Role of resistance index of prostatic capsular artery in diagnosis of prostate cancer
0
Citation
0
Reference
20
Related Paper
Abstract:
Objective To investigate the relationship between resistance index(RI) of prostate capsular artery and prostate cancer(PCa).Methods The RI of prostatic capsular artery was measured in 87 patients undergoing transrectal ultrasound-guided needle prostate biopsy.The results were analyzed with those of total proastate specific antigen(tPSA),free/total PSA(f/tPSA) and proastate specific antigen density(PSAD).The cutoff value of RI for diagnosing PCa was determined by ROC curve.Results Of 81 cases,31 patients were diagnosed as PCa and 56 cases were with benign prostatic hyperplasia(BPH).The RI of prostatic capsular artery was higher in PCa patients than that in BPH patients(0.78±0.10 vs.0.72±0.10)P0.05).The values of tPSA,f/tPSA and PSAD were also significantly different between PCa and BPH patients(P0.05).However,higher RI and PSAD were found only in PCa patients among those with gray PSA value(4-10 ng/ml)(P0.05).The best cutoff value determined by ROC curve to diagnose PCa was 0.72.The sensitivity and specificity for diagnosing PCa were 77.4% and 78.6%,respectively,when two cutoff values of RI≥0.72 and PSAD0.15 ng·ml-1·cm-3 were serially combined.Conclusion RI of prostatic capsular artery might have significant clinical value in differentiating PCa from BPH among the patients underwent needle prostate biopsy,especially among those with PSA gray value.The relative high sensitivity and specitivity of diagnosing PCa could be achieved by serially combined detecting RI of prostatic capsular artery and PSAD.Keywords:
Cut-off
Prostate biopsy
Cite
Objective:To investigate the clinical value of serum total PAS and the ratio of free to total PSA(FT) in differential diagnosis benign prostate hyperplasia(BPH)and prostatic carcinoma(PCa).Methods:Serum FPSA and TPSA were measured in 137 patients with prostate carcimoma(PCa) and benign prostate hyperplasia(BPH) by using enzyne linked immunosorbent assay and the ratio of FPSATPSA was calculated.Results: The comparison of TPSA and FTPSA between total of the two kinds of diseases showed statistical significance.Total PSA,FTPSA were significantly discriminated between PCa and BPH (P0.01) when the assessed value were much higher beyond gray zone.But the assesses value were within the gray zone,only the comparison of FTPSA showed statistical significance (P0.05).The assessed value were in lower value range beyond the gray zone, TPSA, FTPSA could not specifically differentiate between the two conditions (both were P0.05).Conclusion: Serum TPSA is a marker, the determination of TPSA is the important method in diagnosis of prostatic carcinoma,But within gray zone,FTPSA has more important role in discriminating the PCa and BPH.
Prostate carcinoma
Clinical Significance
Cite
Citations (0)
The aim of this study was to explore the value of the prostate-specific antigen (PSA) levels, the ratio of free PSA to total PSA (fPSA/TPSA), the PSA density (PSAD), digital rectal examination (DRE), transrectal prostate ultrasound (TRUS), and multiparameter MRI (MP-MRI) in the differential diagnosis of benign prostatic hyperplasia (BPH) and prostate cancer (PCa).From February 2016 to September 2019, data from 620 patients who underwent systematic transrectal ultrasound-guided prostate biopsy (STURS-PB) in our hospital were retrospectively collected, including the PSA levels, the fPSA/TPSA ratio, the PSAD, DRE, TRUS, MP-MRI, prostate volume, and other clinical data.Among the 620 patients, 249 patients were in the PCa group, and 371 patients in the BPH group. The positive puncture rate was 40.16%. The positive predictive values of DRE, TRUS, mpMRI, and TPSA levels for PCa were 39.91%, 39.38%, 64.14%, and 41.57%, respectively; the sensitivity of these parameters was 37.35%, 51.41%, 74.69%, and 57.43%, respectively; and the specificity of these parameters was 62.26%, 46.90%, 71.97%, and 45.82%, respectively. When the TPSA concentration was in the range of 4-20 ng/mL, the positive puncture rate of STURS-PB was 23.18%, with a high rate of misdiagnosis. When the TPSA concentration was in the range of 4-20 ng/mL, the fPSA/TPSA ratio was 0.15, the PSAD was 0.16, the comprehensive evaluation of PCa was optimal (the sensitivity of these parameters was 88.85% and 84.09%, respectively; the specificity was 80.17% and 67.29%, respectively; the positive predictive value was 57.41% and 51.39%, respectively). When the TPSA concentration >4 ng/mL, the fPSA/TPSA ratio ≤0.15 and the PSAD ≥0.16, the sensitivity, specificity, and correctness index of the PCa and BPH diagnosis were 80.54%, 82.75%, and 67.07%, respectively.When using DRE, TRUS, and MP-MRI to screen for PCa, MP-MRI has a relatively high sensitivity and specificity. Using these three thresholds (TPSA >4 ng/mL combined with an fPSA/TPSA ratio ≤0.15 and a PSAD ≥0.16) is significantly better than using TPSA levels alone for the differential diagnosis of PCa and BPH.
