Determination of Reference Values for Total PSA, F/T and PSAD According to Prostatic Volume in Japanese Prostate Cancer Patients with Slightly Elevated Serum PSA Levels

Abstract

The reference values for total PSA, F/T and PSAD must be changed according to prostatic volume in order to maintain a sufficient diagnostic sensitivity of CAP. Of these parameters, PSAD showed a high specificity in the group with a prostatic volume of <40 ml.

The ratio of prostate‐specific antigen (PSA) to prostate volume (PSA density) as a parameter to improve the detection of prostate carcinoma in PSA values in the range of < 4 ng/mL

“…These results are in contrast to most other studies, which usually preferred PSAD cut-off levels near 0.15. 24,38,42 In another comparable study regarding the number of patients (n ϭ 1913 patients), Kuriyama et al 29 recommended different reference values for PSAD according to prostate volume. It can seen in Table 2 that our data confirm the lower PSAD values with increasing volume.…”

“…4 -9,35 To date, only 1 study has been performed in Ͼ 1000 men to verify the parameters PSA, PSAD, and %fPSA. 29 In 1913 Japanese men who had a tPSA from 2 ng/mL to 20 ng/mL, the specificity of all parameters was low for men who had prostate volumes Ͼ 40 mL but was better in men who had smaller glands (Ͻ 20 mL). 29 The authors of that report concluded that reference values for tPSA, %fPSA, and PSAD must be changed according to prostate volume.…”

“…29 In 1913 Japanese men who had a tPSA from 2 ng/mL to 20 ng/mL, the specificity of all parameters was low for men who had prostate volumes Ͼ 40 mL but was better in men who had smaller glands (Ͻ 20 mL). 29 The authors of that report concluded that reference values for tPSA, %fPSA, and PSAD must be changed according to prostate volume. 29 Although the Japanese study had a large sample size, there are differences in PCa detection rates and other PCa parameters between Japanese men and Caucasian men, making their application on the Western world difficult.…”

“…16,17,[22][23][24][25][26][27][28][29][30][31][32] Although most studies showed an advantage of using PSAD compared with PSA alone, only a few studies could demonstrate further a better performance of PSAD compared with %fPSA. [32][33][34] Two of those studies included relatively small numbers of patients (n ϭ 43 patients and n ϭ 105 patients).…”

“…29 The authors of that report concluded that reference values for tPSA, %fPSA, and PSAD must be changed according to prostate volume. 29 Although the Japanese study had a large sample size, there are differences in PCa detection rates and other PCa parameters between Japanese men and Caucasian men, making their application on the Western world difficult. The objectives of the current study were 1) to evaluate PSAD specifically compared with %fPSA in different tPSA ranges from 2 ng/mL to 20 ng/mL, 2) to evaluate PSAD within different prostate size ranges in a large Caucasian population, and 3) to establish possible cut-off levels depending on the tPSA.…”