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Japanese Journal of Clinical Oncology 30:337-342 (2000)
© 2000 Foundation for Promotion of Cancer Research

The Clinical Utility of Measuring Total PSA, PSA Density, {gamma}-Seminoprotein and {gamma}-Seminoprotein/Total PSA in Prostate Cancer Prediction

Ryusei Sasaki1, Tomonori Habuchi1, Kazunari Sato1, Toshiya Akao1, Hideaki Kakinuma1, Zhang Li-Qing1, Wang Lizhong1, Shigeki Matsuo2, Shuuhei Sasaki2, Osamu Ogawa3 and Tetsuro Kato1

,+ 1Department of Urology, Akita University School of Medicine, Akita, 2Akita Municipal Hospital, Akita and 3Kyoto University Graduate School of Medicine, Kyoto, Japan

Background: To evaluate whether serum total prostate-specific antigen (PSA), PSA density (serum total PSA level divided by prostate volume), {gamma}-seminoprotein and {gamma}-seminoprotein/total PSA ratio could predict prostate cancer (PCa) prior to biopsy.

Methods: A total of 316 consecutive patients who had undergone transrectal prostate biopsy and/or transurethral resection were examined. The prostate volume was determined by trans­rectal ultrasonography (TRUS) and the ability of the above-mentioned four variables to distinguish PCa from benign prostatic hyperplasia (BPH) was evaluated.

Results: PCa was detected in 61 cases. Receiver-operating characteristic (ROC) analysis revealed that both the PSA density and serum total PSA were the most useful predictors of PCa among the four variables. For the patients with a serum total PSA level of 4.1–10.0 ng/ml, PSA density was significantly more accurate than total PSA (p < 0.005). An optimum PSA density value of 0.18 was chosen as a cutoff because it showed the highest sum of sensitivity and specificity, 92 and 54%, respectively. Using this PSA density cutoff, the number of biopsies could have been reduced to 57 from 63% when compared with a PSA density of 0.15.

Conclusions: PSA density was significantly more accurate than other variables in predicting PCa. To avoid unnecessary biopsies, the PSA density cutoff value of 0.18 would be recommendable for determining a prostate biopsy for Japanese males with a serum total PSA level of 4.1–10.0 ng/ml.

+ For reprints and all correspondence: Tetsuro Kato, Department of Urology, Akita University School of Medicine, 1–1–1 Hondo, Akita, 010-8543, Japan


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