Objective: This study aims to evaluate the diagnostic value of the De Ritis ratio (DRR) in predicting prostate cancer (PCa) and clinical significant prostate cancer (csPCa) in biopsy-naïve patients with suspicious for PCa.
Material and Methods: We retrospectively reviewed medical records of 282 male patients who underwent transrectal ultrasound guided prostate needle biopsy (PNB) between January 2015 and July 2019. Demographic and clinical characteristic of the patients including digital rectal examination (DRR) findings, preoperative prostate specific antigene (PSA), aspartate aminotransferase (AST) levels, alanine aminotransferase (ALT) levels, prostate volüme, comorbidities and pathological findings of the PNB specimens were noted in detail for each patient. The study cohort was divided into two groups according to the histopathological results of PNB specimens (Group 1: patients with benign histopathology, Group 2: patients with PCa). The receiver operating characteristic (ROC) curve analysis was conducted to evaluate the diagnostic performance of PSA, PSAD and DRR in predicting PCa.
Results: The median age of the participants was 64 (59 69) years. While 71.6% (n = 202) of the participants were in Group 1, 28.4% (n=80) of them were in Group 2. The median value of Group 1 DRR was 1.08 (range: 0.89 1.32), and the median DRR value of Group 2 was determined as 1.19 (range: 0.95 1.56), and the median value of Group 2 DRR was found to be statistical significant higher than Group 1(p=0.013). Statistically significant but a weak positive correlation was observed between PCa in PNB specimens and DRR (r=0.149, p=0.012), while there was no statistically significant correlation between csPCa in PNB specimens and DRR (r=0.002, p=0.983). The ROC curve analysis showed that the cut-off value of DRR for the presence of PCa in PNB specimens was 1.125 and the area under curve (AUC) was 0.595 (95%CI= 0.518 0.672, p=0.013) for the presence of PCa in PNB specimens.
Conclusion: This study suggests that DRR had restricted diagnostic importance in predicting PCa in biopsy-naïve patients who underwent transrectal PNB.
Key words: Aspartate aminotransferase, alanine aminotransferase, prostate cancer, De Ritis ratio
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