Journal of Reconstructive Urology

.: ORIGINAL RESEARCH
Adjunctive Role of Some Blood Based Parameters to Serum Prostate Specific Antigen and Its Derivations on Prostate Cancer in Men with ''Gray-Zone'' Prostate Specific Antigen Levels: Prospective Clinical Study
Gri Zondaki Prostat Spesifik Antijen Düzeyleri Olan Erkeklerde Prostat Kanseri Tahmininde Bazı Kan Bazlı Parametrelerin Serum Prostat Spesifik Antijen ve Türevlerine Yardımcı Rolü: Prospektif Klinik Çalışma
Abdullah GÜLa, Özgür EKİCİb, Salim ZENGİNa, Çağlar BOYACIa
aDepartment of Urology, University of Health Sciences, Bursa Yüksek İhtisas Education and Research Hospital, Bursa, Türkiye
bClinic of Urology, Nusaybin State Hospital, Mardin, Türkiye
J Reconstr Urol. 2022;12(3):120-8
doi: 10.5336/urology.2022-93881
Article Language: EN
Full Text
ABSTRACT
 Objective: To investigate the adjunctive role of some peripheral blood parameters to serum prostate specific antigen (PSA) in predicting the patients with prostate cancer (PCa) prior to prostate biopsy, and clinically significant PCa among those. Material and Methods: This prospective study included men aged ≥45 years, who were scheduled to undergo a prostate biopsy due to gray-zone PSA levels. The levels of free and total PSA (fPSA and tPSA), total testosterone (TT), PSA density (PSAD), C-reactive protein (CRP), De Ritis ratio (aspartate aminotransferase/alanine transaminase) and hemograms were recorded. Patients were divided into 2 groups as benign prostatic hyperplasia (Group 1) and PCa (Group 2) groups. The PCa group was further divided into 2 subgroups as clinically significant and clinically insignificant PCa. The pre-biopsy values of the variables were compared between the groups. Results: A total of 210 patients were included in the study (Group 1, n=105; Group 2, n=105). The mean age was 65.1±7.4 years, the mean tPSA level was 6.14±2.05 ng/mL, and the mean TT level was 15.46±5.47 nmol/L. Age, prostate volume, the values of fPSA, PSAD, CRP, and the ratios of fPSA/tPSA, CRP/albumin and De Ritis were statistically different between the groups. In the PCa group, only the tPSA level was significantly different between the subgroups (p=0.005). The area under curve and the cut-off value for tPSA to predict clinically significant PCa were 0.669 and 5.8 ng/mL, respectively. Conclusion: CRP, the CRP/albumin ratio and De Ritis ratio may further help predict a diagnosis of PCa.

Keywords: Alanine transaminase; aspartate aminotransferases; C-reactive protein; prostate cancer; testosterone
ÖZET
 Amaç: Biyopsi öncesi biyokimyasal ve hematolojik parametrelerin, prostat kanseri [prostate cancer (PCa)] hastalarını ve bunlardan da klinik anlamlı PCa hastalarını öngörmede prostat spesifik antijene (PSA) yardımcı etkisinin olup olmadığını araştırmaktır. Gereç ve Yöntemler: Çalışmamıza, gri zondaki prostat spesifik antijen (PSA) düzeyleri nedeniyle prostat biyopsisi yapılması planlanan 45 yaş ve üzeri erkekler dâhil edildi. Serbest ve total PSA (sPSA ve tPSA), total testosteron (TT), PSA dansitesi (PSAD), C-reaktif protein (CRP), De Ritis oranı (aspartat aminotransferaz/alanin transaminaz) ve hemogramları kaydedildi. Hastalar benign prostat hiperplazisi (Grup 1) ve PCa (Grup 2) grupları olarak 2'ye ayrıldı. PCa grubu ayrıca klinik anlamlı ve klinik anlamsız PCa olarak 2 alt gruba ayrıldı. Biyopsi öncesi değişkenler gruplar arasında karşılaştırıldı. Bulgular: Çalışmaya toplam 210 hasta dâhil edildi (Grup 1, n=105; Grup 2, n=105). Ortalama yaş 65,1±7,4 yıl, ortalama tPSA seviyesi 6,14±2,05 ng/mL ve ortalama TT seviyesi 15,46±5,47 nmol/L idi. Gruplar arasında yaş, prostat hacmi, sPSA, PSAD, CRP değerleri ve sPSA/tPSA, CRP/albumin ve De Ritis oranları istatistiksel olarak farklı bulundu. PCa grubunda alt gruplar arasında sadece tPSA düzeyi anlamlı olarak farklı bulundu (p=0,005). Klinik olarak anlamlı Pca'yı öngörmek için tPSA'nın eğri altında kalan alan ve cut-off değeri sırasıyla 0,669 ve 5,8 ng/mL idi. Sonuç: CRP, CRP/albumin oranı ve De Ritis oranı, PCa tanısını öngörmede daha fazla yardımcı olabilir.

Anahtar Kelimeler: Alanin transaminaz; aspartat aminotransferazlar; C reaktif protein; prostat kanseri; testosteron
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