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prostate-specific antigen density predicts favorable pathology and biochemical recurrence in patients with intermediate-risk prostate cancer

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Asian Journal of Andrology 2016年第3期18卷 480-484,I0012页

作者： Ho Won Kang Hae Do Jung Joo Yong Lee Jong Kyou Kwon Seong Uk Jeh Kang Su Cho Won Sik Ham Young Deuk Choi Department of Urology Chungbuk National University College of Medicine Cheongju Korea Department of Urology Severance Hospital Urological Science InstituteYonsei University College of Medicine Seoul Korea Department of Urology. Inje university Haeundae Paik Hospital Busan Korea Department of Urology Gyeongsang National University School of Medicine Jinju Korea Department of Urology Gangnam Severance Hospital Urological Science Institute Yonsei University Uollege of Medicine Seoul Korea Robot and Minimal Invasive Surgery Center Severance Hospital Yonsei University College of Medicine Seoul Korea.

This study was designed to identify clinical predictors of favorable pathology and biochemical recurrence （BCR） in patients with intermediate-risk prostate cancer （IRPCa）. Between 2006 and 2012, clinicopathological and oncological data from 203 consecutive men undergoing robot-assisted radical prostatectomy （RARP） for IRPCa were reviewed in a single-institutional retrospective study. Favorable pathology was defined as Gleason score 〈6 and organ-confined cancer as detected by surgical pathology. Logistic regression analysis was used to determine predictive variables of favorable pathology, and the Kaplan-Meier and multivariate Cox regression model were used to estimate BCR-free survival after RARP. Overall, 38 patients （18.7%） had favorable pathology after RARP. Lower quartile prostate-specific antigen density （PSAD） was associated with favorable pathology compared to the highest quartile PSAD after adjusting for preoperative PSA, clinical stage and biopsy Gleason score （odds ratio, 5.42; 95% confidence interval, 1.01-28.97; P = 0.048）. During a median 37.8 （interquartile range, 24.6-60.2） months of follow-up, 66 patients experienced BCR. There were significant differences with regard to BCR free survival by PSAD quartiles （log rank, P = 0.003）. Using a multivariable Cox proportion hazard model, PSAD was found to be an independent predictor of BCR in patients with IRPCa after RARP （hazard ratio, 4.641; 95% confidence interval, 1.109-19.417; P = 0.036）. The incorporation of the PSAD into risk assessments might provide additional prognostic information and identify some patients in whom active surveillance would be appropriate in patients with IRPCa.

关键词： biochemical recurrence prostatectomy prostate-specific antigen prostate-specific antigen density prostatic neoplasms

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prostate-specific antigen Density Variation Rate as a Potential Guideline Parameter for Second prostate Cancer Detection Biopsy

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Chinese Medical Journal 2016年第15期129卷 1800-1804页

作者： Gan-Sheng Xie Jin-Xing Lyv Gang Li Chun-Yin Yan Jian-Quan Hou Jin-Xian Pu Xiang Ding Yu-Hua Huang Department of Urology The First Affiliated Hospital of Soochow University Suzhou Jiangsu 215000 China

Background： The diagnostic value of current prostate-specific antigen （PSA） tests is challenged by the poor detection rate of prostate cancer （PCa） in repeat prostate biopsy. In this study, we proposed a novel PSA-related parameter named PSA density variation rate （PSADVR） and designed a clinical trial to evaluate its potential diagnostic value for detecting PCa on a second prostate biopsy. Methods： Data from 184 males who underwent second ultrasound-guided prostate biopsy 6 months after the first biopsy were included in the study. The subjects were divided into PCa and non-PCa groups according to the second biopsy pathological results. prostate volume, PSA density （PSAD）, free-total PSA ratio, and PSADVR were calculated according to corresponding formulas at the second biopsy. These parameters were compared using t-test or Mann-Whitney U-test between PCa and non-PCa groups, and receiver operating characteristic analysis were used to evaluate their predictability on PCa detection. Results： PCa was detected in 24 patients on the second biopsy. Mean values of PSA, PSAD, and PSADVR were greater in the PCa group than in the non-PCa group （8.39 μg/L vs. 7.16 μg/L, 0.20 vs. 0.16, 14.15% vs. 1.36%, respectively）. PSADVR had the largest area trader the curve, with 0.667 sensitivity and 0.824 specificity when the cutoff was 10%. The PCa detection rate was significantly greater in subjects with PSADVR 〉10% than PSADVR _〈10% （28.6% vs. 6.5%, P 〈 0.001 ）. In addition, PSADVR was the only parameter in this study that showed a significant correlation with mid-to-high-risk PCa （r = 0.63, P = 0.03）. Conclusions： Our results demonstrated that PSADVR improved the PCa detection rate on second biopsies, especially for mid-to-high-risk cancers requiring prompt treatment.

