Can Serum PSA Predict Prostate Volume in Men with Benign Prostatic Hyperplasia?

Yu, Dong Wook; Park, Seung Chol; Seo, Ill Young; Rim, Joung Sik

Abstract

PURPOSE: To analyze the ability of serum prostate specific antigen (s-PSA) to predict the prostate volume by characterizing the relationship between the prostate volume and serum PSA in men with benign prostate hyperplasia.
MATERIALS AND METHODS
We evaluated 1,254 patients, with lower urinary tract symptoms, who had visited our hospital between Jan. 2002 and Aug. 2004. All patients with prostate cancer, prostatitis, and a history of prostatic surgery and alpha-blocker or 5-alpha reductase inhibitor medication were excluded from the study. The baseline s-PSA and prostate volume were determined using standard techniques. Pearson's correlation coefficient was used to analyze the relationship between the s-PSA and prostate volume, and a linear regression model to estimate the prostate volume. Receiver operating characteristics (ROC) curves were constructed to evaluate the ability of the s-PSA to predict cut-off values for assessing prostate enlargement.
RESULTS
The analyses included 959 patients, with mean age, baseline s-PSA and prostate volume of 68.2 years, 3.4ng/ml and 34.4ml, respectively. The s-PSA and prostate volume increased with age. The prostate volume correlated positively with s-PSA (r=0.292, p<0.01). The linear regression analyses showed that the s-PSA and prostate volume had an age-dependent linear relationship. According to the ROC curves, the optimal s-PSA cut-off values for the entire study population were 1.5ng/ml to detect a prostate volume>30ml and 2.0ng/ml to detect a prostate volume>40ml.
CONCLUSIONS
The prostate volume is strongly related to the s-PSA and age in men with benign prostatic hyperplasia (BPH). Since treatment outcomes and the risk of long-term complications depend on the prostate volume, the serum PSA may sufficiently estimate prostate enlargement to be useful in therapeutic decision making in men with BPH.