title: Role of prostate volume in the early detection of prostate cancer in a cohort with slowly increasing prostate specific antigen.
abstract: OBJECTIVE
  To investigate the relationship between prostate volume and the increased risk for being diagnosed with prostate cancer (PCa) in men with slowly increasing prostate specific antigen (PSA).
  
  
  METHODS
  A cohort of 1035 men who visited our hospital's health promotion center and were checked for serum PSA levels more than two times between January 2001 and November 2011 were included. Among them, 116 patients had a change in PSA levels from less than 4 ng/mL to more than 4 ng/mL and underwent transrectal ultrasound guided prostate biopsy. Median age was 55.9 years and 26 (22.4%) had PCa. We compared the initial PSA level, the last PSA level, age, prostate volume, PSA density (PSAD), PSA velocity, and follow-up period between men with and without PCa. The mean follow- up period was 83.7 months.
  
  
  RESULTS
  Significant predictive factors for the detection of prostate cancer identified by univariate analysis were prostate volume, follow-up period and PSAD. In the multivariate analysis, prostate volume (p<0.001, odds ratio: 0.890) was the most significant factor for the detection of prostate cancer. In the receiver operator characteristic curve of prostate volume, area under curve was 0.724. At the cut-off value of 28.8 mL for prostate volume, the sensitivity and specificity were 61.1% and 73.1% respectively.
  
  
  CONCLUSIONS
  In men with PSA values more than 4 ng/mL during the follow-up period, a small prostate volume was the most important factor in early detection of prostate cancer.
authors.affiliation: Deptartment of Pathology, University of Ulsan College of Medicine, Ulsan University Hospital, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan 682-714, Korea.
authors.forename: Young Min
authors.initials: YM
authors.lastname: Kim
authors.forename: Sungchan
authors.initials: S
authors.lastname: Park
authors.forename: June
authors.initials: J
authors.lastname: Kim
authors.forename: Seonghun
authors.initials: S
authors.lastname: Park
authors.forename: Ji Ho
authors.initials: JH
authors.lastname: Lee
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Ryu
authors.forename: Seong Hoon
authors.initials: SH
authors.lastname: Choi
authors.forename: Sang Hyeon
authors.initials: SH
authors.lastname: Cheon
mesh_terms: D001706:Biopsy; D015331:Cohort Studies; D042241:Early Diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D009929:Organ Size; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000473:pathology*; D012680:Sensitivity and Specificity; D014463:Ultrasonography
chemical_list: D017430:Prostate-Specific Antigen
keywords: Prostatic neoplasms; early diagnosis; organ size; prostate-specific antigen
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