title: Diagnostic efficacy of free to total ratio of prostate-specific antigen and prostate-specific antigen velocity, singly and in combination, in detecting prostate cancer in patients with total serum prostate-specific antigen between 4 and 10 ng/ml.
abstract: To assess the diagnostic efficacy of prostate-specific antigen (PSA)-related parameters, using a total of 226 patients with gray zone PSA who underwent prostate biopsy, various cutoff points of free to total ratio of PSA (f/t PSA) and PSA velocity (PSAV) were evaluated. Higher cutoff points of f/t PSA resulted in high sensitivity and negative predictive value (NPV): at f/t PSA <15%, sensitivity was 82.0% (41/50) and NPV 84.7% (50/59), and at f/t PSA <20%, 96.0% (48/50) and 92.3% (24/26). Lowering cutoff points also resulted in higher sensitivity and NPV: at PSAV >or=0.75 ng/ml per year, sensitivity was 71.4% (15/21) and NPV 82.4% (28/34), and at PSAV >or=0.40 ng/ml per year, 95.2% (20/21) and 95.2% (20/21). Further, among the patients with both of these parameters available, both sensitivity and NPV achieved 100% (10/10 and 7/7) when the indication for biopsy was determined as f/t PSA <15% or PSAV >or=0.40 ng/ml per year. Our results showed that unnecessary prostate biopsies could be more effectively avoided among patients with "gray zone PSA" by combination of f/t PSA and PSAV than single usage of these indexes.
authors.affiliation: Department of Urology, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya, Hyogo 663-8501, Japan. shingoy@hyo-med.ac.jp
authors.forename: Shingo
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Takuo
authors.initials: T
authors.lastname: Maruyama
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Kondoh
authors.forename: Michio
authors.initials: M
authors.lastname: Nojima
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Takiuchi
authors.forename: Seiichi
authors.initials: S
authors.lastname: Hirota
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shima
mesh_terms: D000368:Aged; D001707:Biopsy, Needle; D006801:Humans; D007564:Japan; D008297:Male; D017430:Prostate-Specific Antigen / Q000097:blood*; D011470:Prostatic Hyperplasia / Q000097:blood / Q000175:diagnosis*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis*; D012016:Reference Values; D012680:Sensitivity and Specificity; D019564:Unnecessary Procedures
chemical_list: D017430:Prostate-Specific Antigen