关键词： prostate-specific antigen Prostatic Hyperplasia Prostatic Neoplasm Transrectal Ultrasound

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prostate-specific antigen （PSA） velocity： a test of controversial benefit in the era of increased prostate cancer screening

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Asian Journal of Andrology 2011年第4期13卷 614-615页

作者： Michael S Borofsky Danil V Makarov Department of Urology New York University School of Medicine New York NY 10016 USA Department of Urology and The Section on Value and Comparative Effectiveness New York University School of Medicine New York NY 10016 USA

Determining the need for prostate biopsy remains one of the most controversial questions in urology. Over the past 10 years, practice guidelines have changed dramatically, especially among asymptomatic men with low pr... 详细信息

关键词： prostate-specific antigen controversial benefit prostate cancer screening

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prostate-specific antigen reduction after capecitabine plus oxaliplatin chemotherapy:A case report

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World Journal of Clinical Cases 2023年第11期11卷 2528-2534页

作者： Qian Zou Rui-Lin Shen Xiao Guo Chen-Ye Tang Jiaxing University Master Degree Cultivation Base Zhejiang Chinese Medical UniversityHangzhou 310000Zhejiang ProvinceChina Department of Urology The Second Affiliated Hospital of Jiaxing UniversityJiaxing 314001Zhejiang ProvinceChina

BACKGROUND prostate cancer(PC)is currently the most common malignant tumor of the genitourinary system in *** prostatectomy(RP)is recommended for the treatment of patients with localized *** hormonal therapy(AHT)can be administered postoperatively in patients with high-risk or locally advanced *** is a vital remedy for castration-resistant prostate cancer(CRPC),and may also benefit patients with PC who have not progressed to *** SUMMARY A 68-year-old male was admitted to our hospital because of urinary irritation and dysuria with increased prostate-specific antigen(PSA)*** detailed examination,he was diagnosed with PC and treated with laparoscopic RP on August 3,*** using androgen deprivation therapy(ADT)was performed postoperatively because of the positive surgical margin,extracapsular extension,and neural invasion but lasted only 6 ***,he was diagnosed with rectal cancer about half a year after self-cessation of AHT,and was then treated with laparoscopic radical rectal resection and adjuvant chemotherapy using the capecitabine plus oxaliplatin(CapeOx)*** the entire treatment process,the patient's PSA level first declined significantly after treatment of PC with laparoscopic RP and ADT,then rebounded because of self-cessation of ADT,and finally decreased again after CapeOx *** CapeOx chemotherapy can reduce PSA levels in patients with high-risk locally advanced PC,indicating that CapeOx may be an alternative chemotherapy regimen for PC.

关键词： prostate cancer Chemotherapy prostate-specific antigen Rectal tumor Androgen deprivation therapy Case report

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prostate-specific antigen doubling time and response to cabazitaxel in a hormone-resistant metastatic prostate cancer patient

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The Journal of Biomedical Research 2015年第5期29卷 420-422页

作者： Marwan Ghosn Alain Dagher Fadi El-Karak Hematology-Oncology Department Faculty of MedicineSaint-Joseph University

We report a case of metastatic castration-resistant prostate cancer, who received prior treatment with docetaxel and was then given cabazitaxel as salvage therapy. The patient was monitored by prostate-specific antigen doubling time and prostate-specific antigen absolute value. The prostate-specific antigen doubling time was found to be a good response predictor in the patient.

