Value of PSA density in PI-RADS 3 lesions: a single-center retrospective observational study.

IF 1.9 4区医学 Q3 UROLOGY & NEPHROLOGY

International Urology and Nephrology Pub Date : 2026-05-06 DOI:10.1007/s11255-026-05179-0

Patricia Rodriguez-Parras, Alberto Zambudio-Munuera, Ana Donaire-Barrera, Yaiza Yañez-Castillo, Maria Del Carmen Cano-Garcia, Miguel Arrabal-Martin, Miguel Angel Arrabal-Polo

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引用次数: 0

Abstract

Purpose: The aim of this study was to evaluate whether Prostate-specific antigen density (PSAD) improves risk stratification for clinically significant prostate cancer in patients with PI-RADS 3 lesions and to assess its potential role in reducing unnecessary biopsies.

Methods: A single-center retrospective observational study was conducted at Hospital Universitario Clínico San Cecilio (Granada, Spain) between January 2022 and December 2025. A total of 203 patients with a PI-RADS 3 lesion who underwent systematic and targeted biopsy were included. Clinically significant prostate cancer was defined as ISUP ≥ 2. Univariate analysis, logistic regression (age and PSAD ≥ 0.15 ng/mL/cc), ROC curve analysis, and diagnostic performance metrics for PSAD ≥ 0.15 were performed.

Results: Prostate cancer was detected in 73/203 patients (36%) and csPCa in 21/203 (10.3%). PSAD was higher in csPCa cases (0.17 vs 0.11; p = 0.001). PSAD ≥ 0.15 was independently associated with csPCa (OR 4.56; 95% CI 1.58-13.14; p = 0.005), as was age (OR 1.08 per year; p = 0.036). PSAD yielded an AUC of 0.722 and the combined age + PSAD model an AUC of 0.751. With PSAD ≥ 0.15, sensitivity was 76.2%, specificity 61.0%, and negative predictive value 95.7%.

Conclusion: In conclusion, PSAD provides clinical value for risk stratification in PI-RADS 3 lesions and may support biopsy avoidance strategies in selected patients.

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PSA密度在PI-RADS 3病变中的价值：一项单中心回顾性观察研究。

目的：本研究的目的是评估前列腺特异性抗原密度（PSAD）是否能改善PI-RADS 3病变患者临床显著前列腺癌的风险分层，并评估其在减少不必要活检中的潜在作用。方法：于2022年1月至2025年12月在西班牙格拉纳达大学Clínico圣塞西利奥医院进行一项单中心回顾性观察研究。共有203例PI-RADS 3病变患者接受了系统和靶向活检。临床上显著的前列腺癌定义为ISUP≥2。进行单因素分析、logistic回归（年龄和PSAD≥0.15 ng/mL/cc）、ROC曲线分析和PSAD≥0.15的诊断效能指标。结果：前列腺癌73/203例（36%），csPCa 21/203例（10.3%）。PSAD在csPCa患者中较高（0.17 vs 0.11; p = 0.001）。PSAD≥0.15与csPCa独立相关（OR 4.56; 95% CI 1.58-13.14; p = 0.005），年龄独立相关（OR 1.08 /年；p = 0.036）。PSAD模型的AUC为0.722，年龄+ PSAD模型的AUC为0.751。PSAD≥0.15时，敏感性76.2%，特异性61.0%，阴性预测值95.7%。结论：总之，PSAD为PI-RADS 3病变的风险分层提供了临床价值，并可能支持特定患者的活检避免策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Urology and Nephrology 医学-泌尿学与肾脏学

CiteScore

3.40

自引率

5.00%

发文量

329

审稿时长

1.7 months

期刊介绍： International Urology and Nephrology publishes original papers on a broad range of topics in urology, nephrology and andrology. The journal integrates papers originating from clinical practice.