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Prostate cancer detection upon transrectal ultrasound-guided biopsy in relation to digital rectal examination and prostate-specific antigen level： what to expect in the Chinese population？

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Asian Journal of Andrology 2015年第5期17卷 821-825,I0010页

作者： Jeremy YC Teoh steffi kk yuen James HL Tsu Charles KW Wong Brian SH Ho Ada TL Ng Wai-Kit Ma Kwan-Lun Ho Ming-Kwong Yiu Department of Surgery Division of Urology Queen Mary Hospital University of Hong Kong Hong Kong China

We investigated the prostate cancer detection rates upon transrectal ultrasound （TRUS）-guided biopsy in relation to digital rectal examination （DRE） and prostate-specific antigen （PSA）, and risk factors of prostate cancer detection in the Chinese population. Data from all consecutive Chinese men who underwent first TRUS-guided prostate biopsy from year 2000 to 2013 was retrieved from our database. The prostate cancer detection rates with reference to DRE finding and PSA level of 〈 4, 4-10, 10.1-20, 20.1-50 and 〉 50 ng ml^-1 were investigated. Multivariate logistic regression analyses were performed to investigate for potential risk factors of prostate cancer detection. A total of 2606 Chinese men were included. In patients with normal DRE, the cancer detection rates were 8.6%, 13.4%, 21.8%, 41.7% and 85.2% in patients with PSA 〈 4, 4-10, 10.1-20, 20.1-50 and 〉 50 ng ml^-1 respectively. In patients with abnormal DRE, the cancer detection rates were 12.4%, 30.2%, 52.7%, 80.6% and 96.4% in patients with PSA 〈 4, 4-10, 10.1-20, 20.1-50 and 〉 50 ng m1-1 respectively. Older age, smaller prostate volume, larger number of biopsy cores, presence of abnormal DRE finding and higher PSA level were associated with increased risk of prostate cancer detection upon multivariate logistic regression analyses （P 〈 0.001）. Chinese men appeared to have lower prostate cancer detection rates when compared to the Western population. Taking the different risk factors into account, an individualized approach to the decision of TRUS-guided biopsy can be adopted.

关键词： Chinese digital rectal examination prostate biopsy prostate cancer prostate-specific antigen

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The performance characteristics of prostate-specific antigen and prostate-specific antigen density in Chinese men

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Asian Journal of Andrology 2017年第1期19卷 113-116页

作者： Jeremv YC Teoh steffi kk yuen James HL Tsu Charles KW Wong Brian SH Ho Ada TL Ng Wai-Kit Ma Kwan-Lun Ho Ming-Kwong Yiu Division of Urology Department of Surgery Queen Mary Hospital University of Hong Kong Hong Kong China

We investigated the performance characteristics of prostate-specific antigen （PSA） and PSA density （PSAD） in Chinese men. All Chinese men who underwent transrectal ultrasound-guided prostate biopsy （TRUS-PB） from year 2000 to 2013 were included. The receiver operating characteristic （ROC） curves for both PSA and PSAD were analyzed. The sensitivity, specificity, positive predictive value （PPV） and negative predictive value （NPV） at different cut-off levels were calculated. A total of 2606 Chinese men were included. For the ROC, the area under curve was 0.770 for PSA （P〈 0.001） and 0.823 for PSAD （P〈 0.001）. PSA of 4.5 ng ml^-1 had sensitivity of 94.4%, specificity of 14.1%, PPV of 29.5%, and NPV of 86.9%; PSAD of 0.12 ng ml^-1cc^-1 had sensitivity of 94.5%, specificity of 26.6%, PPV of 32.8%, and NPV of 92.7%. On multivariate logistic regression analyses, PSA cut-off at 4.5 ng ml^-1 （OR 1.61, 95% CI 1.05-2.45, P = 0.029） and PSAD cut-off at 0.12 ng ml^-1 cc^-1 （OR 6.22, 95% CI 4.20-9.22, P 〈 0.001） were significant predictors for prostate cancer detection on TRUS-PB. In conclusion, the performances of PSA and PSAD at different cut-off levels in Chinese men were very different from those in Caucasians. PSA of 4.5 ng ml^-1 and PSAD of O. 12 ng ml^-1 cc^-1 had near 95% sensitivity and were significant predictors of prostate cancer detection in Chinese men.