Rectal examination
Prostate biopsy
Cite
Citations (10)
Resistive index
Hematology
Prostate biopsy
Cite
Citations (3)
Objective To study the diagnostic value of prostate specific antigen (PSA) and prostate specific antigen density (PSAD) in benign prostatic hyperplasia (BPH) and prostate cancer (PCA) by quantitative determination of serum PSA,and of PSAD.Methods Measuring serum PSA in 23 cases of BPH,4 cases of PCA and 40 cases of normal person by radio-immunoassay (RIA),and PSAD in 23 cases of BPH,4 cases of PCA by sonography.Results Of 23 cases BPH patients,PSA levels were higher than 10 μg/L in 44%,lower than 10 μg/L in 30%,between 4 μg/L and 10 μg/L in 26%.Of 4 cases PCA patients,PSA levels were higher than 10 μg/L in 75%,lower than 10 μg/L in 25%.PSA levels both in BPH group and in PCA group were significantly higher than in normal group (P0.01).Sensitivity was 75%,25%;specificity was 30%,48%,with cutoff points of 0.1 and 0.2 respectively.Conclusion PSA and PSAD have certain diagnostic value in BPH and PCA,but the value for differentiating PCA from BPH is little.PSAD is not more effective than PSA in the diagnosis of BPH and PCA.
Prostatic Diseases
Cite
Citations (0)
Prostate biopsy
Cite
Citations (2)
Objective To evaluate diagnositic value of prostate specific antigen (PSA), free/total PSA (f/t PSA), and PSA density (PSAD) in differentiating benign prostatic hyperplasia (BPH) and prostatic cancer (PCa) and compare sensitivity and specificity of f/t PSA and PSAD in different setting cutoff. Methods Retrospecetive analyzing of serum tPSA, f/tPSA and PSAD were performed in BPH group(229 patients) and PCa group(138 patients), prostate volume was obtained by transrectal ultrasound(TRUS). Results In group 1(PSA﹤4ng/ml), tPSA, f/t PSA, PSAD had no significant difference(P﹥0.05); in group 2(PSA 4~10ng/ml), f/tPSA, PSAD had statistical difference(P﹤0.05, P﹤0.01);while in group 3(PSA﹥10ng/ml), tPSA, f/t PSA and PSAD had signigicant difference(P﹤0.01). When the cutoff of f/t ratio and PSAD were set as 0.12 and 0.22 respectively, the sensitivity of diagnosing PCa were 68.3% and 83.3%, and speicificity were 75.6% and 63. 8%. Conclusions f/t PSA and PSAD have important clinical value in diagnosing PCa.
Cut-off
Cite
Citations (0)
Objective To study and observe the differential diagnostic value of transrectal ultrasound combined with PSAD on early prostate cancer and benign prostate hyperplsia.Methods The clinical data of 42 patients with prostatic disorders treated in our hospital from May 2009 to June 2012 were analyzed retrospectively.All the patients received differential diagnosis of transrectal ultrasound combined with PSAD after admission.Through the examination and confirmation of prostate needle biopsy or postoperative pathology,19 patients with prostate cancer were set as PCa group and 23 patients with moderate to severe benign prostate hyperplsia were set as BPH group.The characteristics of transrectal ultrasound and test results of PSAD in 2 groups were compared.Results Prostate volume of PCa group was significantly larger than that of BPH group(P0.05),and the incidence rate of abnormal blood flow signal in PCa group was significantly higher than that of BPH group(P0.05).But there was no significant difference in the incidence rate of abnormal echo tubercle between two groups(P0.05).And PSAD value in PCa group was significantly higher than that of BPH group(P0.05).Section distribution rate with more than 0.2 ng/mL in PCa group was significantly higher than that of BPH group(P0.05),and section distribution rate with less than 0.1 ng/mL was significantly lower than that of BPH group.And there was no significant difference in section distribution rate from 0.1 ng/mL to 0.2 ng/mL between two groups(P0.05).Conclusion Abnormal blood flow sign is the characteristic of transrectal ultrasound for prostate cancer and PSAD is a sensitive predictor of prostate cancer.The combination application of them has high differential diagnosis value on prostate cancer and benign prostate hyperplsia.
