PURPOSE: To assess the clinical utility of the prostate-specific antigen mass ratio (PSA- MR), a newly developed PSA derivative, simply defined as the (i) PSA density (PSA-D) multiplied by the plasma volume or (ii) total PSA amount in circulation per prostate volume, for predicting prostate cancer (PCa) among men undergoing repeated prostate biopsy (PBx).
MATERIALS AND METHODS: Patients (n = 286), who underwent a repeated PBx, were analyzed. The various parameters associated with PCa detection were noted in each patient. PSA-MR was also calculated.
RESULTS: PCa was detected in 63 (22.0%) of 286 patients. PSA-MR was the independent predictor in the univariate- and multivariate logistic regression analyses (OR = 3.448, p = 0.001 and OR = 13.430, p = 0.033, respectively). A nomogram that incorporated PSA-MR was considered a useful tool (predictive accuracy: 79.2%, 95% CI: 0.726-0.858, p < 0.001). Furthermore, a nomogram that incorporated PSA-MR would have avoided 59.6% of unnecessary repeated PBx. The predictive accuracy of PSA-MR was also superior to that of PSA or PSA-D (p = 0.013 and 0.009, respectively).
CONCLUSIONS: PSA-MR was an independent predictor, and its consideration would have avoided 59.6% of unnecessary repeated PBx for PCa detection. PSA-MR was also superior than PSA or PSA-D. Our results support the use of PSA-MR to facilitate counseling with patients after a negative initial PBx, and use of PSA-MR might reduce further unnecessary biopsies.
Lee WK, Lee S, Hong SK, Lee SE, Choi WS, Byun SS. Are you the author?
Department of Urology, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea; Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea; Department of Urology, Choi Won Suk Urology Clinic, Yongin, Korea.
Reference: Int Braz J Urol. 2014 Jul-Aug;40(4):484-92.