Prostate Imaging Reporting and Data System score in the diagnosis of prostate cancer patients with borderline PSA values

Objectives. The objective of this study was to evaluate the potential use of Prostate Imaging--Reporting and Data System version 2 (PI-RADS) in combination with Glutathione S-transferase P1 (GST-P1) expression for an improved diagnosis of prostate cancer, in patients with inconclusive values of prostate-specific antigen (PSA). Materials and Methods. The study was conducted on 80 patients for whom PSA values were evaluated and were found to be inconclusive (4-10 ng/ml). These patients underwent imagistic evaluation (PI-RADS), followed by transurethral prostate biopsy, with the evaluation of GST-P1 expression and histopathological examination (for diagnosis confirmation). Results. By combining the results of PI-RADS and GST-P1 the capacity of the tests to correctly identify healthy subjects, with an area under curve of 0,832 (95% CI 0.732-0.907), with a sensitivity of 73,25% and a specificity of 77,78%. Conclusions. PI-RADS lesions and GST-P1 methylation testing when PSA levels are in a "grey zone", provide a better specificity and sensitivity by comparison through single testing. Testing patients with inconclusive PSA levels allows for a more accurate diagnosis and less over-diagnosis by non-invasive procedures, such as repeated biopsies. Keywords: PI-RADS, GST-P1, prostate cancer, diagnosis, prostate-specific antigen