title: Can Prostate-Specific Antigen Kinetics before Prostate Biopsy Predict the Malignant Potential of Prostate Cancer?
abstract: OBJECTIVE
  To predict the malignant potential of prostate cancer (PCa) according to prostate-specific antigen velocity (PSAV), PSA density (PSAD), free/total PSA ratio (%fPSA), and digital rectal examination (DRE).
  
  
  METHODS
  From January 2009 to December 2012, 548 adult male patients were diagnosed with PCa by prostate biopsy at four hospitals in Korea. We retrospectively analyzed 155 adult male patients with an initial PSA level≤10 ng/mL and whose PSA levels had been checked more than two times at least 6 months before they had been diagnosed with PCa, with test intervals of more than 3 months. Patients with a urinary tract infection, and patients who had previously undergone cystoscopy or surgery of the prostate were excluded. We separated patients into two groups according to Gleason sum [Gleason sum≤7 (n=134) or Gleason sum≥8 (n=21)] and the presence of extracapsular invasion [organ confined (n=129) or extracapsular invasion (n=26)]. Differences between the groups were compared.
  
  
  RESULTS
  The group with a Gleason sum≥8 or extracapsular invasion of PCa showed high PSAV and significantly lower %fPSA. There were no significant differences in PSAD and the presence of an abnormality on DRE between two groups.
  
  
  CONCLUSIONS
  In PCa patients treated with other therapies besides prostatectomy, a high PSA velocity and a low %fPSA may predict high grade PCa with a Gleason sum≥8 or the presence of extracapsular invasion.
authors.affiliation: Department of Urology, Myongji Hospital, Goyang, Korea.
authors.forename: Sang Jin
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Urology, Myongji Hospital, Goyang, Korea.
authors.forename: Tae Yoong
authors.initials: TY
authors.lastname: Jeong
authors.affiliation: Department of Urology, Eulji University College of Medicine, Daejeon, Korea.
authors.forename: Dae Seon
authors.initials: DS
authors.lastname: Yoo
authors.affiliation: Department of Urology, Eulji University College of Medicine, Daejeon, Korea.
authors.forename: Jinsung
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Seok
authors.initials: S
authors.lastname: Cho
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Seok Ho
authors.initials: SH
authors.lastname: Kang
authors.affiliation: Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Sang Hyub
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Urology, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Seung Hyun
authors.initials: SH
authors.lastname: Jeon
authors.affiliation: Department of Urology, Hanyang University College of Medicine, Seoul, Korea.
authors.forename: Tchun Yong
authors.initials: TY
authors.lastname: Lee
authors.affiliation: Department of Urology, Hanyang University College of Medicine, Seoul, Korea. syparkuro@hanyang.ac.kr.
authors.forename: Sung Yul
authors.initials: SY
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D051517:Digital Rectal Examination; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011237:Predictive Value of Tests; D011379:Prognosis; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D056910:Republic of Korea; D012189:Retrospective Studies; D047368:Tumor Burden
chemical_list: D017430:Prostate-Specific Antigen
keywords: Gleason score; Prostate-specific antigen; prostatic neoplasms