Zonal adjusted PSA density improves prostate cancer detection rates compared with PSA in Taiwanese males with PSA

Tsung-Hsin Chang,Marcelo Chen,Allen W. Chiu,Wei-Kung Tsai,Jen-Shu Tseng,Pai-Kai Chiang,Wun-Rong Lin

doi:10.1186/s12894-020-00717-z

Abstract

BackgroundThe current study aimed to compare the efficacy of transition zone PSA density (TZPSAD) with traditional PSA and PSA density (PSAD), for the diagnosis of prostate cancer (PCa) in Taiwanese males.MethodsMen with PSA between 4.0 and 20.0 ng/ml who underwent a transrectal ultrasound (TRUS) guided prostate biopsy between the studied period were retrospectively identified. The demographic data, PSAD and TZPSAD were calculated in all patients. Receiver operating characteristic (ROC) curves were used to analyze the accuracy of a positive PCa diagnosis.ResultsThe area under the ROC (AUC) was 0.615, 0.748 and 0.746 for PSA, PSAD and TZPSAD, respectively. The best cut-off of value for TZPSAD in predicting PCa in men with a PSA of 4.0–10.0 ng/ml was 0.367 ng/ml/ml with a sensitivity of 50% and a specificity of 77.5%. In men with a PSA of 10.1–20.0 ng/ml, the best cut-off value was 0.454 ng/ml, with a sensitivity of 74.8% and specificity of 70.9%.ConclusionThe use of TZPSAD can improve the efficiency and specificity of PSA for the diagnosis of PCa in Taiwanese men with PSA 4.0–20.0 ng/ml. TZPSAD efficiency was similar to PSAD but TZPSAD had better cancer specificity.

Highlights

The current study aimed to compare the efficacy of transition zone Prostate specific antigen (PSA) density (TZPSAD) with tradi‐ tional PSA and PSA density (PSAD), for the diagnosis of prostate cancer (PCa) in Taiwanese males
Kalish et al [8] were the first to study the use of transition zone prostate density (TZPSAD) as a more accurate predictor of PCa than PSAD is for PSA levels between 4.1 and 10.0 ng/ml
A total of 207 (27.4%) patients were diagnosed with PCa after their transrectal ultrasound (TRUS) biopsy, while 548 (72.6%) patients were negative with a benign biopsy result

Summary

Introduction

The current study aimed to compare the efficacy of transition zone PSA density (TZPSAD) with tradi‐ tional PSA and PSA density (PSAD), for the diagnosis of prostate cancer (PCa) in Taiwanese males. It has been reported to be the second most commonly diagnosed cancer and the sixth leading cause of cancer-related death among men worldwide [2,3,4]. This growing incidence may be due to the increasing trend for early detection across different countries [5]. Chang et al BMC Urol (2020) 20:151 density (PSAD) as an improved parameter for identifying PCa. Kalish et al [8] were the first to study the use of transition zone prostate density (TZPSAD) as a more accurate predictor of PCa than PSAD is for PSA levels between 4.1 and 10.0 ng/ml. The use of TZPSAD in Asian populations has been previously reported and the results revealed improved detection rates [10,11,12]

Methods

Results

Discussion

Conclusion