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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 high-grade 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 6. PSA, prostate-specific antigen; PSAD, PSA density; PZPSAD, peripheral zone PSAD; TZPSAD, transition zone PSAD.
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f2-pi-1-3-102-2: Receiver operating characteristic curves comparing the performances of PSA, PSAD, PZPSAD, and TZPSAD in the detection of high-grade 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 6. PSA, prostate-specific antigen; PSAD, PSA density; PZPSAD, peripheral zone PSAD; TZPSAD, transition zone PSAD.

Mentions: ROC analyses of volume-adjusted PSA parameters in detecting high-grade PCa are shown in Table 6 and Fig. 2. PZPSAD revealed the highest AUC in group A but did not meet statistical significance compared with PSAD, which revealed the second highest AUC. A notable finding was that PSA was significantly inferior to all volume-adjusted parameters for detecting PCa. The sensitivities of the two highest predictors, i.e., PSAD and PZPSAD, at a set specificity of 40%, were 85% and 87%, respectively. In group B, PSA showed the highest AUC for discriminating high-grade disease. The sensitivity of PSA at 40% specificity was revealed to be 76%.


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 high-grade 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 6. 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

f2-pi-1-3-102-2: Receiver operating characteristic curves comparing the performances of PSA, PSAD, PZPSAD, and TZPSAD in the detection of high-grade 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 6. PSA, prostate-specific antigen; PSAD, PSA density; PZPSAD, peripheral zone PSAD; TZPSAD, transition zone PSAD.
Mentions: ROC analyses of volume-adjusted PSA parameters in detecting high-grade PCa are shown in Table 6 and Fig. 2. PZPSAD revealed the highest AUC in group A but did not meet statistical significance compared with PSAD, which revealed the second highest AUC. A notable finding was that PSA was significantly inferior to all volume-adjusted parameters for detecting PCa. The sensitivities of the two highest predictors, i.e., PSAD and PZPSAD, at a set specificity of 40%, were 85% and 87%, respectively. In group B, PSA showed the highest AUC for discriminating high-grade disease. The sensitivity of PSA at 40% specificity was revealed to be 76%.

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