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KMID : 1001020220200020123
Journal of Urologic Oncology
2022 Volume.20 No. 2 p.123 ~ p.132
Prostate-Specific Antigen Variation as a Predictor of Prostate Cancer in Patients With Prostate-Specific Antigen ¡Â20 ng/mL Who Underwent Magnetic Resonance Imaging-Targeted Prostate Biopsy
Hwang Tae-Hyun

Lee Kwang-Suk
Koo Kyo-Chul
Chung Byung-Ha
Yoo Jeong-Woo
Abstract
Purpose: We investigated the role of prostate-specific antigen (PSA) variation as a predictor of prostate cancer in patients who underwent prebiopsy multiparametric magnetic resonance imaging (MRI).

Materials and Methods: The clinicopathological data of 266 patients with PSA ¡Â20 ng/mL who underwent prebiopsy MRI and prostate biopsy between September 2019 and February 2021 were included. PSA variation was defined as the difference in PSA values taken when a prostate biopsy was recommended and performed (median 20 days). Receiver operating characteristic (ROC) curves and area under the ROC curves (AUCs) for predicting prostate cancer were analyzed through 4 models that considered conventional clinical variables and PSA variation.

Results: Of the 258 patients, 166 (64.3%) were diagnosed with prostate cancer. The prostate cancer (+) group had a lower median PSA variation (-0.09 mg/mL vs. -0.27 ng/mL, p=0.006) and higher proportion of patients with PSA variation within -0.54 to 0.05 ng/mL (40 ng/mL [range, 24.1%] vs. 9 ng/mL [9.8%], p=0.002) than the prostate cancer (-) group. There was no significant difference in the duration between the 2 PSA measurements. When PSA variation and conventional variables, such as age, PSA density, prostate biopsy history, number of target lesions, were considered, the highest AUC value was 0.870. In a subgroup analysis of patients with PSA ¡Â10 ng/mL, the highest AUC value was 0.860 when PSA variation and conventional variables were considered.

Conclusions: A large PSA variation within 1 month was a negative predictor of prostate cancer among patients who underwent prebiopsy MRI.
KEYWORD
Biopsy, Magnetic resonance imaging, Prostate-specific antigen, Prostate cancer, Variation
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