Prostate Specific Antigen and Prostate Cancer in Chinese Men Undergoing Initial Prostate Biopsies Compared with Western Cohorts.
Prostate Specific Antigen and Prostate Cancer in Chinese Men Undergoing Initial Prostate Biopsies Compared with Western Cohorts.
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DOI：
10.1016/j.juro.2016.08.103
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发表时间：
2017-01
期刊：
影响因子：
--
通讯作者：
Prostate Biopsy Collaborative Group
中科院分区：
文献类型：
--
作者：
Chen R;Sjoberg DD;Huang Y;Xie L;Zhou L;He D;Vickers AJ;Sun Y;Chinese Prostate Cancer Consortium;Prostate Biopsy Collaborative Group
旨在确定接受初次前列腺活检的中国男性的特征，并在大型中国多中心队列中评估 PSA 水平与 PCa/HGPCa 检测之间的关系。本回顾性研究纳入了 13,904 名泌尿外科门诊患者接受活检，其适应症如下：PSA 水平 > 4.0 ng/mL 或 PSA 水平 <4.0 ng/ml 但 DRE 结果异常。 PSA 测量是按照各自机构的标准程序进行的。所使用的测定类型已记录并根据世界卫生组织标准重新校准。在任何给定的 PSA 水平上，中国队列中 PCa 和 HGPCa 的发生率均低于西方队列。 PSA 水平为 4.0-10.0 ng/mL 的患者中约有 25% 被发现患有 PCa，而美国临床实践中这一比例约为 40%。此外，风险曲线总体上比西方队列更平坦，也就是说，风险不会随着 PSA 的升高而迅速增加。 PSA水平与前列腺癌风险之间的关系在中国和西方人群中存在显着差异，中国人群的总体风险较低。进一步的研究应该探讨环境或遗传差异是否可以解释这些发现，或者它们是否是由于筛查或良性前列腺疾病中未测量的差异造成的。对中国或具有相似遗传和环境背景的其他亚洲国家的男性实施前列腺癌临床决策规则或预测模型时需要谨慎。
To determine characteristics of Chinese men undergoing initial prostate biopsy and to evaluate the relationship between PSA levels and PCa/HGPCa detection in a large Chinese multicenter cohort. 13,904 Urology outpatients received biopsy for indications as following were included in this retrospective study: PSA levels of > 4.0 ng/mL or PSA levels of <4.0 ng/ml but with abnormal DRE results. The PSA measurements were performed in accordance with the standard procedures at the respective institutions. The type of assay used was documented and recalibrated to the WHO standard. The incidence of PCa and HGPCa were lower in the Chinese cohort than Western cohorts at any given PSA level. Around 25% of patients with PSA levels of 4.0-10.0 ng/mL were found to have PCa compared to approximately 40% in US clinical practice. Moreover, the risk curves were generally flatter than that of the Western cohorts, that is, risk did not increase as rapidly with higher PSA. The relationship between PSA level and prostate cancer risk differs importantly between Chinese and Western populations, with overall lower risk in the Chinese cohort. Further research should explore whether environmental or genetic differences explain these findings or whether they result from unmeasured differences in screening or benign prostate disease. Caution is required for the implementation of prostate cancer clinical decision rules or prediction models to men in China, or other Asian countries with similar genetic and environmental backgrounds.
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DOI：
10.7497/j.issn.2095-3941.2014.01.005
发表时间：
2014-03-01
期刊：
Cancer Biology Medicine
影响因子：
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