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Annals of Clinical & Laboratory Science 33:320-323 (2003)
© 2003 Association of Clinical Scientists

PSA Density and PSA Transition Zone Density in the Diagnosis of Prostate Cancer in PSA Gray Zone Cases

Yilmaz Aksoy1, Aytekin Oral1, Hulya Aksoy2, Azam Demirel1 and Fatih Akcay2
Departments of 1 Urology and 2 Biochemistry, School of Medicine, Ataturk University, Erzurum, Turkey

Address correspondence to Yilmaz Aksoy, M.D., Department of Urology, School of Medicine, Atatürk University, 25240 Erzurum, Turkey; tel 90 442 236 1212/2329; fax 90 442 235 4493; e-mail: yaksoy{at}yahoo.com.

This study assessed the efficacy of prostate specific antigen density (PSAD) and PSA transition zone density (PSATZ) in predicting prostate cancer in men with PSA levels of 4.0–10.0 ng/ml. Between July 1996 and July 2000, PSAD and PSATZ were determined in 202 patients who underwent ultrasonography-guided systemic sextant biopsies plus 2 transitional zone biopsies. Of the 202 patients, 27 (13.4%) had prostate cancer and 175 (86.6%) had benign prostatic hyperplasia (BPH) on pathologic examination. Although there was no significant difference in mean PSA level between the prostate cancer and BPH patients (p = 0.28), the mean PSAD (p = 0.011) and PSATZ (p = 0.036) were significantly higher in prostate cancer than in BPH patients. In discriminating prostate cancer patients, the cut-off values of 0.35 ng/ml/cc for PSATZ, and 0.15 ng/ml/cc for PSAD yielded specificity levels of 69 and 56, and sensitivity levels of 63 and 81%, respectively. In conclusion, no substantial advantage of PSATZ over PSAD could be demonstrated.

Keywords: prostate cancer, benign prostatic hyperplasia, prostate specific antigen






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