Strategy for Prostate Cancer Patients with Low Prostate Specific Antigen Level (2.5 to 4.0 ng/mL)

• Published in: Journal of Korean medical science Vol. 35; no. 41; p. e342
• Main Authors: Chung, Jae Hoon, Yu, Jiwoong, Song, Wan, Kang, Minyong, Sung, Hyun Hwan, Jeon, Hwang Gyun, Jeong, Byong Chang, Seo, Seong IL, Lee, Hyun Moo, Jeon, Seong Soo
• Format: Journal Article
• Language: English
• Published: The Korean Academy of Medical Sciences 26.10.2020; 대한의학회
• Subjects: Original; 의학일반
• ISSN: 1011-8934; 1598-6357
• DOI: 10.3346/jkms.2020.35.e342

BACKGROUNDTo evaluate the strategy for detection of prostate cancer (PCa) with low prostate specific antigen (PSA) level (2.5-4.0 ng/mL), prostate biopsy patients with low PSA were assessed. We evaluated the risk of low PSA PCa and the strategy for screening low-PSA patients. METHODSWe retrospectively analyzed the patients who underwent prostate biopsy with low PSA level. Baseline characteristics, PSA level before prostate biopsy, prostate volume, prostate specific antigen density (PSAD), and pathological data were assessed. RESULTSAmong the 1986 patients, 24.97% were diagnosed with PCa. The PSAD was 0.12 ± 0.04 ng/mL² in the PCa-diagnosed group and 0.10 ± 0.04 ng/mL² in non-cancer-diagnosed group (P < 0.001). Of the 496 patients diagnosed with PCa, 302 (60.89%) were in the intermediate- or high-risk group. PSAD was 0.13 ± 0.04 ng/mL² in the intermediate- or high-risk group and 0.11 ± 0.03 ng/mL² in the very low- and low-risk group (P < 0.001). Of 330 patients who underwent radical prostatectomy, 85.15% were diagnosed as having significant cancer. There was significant correlation between PSAD and PCa (r = 0.294, P < 0.001). PSAD with a specificity of 80.00% of a clinically significant cancer diagnosis was assessed at 0.1226 ng/mL². CONCLUSIONThe PCa detection rate in the low-PSA group was not lower than that of previous studies of patients with PSA from 4.0 to 10.0 ng/mL. Further, it may be helpful to define a strategy for PCa detection using PSAD in the low-PSA group.