Cancer - Prostate(구연) International Session I (I-10) Rm. 202 10월 31일(목) 15:00-16:00 Strategy for prostate cancer patients with low prostate specific antigen level (2.5 to 4.0 ng/mL) 성균관의대 삼성서울병원 정재훈, 유지웅, 강민용, 성현환, 전황균, 정병창, 서성일, 이현무, 전성수 Introduction: To evaluate the strategy for detection of prostate cancer (PCa) with low prostate specific antigen (PSA) level (≥2.5 ng/mL, <4.0 ng/mL), prostate biopsy patients with low PSA were assessed. We evaluated the risk of low PSA PCa and the strategy for screening low-PSA patients. Materials and Methods: We retrospectively analyzed 2204 patients who underwent prostate biopsy with a PSA level of 2.5 ng/mL to less than 4.0 ng/mL. Baseline characteristics, PSA level before prostate biopsy, prostate volume, PSA density (PSAD), and pathological data were evaluated. Results: Of the total 2204 patients, 1986 were enrolled in this study. Among the 1986 patients, 24.97% were diagnosed with PCa (Figure 1). The mean age of PCa patients was 64.48 ± 7.88 years, and the mean age of patients without PCa was 61.19 ± 8.69 years (p<0.001). The PSAD was 0.12 ± 0.04 ng/mL2 in the PCa-diagnosed group and 0.10 ± 0.04 ng/mL2 in non-cancer-diagnosed group (p<0.001). Of the 496 patients diagnosed with PCa, 302 (60.89%) were in the intermediate- or high-risk group. The mean age of the intermediate- or high-risk group was 65.28 ± 7.73 years, and the mean age of the very low- and low-risk group was 63.24 ± 7.97 years (p=0.005). PSAD was 0.13 ± 0.04 ng/mL2 in the intermediate- or high-risk group and 0.11 ± 0.03 ng/mL2 in the very low- and low-risk group (p<0.001). Of 330 patients who underwent radical prostatectomy, 85.15% were diagnosed as having significant cancer. There was significant correlation between PSAD and PCa (r=0.294, p<0.001). Prostate-specific antigen density with a specificity of 80.00% of a clinically significant cancer diagnosis was assessed at 0.1226 ng/mL2. Conclusions: The PCa detection rate in the low-PSA group was not lower than that of previous studies of patients with PSA from 4.0 to 10.0 ng/mL. Further, it may be helpful to define a strategy for PCa detection using PSAD in the low-PSA group. keywords : Prostate cancer, prostate specific antigen