title: The use of prostate specific antigen (PSA) density in detecting prostate cancer in Chinese men with PSA levels of 4-10 ng/mL.
abstract: OBJECTIVE
  To investigate the utility of prostate specific antigen density for detecting prostate cancer in men with serum PSA levels of 4-10 ng/mL.
  
  
  METHODS
  Between January 2003 and November 2007, 237 men (aged 48-84 years, median 71) with total PSA levels of 4-10 ng/mL participated in a protocol for prostate cancer screening. Eligible patients were recommended for transrectal ultrasonography (TRUS)-guided prostate biopsies after measuring prostate volumes transrectally. The diagnostic value of PSA levels and the free-to-total PSA ratio (f/tPSA), PSA densities (PSAD) were compared using receiver operating characteristic analysis.
  
  
  RESULTS
  Prostate cancer was diagnosed in 44 (18.6%) of the 237 men who had biopsies. There were significant differences between the groups in the prostate volumes determined by TRUS, PSAD, PSA levels and f/tPSA, whereas there was no significant difference in patient age. The area under the curve (AUC) of PSA (0.6786) and PSAD (0.717) was similar and significantly greater than that of f/tPSA (AUC 0.329). PSAD was a significantly better indicator of prostate cancer than f/tPSA. The sensitivity and specificity of PSA density at a cutoff of 0.134 ng/mL(2) was 90 and 33.7%, respectively.
  
  
  CONCLUSIONS
  PSAD was a better predictor of prostate cancer in Chinese men with PSA levels of 4-10 ng/mL, especially those who have had prior ultrasound-determined measurements of prostate volume. Our data suggest that different PSAD cutoffs may need to be defined for Chinese.
authors.affiliation: Department of Urology, First Affiliated Hospital, Zhejiang University School of Medicine, 310003, Hangzhou, China.
authors.forename: Xiang-Yi
authors.initials: XY
authors.lastname: Zheng
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Xie
authors.forename: Yu-Yong
authors.initials: YY
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Ding
authors.forename: Kai
authors.initials: K
authors.lastname: Yang
authors.forename: Hua-Feng
authors.initials: HF
authors.lastname: Shen
authors.forename: Jie
authors.initials: J
authors.lastname: Qin
authors.forename: Yu
authors.initials: Y
authors.lastname: Bai
authors.forename: Zhao-Dian
authors.initials: ZD
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011467:Prostate / Q000033:anatomy & histology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011469:Prostatic Diseases / Q000097:blood / Q000175:diagnosis; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D012372:ROC Curve; D015203:Reproducibility of Results; D014463:Ultrasonography / Q000379:methods
chemical_list: D017430:Prostate-Specific Antigen