After pairwise comparison, the AUC of aPSADPZ was significantly larger than PSA and PSAD for PCa diagnosis (aPSADPZ vs. PSA, Z value: 3.488, p < 0.01; aPSADPZ vs. PSAD, Z value: 3.169, p < 0.01) and csPCa diagnosis (aPSADPZ vs. PSA, Z value: 2.440, p = 0.01; aPSADPZ vs. PSAD, Z value: 2.560, p = 0.01). Here, KLK3 is linked to posterior cortical atrophy.