STUDY OF THE IMPORTANCE OF PROSTATE-SPECIFIC ANTIGEN DENSITY (PSA DENSITY) AS A PREDICTIVE INDICATOR FOR THE PRESENCE OF PROSTATE CANCER IN PATIENTS WITH T PSA (4-20) NG/ML

Ali Hasan*, Khidr Raslan and Aiman Harfoush

ABSTRACT

Background: Prostate-specific antigen (PSA) and the digital rectal exam (DRE) have moderate sensitivity but low specificity for cancer diagnosis, potentially causing unnecessary treatment complications with prostate biopsy. Transrectal ultrasound (TRUS) to evaluate prostate size and calculate PSA density can improve the specificity of PSA in predicting cancer. We evaluated the sensitivity and specificity of different pre-biopsy tests to detect prostate cancer Objective: Study of the prognostic value of PSA density in predicting the outcome of prostate biopsy in patients with T PSA (4-20) ng/mL from Lattakia University Hospital visitors between 2022-2023. Methods and materials: The research sample included 97 patients from the urology clinic and department at Lattakia University Hospital during the period between 2022-2023. Each patient was studied by taking a clinical history, clinical examination, radiology and laboratory, recording findings of prostate volume, digital rectal examination, total PSA value, PSA density calculation, and performing prostate biopsy for patients who met the inclusion and exclusion criteria; a special form was organized that included the clinical history, clinical examination, laboratory results and pathological report. Taking into consideration the withdrawal of blood samples before performing DRE. Results: The research sample included 97 patients from Lattakia University Hospital with TPSA value (4-20ng/ML) and age more than 50 years or age more than 45 years with a first-degree relative diagnosed with prostate cancer or age more than 40 years with two first-degree relatives diagnosed with prostate cancer and who met the inclusion criteria in the research. The patients' ages ranged from 52 to 80 years with an average of 66.22±7.8 years. Conclusion: PSA density is recommended as an adjunct to T PSA to predict the presence of prostate cancer and thus avoid unnecessary biopsies and potential complications in patients with PSA values within the range of 4-20 ng/ml, with a cut-off point of 0.15 being highly accurate in diagnosis.

Keywords: PSA, PSA Density, Prostate Cancer.