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Strategy for Prostate Cancer Patients with Low Prostate Specific Antigen Level (2.5 to 4.0 ng/mL)

Journal of Korean Medical Science 2020년 35권 41호 p.342 ~ 342
정재훈, 유지웅, Song Wan, 강민용, 성현환, 전황균, 정병창, 서성일, 이현무, 전성수,
소속 상세정보
정재훈 ( Chung Jae-Hoon ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
유지웅 ( Yu Ji-Woong ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
 ( Song Wan ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
강민용 ( Kang Min-Yong ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
성현환 ( Sung Hyun-Hwan ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
전황균 ( Jeon Hwang-Gyun ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
정병창 ( Jeong Byong-Chang ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
서성일 ( Seo Seong-Il ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
이현무 ( Lee Hyun-Moo ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology
전성수 ( Jeon Seong-Soo ) - Sungkyunkwan University School of Medicine Samsung Medical Center Department of Urology

Abstract


Background: To evaluate the strategy for detection of prostate cancer (PCa) with low prostate specific antigen (PSA) level (2.5?4.0 ng/mL), prostate biopsy patients with low PSA were assessed. We evaluated the risk of low PSA PCa and the strategy for screening low-PSA patients.

Methods: We retrospectively analyzed the patients who underwent prostate biopsy with low PSA level. Baseline characteristics, PSA level before prostate biopsy, prostate volume, prostate specific antigen density (PSAD), and pathological data were assessed.

Results: Among the 1986 patients, 24.97% were diagnosed with PCa. The PSAD was 0.12 ± 0.04 ng/mL2 in the PCa-diagnosed group and 0.10 ± 0.04 ng/mL2 in non-cancer-diagnosed group (P < 0.001). Of the 496 patients diagnosed with PCa, 302 (60.89%) were in the intermediate- or high-risk group. PSAD was 0.13 ± 0.04 ng/mL2 in the intermediate- or high-risk group and 0.11 ± 0.03 ng/mL2 in the very low- and low-risk group (P < 0.001). Of 330 patients who underwent radical prostatectomy, 85.15% were diagnosed as having significant cancer. There was significant correlation between PSAD and PCa (r = 0.294, P < 0.001). PSAD with a specificity of 80.00% of a clinically significant cancer diagnosis was assessed at 0.1226 ng/mL2.

Conclusion: The PCa detection rate in the low-PSA group was not lower than that of previous studies of patients with PSA from 4.0 to 10.0 ng/mL. Further, it may be helpful to define a strategy for PCa detection using PSAD in the low-PSA group.

키워드

Prostatic Neoplasms; Prostate-Specific Antigen; Diagnosis; Biopsy

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