Predicted Value Of Prostate Specific Antigen Density(PSAD),(f/t)PSAD And MRI In The Diagnosis Of Prostate Cancer With PSA Between 4 And 20 Ng/ml

Objective:Evaluate the predictive value in prostate cancer diagnosis with PSA between 4 to 20 ug/ml by PSAD,(f/t)/PSAD,MRI results and combined index of analysis.Methods:Retrospective analysis the clinical data of 219 cases that PSA in 4-20 ng/ml range and conducted by transrectal ultrasound guided prostate biopsy in first time,then process statistical analysis of tPSA,PSAD,(f/t)/PSAD,MRI results and PSAD +(f/t)/PSAD + MRI index respectively.Results:219 patients included in the study,then according to the results of prostate biopsy pathology,divided all patients into two groups,prostate hyperplasia and prostate cancer?In which adenocarcinoma patients are 73 patients(33.3%),hyperplasia patients are 146 cases(66.7%).Two groups of adenocarcinoma and hyperplasia were no statistically significant difference(P>0.05)in age,tPSA and f/tPSA value,and PSAD values of adenocarcinoma is increased significantly(P<0.05)than hyperplasia group,(f/t)/PSAD values significantly reduced(P<0.05)?Draw the ROC curve,AUC value size order is followed by PSAD(AUC=0.800)>(f/t)/PSAD(AUC =0.717)>tPSA(AUC=0.583)>f/tPSA(AUC=0.543).The sensitivity of PSAD is 76.7%,specific degrees is 75.3%and the positive predictive value is 57.7%?.The specific degrees of(f/t)/PSAD is 74.7%:the sensitivity is 56.2%and positive predictive value is 52.6%.There are 73 patients in adenocarcinoma group,62 cases(84.93%)are diagnosised prostate cancer by MRI,112 cases(76.72%)of 146 patients in hyperplasia group are diagnosised prostatic hyperplasia by MRI.By pairing chi-square analysis two groups of MRI diagnosis and pathological diagnosis diagnostic rate had difference(P<0.05),adenocarcinoma hyperplasia of MRI diagnosis rate is higher than that of the hyperplasia group.In addition,the sensitivity of MRI in the diagnosis of prostate cancer is 84.9%,the specific degrees is 76.7%and positive predictive value is 64.6%.The sensitivity(97.3%)and positive predictive value(67.0%)of the index combined by PSAD,(f/t)/PSAD and MRI are higher than single index,specific degrees(76.0%)is higher than PSAD and(f/t)/PSAD,but slightly lower than MRI.Conclusion:In PSA 4-20 ng/ml range,the use of the PSAD,(f/t)/PSAD,MRI results and combined index have important value in predict the diagnosis of prostate cancer.