Comparison Between Free PSA Percentage, PSA Density And PSA Density In The Transition Zone In The Detection Of Incidental Adenocarcinoma Of Prostat In Patients With Serum PSA Between 4 And 10 Ng/ml

Objective: Compare the capacity of the Free PSA percentage (f/t PSA) ,PSA density (PSAD), and PSA transition zone density (PSATZ) in improving the sensitivity and specificity of the PSA to detect prostate cancer (PCa) in men with a PSA between 4 and 10 ng/mL.Materials and Methods: One hundred and twelve men with PSA between 4 and 10 ng/mL were retrospectively studied. Blood collection for the total PSA and free PSA was performed as well as transrectal ultra-sound with prostate biopsy and measurement of the total prostate volume (TPV) and transition zone volume (TZV). Patients with initial negative biopsy were followed and the prostate biopsy was repeated in those that presented PSA increase. The capacity of the PSAD, f/t PSA and PSADTZ in improving the sensitivity and specificity of the PSA test to the detection of the PCa was assessed by univariate analyses and through the ROC curve.Results: significant difference in PSAD, f/t PSA and PSADTZ between two groups was found. The ROC curve analysis showed that the PSADTZ was more powerful and highly significant PCa predictors. Conclusion: The determination of f/t PSA and PSAD can allow a better discrimination between PCa and benign disease that the isolated use of PSA. PSADTZ promote a high accuracy for PCa detection.