Korean J Urol.  2011 Mar;52(3):166-171.

Predictive Factors for Prostate Cancer in Biopsy of Patients with Prostate-Specific Antigen Levels Equal to or Less Than 4 ng/ml

• Kim HW
• Ko YH
• Kang SH
• Lee JG

Abstract

PURPOSE
This study was conducted to identify the predictive factors for prostate cancer in patients with prostate-specific antigen (PSA) levels equal to or less than 4 ng/ml.
MATERIALS AND METHODS
A retrospective study of medical records was conducted on 292 patients with initial serum PSA < or =4 ng/ml among 2,305 patients who underwent prostate biopsy from January 2003 to December 2008. Prostate biopsy was performed on patients with PSA < or =4 ng/ml in the case of abnormal findings in the digital rectal examination (DRE) or transrectal ultrasonography (TRUS) or in those with a PSA level higher than the age-adjusted PSA levels. The patients were divided into the group diagnosed with prostate cancer and the non-prostate-cancer group. Subsequently, the variables of the two groups were compared.
RESULTS
The patients' mean age was significantly higher in the prostate cancer group (n=28) than in the non-prostate-cancer group (n=264; p=0.033). In addition, for the patients with a PSA range of 2.0-2.9 ng/ml, their age (p=0.049) and PSA density (PSAD; p=0.042) were significantly higher and the prostate volume (p=0.028) was significantly smaller in the prostate cancer group than in the non-prostate-cancer group.
CONCLUSIONS
Of the patients with PSA < or =4 ng/ml, the age of the patients who showed abnormal findings in the DRE or TRUS or who had a PSA level higher than the age-adjusted PSA level was a significant predictive factor for prostate cancer. In particular, for the PSA range of 2.0-2.9 ng/ml, a thorough screening test for prostate cancer was required if the patients had conditions such as higher age, smaller prostate, and higher PSAD.

Keyword

Prostate-specific antigen; Prostatic neoplasms

MeSH Terms

Biopsy
Digital Rectal Examination
Humans
Mass Screening
Medical Records
Prostate
Prostate-Specific Antigen
Prostatic Neoplasms
Retrospective Studies
Prostate-Specific Antigen

Figure

• 

  FIG. 1 Receiver operating characteristic curve analysis of age, prostate volume, and PSAD with PSA value of 2.0-2.9 ng/ml. PSAD: prostate-specific antigen density, PSA: prostate-specific antigen.

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