title: The implications of prostate-specific antigen density to predict clinically significant prostate cancer in men ≤ 50 years.
abstract: To investigate the appropriate cut-off level of PSA or other clinical parameters at aged ≤ 50 years. The rate of detection of PCa in young men will continue to rise associated with the advancement of the current and evolving practices of screening and detection. In this study, we determined whether to investigate the appropriate cut-off level of PSA or other clinical parameters at aged ≤ 50 years. The study population included 106 patients aged ≤ 50 years who had prostate biopsy at our institute. The differences of clinical variables including various PSA related parameters between the patients with significant PCa and insignificant PCa were analyzed. Receiver operating characteristics (ROC) curves and the corresponding areas under the ROC curves (AUC) were calculated. There were no significant differences between no-PCa and PCa patients regarding PSA value, prostate volume (P vol), PSA density (PSAD), transition zone volume (TZ vol), PSATZ density (PSATZD). When the patients meeting the following criteria, Gleason score was ≤ 6 with less than 2 positive biopsy cores, were classified as having insignificant prostate cancer, PSAD could become a useful predictor of significant PCa in men. The AUC was significantly greater in PSAD (0.801) than for the other parameters. The sensitivity and specificity of a PSAD threshold of 0.32 were 85.7% and 77.8%, respectively. In conclusion, PSAD can be a useful and very effective predictor in a man aged ≤ 50 and we can counsel patients with discretion regarding the likelihood of significant PCa.
authors.affiliation: Department of Urology, Keio University School of Medicine Tokyo, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Kosaka
authors.affiliation: Department of Urology, Keio University School of Medicine Tokyo, Japan.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Mizuno
authors.affiliation: Department of Urology, Keio University School of Medicine Tokyo, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Shinojima
authors.affiliation: Department of Urology, Keio University School of Medicine Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Miyajima
authors.affiliation: Department of Urology, Keio University School of Medicine Tokyo, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Kikuchi
authors.affiliation: Department of Urology, Keio University School of Medicine Tokyo, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Tanaka
authors.affiliation: Department of Urology, Keio University School of Medicine Tokyo, Japan.
authors.forename: Kazunobu
authors.initials: K
authors.lastname: Shinoda
authors.affiliation: Department of Urology, Keio University School of Medicine Tokyo, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Morita
authors.affiliation: Department of Pathology, Keio University School of Medicine Tokyo, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Mikami
authors.affiliation: Department of Urology, Keio University School of Medicine Tokyo, Japan.
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Oya
keywords: PSA density; Prostate cancer; insignificant prostate cancer; prostate biopsy