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Peripheral zone prostate-specific antigen density: an effective parameter for prostate cancer prediction in men receiving 5α-reductase inhibitors.

Koo KC, Lee DH, Lee SH, Chung BH - Prostate Int (2013)

Bottom Line: In the 5ARI group, the AUC for PZPSAD was even higher than that for PSAD (0.781 vs. 0.751, P=0.038); in the 5ARI-naïve group, however, PZPSAD failed to achieve significant superiority (0.652 vs. 0.649, P=0.321).The diagnostic performance of PSAD in the detection of PCa is superior to that of PSA.For patients receiving 5ARI for more than 6 months, PZPSAD confers additional benefits for detecting both PCa and high-grade PCa.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To evaluate the predictive performance of various parameters derived from volume-adjusted prostate-specific antigen (PSA) values in detecting prostate cancer (PCa) and high-grade (Gleason score≥7) PCa according to treatment with a 5α-reductase inhibitor (5ARI).

Methods: The results of 3,520 prostate biopsies performed between May 2006 and January 2013 were retrospectively assessed. With adjustment for age, 291 patients who had received 5ARI treatment for more than 6 months were identified and matched 1:3 to patients naïve to 5ARIs, resulting in a total of 873 patients. Peripheral zone (PZ) and transition zone (TZ) volumes were determined by transrectal ultrasonography. Receiver-operating characteristic (ROC) curve analysis was used to compare predictive performances of PSA, PSA density (PSAD; PSA/prostate volume), PZPSAD (PSA/PZ volume), and TZPSAD (PSA/TZ volume) for detecting PCa and high-grade PCa for each group.

Results: The area under the ROC curve (AUC) was higher for PSAD than for PSA in the 5ARI group (0.751 vs. 0.677) and in the 5ARI-naïve group (0.649 vs. 0.582), respectively (P<0.001). In the 5ARI group, the AUC for PZPSAD was even higher than that for PSAD (0.781 vs. 0.751, P=0.038); in the 5ARI-naïve group, however, PZPSAD failed to achieve significant superiority (0.652 vs. 0.649, P=0.321). All volume-adjusted PSA indexes showed higher predictive accuracies for detecting PCa than did PSA in both groups. For detecting high-grade cancer, PZPSAD also revealed the highest predictive value in the 5ARI group, whereas PSA revealed the highest predictive value in the 5ARI-naïve group.

Conclusions: The diagnostic performance of PSAD in the detection of PCa is superior to that of PSA. For patients receiving 5ARI for more than 6 months, PZPSAD confers additional benefits for detecting both PCa and high-grade PCa.

No MeSH data available.


Related in: MedlinePlus

Receiver operating characteristic curves comparing the performances of PSA, PSAD, PZPSAD, and TZPSAD in the detection of prostate cancer in group A (A) and group B (B). The receiver-operating characteristic area under the curve and comparisons of each parameter are shown in Table 5. PSA, prostate-specific antigen; PSAD, PSA density; PZPSAD, peripheral zone PSAD; TZPSAD, transition zone PSAD.
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f1-pi-1-3-102-2: Receiver operating characteristic curves comparing the performances of PSA, PSAD, PZPSAD, and TZPSAD in the detection of prostate cancer in group A (A) and group B (B). The receiver-operating characteristic area under the curve and comparisons of each parameter are shown in Table 5. PSA, prostate-specific antigen; PSAD, PSA density; PZPSAD, peripheral zone PSAD; TZPSAD, transition zone PSAD.

Mentions: ROC analyses of volume-adjusted PSA parameters in the detection of PCa are shown in Table 5 and Fig. 1. The ROC curves of group A showed that PZPSAD had the highest accuracy for discriminating PCa, followed by PSAD, TZPSAD, and PSA. PSAD and PZPSAD revealed significantly higher AUCs than that of PSA, whereas the superiority of PZPSAD compared with PSAD was statistically significant (P=0.039). The sensitivities of the two highest predictors, i.e., PSAD and PZPSAD, at a set specificity of 40%, were 84% and 88%, respectively. In group B, PSAD and PZPSAD showed significantly higher AUCs than did PSA (P<0.001); however, the AUC of PZPSAD failed to significantly surpass that of PSAD (P=0.321). TZPSAD showed no better accuracy than PSA. The sensitivities of the two highest predictors, i.e., PSAD and PZPSAD, at a set specificity of 40%, were 81% and 79%, respectively.