Prostate biopsy
Cite
Citations (0)
Objective To investigate the utility of serum prostate specific antigen(PSA) density (PSAD),prostate antigen transition zone density(PSAT) and the ratio of free/total PSA with PSAD [(F/T)/PSAD] in the diagnosis of prostatic carcinoma (PCa) by three-dimensional ultrasonography.Methods Seventy-eight patients (serum prostate-specific antigen between 4-20 μg/L ) were involved.The prostatic volume and its transition zone volume were measured by three-dimensional ultrasonography.Then the relative parameters of PSA [PSAD,PSAT and (F/T)/PSAD] were calculated.Pathologic types were determined by using needle biopsy of prostate.Results Among them,27 patients were suffering from PCa,while the other 51 benign prostate hypertrophy (BPH).The difference of PSAD,PSAT and (F/T)/PSAD between PCa and BPH had arrived statistical significance (P 0.20,PSAT>0.33,(F/T)/PSAD<0.8.Conclusions When the serum PSA level is between 4 μg/L and 20 μg/L,PSAD,PSAT and (F/T)/PSAD are of significant value to differentiate PCa from benign prostatic hyperplasia patients.The data are more reliable if prostatic volume are calculated by three-dimensional transrectal ultrasonography.
Key words:
Ultrasonography; Prostatic neoplasms; Prostatic hyperplasia; Prostate-specific antigen
Transrectal ultrasonography
Cite
Citations (0)
To evaluate if prostate specific antigen density (PSAD), the ratio of serum PSA level to volume of prostate, can enhance the ability of PSA in differentiating prostatic adenocarcinoma (PCa) from benign prostatic hyperplasia (BPH), a retrospective study was conducted on patients having undergoing prostatic operations in our institution between April 1993 and Janurary 1996. Of the 517 patients with a preoperative serum PSA level ＜50 ng/Ml, 50 were documented to be PCa and 467 were to be BPH. There were significant differences in both the mean PSA (20.5 vs. 7.2 ng/mL, P＜0.001) and the mean PSAD (0.94 vs. 0.21, P＜0.001) values between patients with PCa and those with BPH. These patients were then divided into 4 groups according to their serum PSA levels (PSA: 0-4.0 ng/mL; 4.1-10.0 ng/mL; 10.1-20.0 ng/Ml; and 20.1-50.0 ng/mL) and patients with PCa and those with BPH were compared in each group with respect to the values of PSA and PSAD. PSAD was significantly better than PSA in differentiating PCa from BPH in the group with serum PSA level of 4.1 to 10.0 ng/mL (P＜0.0001 vs. P=0.69) and in that with a serum PSA level of 10.1 to 20.0 ng/mL(P＜0.0001 vs. P=0.82). Subsequently, the diagnostic efficacy of PSAD in distinguishing PCa from BPH in patients with a serum PSA of 4.1 to 20.0 ng/mL was evaluated. By using PSAD of 0.15 as a cutoff point, the sensitivity in differentiating PCa from BPH was 85%, the specificity was 22%, and the positive predictive value was 9%. Raising the cutoff value to 0.20 resulted in a sensitivity of 80%, a specificity of 48% and a positive predictive value of 12%. We conclude from this study that although PSAD could better discriminate between PCa and PBH in patients with a serum PSA of 4.1 to 20.0 ng/mL than PSA, its clinical value when used alone is limited by its imperfect specificity and positive predictive value.
Cite
Citations (0)
Objective
To explore the clinical value of resistance index (RI) of prostatic capsular artery in predicting or screening of prostate cancer (PCa) by comparing prostatic capsular artery RI with the serum total prostatic specific antigen (TPSA), fPSA/tPSA ratio and prostatic specific antigen dernsity (PSAD).
Methods
RI of prostate capsular artery, serum TPSA, of fPSA/tPSA ratio and PSAD were measured with colour Doppler ultrasonography in this subset of 203 patients who had undergone transrectal ultrasound guided prostate puncture biopsy. The patients were divided into two groups [PCa and benign prostatic hyperplasia (BPH) group] for comparative study.
Results
Of them, the level of TPSA were between 4 and 10 ng/ml (grey area) in 34 cases, accounts for 16.75% of the total subjects. All the others were outside the grey area. ROC curve analysis showed that the area under the curve (AUC) of RI of the capsular artery was 0.77, which was close to 0.84 and 0.86 of TPSA and PSAD. It indicated a similar value in predicting or screening PCa; while the AUC of fPSA/tPSA ratio was only 0.49, which had little clinical value. The fPSA/tPSA ratio and the mean value of PSAD in the grey area had significant differences (t=2.78, 3.94, P 0.05). And the mean value of RI of prostatic capsular artery had significant differences between the two groups both in the grey area and in the high value area outside the grey area (t=4.56, 5.10, P<0.001).
Conclusions
RI of prostatic capsular artery can be steadily used to predict or screen PCa. It is not affected by the gray area of TPSA and is of great value in clinical practice.
Key words:
Prostatic neoplasms; Total prostatic specific antigen; Prostatic specific antigen dernsity
Transrectal ultrasonography
Prostate biopsy
Cite
Citations (0)