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Asian Journal of Andrology (2013) 15, 249–253; doi:10.1038/aja.2012.132; published online 28 January 2013
Serum prostate-specific antigen as a predictor of prostate volume and lower urinary tract symptoms in a community-based cohort: a large-scale Korean screening study
Dong Soo Park1, Jong Jin Oh1,2, Jae Yup Hong1, Young Kwon Hong1, Don Kyung Choi1, In Hyuck Gong1, Jin Ho Hwang1 and Sung Won Kwon3,4
1 Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam 463-712, Korea
2 CHA Cancer Research Center, Seoul 135-081, Korea
3 Department of Urology, CHA Gangnam Medical Center, CHA University, Seoul 135-081, Korea
4 Korea Prostate Health Council, Seoul 137-070, Korea
Correspondence: Dr JJ Oh, (bebsuzzang@naver.com)
Received 24 September 2012; Revised 9 October 2012; Accepted 31 October 2012
Advance online publication 28 January 2013
| Abstract |
The aim of this study is to assess the ability of serum prostate-specific antigen (PSA) to predict prostate volume (PV) and lower urinary tract symptoms (LUTS) represented by the international prostate symptom score (IPSS). From January 2001 to December 2011, data were collected from men who first enrolled in the Korean Prostate Health Council Screening Program. Patients with a serum PSA level of >10 ng ml−1 or age <40 years were excluded. Accordingly, a total of 34 857 men were included in our study, and serum PSA, PV and the IPSS were estimated in all patients. Linear and age-adjusted multivariate logistic analyses were used to assess the potential association between PSA and PV or IPSS. The predictive value of PSA for estimating PV and IPSS was assessed based on the receiver operating characteristics-derived area under the curve (AUC). The mean PV was 29.9 ml, mean PSA level was 1.49 ng ml−1 and mean IPSS was 15.4. A significant relationship was shown between PSA and PV, and the IPSS and PSA were also significantly correlated after adjusting by age. The AUCs of PSA for predicting PV >20 ml, >25 ml and >35 ml were 0.722, 0.728 and 0.779, respectively. The AUCs of PSA for predicting IPSS >7, >13 and >19 were 0.548, 0.536 and 0.537, respectively. Serum PSA was a strong predictor of PV in a community-based cohort in a large-scale screening study. Although PSA was also significantly correlated with IPSS, predictive values of PSA for IPSS above the cutoff levels were not excellent. Further investigations are required to elucidate the exact interactions between PSA and LUTS and between PSA and PV in prospective controlled studies. Such studies may suggest how PSA can be used to clinically predict PV and the IPSS.
Keywords: lower urinary tract symptoms (LUTS); prostate; prostate-specific antigen (PSA); prostate volume (PV) |
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