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).