[The value of PSA density for the diagnosis of XXXX and for the indication of radical prostatectomy].

@entity1 @entity263 @entity5450 @entity5
We evaluated the diagnostic and prognostic value of PSA density (PSAD) in a prospective study of 100 @entity1 consulting for various @entity5450 . PSAD was calculated by the ratio of serum PSA over the ultrasonographic volume of the prostate gland, and was expressed in ng/ml/ml. The mean PSAD of 31 @entity1 with @entity263 was significantly higher than that of the 69 @entity1 without @entity263 (p = 0.0003). The @entity1 were classified into two groups according to the serum PSA value. Forty nine @entity1 had a serum PSA < or = 10 ng/ml, 31 of whom had a PSAD < or = 0.15 ng/ml/ml and 29 of these 31 @entity1 (94%) did not have @entity263 ; 18 @entity1 had a PSAD > 0.15 ng/ml/ml and six of them (33%) had @entity263 (p = 0.04). Fifty one @entity1 had a serum PSA > 10 ng/ml and 23 of them (45%) has @entity263 ; 14 of these 51 @entity1 had a PSAD < or = 0.30 ng/ml/ml and two of them (14%    had @entity263 ; 37 @entity1 had a PSAD > 0.30 ng/ml/ml, 21 of whom (57%) had @entity263 (p = 0.016). Twenty one of these 31 @entity1 with @entity263 were candidates for radical prostatectomy. Four @entity1 were N+ and 17 underwent radical prostatectomy. Capsular invasion was significantly correlated with PSAD. None of the four @entity1 with PSAD < or = 0.30 ng/ml/ml showed capsular invasion, while 11 of the 13 @entity1 (85%) with PSAD > 0.30 ng/ml/ml had capsular invasion. In conclusion, in @entity1 with PSA < or = 10 ng/ml, calculation of the PSAD avoids approximately two-thirds of prostatic biopsies, with a very low risk of missing a clinically significant @entity5 . On the other hand, PSAD is of more limited value in @entity1 with PSA > 10 ng/ml. In @entity5 considered to be operable clinically, the cut-off value of 0.30 ng/ml/ml for PSAD is predictive of capsular or lymph node invasion with a diagnostic accuracy of 94%.
