Comparison Between Free PSA Percentage, PSA Density And PSA Density In The Transition Zone In The Detection Of Incidental Prostate Cancer In Patients With Serum PSA Between4and10ng/mL

【Objective】:Compare the capacity of the Free PSA percentage (%FPSA),PSAdensity (PSAD) and PSA transition zone density (PSATZ) in improving the sensitivityand specificity of the PSA to detect Incidental Prostate Cancer (IDPC) in men with aPSA between4and10ng/mL.【Materials and Methods】:In this prospective study,From January2009toDecember2012,a total of125patients was underwent with TURP or prostatectomy,who’s serum PSA was between4and10ng/mL.20of them were found to be prostaticcarcinoma.A random sample of25patients was chooed from the rest of patients withhyperplasia of prostate.We compare the diagnostic value of the Free PSA percentage(%FPSA),PSA density (PSAD) and PSA transition zone density (PSATZ) indiagnosis of prostate cancer wiht t test and ROC curves.【Results】:Of the45patients, there were no significant difference between prostatecancer group and BPH group in Free PSA percentage,whereas significant differencein PSAD and PSATZ;The area under the curve of PSAD was0.786similar to thePSATZ(0.805);At85%sensitivity, PSAD carried a specificity of68%no less thanPSATZ.【Conclusion】:In detection of prostate cancer in patients with serum PSA levels4.0-10.0ng/ml,PSAD and PSATZ were both good predictors,whereas Free PSApercentage was no.PSATZ was no much better than PSAD.The combination of FreePSA percentage, PSAD and PSATZ promote a high accuracy for PCa detection.