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Total and free prostate-specific antigen indexes in prostate cancer screening:value and limitation for Japanese populations

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Asian Journal of Andrology 2006年第4期8卷 429-434,514-515页

作者： Noboru Hara YasuoKitamura ToshihiroSaito ShuichiKomatsubara Department of Urology Niigata Cancer Center HospitalNiigata 951-8133Japan Division of UrologyDepartment of Regenerative and Transplant MedicineGraduate School of Medical and Dental SciencesNiigata UniversityNiigata 951-8510Japan Department of Urology Niigata Cancer Center HospitalNiigata 951-8133Japan

Aim:To assess the efficacy and limitation of free/total prostate-specific antigen ratio(f/tPSA)at a single institution in Japan,focusing on the avoidance of pointless prostate ***:In total,631 men between 44 and 93 years old(mean 69.8 years)with elevated PSA underwent power-Doppler ultrasoundgraphy-guided transrectal 10-core prostate biopsies at Niigata Cancer Center Hospital,and their histological features were investigated with total PSA (tPSA)and f/***:PCa was detected in 126 of 134 patients(94.3%)with tPSA of 26 ng/mL or *** detection rate was 59.4% for tPSA of 21-25 ng/mL,followed by 39.2% for 16-20 ng/mL,30.0% for 11-15 ng/mL, 20.0% for 4.1-10 ng/mL and 7.6% for≤4.0 ng/mL,f/tPSA of the PCa group was significantly lower than that of non-malignamt disorders in any tPSA ranges(mean 0.122 vs.0.160,P<0.001).Receiver-operating characteristics analyses showed that f/tPSA(AUC:0.664)performed more valuably than tPSA(AUC:0.559)in patients with tPSA between 3.0-10 ng/mL(P<0.01).Although f/tPSA of 0.250 for the cut-off value might miss 1.8% PCa patients,it potentially spares 9.2% of unnecessary ***:f/tPSA is more valuable compared with tPSA alone for the prediction of the occurrence of *** recommend 0.250 as the cut-off value for f/tPSA in PCa screening for Asian men having so-called grey-zone tPSA.(Asian J Androl 2006 Jul;8:429-434)

关键词： prostate cancer screening free/total prostate-specific antigen ratio multi-site biopsy single-institutional trial

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