We retrospectively investigated 284 patients admitted to the Second Hospital of Shandong University between July 20 for prostate biopsy because of high PSA levels (>4 ng/ml). This study was approved by the Ethics Committee of the Second Hospital of Shandong University. Materials and Methods Study Subjects and Inclusive or Exclusive Criteria This is to mainly see whether MPV and PDW in combination with PSA could increase the sensitivity or specificity of PSA for PCa identification, and to finally avoid unnecessary biopsy. Therefore, the current study aimed to determine the diagnostic value of MPV and PDW in a population of patients who underwent biopsy (PSA > 4 ng/ml). In clinical practice, a biopsy was usually conducted on suspected patients with PCa with a PSA > 4 ng/ml, and unnecessary biopsies were not in the minority. They concluded that MPV and PDW combined with PSA could differentiate PCa from BPH patients. It is reported that decreased MPV and increased PDW were found in patients with PCa compared to patients with benign prostatic hyperplasia (BPH) who underwent surgery ( 16). Several studies also revealed the association of MPV and PDW with prostate cancer ( 15– 17). MPV and PDW have been shown to have diagnostic values for these cancers. Mean platelet volume (MPV) and platelet distribution width (PDW) are markers of activated platelets and are associated with gastric cancer, ovarian cancer, lung cancer, colon cancer, and breast cancer ( 10– 14). Activated platelets are associated with cancer progression and metastasis ( 9). Recent investigations showed that platelets play critical roles in mediating the growth, dissemination, and angiogenesis of cancer cells ( 8). Other novel cost-effective and convenient hematological biomarkers with higher predictive sensitivity and specificity need to be explored ( 6, 7). Also due to the low specificity of PSA, unnecessary biopsy rates are high ( 5). Although PSA has improved the early detection rate of PCa, the low sensitivity and specificity of PSA are often associated with over-diagnosis and lack of tumor specificity ( 4). Prostate-specific antigen (PSA) is the preoperative diagnostic of this disease and has been widely employed in predicting the pathological features of PCa. The incidence of PCa is increasing in most Asian countries including China ( 3). Prostate cancer (PCa) is the most diagnosed cancer and the second leading cause of cancer-related death for men in the United States ( 1, 2). MPV in combination with TPSA or FPSA could enhance the specificity of PSA and may reduce the rate of unnecessary biopsy for patients with high levels of PSA. These findings suggested that MPV could have a predictive value for the diagnosis of PCa. Furthermore, MPV combined with TPSA or FPSA further enhanced the specificity of TPSA (0.844) or FPSA (0.927), but PDW did not. However, the specificity of MPV was larger than that of TPSA (0.461) or FPSA (0.561). AUC and the sensitivity of MPV were comparable with total PSA (TPSA) or free PSA (FPSA). ROC analysis identified MPV ≤ 9.05 fl as a cut-off value for potential PCa with area under the ROC curve (AUC) = 0.783, 95% CI = 0.733–0.833, sensitivity = 0.746, and specificity = 0.708. MPV was significantly decreased and PDW increased in PCa than that of non-PCa among men. Among all parameters analyzed, the difference was only found in MPV, platelet distribution width (PDW), and PSA between PCa and non-PCa patients. Receiver operating characteristic (ROC) analysis was used to explore the diagnostic value of MPV for PCa. The correlation between MPV and clinical characteristics was analyzed. The above parameters were compared between PCa and non-PCa patients. Clinical data and pre-biopsy hematological parameters were collected. For this study, 107 pathologically confirmed PCa and 177 non-PCa patients who underwent prostate biopsy were retrospectively studied. We investigated the value of MPV as a diagnostic marker for prostate cancer (PCa) and examined whether MPV in combination with prostate-specific antigen (PSA) could increase the sensitivity or specificity of PSA for PCa diagnosis. Mean platelet volume (MPV) is an indicator of platelet activation and has been proposed as a diagnostic marker for several kinds of cancers. 5Clinical Department, Jinan Nursing Vocational College, Jinan, China.4Department of Kidney Transplantation, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.3Department of Urology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.2Department of Urology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.1School of Basic Medical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China.Wei Song 1,2, Ning Ding 3, Xiulin Zhang 3, Jiaxin Liu 4, Yuzhen Wang 5, Jieke Yan 4 * † and Shuangde Liu 4 * †
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