Cumulative probability of prostate cancer detection in biopsy according to free/total PSA ratio in men with total PSA levels of 2.1-10.0 ng/ml at population screening
Cumulative probability of prostate cancer detection in biopsy according to free/total PSA ratio in men with total PSA levels of 2.1-10.0 ng/ml at population screening
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DOI：
10.1007/s00432-013-1543-9
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发表时间：
2014-01-01
影响因子：
3.6
通讯作者：
Namiki, Mikio
中科院分区：
文献类型：
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作者：
Kitagawa, Yasuhide;Ueno, Satoru;Namiki, Mikio
本研究的目的是研究在PSA水平为2.1-10.0 ng/ml的男性中，根据游离/总前列腺特异性抗原（PSA）比值检测前列腺癌的累积概率，以及在基于人群的筛查中检测临床无关的前列腺癌的可能性。在2000年至2011年期间，在金泽市人群筛查中筛查的总PSA （tPSA）水平为2.1-10.0 ng/ml的男性共1277名，年龄在55岁至69岁之间，并接受了系统经直肠超声引导的前列腺活检。根据年龄、血清tPSA和游离总PSA （f/t PSA）比值，研究前列腺癌活检的累积概率。我们还对筛查出的前列腺癌的临床病理特征进行了研究。在1277名研究对象中，320人（25.0%）在观察期间被诊断患有前列腺癌。PSA比值为0.08、0.09-0.13、0.14-0.22、0.23的男性，3年前列腺癌检出率分别为64.5、41.2、28.5、14.3%；不同f/t PSA比值的男性前列腺癌检出率差异有统计学意义。在320例患者中，84例（26.3%）具有良好的临床病理特征，适合进行主动监测。恶性肿瘤患者的f/t PSA比值明显低于恶性肿瘤患者。目前的研究表明，在人群筛查中，总PSA水平为2.1-10.0 ng/ml的男性，f/t PSA比值是未来癌症检测和前列腺活检中不利癌症特征的有力预测因子。
The aim of this study was to investigate the cumulative probability of prostate cancer detection according to free/total prostate-specific antigen (PSA) ratio in men with PSA levels of 2.1-10.0 ng/ml and also likelihood of detecting clinically insignificant prostate cancer in population-based screening.A total of 1,277 men aged between 55 and 69 years with total PSA (tPSA) levels of 2.1-10.0 ng/ml screened in population screening in Kanazawa city and underwent systematic transrectal ultrasonography-guided prostate biopsy between 2000 and 2011 were enrolled. The cumulative probability of prostate cancer detection in biopsy according to age, serum tPSA, and free-to-total PSA (f/t PSA) ratio was investigated. The clinicopathological features of screening-detected prostate cancer were also investigated.Of the 1,277 subjects in the study population, 320 (25.0 %) were diagnosed with prostate cancer during the observation period. The probabilities of prostate cancer detection at 3 years were 64.5, 41.2, 28.5, and 14.3 % for the men with f/t PSA ratio a parts per thousand currency sign0.08, 0.09-0.13, 0.14-0.22, and a parts per thousand yen0.23, respectively; the differences in probabilities of prostate cancer detection among men with different f/t PSA ratios were statistically significant. Among 320 patients, 84 (26.3 %) had favorable clinicopathological features that made them suitable for active surveillance. The f/t PSA ratio in unfavorable cancer patients was significantly lower that that in favorable cancer patients.The present study demonstrated that the f/t PSA ratio was a strong predictor of future cancer detection and unfavorable cancerous features in prostate biopsy in men with total PSA levels of 2.1-10.0 ng/ml at population screening.