Can volume measurement of the prostate enhance the performance of complexed prostate-specific antigen?

Yoshio Naya, Thomas A. Stamey, Carol D. Cheli, Alan W. Partin, Lori J. Sokoll, Daniel W. Chan, Michael K. Brawer, Samir S. Taneja, Herbert Lepor, Georg Bartsch, Stacy Childs, Herbert A. Fritsche, Richard J. Babaian

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Abstract

We assessed whether volume-based complexed prostate-specific antigen (cPSA) indices could enhance prostate cancer detection in men with serum total PSA (tPSA) between 2.5 and 10.0 ng/mL. Between December 1998 and April 2000, cPSA assay was measured in 480 men who underwent transrectal ultrasound-guided prostate biopsies at 7 institutions. We compared the usefulness of cPSA and its indices with the ratio of free PSA (fPSA) to tPSA (percent fPSA) for early detection of prostate cancer. Overall, 168 men (35%) had cancer. In the 341 men with tPSA between 4.01 and 10.0 ng/mL at approximately 90% sensitivity and areas under the receiver operating characteristics curve, the performances of volume-based parameters were significantly better (P <0.05) than those of tPSA and cPSA. In the 139 men with tPSA between 2.5 and 4.0 ng/mL, at 90% sensitivity, the specificity of the ratio of cPSA to tPSA (percent cPSA) was best, followed by cPSA density (cPSAD). In the 101 men with the history of a previous prostate biopsy, at approximately 90% sensitivity, the specificity of cPSAD was significantly better than those of tPSA and percent fPSA (P <0.05). In the 371 men with a total prostate volume of ≥30 cm3 at approximately 90% sensitivity, the specificity of the cPSAD was significantly better than that of tPSA, percent fPSA, and cPSA (P <0.05). In the 109 men with a total prostate volume of <30 cm3, at 90% sensitivity the specificity of cPSA and cPSAD was better than that of percent fPSA. In conclusion, volume-based cPSA can modestly enhance the performance of cPSA.

Original languageEnglish (US)
Pages (from-to)36-41
Number of pages6
JournalUrology
Volume60
Issue number4 SUPPL.
DOIs
StatePublished - Oct 1 2002

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ASJC Scopus subject areas

  • Urology

Cite this

Naya, Y., Stamey, T. A., Cheli, C. D., Partin, A. W., Sokoll, L. J., Chan, D. W., Brawer, M. K., Taneja, S. S., Lepor, H., Bartsch, G., Childs, S., Fritsche, H. A., & Babaian, R. J. (2002). Can volume measurement of the prostate enhance the performance of complexed prostate-specific antigen? Urology, 60(4 SUPPL.), 36-41. https://doi.org/10.1016/S0090-4295(02)01696-5