关键词： Chinese prostate cancer transrectal ultrasound-guided prostate biopsy prostate-specific antigen prostate-specific antigen density

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Association of time to prostate-specific antigen nadir and logarithm of prostate-specific antigen velocity after progression in metastatic prostate cancer with prior primary androgen deprivation therapy

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Asian Journal of Andrology 2017年第1期19卷 98-102页

作者： Jeremy YC Teoh James HL Tsu steffi kk yuen Peter KF Chiu Samson YS Chan Ka-Wing Wong Kwan-Lun Ho Simon SM Hou Chi-Fai Ng Ming-Kwong Yiu Division of Urology Department of Surgery The Chinese University of Hong Kong Prince of Wales Hospital Shatin Hong Kong China Division of Urology Department of Surgery Queen Mary Hospital University of Hong Kong Hong Kong China.

We investigated the association of time to prostate-specific antigen nadir （TTPN） and logarithm of prostate-specific antigen velocity after progression Log（PSAVAP） in metastatic prostate cancer with prior primary androgen deprivation therapy （ADT）. All metastatic prostate cancer patients treated with primary ADT from 2000 to 2009 were reviewed. Patients who developed disease progression were included in the subsequent analyses. Patients were categorized into three groups according to their TTPN： TTPN of 〈3 months, 3-17 months, and 〉17 months. We compared the Log（PSAVAP） between the different TTPN groups using Mann-Whitney U-test and Kruskal-Wallis test. Further multiple linear regression analyses on Log（PSAVAP） were performed to adjust for other potential confounding factors. Among 419 patients who were treated with primary ADT, 306 patients developed disease progression with a median follow-up of 28 months, Longer TTPN was associated with lower Log（PSAVAP）（P = 0.008） within all subgroup analyses （TTPN of 〈3 vs 3-17 months, P = 0.020; TTPN of 3-17 vs 〉17 months, P = 0.009; and TTPN of 〈3 vs 〉17 months, P = 0.001）. Upon multiple linear regression analyses, baseline PSA （regression coefficient 0.001, P = 0.045）, PSA nadir （regression coefficient 0.002, P = 0.040）, and TTPN （regression coefficient -0.030, P = 0.001） were the three factors that were significantly associated with Log（PSAVAP）. In conclusion, a longer TTPN was associated with lower Log（PSAVAP） in metastatic prostate cancer patients following primary ADT. TTPN cut-offs at 3 months and 17 months appeared to have prognostic significance in predicting Log（PSAVAP）. TTPN may serve as a good prognostic indicator in deciding the treatment strategy in patients with disease progression.

关键词： androgen deprivation therapy prostate cancer prostate-specific antigen velocity after progression ti me to prostate-specific antigen nadir

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Defining minimal invasive surgical therapy for benign prostatic obstruction surgery: Perspectives from a global knowledge, attitude, and practice survey

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Asian Journal of Urology 2024年第1期11卷 55-64页

作者： Bryan Kwun-Chung Cheng steffi Kar-Kei yuen Daniele Castellani Marcelo Langer Wroclawski Hongda Zhao Mallikarjuna Chiruvella Wei-Jin Chua Ho-Yee Tiong Yiloren Tanidir Jean de la Rosette Enrique Rijo Vincent Misrai Amy Krambeck Dean S.Elterman Bhaskar K.Somani Jeremy yuen-Chun Teoh Vineet Gauhar Department of Surgery United Christian HospitalHong KongChina S.H.Ho Urology Centre Department of SurgeryPrince of Wales HospitalThe Chinese University of Hong KongHong KongChina Department of Urology University Hospital“Ospedali Riuniti”and Polytechnic University of Marche RegionAnconaItaly Hospital Israelita Albert Einstein Sao PauloSPBrazil BP—A Beneficencia Portuguesa de Sao Paulo Sao PauloSPBrazil Faculdade de Medicina do ABC Santo AndreSPBrazil Department of Urology Asian Institute of Nephrology and UrologyHyderabadTGIndia Department of Urology National University HospitalSingapore Department of Urology Marmara University School of MedicineIstanbulTurkey Department of Urology Medipol Mega University HospitalIstanbul Medipol UniversityIstanbulTurkey Department of Urology Hospital Quiron BarcelonaBarcelonaSpain Department of Urology Clinique PasteurToulouseFrance Department of Urology Indiana University School of MedicineIndianapolisINUSA Division of Urology Department of SurgeryUniversity Health NetworkUniversity of TorontoTorontoCanada Department of Urology University Hospital Southampton NHS TrustSouthamptonUK Department of Urology Ng Teng Fong General HospitalNUHSSingapore

