Prostate-specific antigen for the detection of prostate cancer (Doctoral thesis)

Βλαχάκη, Αγγελική Χ.

To evaluate the potential of prostate cancer detection on the basis of PSA-levels based on theoutcome of prostate needle biopsyDesign A retrospective study conducted in the University Hospital of Ioannina.Methodology The clinical and histopathological data of 1053 patients that underwent prostate biopsyin the Urologic Clinic from January 2014 to August 2017 was obtained from the medical record. PSAand %fPSA were compared to biopsy outcome.Results The mean PSA values and %fPSA of the cancer versus noncancer (prostatitis, LGPIN andHGPIN) groups were significantly different (p<0.05). However there was an overlap in individual values.The mean PSA levels were significantly correlated with the prostate cancer grade group (p<0.05). Thepositive predictive value (PPV) of PSA in patients with PSA levels between 4 and 10 ng/ml was 28%while the negative predictive value (NPV) in patients with PSA levels < 4 ng/ml was 81%. On the otherhand PPV and NPV of %fPSA in patients with PSA levels between 4 and 10 ng/ml was 23% and 86%,respectively. Receiver operating characteristic (ROC) curve analysis was performed in the total sampleof the 980 patients with and without prostate cancer for the complete PSA range (0.90-450 ng/ml) aswell as for the patients with PSA levels between 4 and 10 ng/ml (n=647). The area under the curve(AUC) for PSA values from 0.9-450 ng/ml and 4-10 ng/ml was calculated at 0.619 (95% CI, 0.580-0.657) and 0.482 (95% CI, 0.374-0.590). ROC analysis for %fPSA and for the same PSA groups was0.403 (95% CI, 0.315-0.492) and 0.349 (95% CI, 0.246-0.451), respectively.Discussion These results indicated that PSA and %fPSA were weekly correlated with prostatemalignancy and lack of ability to define the progression potential of the disease. PSA and %fPSA,though informative and suggestive, are not definitive for cancer or noncancer. The development ofnew, more accurate (specific and sensitive) and cost-efficient biomarkers is imperative. Future studiesshould also examine the benefits of the multivariable models implementation for prostate cancerscreening.
Alternative title / Subtitle: συσχέτιση με ιστολογικές διαγνώσεις
correlation with histological diagnosis
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Subject classification: Προστάτης -- Καρκίνος
Keywords: Προστάτης,Ειδικό προστατικό αντιγόνο,Κακοήθεια,Φλεγμονές,Ιστολογική διάγνωση,Ελέυθερο,Ολικό ειδικό προστατικό αντιγόνο,Prostate,Prostate-specific antigen,Cancer,Inflammation,Biopsy,Free: total prostate specific antigen
Appears in Collections:Διδακτορικές Διατριβές

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