The Predictive Value Of PSA And PSAD In The Diagnosis Of Prostate Cancer In Patients With Acute Urinary Retention

Objective The aim of this study is to analyze the clinicopathological characteristics of patients who were transurethrally cathetered due to acute urinary retention(AUR) and evaluate the predictive value of prostate specific antigen (PSA) and prostate specific antigen density (PSAD) in the diagnosis of prostate cancer (PCa) in patients of this kind.Methods This study comprised a retrospective analysis of data from102patients who had been transurethrally cathetered due to AUR and underwent transrectally ultrasound-guided prostate biopsy. The incidence of PCa was recorded according to total PSA levels, while receiver operating characteristic curve (ROC curve) was plotted for appraisement on the predictive value of PSAD.Results Overall,19.6%of patients presented a diagnosis of PCa. PCa incidence according to PSA levels was0.0%,5.9%,18.5%and68.4%for patients with PSA4.1ng/ml-10.0ng/ml,10.1ng/ml-20.0ng/ml,20.1ng/ml-50.0ng/ml and>50.1ng/ml, respectively. In patients with PSA<50ng/ml, the area under ROC curve of PSAD was 0.895, and the optimal cutoff was>0.28ng·ml-1·cc-1, while corresponding sensitivity specificity, positive predictive value, negative predictive value was100.0%and68.4%,22.6%and100.0%, respectively.Conclusions Prostate biopsy should not be performed on all AUR patients with transurethral catheters and elevated PSA levels. Patients with PSA>50.1ng/ml are at higher risk of PCa diagnosis. If PSAD is considered together, patients with PSA <50.0ng/ml and PSAD>0.28ng·ml’·cc-1have a higher incidence of PCa.