title: Can volume measurement of the prostate enhance the performance of complexed prostate-specific antigen?
abstract: We assessed whether volume-based complexed prostate-specific antigen (cPSA) indices could enhance prostate cancer detection in men with serum total PSA (tPSA) between 2.5 and 10.0 ng/mL. Between December 1998 and April 2000, cPSA assay was measured in 480 men who underwent transrectal ultrasound-guided prostate biopsies at 7 institutions. We compared the usefulness of cPSA and its indices with the ratio of free PSA (fPSA) to tPSA (percent fPSA) for early detection of prostate cancer. Overall, 168 men (35%) had cancer. In the 341 men with tPSA between 4.01 and 10.0 ng/mL at approximately 90% sensitivity and areas under the receiver operating characteristics curve, the performances of volume-based parameters were significantly better (P <0.05) than those of tPSA and cPSA. In the 139 men with tPSA between 2.5 and 4.0 ng/mL, at 90% sensitivity, the specificity of the ratio of cPSA to tPSA (percent cPSA) was best, followed by cPSA density (cPSAD). In the 101 men with the history of a previous prostate biopsy, at approximately 90% sensitivity, the specificity of cPSAD was significantly better than those of tPSA and percent fPSA (P <0.05). In the 371 men with a total prostate volume of >or=30 cm(3) at approximately 90% sensitivity, the specificity of the cPSAD was significantly better than that of tPSA, percent fPSA, and cPSA (P <0.05). In the 109 men with a total prostate volume of <30 cm(3), at 90% sensitivity the specificity of cPSA and cPSAD was better than that of percent fPSA. In conclusion, volume-based cPSA can modestly enhance the performance of cPSA.
authors.affiliation: Department of Urology, University of Texas MD Anderson Cancer Center, Houston, Texas 77030-4095, USA.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Naya
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Stamey
authors.forename: Carol D
authors.initials: CD
authors.lastname: Cheli
authors.forename: Alan W
authors.initials: AW
authors.lastname: Partin
authors.forename: Lori J
authors.initials: LJ
authors.lastname: Sokoll
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Chan
authors.forename: Michael K
authors.initials: MK
authors.lastname: Brawer
authors.forename: Samir S
authors.initials: SS
authors.lastname: Taneja
authors.forename: Herbert
authors.initials: H
authors.lastname: Lepor
authors.forename: Georg
authors.initials: G
authors.lastname: Bartsch
authors.forename: Stacy
authors.initials: S
authors.lastname: Childs
authors.forename: Herbert A
authors.initials: HA
authors.lastname: Fritsche
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Babaian
mesh_terms: D006801:Humans; D008297:Male; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood* / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012372:ROC Curve; D012016:Reference Values; D012680:Sensitivity and Specificity; D014463:Ultrasonography
chemical_list: D017430:Prostate-Specific Antigen