Possibilities of using novel diagnostic indices to detect prostate cancer
https://doi.org/10.17650/1726-9776-2007-3-3-46-51
Abstract
Introduction and Objectives. The low specificity of PSA for the early diagnosis of prostate cancer was a reason for elaboration of new diagnostic methods. The aim of the study was to create novel diagnostic indices of random mathematic combinations of numeric clinical patient parameters and to estimate these values as a diagnostic tool for the detection of prostate cancer.
Material and Methods. A total of 326 male patients aged 47—83 years (mean age was 65.56.5 years) who had undergone TRUS-guided 12-core systematic transrectal prostate biopsy were included in the study. The detection rate of prostate cancer was 43,6%. To compare the accuracy of the diagnostic indices, receiver-operator characteristic (ROC) curves were plotted for any of the indices and the areas under ROC curves were calculated. Age, prostate volume, transition zone volume, peripheral and central zone volume, concentration of PSA, and biopsy result were recorded in the patients.
Results. A total of 37 indices were generated. The maximal accuracy equal to 0,664 was in «PSA Density in Transition Zone (PSAD-TZ) × Age». «PSAD × Age» and «PSAD-TZ» with an accuracy equal to 0,656 and 0,655 were on 2nd and 3rd rank positions, respectively. PSA with an accuracy of 0,583 was on 31st rank position only. With 90% specificity, the sensitivity of «PSAD × Age», «PSAD-TZ × Age», and «PSA» were 24, 22, and 19%, respectively. With 80% specificity, the sensitivity of «PSAD-TZ × Age», «PSAD × Age», and «PSA» were 47, 40, and 30%, respectively. With 90% sensitivity, there were no differences in the reduction in unnecessary biopsies. At the same time, with 80% sensitivity, «PSAD-TZ*Age» showed a 17% reduction in unnecessary biopsies as compared with «PSA» (р = 0,001).
Conclusions. The indices «PSAD-TZ × Age» and «PSAD × Age» may be used in counseling patients with suspected prostate cancer. Further multicenter studies may be required to evaluate the effectiveness of the novel indices widely used in clinical practice.
About the Authors
A. Yu. Plekhanov
«Andros» Clinic
Russian Federation
Saint Petersburg
Russian Federation
Saint Petersburg
A. V. Zhivov
«Andros» Clinic
Russian Federation
Saint Petersburg
Russian Federation
Saint Petersburg
Ye. I. Veliyev
Russian Medical Academy of Postgraduate Education
Russian Federation
Moscow
Russian Federation
Moscow
S. V. Galanin
«Andros» Clinic
Russian Federation
Saint Petersburg
Russian Federation
Saint Petersburg
A. I. Urbansky
Central Research X-Ray Radiology, Ministry of Health of the Russian Federation
Russian Federation
Saint Petersburg
Russian Federation
Saint Petersburg
References
1. Ferlay J., Bray F., Pisani P., Parkin D.M. GLOBOCAN 2002: Cancer incidence, mortality and prevalence worldwide. IARC CancerBase No.5 version 2.0. Lyon, IARC Press; 2004.
2. Матвеев Б.П., Бухаркин Б.В., Матвеев Б.В. Рак предстательной железы. М.; 2002.
3. Ellis W.J., Chetner M.P., Preston S.D., Brawer M.K. Diagnosis of prostatic carcinoma: the yield of serum prostate specific antigen, digital rectal examination and transrectal ultrasonography. J Urol 1994;152 (5 Pt 1): 1520—5.
4. Mistry K., Cable G. Meta-analysis of prostate specific antigen and digital rectal examination as screening test for prostate carcinoma. J Am Board Fam Pract 2003;16(2):95—101.
5. Stamey T.A., Yang N., Hay A.R. et al. Prostate-specific antigen as serum marker for adenocarcinoma of the prostate. N Engl J Med 1987;317(15):909—16.
6. Papsidero L.D., Wang M.C., Valenzuela L.A. et al. A prostate antigen in sera of prostatic cancer patients. Cancer Res 1980;40(7):2428—32.
7. Catalona W.J., Richie J.P., Ahmann F.R. et al. Comparison of digital rectal examination and serum prostate specific antigen in the early detection of prostate cancer: Results of multicenter clinical trial of 6630 men. J Urol 1994;151(5):1283—90.
8. Kranse R., Beemstreboer P., Rietbergen J. et al. Predictors for biopsy outcome in the European Randomized Study of Screening for Prostate Cancer (Rotterdam region). Prostate 1999;39(4):316—22.
9. Nixon R.G., Brawer M.K. Enchansing the specificity of prostate specific antigen (PSA): an overview of PSA density, velocity and age-specific ranges. Br J Urol 1997;79 (Suppl 1):61—7.
10. Catalona W.J., Southwick P.C., Slawin K.M. et al. Comparison of percent free PSA PSA Density, and age-specific PSA cutoffs for prostate cancer detection and staging. Urology 2000;56(2):255—60.
11. Урбанский А.И., Маркочев А.Б., Плеханов А.Ю. и др. Техническое усовершенствование в обработке столбиков ткани при биопсии предстательной железы. Арх патол 2005;67(2):50—1.
12. Terrris M.K., Stamey T.A. Determination of prostate volume by transrectal ultrasound. J Urol 1991;145(5):984—7.
13. Bates T.S., Reynand J.M., Peters T.J., Gingell J.S. Determination of prostate volume with transrectal ultrasound: a study of intraobserver and interobserver validation. J Urol 1996;155(4):1299—300.
Review
For citations:
Plekhanov A.Yu., Zhivov A.V., Veliyev Ye.I., Galanin S.V., Urbansky A.I. Possibilities of using novel diagnostic indices to detect prostate cancer. Cancer Urology. 2007;3(3):46-51. (In Russ.) https://doi.org/10.17650/1726-9776-2007-3-3-46-51
Views:
281
Email this article 