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PROSTATE SPECIFIC ANTIGEN DENSITY OF THE TRANSITION ZONE FOR EARLY DETECTION OF PROSTATE CANCER

1998; Lippincott Williams & Wilkins; Volume: 160; Issue: 2 Linguagem: Inglês

10.1016/s0022-5347(01)62911-2

1527-3792

Bob Djavan, Alexandre R. Zlotta, Geert Byttebier, Shahrokh F. Shariat, Mahmoud Omar, Claude C. Schulman, Michael Marberger,

Bladder and Urothelial Cancer Treatments

No AccessJournal of UrologyClinical Urology: Original Articles1 Aug 1998PROSTATE SPECIFIC ANTIGEN DENSITY OF THE TRANSITION ZONE FOR EARLY DETECTION OF PROSTATE CANCER B. DJAVAN, A.R. ZLOTTA, G. BYTTEBIER, S. SHARIAT, M. OMAR, C.C. SCHULMAN, and M. MARBERGER B. DJAVANB. DJAVAN , A.R. ZLOTTAA.R. ZLOTTA , G. BYTTEBIERG. BYTTEBIER , S. SHARIATS. SHARIAT , M. OMARM. OMAR , C.C. SCHULMANC.C. SCHULMAN , and M. MARBERGERM. MARBERGER View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)62911-2AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We compare the ability of several prostate specific antigen (PSA) parameters, including PSA density of the whole prostate and of the transition zone, percent free PSA and PSA velocity, to enhance the specificity for prostate cancer detection and to reduce unnecessary biopsies in men with serum PSA levels of 4 to 10.0 ng./ml. Materials and Methods: This prospective study included 559 consecutive men referred for early prostate detection or lower urinary tract symptoms who had a serum PSA of 4.0 to 10.0 ng./ml. All men underwent prostatic ultrasonography and sextant biopsy with 2 additional transition zone biopsies. Specific biopsies of abnormal findings on digital rectal examination were also performed. In all cases if first biopsies were negative an additional set of biopsies was performed within 6 weeks. The ability of PSA density, PSA transition zone, PSA velocity and percent free PSA to improve the power of PSA in the detection of prostate cancer was evaluated with univariate and multivariate analyses as well as receiver operating characteristics (ROC) curves. Results: Of 559 patients 342 had histologically confirmed benign prostatic hyperplasia and 217 had prostate cancer. Mean serum PSA, PSA velocity, PSA density and PSA transition zone were statistically higher (p <0.018, p <0.037, p <0.0001 and p <0.0001, respectively) and percent free PSA was statistically lower (p <0.0001) in patients with prostate cancer than in those with benign disease. Multivariate analysis and ROC curves showed that PSA transition zone and percent free PSA were the most powerful and highly significant predictors of prostate cancer. Areas under the ROC curve for PSA transition zone and percent free PSA were 0.827 and 0.778, respectively (p = 0.01 McNemar test). Combination of free-to-total PSA with PSA transition zone significantly increased the area under the ROC curve compared to PSA transition zone alone (p = 0.020). With a 95% sensitivity for prostate cancer detection a PSA transition zone cutoff of 0.25 ng./ml./cc would result in the lowest number of unnecessary biopsies (47% PSA transition zone specificity) compared to all other PSA parameters. 