title: The performance characteristics of prostate-specific antigen and prostate-specific antigen density in Chinese men.
abstract: We investigated the performance characteristics of prostate-specific antigen (PSA) and PSA density (PSAD) in Chinese men. All Chinese men who underwent transrectal ultrasound-guided prostate biopsy (TRUS-PB) from year 2000 to 2013 were included. The receiver operating characteristic (ROC) curves for both PSA and PSAD were analyzed. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) at different cut-off levels were calculated. A total of 2606 Chinese men were included. For the ROC, the area under curve was 0.770 for PSA (P < 0.001) and 0.823 for PSAD (P < 0.001). PSA of 4.5 ng ml-1 had sensitivity of 94.4%, specificity of 14.1%, PPV of 29.5%, and NPV of 86.9%; PSAD of 0.12 ng ml-1 cc-1 had sensitivity of 94.5%, specificity of 26.6%, PPV of 32.8%, and NPV of 92.7%. On multivariate logistic regression analyses, PSA cut-off at 4.5 ng ml-1 (OR 1.61, 95% CI 1.05-2.45, P= 0.029) and PSAD cut-off at 0.12 ng ml-1 cc-1 (OR 6.22, 95% CI 4.20-9.22, P< 0.001) were significant predictors for prostate cancer detection on TRUS-PB. In conclusion, the performances of PSA and PSAD at different cut-off levels in Chinese men were very different from those in Caucasians. PSA of 4.5 ng ml-1 and PSAD of 0.12 ng ml-1 cc-1 had near 95% sensitivity and were significant predictors of prostate cancer detection in Chinese men.
authors.affiliation: Division of Urology, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
authors.forename: Jeremy Yc
authors.initials: JY
authors.lastname: Teoh
authors.affiliation: Division of Urology, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
authors.forename: Steffi Kk
authors.initials: SK
authors.lastname: Yuen
authors.affiliation: Division of Urology, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
authors.forename: James Hl
authors.initials: JH
authors.lastname: Tsu
authors.affiliation: Division of Urology, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
authors.forename: Charles Kw
authors.initials: CK
authors.lastname: Wong
authors.affiliation: Division of Urology, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
authors.forename: Brian Sh
authors.initials: BS
authors.lastname: Ho
authors.affiliation: Division of Urology, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
authors.forename: Ada Tl
authors.initials: AT
authors.lastname: Ng
authors.affiliation: Division of Urology, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
authors.forename: Wai-Kit
authors.initials: WK
authors.lastname: Ma
authors.affiliation: Division of Urology, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
authors.forename: Kwan-Lun
authors.initials: KL
authors.lastname: Ho
authors.affiliation: Division of Urology, Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong, China.
authors.forename: Ming-Kwong
authors.initials: MK
authors.lastname: Yiu
mesh_terms: D000368:Aged; D019540:Area Under Curve; D044466:Asian People; D062005:Biopsy, Large-Core Needle; D002681:China; D006801:Humans; D061705:Image-Guided Biopsy; D007610:Kallikreins / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000378:metabolism*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014463:Ultrasonography
chemical_list: C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen