The use of prostate specific antigen density to enhance the predictive value of intermediate levels of serum prostate specific antigen

Prostate specific antigen (PSA) is an extremely valuable tumor marker. However, its use in detection is limited by its low positive and negative predictive values. The ability of serum PSA to distinguish between benign and malignant prostatic conditions is particularly poor in the intermediate range...

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Bibliographic Details
Published inThe Journal of urology Vol. 147; no. 3 Pt 2; p. 817
Main Authors Benson, M C, Whang, I S, Olsson, C A, McMahon, D J, Cooner, W H
Format Journal Article
LanguageEnglish
Published United States 01.03.1992
Subjects
Aged
Aged, 80 and over
Antigens, Neoplasm - blood
Biomarkers, Tumor - blood
Densitometry
Humans
Male
Middle Aged
Predictive Value of Tests
Prostate - diagnostic imaging
Prostate - pathology
Prostate-Specific Antigen
Ultrasonography
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Summary:Prostate specific antigen (PSA) is an extremely valuable tumor marker. However, its use in detection is limited by its low positive and negative predictive values. The ability of serum PSA to distinguish between benign and malignant prostatic conditions is particularly poor in the intermediate range of 4.1 and 10 ng./ml. by the Hybritech assay. We used transrectal ultrasound determined prostate volumes in a well characterized population of 533 men to form a serum PSA/prostate volume ratio called prostate specific antigen density (PSAD). The prevalence of cancer in the entire population was 18.4%. Discriminant analysis according to negative or positive outcome allowed for the construction of nomograms, which resulted in a PSAD defined cancer risk ranging from 3 to 100%. Predictive value nomograms created from PSAD may allow for a more individualized approach to evaluation of patients with intermediate levels of Hybritech serum PSA.
ISSN:0022-5347
DOI:10.1016/S0022-5347(17)37394-9