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Google Scholar Departments of Urology, University Hospital of Vienna, Vienna, Austria, and Erasme Hospital, University Clinics of Brussels, Brussels, Belgium© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited ByLIN T, HUANG W and CHEN K (2018) DIFFERENTIATION OF BENIGN PROSTATIC HYPERPLASIA FROM PROSTATE CANCER USING PROSTATE SPECIFIC ANTIGEN DYNAMIC PROFILE AFTER TRANSRECTAL PROSTATE BIOPSYJournal of Urology, VOL. 171, NO. 6 Part 1, (2226-2229), Online publication date: 1-Jun-2004.KARAZANASHVILI G and ABRAHAMSSON P (2018) Prostate Specific Antigen and Human Glandular Kallikrein 2 in Early Detection of Prostate CancerJournal of Urology, VOL. 169, NO. 2, (445-457), Online publication date: 1-Feb-2003.EGAWA S, SUYAMA K, MATSUMOTO K, KUWAO S and BABA S (2018) PROSPECTIVE EVALUATION OF PROSTATE CANCER DETECTION BY PROSTATE SPECIFIC ANTIGEN RELATED PARAMETERS: COMPARISON IN SERUM AND PLASMA SAMPLESJournal of Urology, VOL. 167, NO. 1, (97-102), Online publication date: 1-Jan-2002.DJAVAN B, RAVERY V, ZLOTTA A, DOBRONSKI P, DOBROVITS M, FAKHARI M, SEITZ C, SUSANI M, BORKOWSKI A, BOCCON-GIBOD L, SCHULMAN C and MARBERGER M (2018) PROSPECTIVE EVALUATION OF PROSTATE CANCER DETECTED ON BIOPSIES 1, 2, 3 AND 4: WHEN SHOULD WE STOP?Journal of Urology, VOL. 166, NO. 5, (1679-1683), Online publication date: 1-Nov-2001.DJAVAN B, WALDERT M, ZLOTTA A, DOBRONSKI P, SEITZ C, REMZI M, BORKOWSKI A, SCHULMAN C and MARBERGER M (2018) SAFETY AND MORBIDITY OF FIRST AND REPEAT TRANSRECTAL ULTRASOUND GUIDED PROSTATE NEEDLE BIOPSIES: RESULTS OF A PROSPECTIVE EUROPEAN PROSTATE CANCER DETECTION STUDYJournal of Urology, VOL. 166, NO. 3, (856-860), Online publication date: 1-Sep-2001.BRAWER M, CHELI C, NEAMAN I, GOLDBLATT J, SMITH C, SCHWARTZ M, BRUZEK D, MORRIS D, SOKOLL L, CHAN D, YEUNG K, PARTIN A and ALLARD W (2018) COMPLEXED PROSTATE SPECIFIC ANTIGEN PROVIDES SIGNIFICANT ENHANCEMENT OF SPECIFICITY COMPARED WITH TOTAL PROSTATE SPECIFIC ANTIGEN FOR DETECTING PROSTATE CANCERJournal of Urology, VOL. 163, NO. 5, (1476-1480), Online publication date: 1-May-2000.DJAVAN B, ZLOTTA A, REMZI M, GHAWIDEL K, BASHARKHAH A, SCHULMAN C and MARBERGER M (2018) OPTIMAL PREDICTORS OF PROSTATE CANCER ON REPEAT PROSTATE BIOPSY: A PROSPECTIVE STUDY OF 1,051 MENJournal of Urology, VOL. 163, NO. 4, (1144-1149), Online publication date: 1-Apr-2000.STAMEY T and YEMOTO C (2018) EXAMINATION OF THE 3 MOLECULAR FORMS OF SERUM PROSTATE SPECIFIC ANTIGEN FOR DISTINGUISHING NEGATIVE FROM POSITIVE BIOPSY: RELATIONSHIP TO TRANSITION ZONE VOLUMEJournal of Urology, VOL. 163, NO. 1, (119-126), Online publication date: 1-Jan-2000.ZLOTTA A, DJAVAN B, PETEIN M, SUSANI M, MARBERGER M and SCHULMAN C (2018) PROSTATE SPECIFIC ANTIGEN DENSITY OF THE TRANSITION ZONE FOR PREDICTING PATHOLOGICAL STAGE OF LOCALIZED PROSTATE CANCER IN PATIENTS WITH SERUM PROSTATE SPECIFIC ANTIGEN LESS THAN 10 NG./ML.Journal of Urology, VOL. 160, NO. 6 Part 1, (2089-2095), Online publication date: 1-Dec-1998. Volume 160Issue 2August 1998Page: 411-418 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information B. DJAVAN More articles by this author A.R. ZLOTTA (ZLOTTA) Supported by a grant from the Erasme Foundation. More articles by this author G. BYTTEBIER More articles by this author S. SHARIAT More articles by this author M. OMAR More articles by this author C.C. SCHULMAN More articles by this author M. MARBERGER More articles by this author Expand All Advertisement PDF DownloadLoading ...