THE ROLE OF ZONE VOLUME-ADJUSTED DENSITY PROSTATE SPECIFIC ANTIGEN IN THE DIAGNOSIS OF TRANSITIONAL ZONE PROSTATE CANCER

Đình Âu Hoàng1,, Thị Thanh Trương1
1 Hanoi Medical University Hospital

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Abstract

Purpose: To evaluate the role of zone volume-adjusted transitional zone (VTZ) of prostate-specific antigen density (PSAd) in the diagnosis of transitional zone cancer. Material and methods: Descriptive study on 60 patients with suspected prostate cancer, PSA test, transition zone lesion nodules on MRI, who had prostate biopsy under transrectal ultrasound guided at Hanoi Medical University Hospital from February 2019 to May 2022. Total prostate volume (Vt) and transition zone volume (VTZ) were measured on MRI. Compare the values of total PSA (PSAt), density PSA (PSAd) and transitional density PSA (PSAdTZ) between cancer of TZ and non-cancer groups, established ROC curve and compare diagnostic value of these parameters. Results: The mean age of the patients was 65.8±8. The mean total volume of prostate (Vt) was 57.9±42.1 cm3. The mean volume of the prostate transition zone (VTZ) was 38.1±34.6 cm3. The mean value of PSAt was 29.8±25.8 ng/ml, that of PSAd was 0.68±0.61 ng/ml2, of PSAdTZ was 1.4±1.5 ng/ml2. There were 27 cancerous and 33 non-cancerous patients. There was a statistically significant difference between the cancer group and the non-cancer groups in terms of Vt (p=0.01), VTZ (p=0.001), PSAt (p=0.04), PSAd (p=0.005) and PSAdTZ (p=0.003). The diagnostic value for transition zone cancer of Vt, VTZ, PSAt, PSAd and PSAdTZ was 0.71; 0.77; 0.67; 0.74 and 0.77, respectively. With a cut-off value of PSAdTZ of 0.74 ng/ml2, the sensitivity and specificity for diagnosing of TZ cancer were 74% and 70%, respectively. Conclusion: PSAdTZ was more valuable than PSAt as well as PSAd in the diagnosis of prostate transition zone cancer. It was necessary to use PSAdTZ instead of PSAt or PSAd to screen for transition zone prostate cancer in order to reduce false-positive cases.

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References

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