VALUE OF TOTAL PROSTATE SPECIFIC ANTIGEN, COMPLEX PROSTATE SPECIFIC ANTIGEN AND IT IS FORMS OF VOLUME-RELATED IN THE DIAGNOSIS OF PROSTATE CANCER

Introduction: In this study, we aimed to examine value of complex prostate specific antigen (cPSA) and total prostate specific antigen (tPSA) adjusted by prostate volume measured using transrectal ultrasonography in prostate cancer detection among men with elevated tPSA. Materials and Methods: 49 men aged 75 years or younger with serum PSA levels of 4.0-20.0 ng/mL and normal digital rectal examination findings were studied in terms of total and complex PSA (cPSA), prostate volumes with transrectal (TRUS) ultrasonography and transition zone volumes with TRUS prior to transrectal 10-core biopsy. In addition to sole PSA values and the complex- to- total PSA ratio, volume- adjusted PSA values, PSA densities determined by TRUS (PSAD) and PSA transition zone densities (PSATzD), volumeadjusted cPSA values, cPSA densities determined by TRUS (cPSAD) and cPSA transition zone densities (cPSATzD), were compared using receiver operating characteristic (ROC) analysis. Results: Prostate cancer was diagnosed in 14 (28.5%) of the 49 men who underwent prostate biopsies. Serum c PSA levels were significantly higher in patients with prostate cancer compared with patients of benign prostate disease, but serum tPSA levels weren't differences between prostate cancer. cPSA was not performed better than t PSA in the differentiation between benign disease and prostate cancer. Of the areas under ROC curves (AUC) of studied parameters, cPSA (AUC 0.689), PSAD (AUC 0.766), PSATzD (AUC 0.769) CPSAD (AUC 0.812) and CPSATzD (AUC 0.789) was superior to PSA (AUC 0.651) and there was no significant difference between there. Conclusions: cPSA was more specific than tPSA. PSAD, PSATzD, CPSAD and CPSATzD could be better indicators for prostate cancer than tPSA and cPSA.