Correlation and diagnostic performance of the prostate-specific antigen level with the diagnosis, aggressiveness, and bone metastasis of prostate cancer in clinical practice

Abstract

PurposeThe common tool for diagnosing prostate cancer is serum prostate-specific antigen (PSA) testing and digital rectal examination, but the disadvantage of the high sensitivity and low specificity of PSA testing in the diagnosis of prostate cancer is a problem in clinical practice. We studied the correlation and diagnostic performance of the PSA level with cancer diagnosis, aggressiveness of prostate cancer (Gleason score>7), and bone metastasis.MethodsA total 1,116 patients who underwent transrectal ultrasound and prostate biopsy were retrospectively studied. The patients were divided into subgroups by baseline PSA level as follows: ≤4, 4.1–10, 10.1–20, 20.1–50, 50.1–100, and >100 ng/mL. The area under the receiver operating characteristic curve (AuROC), sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of each PSA level were evaluated for correlation and diagnostic performance with positive biopsy, Gleason score for aggressiveness, and bone metastasis.ResultsA positive biopsy result was found in 395 patients (35.39%). The PSA level corresponded well with the diagnosis of prostate cancer and a positive bone scan but moderately well with Gleason score as shown by AuROC for diagnosis of prostate cancer (0.82), positive bone scan (0.88), and Gleason score>7 (0.78). The specificity of a PSA level of 4.1–10, 10.1–20, 21.1–50, 50.1–100, and >100 ng/mL in the diagnosis prostate cancer was 9.3, 55.5, 87.5, 98.2, and 99.7, respectively.ConclusionsThe data showed a strong correlation of PSA level with tumor diagnosis, tumor aggressiveness, and bone metastasis. The prevalence of prostate cancer in this cohort was 35.39%. The chance of diagnosis of prostate cancer was greater than that for benign prostatic hyperplasia when the PSA level was higher than 20 ng/mL.

Serum levels of PSA, ALP, ICTP, and BSP in prostate cancer patients and the significance of ROC curve in the diagnosis of prostate cancer bone metastases

“…It showed a positive correlation with the number of bone metastatic lesions and increased following bone metastasis upstaging. It is also important for malignant tumor curative effect evaluation, clinical stage, and prognosis (Lojanapiwat et al, 2014;Fizazi et al, 2015). This study result showed that serum BSP, ALP, ICTP, and PSA levels were elevated in prostate cancer patients and were higher in the bone metastasis group compared with nonbone metastasis group.…”

Correlation between Prostate-Specific-Antigen (PSA) Level and Prostate Volume in Benign Prostatic Hyperplasia at Bhayangkara Hospital Mataram

“…4 Salah satu parameter dalam mendeteksi adanya pembesaran prostat adalah pemeriksaan kadar ProstateSpecific-Antigen (PSA) dalam darah. 5,6 Prostate-Specific-Antigen merupakan suatu protein yang disekresikan oleh kelenjar prostat. Jumlah sekresi PSA ditentukan oleh banyak faktor seperti adanya proses inflamasi, pembesaran baik BPH dan keganasan, serta manipulasi kelenjar prostat pada pemeriksaan colok dubur, masase prostat, ataupun pemasangan kateter.…”

“…Beberapa penelitian mengemukakan bahwa korelasi antara kadar PSA dengan volume prostat dapat menentukan adanya progresivitas terhadap pembesaran prostat. 5,6,9 Ras dan etnis diteliti memiliki pengaruh terhadap pembesaran prostat. 2,10,11 Terdapat perbedaan jaringan kelenjar prostat antara ras Asia dengan ras kulit putih di Negara Barat seperti Eropa dan Amerika.…”

Non-invasive Quantitative Characterization of Skeletal Metastasis in Carcinoma Prostate by Tc99m MDP Bone Scans Using Dr. V. Siva’s Retention Ratio in Correlation with Serum PSA Levels

“…In a study of 1116 it had been proved that the chance of detecting bone metastasis was greater when the srum PSA level was >20 ng/ml by Lojanapiwat et al [13]. In a study of 48 patients of Ca.…”