Does Prostate-Specific Antigen Density Alter Decision Making on Biopsy?
| Autor: | T.M. De Reijke, G. van Andel, R. Vleeming, Karl-Heinz Kurth, A. J. M. De Craen |
|---|---|
| Přispěvatelé: | Other departments |
| Rok vydání: | 1996 |
| Předmět: |
Adult
Male medicine.medical_specialty Adenoma Biopsy Urology Decision Making urologic and male genital diseases Prostate cancer Prostate medicine Humans Aged Probability Ultrasonography Aged 80 and over Palpation medicine.diagnostic_test business.industry Biopsy Needle Prostatic Neoplasms Rectal examination Middle Aged Prostate-Specific Antigen medicine.disease Surgery Pre- and post-test probability Prostate-specific antigen medicine.anatomical_structure ROC Curve Transrectal ultrasonography business |
| Zdroj: | European urology, 29(1), 10-14. Elsevier |
| ISSN: | 1873-7560 0302-2838 |
| DOI: | 10.1159/000473710 |
| Popis: | Objective : The ability of prostate-specific antigen density (PSAD) to predict prostate cancer in biopsy specimens is evaluated in patients with benign digital rectal examination (DRE) and prostate-specific antigen (PSA) between 4.0 and 10.0 ng/ml. Material and Methods : 144 referred patients with a benign DRE and PSA > 4.0 ng/ml were additionally evaluated by transrectal ultrasonography and transrectal biopsies. PSAD values were calculated and statistical analysis was performed. Results : The mean PSAD value was able to distinguish significantly between benign prostate conditions and prostate cancer in patients with PSA > 4.0 ng/ml. However, in 73 patients with 4.0 < PSA ≤ 10.0 ng/ml no significant stratification was obtained. At a PSAD value of 0.15 the pretest probability of 18% for positive biopsy was lowered to a posttest probability of 8.1% and PSAD appeared to be of limited value regarding sensitivity and specificity at different cutoff values (ROC curve). Applying age-specific reference ranges would have reduced diagnostic procedures for men between 60 and 79 years old with 7.0% without missing prostate cancer. Conclusions: In this study PSAD was shown to have only a moderate additive value in decision making to omit biopsy for the individual patient with benign DRE and PSA between 4.0 and 10.0 ng/ml. Age-specific reference ranges of PSA can prevent unnecessary diagnostic procedures. |
| Databáze: | OpenAIRE |
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