关键词： prostate-specific antigen doubling time prostate cancer cabazitaxel docetaxel

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Combining clinical parameters and multiparametric magnetic resonance imaging to stratify biopsy-naïve men for an optimum diagnostic strategy with prostate-specific antigen 4 ng ml^(−1) to 10 ng ml^(−1)

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Asian Journal of Andrology 2023年第4期25卷 492-498页

作者： Chi-Chen Zhang Xiang Tu Tian-Hai Lin Di-Ming Cai Ling Yang Shi Qiu Zhen-Hua Liu Lu Yang Qiang Wei Department of Urology Institute of UrologyWest China HospitalSichuan UniversityChengdu 610041China Department of Ultrasound West China HospitalSichuan UniversityChengdu 610041China Department of Radiology West China HospitalSichuan UniversityChengdu 610041China

We attempted to perform risk categories based on the free/total prostate-specific antigen ratio (%fPSA), prostate-specific antigen(PSA) density (PSAD, in ng ml^(−2)), and multiparametric magnetic resonance imaging (mpMRI) step by step, with the goal ofdetermining the best clinical diagnostic strategy to avoid unnecessary tests and prostate biopsy (PBx) in biopsy-naïve men with PSAlevels ranging from 4 ng ml^(−1) to 10 ng ml^(−1). We included 439 patients who had mpMRI and PBx between August 2018 and July2021 (West China Hospital, Chengdu, China). To detect clinically significant prostate cancer (csPCa) on PBx, receiver-operatingcharacteristic (ROC) curves and their respective area under the curve were calculated. Based on %fPSA, PSAD, and prostateImaging-Reporting and Data System (PI-RADS) scores, the negative predictive value (NPV) and positive predictive value (PPV) werecalculated sequentially. The optimal %fPSA threshold was determined to be 0.16, and the optimal PSAD threshold was 0.12 for%fPSA ≥0.16 and 0.23 for %fPSA <0.16, respectively. When PSAD <0.12 was combined with patients with %fPSA ≥0.16, the NPVof csPCa increased from 0.832 (95% confidence interval [CI]: 0.766–0.887) to 0.931 (95% CI: 0.833–0.981);the detection rateof csPCa was similar when further stratified by PI-RADS scores (P = 0.552). Combining %fPSA <0.16 with PSAD ≥0.23 ng ml^(−2)predicted significantly more csPCa patients than those with PSAD <0.23 ng ml^(−2) (58.4% vs 26.7%, P < 0.001). Using PI-RADSscores 4 and 5, the PPV was 0.739 (95% CI: 0.634–0.827) when further stratified by mpMRI results. In biopsy-naïve patientswith PSA level of 4–10 ng ml^(−1), stratification of %fPSA and PSAD combined with PI-RADS scores may be useful in the decisionmaking process prior to undergoing PBx.

关键词： multiparametric magnetic resonance imaging predictive value prostate biopsy prostate cancer prostate-specific antigen PSA-derived parameter

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Understanding prostate-specific antigen dynamics in monitoring metastatic castration-resistant prostate cancer： implications for clinical practice

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Asian Journal of Andrology 2017年第2期19卷 143-148页

作者： Atsushi Mizokami Kouji Izumi Hiroyuki Konaka Yasuhide Kitagawa Yoshifumi Kadono Kazutaka Narimoto Takahiro Nohara Amit K Bahl Mikio Namiki Department of Integrative Cancer Therapy and Urology Kanazawa University Graduate School of Medical Science 13-1 Takaramachi Kanazawa 920-8640 Japan Bristol Haematology and Oncology Centre University Hospitals Bristol Bristol BS2 8ED UK

Availability of novel hormonal therapies as well as docetaxel and cabazitaxel treatment for metastatic castration-resistant prostate cancer （CRPC） has changed the outlook for this group of patients with improvements in progression-free survival and overall survival. Physicians often diagnose the progression of prostate cancer using serum prostate-specific antigen （PSA）. However, serum PSA is not always correlated with the clinical status in CRPC. To evaluate the PSA dynamics with greater precision, understanding of the control of PSA and of the mechanisms of development of CRPC is needed. Moreover, it is necessary to use new hormonal therapies with an appropriate timing to optimally improve the prognosis and the QOL of the patients. In the present review, we ascertain the PSA dynamics and the mechanisms of the development of CRPC to assist in optimal utilization of the new treatments for mCRPC.

