Journal of Diagnostics Concepts & Practice >
A self-established scoring method for risk stratification of prostate cancer in subjects with gray zone PSA
Received date: 2020-02-13
Online published: 2020-06-25
Objective: To establish a scoring method for assessing the risk of prostate cancer in subjects with prostate specific antigen（PSA） in gray zone, and evaluate its diagnostic value. Methods: A total of 412 cases with gray zone PSA (4~10 μg/L) were enrolled from April 2017 to November 2019, and all had transperineal prostate biopsy performed under ultrasound guidance. Patients were divided into benign and malignant groups based on biopsy. Differences in age, prostate volume, serological indicators, PSA density (PSAD) and transrectal ultrasonography （TRUS） imaging between benign and malignant groups were compared with U test and Chi-square test. Receiver operator characteristic (ROC) curve was used to screen for the valid parameters and determine the cutoff values. The risk scoring method using valid parameters was then established for differentiating benign from malignant lesions in patients with gray zone PSA. The capability of the risk scoring method was assessed by ROC curve. Results: The age, prostate volume, free/total PSA ratio（f/t PSA） and PSAD between benign and malignant groups were statistically different (P<0.05). The detection rates of suspicious -looking nodules by TRUS between benign and malignant groups were also statistically different (P<0.05). The above mentioned indice including age, prostate volume, f/t PSA, PSAD and TRUS imaging findings were accepted to establish the risk scoring method. As scores of the scoring method increased from 0 to 5, the malignancy rates of prostate lesions assessed were 3.12%, 9.57%, 18.02%, 30.48%, 53.45% and 100%, respectively. The area under the ROC curve of the risk scoring method(cut off value >2.5) for diagnosing prostate cancer was 0.759, and the sensitivity and specificity were 71.41%, 67.39%, respectively. The performance of the established risk scoring method was superior to any other single index. Conclusions: The self-established scoring method could be used to assess malignant risk of prostate cancer in patients with gray zone PSA, which might facilitate the diagnosis of prostate cancer.
Key words： Prostate; Prostate specific antigen; Gray zone; Biopsy; Scoring of malignant risk
YU Yifei, WANG Zhiqian, LI Min, LIU Jun, ZHAN Weiwei . A self-established scoring method for risk stratification of prostate cancer in subjects with gray zone PSA[J]. Journal of Diagnostics Concepts & Practice, 2020 , 19(03) : 314 -318 . DOI: 10.16150/j.1671-2870.2020.03.020
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