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[Clinical utility of available diagnostic tests in prostatic carcinoma. Results of 500 biopsies. I. PSA, PSA density, and predicted PSA].

OBJECTIVE
To study the utility of PSA density and predicted PSA results in the diagnosis of prostatic cancer using gland volume.


METHODS
500 patients suspected as having prostatic cancer underwent ultrasound-guided transrectal biopsy. Prostate volume and ultrasound characteristics, serum PSA density, predicted PSA and the difference between both were determined.


RESULTS
44.8% of the patients showed evidence of cancer in the biopsy specimen. These patients had a significantly smaller prostate. The 0.1 and 0.15 PSA density cutoffs had a sensitivity of 96% and 94%, specificity of 10% and 20% and positive predictive value of 46% and 49%, respectively. The statistical values for PSA difference of 1 and 2 were 94% and 92%, 13% and 18%, 47% and 48%, respectively.


CONCLUSION
PSA density and predicted PSA results could be useful to avoid biopsies in patients with PSA between 4 and 10 ng/ml and no malignant tumor of the prostate.