Peripheral zone prostate-specific antigen density: an effective parameter for prostate cancer prediction in men receiving 5α-reductase inhibitors.

Koo KC, Lee DH, Lee SH, Chung BH - Prostate Int (2013)

Receiver operating characteristic curves comparing the performances of PSA, PSAD, PZPSAD, and TZPSAD in the detection of prostate cancer in group A (A) and group B (B). The receiver-operating characteristic area under the curve and comparisons of each parameter are shown in Table 5. PSA, prostate-specific antigen; PSAD, PSA density; PZPSAD, peripheral zone PSAD; TZPSAD, transition zone PSAD.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3814120&req=5

f1-pi-1-3-102-2: Receiver operating characteristic curves comparing the performances of PSA, PSAD, PZPSAD, and TZPSAD in the detection of prostate cancer in group A (A) and group B (B). The receiver-operating characteristic area under the curve and comparisons of each parameter are shown in Table 5. PSA, prostate-specific antigen; PSAD, PSA density; PZPSAD, peripheral zone PSAD; TZPSAD, transition zone PSAD.
Mentions: ROC analyses of volume-adjusted PSA parameters in the detection of PCa are shown in Table 5 and Fig. 1. The ROC curves of group A showed that PZPSAD had the highest accuracy for discriminating PCa, followed by PSAD, TZPSAD, and PSA. PSAD and PZPSAD revealed significantly higher AUCs than that of PSA, whereas the superiority of PZPSAD compared with PSAD was statistically significant (P=0.039). The sensitivities of the two highest predictors, i.e., PSAD and PZPSAD, at a set specificity of 40%, were 84% and 88%, respectively. In group B, PSAD and PZPSAD showed significantly higher AUCs than did PSA (P<0.001); however, the AUC of PZPSAD failed to significantly surpass that of PSAD (P=0.321). TZPSAD showed no better accuracy than PSA. The sensitivities of the two highest predictors, i.e., PSAD and PZPSAD, at a set specificity of 40%, were 81% and 79%, respectively.

Bottom Line: In the 5ARI group, the AUC for PZPSAD was even higher than that for PSAD (0.781 vs. 0.751, P=0.038); in the 5ARI-naïve group, however, PZPSAD failed to achieve significant superiority (0.652 vs. 0.649, P=0.321).The diagnostic performance of PSAD in the detection of PCa is superior to that of PSA.For patients receiving 5ARI for more than 6 months, PZPSAD confers additional benefits for detecting both PCa and high-grade PCa.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Purpose: To evaluate the predictive performance of various parameters derived from volume-adjusted prostate-specific antigen (PSA) values in detecting prostate cancer (PCa) and high-grade (Gleason score≥7) PCa according to treatment with a 5α-reductase inhibitor (5ARI).

Methods: The results of 3,520 prostate biopsies performed between May 2006 and January 2013 were retrospectively assessed. With adjustment for age, 291 patients who had received 5ARI treatment for more than 6 months were identified and matched 1:3 to patients naïve to 5ARIs, resulting in a total of 873 patients. Peripheral zone (PZ) and transition zone (TZ) volumes were determined by transrectal ultrasonography. Receiver-operating characteristic (ROC) curve analysis was used to compare predictive performances of PSA, PSA density (PSAD; PSA/prostate volume), PZPSAD (PSA/PZ volume), and TZPSAD (PSA/TZ volume) for detecting PCa and high-grade PCa for each group.

Results: The area under the ROC curve (AUC) was higher for PSAD than for PSA in the 5ARI group (0.751 vs. 0.677) and in the 5ARI-naïve group (0.649 vs. 0.582), respectively (P<0.001). In the 5ARI group, the AUC for PZPSAD was even higher than that for PSAD (0.781 vs. 0.751, P=0.038); in the 5ARI-naïve group, however, PZPSAD failed to achieve significant superiority (0.652 vs. 0.649, P=0.321). All volume-adjusted PSA indexes showed higher predictive accuracies for detecting PCa than did PSA in both groups. For detecting high-grade cancer, PZPSAD also revealed the highest predictive value in the 5ARI group, whereas PSA revealed the highest predictive value in the 5ARI-naïve group.

Conclusions: The diagnostic performance of PSAD in the detection of PCa is superior to that of PSA. For patients receiving 5ARI for more than 6 months, PZPSAD confers additional benefits for detecting both PCa and high-grade PCa.

No MeSH data available.


Related in: MedlinePlus