Objective: To evaluate the association of prostate volume, PSAD and F/T with prostate cancer detection rate in males with a total PSA of 4-10 μg/L.
Methods: Clinical data of 196 patients who underwent prostate biopsy from November 2006 to September 2010 and with a PSA of 4-10 μg/L were retrospectively analyzed. The association of detection rate of prostate cancer with prostate volume, prostate specific antigen density PSAD) and free PSA/total PSA ratio (F/T) was analyzed by Spearman coefficient, receiver operating characteristic curve and logistic regression analysis.
Results: The prostate volume, PSAD and F/T had a significant association with detection rate of prostate cancer (P<0.05 for all). The odd ratio was 0.96, 1.91 and 0.02, respectively. The area under curve (AUR) was 0.31, 0.66 and 0.63, respectively. The cancer detection rate was decreased along with the increase of prostate volume. When PSAD 0.15 ng·ml(-1)·ml(-1) was used as the cut-off value, the sensitivity, specificity, positive prediction rate and negative prediction rate was 72.3%, 51.1%, 42.3% and 21.2%, respectively. When the patients were divided by prostate volume into <19.9, 20-39.9, 40-59.9, 60-79.9 and >80 ml subgroups, the cancer detection rate of each subgroup was 50.0%, 45.6%, 30.8%, 15.4% and 5.6%, respectively.
Conclusion: In patients with a total PSA of 4-10 μg/L, the prostate cancer detection rate has a significant association with prostate volume, PSAD and F/T.