title: The combination of ovarian volume and outline has better diagnostic accuracy than prostate-specific antigen (PSA) concentrations in women with polycystic ovarian syndrome (PCOs).
abstract: OBJECTIVE
  The aim of this study was to determine the performance of prostate specific antigen (PSA) and ultrasound parameters, such as ovarian volume and outline, in the diagnosis of polycystic ovary syndrome (PCOS).
  
  
  METHODS
  This prospective, observational, case-controlled study included 43 women with PCOS, and 40 controls. Between day 3 and 5 of the menstrual cycle, fasting serum samples were collected and transvaginal ultrasound was performed. The diagnostic performance of each parameter [total PSA (tPSA), total-to-free PSA ratio (tPSA:fPSA), ovarian volume, ovarian outline] was estimated by means of receiver operating characteristic (ROC) analysis, along with area under the curve (AUC), threshold, sensitivity, specificity as well as positive (+) and negative (-) likelihood ratios (LRs). Multivariate logistical regression models, using ovarian volume and ovarian outline, were constructed.
  
  
  RESULTS
  The tPSA and tPSA:fPSA ratio resulted in AUC of 0.74 and 0.70, respectively, with moderate specificity/sensitivity and insufficient LR+/- values. In the multivariate logistic regression model, the combination of ovarian volume and outline had a sensitivity of 97.7% and a specificity of 97.5% in the diagnosis of PCOS, with +LR and -LR values of 39.1 and 0.02, respectively.
  
  
  CONCLUSIONS
  In women with PCOS, tPSA and tPSA:fPSA ratio have similar diagnostic performance. The use of a multivariate logistic regression model, incorporating ovarian volume and outline, offers very good diagnostic accuracy in distinguishing women with PCOS patients from controls.
authors: Eleni
authors: E
authors: Bili
authors: First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece. Electronic address: helbil@auth.gr.
authors: Authors Eleni
authors: AE
authors: Bili
authors: First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.
authors: Kaliopi
authors: K
authors: Dampala
authors: Third Department of Nuclear Medicine, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.
authors: Ioannis
authors: I
authors: Iakovou
authors: First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.
authors: Dimitrios
authors: D
authors: Tsolakidis
authors: Department of Immunology, Papageorgiou General Hospital, Thessaloniki, Greece.
authors: Anastasia
authors: A
authors: Giannakou
authors: First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece.
authors: Basil C
authors: BC
authors: Tarlatzis
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D009929:Organ Size; D010053:Ovary / Q000000981:diagnostic imaging*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood*; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D017430:Prostate-Specific Antigen
keywords: Diagnostic performance; Hyperandrogenemia; Polycystic ovary syndrome; Prostate specific antigen; Transvaginal ultrasound