Results
The mean age of all the patients with ASAP was 62.9±7.8 years (40-78).
In first prostate biopsy, the mean tPSA level, fPSA level, f/tPSA rate
and PSA-D level were found as 8.63 ng/mL (0.9- 32.5), 1.59 ng/mL
(0.0017-8.9), 0.19 (0.0014-0.79), and 0.19 ng/mL/cc (0.01-0.98),
respectively. The second prostate biopsy results were reported as benign
prostate pathology for 77 patients (60.2%) and PCa for 51 patients
(39.8%) (ISUP Grade Group 1: 36, ISUP Grade Group 2: 10 and ISUP Grade
Group 4: 5 patients). The mean PV in group 1 and 2 were 58.96±30.66 and
47.71±25.44 mL, respectively. This difference was found as statistically
significant (p<0.037).
According to the first biopsy result of patients with PCa, tPSA levels
increased before the second prostate biopsy while the patients with
benign prostate pathology decreased and this difference was found as
statistically significant (p: 0.001). The increase in fPSA levels before
the second prostate biopsy compared to the first biopsy result of the
patients with PCa was statistically significantly lower than the cases
with benign prostate pathology (p: 0.002). Also f/tPSA levels decreased
in group 2 before the second prostate biopsy while it increased in
patients with benign prostate pathology and this difference was found as
statistically significant (p: 0.001). In group 2, PSA-D levels increased
before the second prostate biopsy while it decreased in patients with
benign prostate pathology and this difference was found as statistically
significant (p: 0.001) (Table 2). Changes in “PSA forms” before the
second prostate biopsy and statistical evaluation of these parameters
between the two groups were summarized in Table 3. ASS-RT scores of the
patients with PCa were statistically significantly higher than the
patients with benign prostate pathology (p:0.001).
The ROC curve of ASS-RT score was evaluated in the diagnosis of PCa. The
area under the curve was 0.804 and the standard error was 0.04. The area
under the ROC curve was significantly higher than 0.5 (p: 0.001; p
<0.05). The cut-off point of the ASS-RT score in diagnosis of
PCa was ≥ 7. The sensitivity and specificity of threshold value were
found as 60.8% and 80.5%, respectively (Figure 1).
The ROC curve of tPSAv was evaluated in the diagnosis of
PCa. The area under the curve was 0.790 and standard error was 0.04. The
area under the ROC curve was significantly higher than 0.5 (p: 0.001; p
<0.05). The detirmened cut-off point of the
tPSAv in the diagnosis of PCa was >0.4. The
sensitivity and specificity of threshold value were found as 88.2% and
71.4%, respectively (Figure 1).
The ROC curve of fPSAv was evaluated in the diagnosis of
PCa. The area under the curve was 0.664 and standard error was 0.05. The
area under the ROC curve was significantly higher than 0.5 (p: 0.001; p
<0.05). The detected cut-off point of the
fPSAv in diagnosis of PCa was ≤0.12. The sensitivity and
specificity of threshold value were found as 78.4% and 62.3%,
respectively (Figure 1).
The ROC curve of f/tPSAv was evaluated in the diagnosis
of PCa. The area under the curve was 0.696 and standard error was 0.05.
The area under the ROC curve was significantly higher than 0.5 (p:
0.001; p <0.05). The detected cut-off point of
f/tPSAv in diagnosis of PCa was ≤0.02 The sensitivity
and specificity of threshold value were found as 92.2% and 40.3%,
respectively (Figure 1).
The ROC curve of PSA-Dv was evaluated in the diagnosis
of PCa. The area under the curve was 0.745 and standard error was 0.04.
The area under the ROC curve was significantly higher than 0.5 (p:
0.001; p <0.05). The detected cut-off point of the
PSA-Dv in the diagnosis of PCa was >0.02.
The sensitivity and specificity of threshold value were found as 88.2%
and 58.4%, respectively (Figure 1).