J Korean Continence Soc.  2006 Dec;10(2):165-170.

Serum Prostate-Specific Antigen as a Predictor of Prostate Volume in Men with Benign Prostatic Hyperplasia

Affiliations
  • 1Department of Urology, Sungkyunkwan University School of Medicine, Masan Samsung Hospital, Masan, Korea. natisururo@yahoo.co.kr

Abstract

PURPOSE: The purpose of this study was to assess the utility of total prostate-specific antigen(PSA) as a predictor of the prostatic volume in men with symptomatic benign prostate hyperplasia(BPH).
MATERIALS AND METHODS
From 1999 to 2003, data were collected from 942 patients complaining of lower urinary tract symptoms(LUTS). Baseline prostatic volume(PV) and serum PSA were measured using transrectal sonography and ELSA-PSA2 kit. Patients with a history of prostate surgery, prostatic cancer and conditions other than BPH at baseline were excluded. Transrectal prostatic biopsy was performed in 162 of patients with a serum PSA >4.0 ng/ml to exclude prostatic cancer. A log-transformed linear regression model was used to estimate threshold PVs in men with BPH, and to select the optimal serum PSA cut-off values.
RESULTS
The analyses included 942 patients with a mean age of 63.8 years, mean baseline PV 29.59 ml, and mean baseline PSA value 2.37 ng/ml. PV as well as serum PSA increased with age. Linear regression analyses showed that PV and serum PSA have an age-dependent log-linear relationship. Optimal serum PSA cut-off values for the overall study population irrespective of age was 1.7 ng/ml (AUC: 0.800+/-0.053) to detect PV >30 ml and 2.2 ng/ml (AUC: 0.805+/-0.027) to detect PV >40 ml. The age-specific criteria for detecting men with prostate glands exceeding 40 ml are PSA >1.9 ng/ml (AUC: 0.800+/-0.053), >2.2 ng/ml (AUC: 0.805+/-0.027), and >3.4 ng/ml (AUC: 0.763+/-0.039) for men with BPH in their 50 s, 60 s, and 70 s, respectively.
CONCLUSION
This study suggests that PV is strongly related to serum PSA in men with BPH and the relationship depends on age. The age-specific criteria for detecting men with prostate glands exceeding 40 ml are PSA >1.9 ng/ml, >2.2 ng/ml, and >3.4 ng/ml for men with BPH in their 50 s, 60 s, and 70 s, respectively. And in the absence of reliable direct measurement of PV, serum PSA can estimate the degree of prostate enlargement accurately to be useful for therapeutics, especially medical management.

Keyword

Benign prostatic hyperplasia; Prostate-specific antigen; Prostate volume

MeSH Terms

Biopsy
Humans
Linear Models
Male
Prostate*
Prostate-Specific Antigen*
Prostatic Hyperplasia*
Prostatic Neoplasms
Urinary Tract
Prostate-Specific Antigen
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