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document
Comparison of prostate-specific antigen corrected for total prostate volume and transition zone volume in a population-based screening study . OBJECTIVES To compare the discriminatory potential between prostate cancer and benign conditions of the prostate in a population-based screening study , of serum prostate-specific antigen levels ( PSA ) and PSA corrected for both the total prostate volume ( PSA-D ) and the transition zone volume ( PSA-T ) . METHODS In a randomized population-based screening study ( Rotterdam section of the European Randomized Study of Screening for Prostate Cancer ) , in which 10,865 men have been screened , the biopsy results of 1202 men with PSA levels of 4 ng/mL or more were evaluated . Planimetric and prolate ellipsoid volumes of the total prostate as well as of the transition zone were measured . The measured volumes were compared with the volumes of 57 radical prostatectomy specimens through Spearman 's rank correlation coefficient and agreement tests . A receiver operating characteristic ( ROC ) curve analysis was done of sensitivity and specificity of biopsy indications through PSA and PSA corrected for the volumes measured with transrectal ultrasound . RESULTS In the 1202 men studied , 361 cases of prostate cancer were diagnosed . Both PSA-D and PSA-T showed a significantly higher area under the ROC curve ( 0.77 and 0.79 , respectively ) than PSA alone ( area 0.65 ) . There was no significant difference between PSA-D and PSA-T . The use of a PSA-D threshold value of 0 . 10 ng/mL/cc would have avoided 28 % of biopsies at the cost of 10 % of detectable cancers . A PSA-D threshold of 0.15 ng/mL/cc would have avoided 73.8 % of biopsies at the cost of not diagnosing 43.8 % of detectable cancers . CONCLUSIONS The planimetrically obtained prostate volume showed a more favorable agreement with the radical prostatectomy volume than the prolate ellipsoid volume . The discriminatory potential of the corrected PSA value is better at predicting the results of needle biopsy of the prostate when compared with PSA alone . The use of the transition zone volume for this correction results in a higher discriminatory potential when compared to the use of the total prostate volume ; however , the observed difference was not statistically significant .
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Intervention_Pharmacological
prostate-specific antigen corrected for total prostate volume
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Intervention_Pharmacological
transition zone volume
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Intervention_Physical
biopsy
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Intervention_Physical
Planimetric and prolate ellipsoid volumes of the total prostate as well as of the transition zone
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Intervention_Physical
volumes of 57 radical prostatectomy specimens
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Intervention_Physical
transition zone volume
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Intervention_Physical
total prostate volume
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Outcome_Other
area under the ROC curve
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Outcome_Physical
PSA value
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Participant_Condition
prostate cancer and benign conditions of the prostate
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Participant_Condition
PSA levels
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Participant_Sample-size
1202