关键词： castration-resistant prostate cancer new hormonal therapy prostate-specific antigen

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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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Relationship between insulin resistance, obesity and serum prostate-specific antigen levels in healthy men

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Asian Journal of Andrology 2010年第3期12卷 400-404,I0011页

作者： June Hyun Han Yong Taec Lee Kyung Won Kwak Seung Hyun Ahn In Ho Chang Soon Chul Myung Seung Young Oh Yong-Seong Lee Wonyong Kim Young-Woo Jin Tae-In Choi Sook Hee Sung Department of Urology KEPCO Medical Foundation Hanil General Hospital Seou1132-703 Korea Department of Urology Chung-Ang University Hospital Seoul 140-757 Korea Department of Urology Hyundae General Hospital Namyangju 472-865 Korea Department of Urology Hallym University Hangang Sacred Heart Hospital Seoul 150-719 Korea Department of Microbiology College of Medicine Chung-Ang University Seoul 156- 756 Korea Radiation Health Research Institute Korea Hydro ＆ Nuclear Power Co. LTD Seoul 132-703 Korea

The purpose of this study was to determine the relationship between insulin resistance, obesity and serum prostate-specific antigen （PSA） levels in healthy men with serum PSA level below 4 ng mL-1. The men included in the study cohort were 11 827 healthy male employees of the Korea Hydro and Nuclear Power Co., LTD who had undergone medical checkups including fasting glucose, fasting insulin and serum PSA between January 2003 and December 2008. Insulin resistance was calculated by homeostasis model assessment （HOMA [fasting glucose × fasting insulin]/22.5） and quantitative insulin sensitivity check index （QUICK/; 1/[log （fasting insulin）＋ log （fasting glucose）]）. Age-adjusted body mass index （BMI） was significantly increased according to increasing quartile of insulin resistance as determined by HOMA and QUICKI, respectively, in analysis of variance （ANOVA） test and Duncan＇s multiple comparison test （P 〈 0.001）, but age-adjusted serum PSA concentration was significantly decreased according to increasing quartile of insulin resistance as determined by HOMA and QUICK/（P 〈 0.001）. Age, BMI, insulin resistance by HOMA or QUICK/were significantly independent variables to serum PSA level in a multivariate linear regression analysis （P 〈 0.001）. Insulin resistance was a significant independent variable to serum PSA level along with BMI. Insulin resistance and BMI were negatively correlated with serum PSA level in healthy men. Insulin resistance was positively correlated with BMI.

关键词： body mass index insulin resistance metabolic syndrome X obesity prostate-specific antigen

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Distribution of serum prostate-specific antigen in Chinese healthy men： a population-based study

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Chinese Medical Journal 2011年第8期124卷 1189-1192页

作者： YUAN Xiao-dong DONG Zhi-gang ZHANG Hui LIN Hai-yan SONG Xin-hong NIU Zhi-hong FU Qiang LIU Shuai SUN Zhi-jian LU Jia-ju Department of Urology Provincial Hospital Affiliated to Shandong University Jinan Shandong 250021 China Department of Health Examination Center Provincial Hospital Affiliated toShandong University Jinan Shan_dong 250021 China

Background The morbidity and mortality of prostate cancer have been increasing rapidly in recent China. There were few studies investigating prostate-specific antigen （PSA） values ranges in the healthy Chinese population. We performed this study to determine the distribution of serum PSA in a large healthy Chinese *** From January 2001 to May 2008, 11 150 healthy Chinese men aged 30-79 years came to our hospital for routine health check-up. All subjects without a previous diagnosis of prostate cancer, a history of prostate surgery, or urogenital tract infection were proposed to undergo systematic serum PSA measurement and digital rectal examination （DRE）. Men with normal DRE and PSA ≤4.0 ng/ml and those PSA ＞4.0 ng/ml or abnormal DRE but without adverse findings on prostate biopsy were included （n=9358）. Age and serum PSA concentration were recorded and correlated through Logistic regression *** The 95th percentile serum PSA concentration was 1.89 ng/ml for men aged 30 to 39 years, 2.19 ng/ml for men aged 40 to 49 years, 2.88 ng/ml for men aged 50 to 59 years, 4.42 rng/ml for men aged 60 to 69 years, and 6.52 ng/ml for men aged 70 to 79 years. The serum PSA concentration correlated with age （P ＜0.0001） with an annual increase of 0.97% for men in 40 years, 1.58% for men in 50 years, 3.04% for men in 60 years, and 3.99% for men in 70 *** The serum PSA level correlates directly with age in Chinese men older than 40 years, not in Chinese men younger than 40 years old. Chinese men have lower PSA level compared with white men above 60 years of age, not in those under 60 years of age.

关键词： Asian Caucasian Chinese prostate-specific antigen reference ranges

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