Peripheral zone PSA density: a predominant variable to improve prostate cancer detection efficiency in men with PSA higher than 4 ng ml(-1).
Peripheral zone PSA density: a predominant variable to improve prostate cancer detection efficiency in men with PSA higher than 4 ng ml(-1).
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外周区PSA密度：PSA高于4 ng ml~(-1)的男性提高前列腺癌检出效率的主要变量
DOI：
10.4103/aja.aja_72_20
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发表时间：
2021-07
影响因子：
2.9
通讯作者：
Zhao FJ
中科院分区：
文献类型：
--
作者：
Wang C;Wang YY;Wang SY;Ding JX;Ding M;Ruan Y;Wang XH;Jing YF;Han BM;Xia SJ;Jiang CY;Zhao FJ
为了提高前列腺癌（PCa）的诊断效率，减少不必要的活检，我们定义并分析了外周带前列腺特异性抗原（PSA）密度（PZ-PSAD）的诊断效率。回顾性确定了2012年1月至2018年1月期间在上海总医院（中国上海）接受系统性12芯前列腺活检的患者（n = 529）。另一组良性前列腺增生患者（n = 100）被随机预选，以获得非PCa队列（N-PSAD）的PSA密度。使用多参数磁共振成像（mpMRI）测量前列腺体积和移行区体积，并将其与PSA和N-PSAD相结合，以通过特定算法获得PZ-PSAD。采用受试者工作特征（ROC）曲线分析，PZ-PSAD的ROC曲线下面积（AUC）高于PSA、PSA密度（PSAD）和移行区PSA密度（TZ-PSAD）。PZ-PSAD可以修正一半以上经直肠超声（TRUS）和mpMRI结果不准确的患者的诊断。当TRUS和mpMRI结果对预测PCa不明确时（PIRADS评分≤3分），PZ-PSAD可将活检阳性率从21.7%提高到54.7%，并帮助63.8%（150/235）的患者避免不必要的前列腺活检。在PSA为4.0-10.0 ng ml−1、10.1-20.0 ng ml−1和>20.0 ng ml−1的患者中，预测具有临床意义的PCa的理想PZ-PSAD截止值分别为0.019 ng ml−2、0.297 ng ml−2和1.180 ng ml−2（灵敏度>90%）。与PSA、PSAD和TZ-PSAD相比，PZ-PSAD预测PCa的效率最高，导致漏诊和不必要的活检较少。
To improve the diagnostic efficiency of prostate cancer (PCa) and reduce unnecessary biopsies, we defined and analyzed the diagnostic efficiency of peripheral zone prostate-specific antigen (PSA) density (PZ-PSAD). Patients who underwent systematic 12-core prostate biopsies in Shanghai General Hospital (Shanghai, China) between January 2012 and January 2018 were retrospectively identified (n = 529). Another group of patients with benign prostatic hyperplasia (n = 100) were randomly preselected to obtain the PSA density of the non-PCa cohort (N-PSAD). Prostate volumes and transition zone volumes were measured using multiparameter magnetic resonance imaging (mpMRI) and were combined with PSA and N-PSAD to obtain the PZ-PSAD from a specific algorithm. Receiver operating characteristic (ROC) curve analysis was used to assess the PCa detection efficiency in patients stratified by PSA level, and the area under the ROC curve (AUC) of PZ-PSAD was higher than that of PSA, PSA density (PSAD), and transition zone PSA density (TZ-PSAD). PZ-PSAD could amend the diagnosis for more than half of the patients with inaccurate transrectal ultrasonography (TRUS) and mpMRI results. When TRUS and mpMRI findings were ambiguous to predict PCa (PIRADS score ≤3), PZ-PSAD could increase the positive rate of biopsy from 21.7% to 54.7%, and help 63.8% (150/235) of patients avoid unnecessary prostate biopsy. In patients whose PSA was 4.0–10.0 ng ml−1, 10.1–20.0 ng ml−1, and >20.0 ng ml−1, the ideal PZ-PSAD cut-off value for predicting clinically significant PCa was 0.019 ng ml−2, 0.297 ng ml−2, and 1.180 ng ml−2, respectively (sensitivity >90%). Compared with PSA, PSAD, and TZ-PSAD, the efficiency of PZ-PSAD for predicting PCa is the highest, leading to fewer missed diagnoses and unnecessary biopsies.
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影响因子：
2.9
作者：
Xia, Shu-Jie
通讯作者：
Xia, Shu-Jie
影响因子：
2.1
作者：
BAZINET, M;MESHREF, AW;ELHILALI, MM
通讯作者：
ELHILALI, MM
DOI：
10.1016/j.juro.2016.08.103
发表时间：
2017-01
期刊：
The Journal of urology
影响因子：
--
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
通讯作者：
Prostate Biopsy Collaborative Group
DOI：
10.1158/1078-0432.ccr-17-0413
发表时间：
2017-11-15
期刊：
Clinical cancer research : an official journal of the American Association for Cancer Research
影响因子：
--
作者：
Labbé DP;Sweeney CJ;Brown M;Galbo P;Rosario S;Wadosky KM;Ku SY;Sjöström M;Alshalalfa M;Erho N;Davicioni E;Karnes RJ;Schaeffer EM;Jenkins RB;Den RB;Ross AE;Bowden M;Huang Y;Gray KP;Feng FY;Spratt DE;Goodrich DW;Eng KH;Ellis L
通讯作者：
Ellis L
影响因子：
6.2
作者：
Williams, Stephen B.;Salami, Simpa;Sanda, Martin G.
通讯作者：
Sanda, Martin G.