Value of various PSA parameters for diagnosing prostate cancer in men with normal digital rectal examination

Abstract

Objectives: The risks of identifying prostate cancer (PCa) in patients with serum total PSA (tPSA) between 4 and 10 ng/dl are between 25 and 35%. There are no data in Brazil showing the incidence of disease when all variables for PSA assessment are considered altogether, specifically tPSA, free fraction, PSA velocity and PSA stratified by age. The objective in this work was to define the incidence of disease in a population of men with abnormal values of PSA variables and normal digital rectal examination.Materials and Methods: Between 1998 and 2003, 273 prostate biopsies were performed by the same radiologist and analyzed by the same pathologist. All patients had a normal digital rectal examination and biopsy had been indicated due to tPSA above 4 ng/dl or free-to-total PSA ratio (F/T PSA) below 15% or PSA velocity higher than 25% per year or a PSA level regarded as high for the age range. The relationship between these parameters and the positivity for prostate caner was determined.Results: Patients' mean age was 63.8 years, and PCa was identified in 135 cases (49.5%). The incidence of PCa, related to unitary variations in tPSA, ranged from the limits of 33 to 80%, respectively, in tPSA < 3 and PSA between 15.1 to 20. When the other PSA parameters were assessed (free PSA, PSA according to age, rise velocity) PCa was detected in more than 25.3% of cases.Conclusion: When patients with normal digital rectal examination are selected for prostate biopsy due to tPSA levels above 4 or F/T PSA ratio lower than 15% or PSA velocity higher than 25% per year or high PSA for the age range, the incidence of PCa is quite higher than that observed in a population selected exclusively with basis on total PSA value.

The Diagnostic Values of Pretreatment Serum Inflammation Markers and Lipoprotein in Men With Total Prostate-Specific Antigen Between 4 and 10 ng/ml

“…The Perdana et al study reviewed the risk factors of PCa and found that the risk increased significantly in black men aged over 40 and white men aged over 50 without family history of the cancer ( 12 ). The Miotto et al study found that serum tPSA level could be the basis of selecting transrectal ultrasound-guided prostate biopsy as a treatment ( 13 ). Now, tPSA has been widely used clinically in the diagnosis of prostate cancer.…”

Association of the Serum Vascular Endothelial Growth Factor Levels With Benign Prostate Hyperplasia and Prostate Malignancies

“…According to our study, it may differentiate cancerous prostate from benign hyperplasia and according to Duque et al study (7), it can discriminate metastatic disease from its localized form. In this regards, VEGF may resolve the drawback of PSA, which is tissue-specific rather than prostate cancer-specific and its serum concentration might be affected by several benign conditions (1, 18). Such false-positive results of PSA may unsubstantially necessitate further diagnostic evaluation, impose extra expenses, and lead to the employing more invasive procedures.…”

“…Due to the magnitude of the impact over public health, strong efforts have been made aiming the prevention, early diagnosis, and treatment of this disease (1). …”

Thioredoxin Reductase as Biomarker for Differential Diagnosis of Prostate Cancer

“…Prostate cancer is the fourth cause of death in men worldwide. Due to the magnitude of the impact over public health, strong efforts have been made aiming the prevention, early diagnosis, and treatment of this disease (Miotto et al, 2004 andMiyoshi et al, 2014).…”