Diagnostic Performance of the Prostate-Specific Antigen Level for Detecting Prostate Cancer in Nakornping Hospital
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Abstract
Background: The most common tools for diagnosing prostate cancer are digital rectal examination (DRE) and serum prostate-specific antigen (PSA). There was no previous study about usefulness of these tests in Nakornping Hospital.
Objective: To determine diagnostic performances of PSA level and DRE for detecting prostate cancer in Nakornping Hospital.
Materrial and method: A retrospective-analytical study was conducted on 198 men who underwent transrectal ultrasound guided prostate biopsy at Nakornping Hospital between October 2013 and September 2015. The patients were divided into 6 groups according to their PSA levels as follows: <4, 4.1–10, 10.1–20, 20.1–50, 50.1–100, and >100 ng/mL. Baseline data, DRE and pathological results were recorded. Diagnostic performances at each PSA level were calculated.
Results: The mean age was 70.8 ± 8.6 years (range, 46-94) and PSA level was 240.5 ± 663.6 ng/mL (range, 0.8 - 5,618). Positive biopsy results were found in 126 patients (prevalence 63.6%). Among these, thirty-eight had Gleason score >7 (19.2 %). PPV at PSA cutoff point of 4, 10, 20, 50 and 100 ng/mL were 66%, 72%, 85.3%, 94% and 98.3% respectively. Using PSA combined with DRE could increase those PPV to 81.9%, 87.4%, 92%, 97% and 100% respectively. The sensitivity
and specificity to diagnose prostate cancer for PSA level >20ng/mL were 78.6% and 76.4% respectively, and those for PSA level >50ng/mL were 61.9 % and 93.1% respectively. AuROC for using PSA level to diagnose prostate cancer was 0.84 and to detect high grade cancer was 0.7. Conclusion: PSA level had good accuracy for prostate cancer diagnosis and fair accuracy to detect high grade cancer. Using PSA level combined with DRE provided higher PPV than using
PSA level alone.
Article Details
บทความที่ส่งมาลงพิมพ์ต้องไม่เคยพิมพ์หรือกำลังได้รับการพิจารณาตีพิมพ์ในวารสารอื่น เนื้อหาในบทความต้องเป็นผลงานของผู้นิพนธ์เอง ไม่ได้ลอกเลียนหรือตัดทอนจากบทความอื่น โดยไม่ได้รับอนุญาตหรือไม่ได้อ้างอิงอย่างเหมาะสม การแก้ไขหรือให้ข้อมูลเพิ่มเติมแก่กองบรรณาธิการ จะต้องเสร็จสิ้นเป็นที่เรียบร้อยก่อนจะได้รับพิจารณาตีพิมพ์ และบทความที่ตีพิมพ์แล้วเป็นสมบัติ ของลำปางเวชสาร
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