Developing a new score system for patients with PSA ranging from 4 to 20 ng/mL to improve the accuracy of PCa detection

OBJECTIVE To develop a new score system for patients with prostate specific antigen (PSA) ranging from 4 to 20 ng/mL to improve the accuracy of prostate cancer (PCa) detection, and to evaluate it with receiver operating characteristic curve. METHODS A total of 797 patients (208 with prostate cancer) with total PSA 4-20 ng/mL who had undergone transrectal ultrasound (TRUS)-guided 12 + 1-core prostate biopsy during Sept. 2009-Jan. 2013 were retrospectively evaluated in the study. Age, PSA, fPSA, PV, f/T, PSAD, DRE findings and ultrasound findings were considered as predictive factors and tested by logistic regression. Predictors with P < 0.05 were selected to develop a new score system. RESULTS Age, PSA, PV, f/T, DRE findings, and hypoechoic in ultrasound were selected in our new score system. The risk of PCa increased with the score. From 0 to 6, the risk was 2.0, 8.4, 13.9, 33.5, 63.8, 75.0 and 100.0 % respectively. Area under curve (AUC) of our new score system was 0.804, which was significantly higher than The Prostate Cancer Risk Calculator by Stichting Wetenschappelijk Onderzoek Prostaatkanker (SWOP) (0.720, P = 0.002). CONCLUSIONS We developed a new simple score system for patients with PSA ranging from 4 to 20 ng/mL to improve the accuracy of PCa detection.