Assessment of PSA-Age volume score in predicting positive prostate biopsy findings in Turkey

• Published in: International Brazilian Journal of Urology Vol. 41; no. 5; pp. 864 - 868
• Main Authors: Uçer, Oktay, Yücetas, Ugur, Çelen, Ilker, Toktas, Gökhan, Müezzinoglu, Talha
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Urologia 01-10-2015
• Subjects: Adult; Age Factors; Aged; Biopsy; Digital Rectal Examination; Humans; Male; Middle Aged; Organ Size; Original; Prostate; Prostate - pathology; Prostate-Specific Antigen; Prostate-Specific Antigen - blood; Prostatic Neoplasms; Prostatic Neoplasms - blood; Prostatic Neoplasms - pathology; Reference Standards; Reference Values; Reproducibility of Results; Retrospective Studies; Sensitivity and Specificity; Turkey; Turkey
• ISSN: 1677-5538; 1677-6119; 1677-6119; 1677-5538
• DOI: 10.1590/S1677-5538.IBJU.2014.0462

To evaluate PSA-age volume (AV) scores in predicting positive prostate biopsy findings in Turkey.
PSA-AV was calculated by multiplying the patient's age by the prostate volume and dividing it by the PSA level. Sensitivities and specificities of the PSA-AV were assessed by retrospective analysis of findings from 4,717 prostate biopsies.
The population's average age was 63.71±7.63 years, the mean PSA level was 9.73±17.01ng/mL, the mean prostate volume was 44.46±23.88 cm3. Of the 4,717 prostate biopsies, 1,171 biopsy specimens (24.8%) were positive for prostate cancer. A PSA-AV score of 700 had a sensitivity and specificity of 95% and 15%, respectively. These values were similar to the sensitivity and specificity for a PSA cut-off of 4ng/mL (94% and 13%, respectively). Although the sensitivity of a PSA-AV cut-off of 700 in patients over 60 years was similar to the PSA cut-off of 4ng/mL and the age-adjusted PSA, in patients < 60 years, its sensitivity was higher. While the sensitivities of a PSA-AV cut-off of 700 in patients with low prostate volume was higher than a PSA cut-off of 4ng/mL, the sensitivities of both methods with moderate prostate volumes were similar.
Considering all the biopsies, the sensitivity and specificity of a PSA-AV of 700 for predicting positive biopsy findings were similar to a PSA of 4ng/mL. We suggest the PSA-AV cut-off of 700 should only be used in patients younger than 60 with low prostate volumes (< 20cm3).