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Comparison of Prostate‐Specific Antigen Adjusted for Transition Zone Volume Versus Prostate‐Specific Antigen Density in Predicting Prostate Cancer by Transrectal Ultrasonography
Author(s) -
Sung Deuk Jae,
Cho Sung Bum,
Kim Yun Hwan,
Oh Yu Whan,
Lee Nam Joon,
Kim Jung Hyuk,
Chung Kyoo Byung,
Moon Du Geon
Publication year - 2004
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.7863/jum.2004.23.5.615
Subject(s) - medicine , transrectal ultrasonography , prostate specific antigen , prostate , urology , prostate cancer , ultrasonography , antigen , radiology , cancer , immunology
Objective. Prostate‐specific antigen is an excellent tumor marker, but it is not specific for prostate cancer. We evaluated the efficacy of prostate‐specific antigen adjusted for transition zone volume calculated by transrectal ultrasonography in predicting prostate cancer in men with intermediate prostate‐specific antigen levels of 4.1 to 10.0 ng/mL compared with prostate‐specific antigen density. Methods. Between June 1998 and December 2001, prostate‐specific antigen adjusted for transition zone volume was obtained from 131 patients who underwent ultrasonographically guided biopsies and had prostate‐specific antigen of 4.1 to 10.0 ng/mL. Prostate‐specific antigen density was calculated by dividing total serum prostate‐specific antigen by total prostate volume, and total serum prostate‐specific antigen was divided by transition zone volume to yield prostate‐specific antigen adjusted for transition zone volume. This was compared with prostate‐specific antigen density via receiver operating characteristic curves. Results. Of 131 patients, 34 (26%) had prostate cancer, and 97 (74%) had benign prostatic hyperplasia on pathologic examination. Total prostate volume was correlated with transition zone volume ( P < .001). Mean prostate‐specific antigen adjusted for transition zone volume and prostate‐specific antigen density were 0.71 ± 0.25 and 0.27 ± 0.09 ng • mL −1 • mL −1 in patients with prostate cancer and 0.32 ± 0.09 and 0.16 ± 0.05 ng • mL −1 • mL −1 in patients with benign prostatic hyperplasia. With a cutoff value of 0.35 ng • mL −1 • mL −1 , prostate‐specific antigen adjusted for transition zone volume had sensitivity of 82% and specificity of 84%. Receiver operating characteristic curve analysis showed that prostate‐specific antigen adjusted for transition zone volume predicted biopsy outcome significantly better than prostate‐specific antigen density ( P < .05). Conclusions. Prostate‐specific antigen adjusted for transition zone volume is more accurate than prostate‐specific antigen density in distinguishing prostate cancer from benign prostatic hyperplasia in men with intermediate serum prostate‐specific antigen of 4.1 to 10.0 ng/mL. Determination of transition zone volume by transrectal ultrasonography may be helpful for predicting the probability of positive biopsy results.