Preliminary Study On The Value Of PSA-related Derivative Indexes In Prostate Cancer Screening

Objective(s):Prostate cancer is a malignant tumor with a high incidence in men,which is a serious threat to the life and health of men.In recent years,the incidence of prostate cancer in China has shown an obvious upward trend year by year.The early symptoms of prostate cancer are often very similar to the symptoms of benign prostatic hyperplasia,which is easy to be ignored,and often delay the best time for treatment,so prostate cancer screening has been a research focus.At present,the concentration of serum tPSA commonly used in clinic for early diagnosis of prostate cancer patients,but resulting in a large number of patients with excessive diagnosis and treatment.In order to further improve the value of PSA in prostate cancer screening,some scholars have proposed PSA derivative indexes of PS AD,PS AM and PSAMR in recent years.In this study,248 patients with benign prostatic hyperplasia and prostate cancer treated in our hospital were selected to analyze the differences of serum tPSA concentration and PSA-related derivative indexes PSAD,PSAM and PSAMR between patients with benign prostatic hyperplasia and patients with prostate cancer.The ROC curve was used to evaluate the value of the above indexes and their combined application in the early diagnosis of prostate cancer,in order to improve the early screening efficiency of prostate cancer and reduce the rate of misdiagnosis and unnecessary prostate puncture.Methods:In this study,248 patients with benign prostatic hyperplasia and prostate cancer who were hospitalized in our department from January 2018 to December 2018 were selected,and their clinical data were calculated by the corresponding formula.The PSAD,PSAM and PSAMR values of each patient were calculated respectively,and the differences of serum tPSA concentration and PSA-related derivative indexes PSAD,PSAM and PSAMR in patients with benign prostatic hyperplasia and prostate cancer were analyzed.ROC curve and consistency were used to evaluate the value of the above indexes and their combination in the early diagnosis of prostate cancer.Results:Of the 248 patients,163(65.73%)had benign prostatic hyperplasia and 85(34.27%)had prostate cancer.The area of ROC curve was analyzed and compared by ROC curve.the order of area from large to small was PSAMR(0,827),PSAD(0.820),PSAM(0.812)and serum tPSA concentration(0.840).The results of Kappa value analysis were consistent with the results of pathological diagnosis of gold standard.The results showed that all the three indexes had moderate intensity consistency,suggesting that the three indexes had certain clinical guiding significance for the diagnosis of prostate cancer,and the Kappa value of PSAMR was the highest.The area under the ROC curve of the combined application of PSAMR and PSAM or PSAD was larger than that of the combined application of serum tPSA concentration and PSAMR according to the analysis of the ROC curve of the combined application of the three derivative indexes,which was 0.5551.according to the analysis of the ROC curve,the area under the ROC curve was larger than that of serum tPSA concentration and PSAMR.Among them,the area under the curve of PSAMR combined with PSAD in the diagnosis of prostate cancer was the largest,and the sensitivity and specificity were at a higher level,compared with PSAMR alone Under the condition of maintaining high specificity,the area and sensitivity under the ROC curve were improved.Conclusion(s):1.As a derivative index of PSA,PS AD,PSAM and PS AMR are simple and scientific in calculation,and will not cause economic burden to patients,so they have certain advantages in prostate cancer screening.2.In the case of PSA,PS AD,PSAM and PS AMR applied alone,the area and specificity under the ROC curve of PS AMR are the highest,but its sensitivity is low,so the rate of missed diagnosis should be noted.3.In the consistency analysis of PS AD,PSAM and PS AMR in the diagnosis of prostate cancer,the three indicators have moderate consistency,among which PSAMR has a high coincidence rate.4.When combined with PSAMR,PSAD can maintain high diagnostic specificity and effectively improve AUC and sensitivity,which has certain feasibility and clinical application value as the optimal scheme for prostate cancer screening.