The Value Of PSA And PSAD In The Differential Diagnosis Of Prostate Carcinoma And Benign Prostatic Hyperplasia

Objective To study the value of prostate specific antigen (PSA) and PSA density(PSAD)in the differential diagnosis of prostate carcinoma and benign prostatic hyperplasia. Methods SerumPSAlevels were measured by CLIA in 31 patients with prostate carcinoma and 50 patients with benign prostatic hyperplasia. Prostatic volume was measured with ultrasonography and PSAD was calculated. Results Serum PSA levels and PSAD in patients with prostate carcinoma were significantly higher than those in patients with benign prostatic hyperplasia (P<0.01),There was no significantly difference in prostate volume between two groups(P>0.05). There was NO significantly difference with Serum PSA levels and PSAD between Wei Wu Er,Ha Sa Ke Zu and Han people (P>0.05) in both groups.There was significant difference with Serum PSA levels and PSAD in patients withPCaand BPH with Prostate volume 30～60g(P<0.05).The PSAD cutoff value of 0.15 resulted in sensitivity of 90.32%,specificity accuracy positive predictive value of 52.00%, 66.67%, 53.85%respectively in whole patients.The PSAD cutoff value of 0.15 in patients with Serum PSA levels 4～20 ng/ml resulted in sensitivity of 86.67%, specificity,accuracy,positive predictive value of 59.09%,66.10%, 41.94%. respectively.When the PSAD cutoff value was increased to 0.20, specificity was increased, but the sensitivity,accuracy,positive predictive value were decreased significantly. When the PSAD cutoff value was 0.10, The sensitivity,specificity,accuracy and the positive predictive value were 86.67%, 45.45%, 55.93%, 35.13% respectively. Conclusions Both PSA and PSAD can increase the efficiency of differential diagnosis of PCa and BPH. PSAD can decrease the unnecessary biopsies. But the independent use of PSA and PSAD was limited because of lower specificity and lower positive predictive value.