for PSAt and 96.9%; 31.4%; 91.7%; 56.4%; 62.7% respectively for PSAd. The diagnostic performance of PSAd (AUC=0.77) was higher than that of PSAt (AUC=0.7) for TZ cancer diagnosis. Conclusion: PSAd was more valuable than PSAt in the diagnosis of TZ cancer. It is necessary to use PSAd instead of PSAt to prostate cancer screening in order to limit false-positive cases due to BHP or prostatitis.
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Keywords
Total prostate-specific antigen, density prostate-specific antigen, prostate transition zone cancer
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