Objective:To scrutinize the definitions of minimal invasive surgical therapy(MIST)and to investigate urologists’knowledge,attitudes,and practices for benign prostatic obstruction ***:A 36-item survey was developed with a Delphi *** on definitions of MIST and attitudes and practices of benign prostatic obstruction surgeries were *** were invited globally to complete the online *** was achieved when more than or equal to 70%responses were“agree or strongly agree”and less than or equal to 15%responses were“disagree or strongly disagree”(consensus agree),or when more than or equal to 70%responses were“disagree or strongly disagree”and less than or equal to 15%responses were“agree or strongly agree”(consensus disagree).Results:The top three qualities for defining MIST were minimal blood loss(n=466,80.3%),fast post-operative recovery(n=431,74.3%),and short hospital stay(n=425,73.3%).The top three surgeries that were regarded as MIST were Urolift®(n=361,62.2%),Rezum®(n=351,60.5%),and endoscopic enucleation of the prostate(EEP)(n=332,57.2%).Consensus in the knowledge section was achieved for the superiority of Urolift®,Rezum®,and iTIND®over transurethral resection of the prostate with regard to blood loss,recovery,day surgery feasibility,and post-operative *** in the attitudes section was achieved for the superiority of Urolift®,Rezum®,and iTIND®over transurethral resection of the prostate with regard to blood loss,recovery,and day surgery *** on both sections was achieved for EEP as the option with the better symptoms and flow improvement,lower retreatment rate,and better suitable for prostate more than 80 ***:Minimal blood loss,fast post-operative recovery,and short hospital stay were the most important qualities for defining ***®,Rezum®,and EEP were regarded as MIST by most urologists.

关键词： Benignprostate hyperplasia Minimalinvasive surgical therapy Surgery Bladderoutlet obstruction

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Metabolic syndrome and benign prostatic hyperplasia:An update

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Asian Journal of Urology 2017年第3期4卷 164-173页

作者： Ho-Yin Ngai Kar-Kei steffi yuen Chi-Man Ng Cheung-Hing Cheng Sau-Kwan Peggy Chu Division of Urology Department of SurgeryQueen Elizabeth HospitalHong KongChina Division of Urology Department of SurgeryTuen Mun HospitalHong KongChina

Metabolic syndrome(MetS)is a cluster of metabolic abnormalities related to central adiposity and insulin *** importance is increasingly recognized as it associates with increased risks of metabolic and cardiovascular *** metabolic aberrations of MetS may lead to development of benign prostatic hyperplasia(BPH)and lower urinary tract symptoms(LUTS)in men.A 26.5%-55.6% prevalence of MetS in men with LUTS was reported in worldwide *** the exact biological pathway is not clear yet,insulin resistance,increased visceral adiposity,sex hormone alterations and cellular inflammatory reactions played significant roles in the related pathophysiological *** should recognize the cardiovascular and metabolic impacts of MetS in men with LUTS,early risk factors optimization and use of appropriate medical therapy may possibly alter or slower the progression of LUTS/BPH,and potentially avoid unnecessary morbidities and mortalities from cardiovascular and metabolic diseases for those men.

关键词： Inflammation Insulin resistance Lower urinary tract symptoms Metabolic syndromeX Prostatic hyperplasia

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