Akduman B, Alkibay T, Tuncel A, Bozkirli I
Department of Urology, Gazi University School of Medicine, Besevler, Ankara, Turkey.
Can J Urol. 2000 Oct;7(5):1104-9.
This study was undertaken to evaluate the value of percent free prostate specific antigen (PSA), PSA density of the whole prostate (PSAD) and of the transition zone (TZPSAD) in reducing unnecessary biopsies in Turkish men with serum PSA levels between 2.5 and 20 ng/mL.
A total of 105 patients referred for early prostate cancer detection or lower urinary tract symptoms participated in the study. All patients had serum total PSA level, PSAD, total prostate volume, and rectal examination, 43 patients had serum free PSA level, and 65 patients had TZPSAD. Using transrectal ultrasound, sextant biopsy and two additional transitional zone biopsies were performed. The value of percent PSA, PSAD, and TZPSAD in reducing unnecessary biopsies was evaluated.
Prostate carcinoma was detected in 25 of 105 patients (23.8%). Overall, areas under the ROC curves for percent free PSA, PSAD, and TZPSAD were 0.553, 0.595, and 0.550, respectively. In patients with a benign rectal examination, the value of percent free PSA slightly increased. On the other hand, in patients with prostate volume smaller than 50 cc, the value of percent free PSA and TZPSAD was encouraging. Areas under the ROC curves for percent free PSA, and TZPSAD were 0.615 and 0.642 respectively.
In Turkish men with intermediate serum PSA concentrations, percent free PSA, PSAD, and TZPSAD are poor predictors of biopsy outcome, whereas in the prostate smaller than 50 cc, percent free PSA and TZPSAD provide additional information. This may reflect ethnic differences between this population and those reported in other series.
本研究旨在评估游离前列腺特异性抗原（PSA）百分比、整个前列腺的PSA密度（PSAD）以及移行带的PSA密度（TZPSAD）在减少血清PSA水平介于2.5至20 ng/mL之间的土耳其男性不必要活检方面的价值。
共有105名因早期前列腺癌检测或下尿路症状而转诊的患者参与了本研究。所有患者均进行了血清总PSA水平、PSAD、前列腺总体积以及直肠检查，43名患者进行了血清游离PSA水平检测，65名患者进行了TZPSAD检测。使用经直肠超声进行了六分区活检以及另外两次移行带活检。评估了PSA百分比、PSAD和TZPSAD在减少不必要活检方面的价值。
105名患者中有25名（23.8%）检测出前列腺癌。总体而言，游离PSA百分比、PSAD和TZPSAD的ROC曲线下面积分别为0.553、0.595和0.550。在直肠检查为良性的患者中，游离PSA百分比的值略有增加。另一方面，在前列腺体积小于50 cc的患者中，游离PSA百分比和TZPSAD的值令人鼓舞。游离PSA百分比和TZPSAD的ROC曲线下面积分别为0.615和0.642。
在血清PSA浓度处于中等水平的土耳其男性中，游离PSA百分比、PSAD和TZPSAD对活检结果的预测能力较差，而在前列腺体积小于50 cc的患者中，游离PSA百分比和TZPSAD可提供额外信息。这可能反映了该人群与其他系列报道人群之间的种族差异。
