Postma Renske, van Leenders Arno G J L H, Roobol Monique J, Schröder Fritz H, van der Kwast Theodorus H
Department of Pathology, Erasmus MC, Rotterdam, The Netherlands.
Eur Urol. 2006 Jul;50(1):70-5. doi: 10.1016/j.eururo.2005.11.005. Epub 2005 Dec 19.
To compare tumour characteristics at the time of diagnosis of cancers detected in the screening and control arm at the Rotterdam section of the European Randomized study of Screening for Prostate Cancer.
Data were retrieved from the Rotterdam section of the ERSPC. Men were randomized to the screening arm (n=21,210) or the control arm (n=21,166). Men randomized to screening were offered PSA testing every 4 years. Through linkage with the cancer registry, men randomized to the control arm were detected. The biopsy Gleason score was determined in 1,591 and 373 patients in the screening and control arm, respectively. TURP, radical prostatectomy (RP) and cystoprostatectomy were evaluated for Gleason score, pathological (p)T stage and tumour volume.
More prostate cancers were detected in the screening arm (15.9 vs. 4.2 per 1000 man years, p<0.0001). Clinical stage distribution as well as biopsy and RP Gleason score distribution were significantly less favourable in the control arm. The incidence in man years of advanced disease (i.e. T4/N1/M1) was higher in the screening arm (6.0 per 100,000) as compared to the control arm (4.6 per 100,000). The 5-year PSA progression free survival after RP was 68% in the control arm and 89% in the screening arm (p<0.0001). The proportion of Incidental prostate cancers was 9.3% of all cancers detected in the control arm.
Although the number of men with advanced prostate cancer is slightly higher in the screening arm, the proportion of prostate cancers with favourable features is increased in the screening arm as compared to that in the control arm.
在欧洲前列腺癌筛查随机研究的鹿特丹分部，比较筛查组和对照组在前列腺癌诊断时的肿瘤特征。
数据取自ERSPC的鹿特丹分部。男性被随机分为筛查组（n = 21,210）或对照组（n = 21,166）。随机分配到筛查组的男性每4年接受一次PSA检测。通过与癌症登记处的关联，检测出随机分配到对照组的男性。分别在筛查组和对照组的1591例和373例患者中确定活检Gleason评分。对经尿道前列腺切除术（TURP）、根治性前列腺切除术（RP）和膀胱前列腺切除术的Gleason评分、病理（p）T分期和肿瘤体积进行评估。
筛查组检测到的前列腺癌更多（每1000人年15.9例对4.2例，p<0.0001）。对照组的临床分期分布以及活检和RP Gleason评分分布明显更差。筛查组晚期疾病（即T4/N1/M1）的人年发病率高于对照组（每100,000人6.0例对4.6例）。RP术后5年的PSA无进展生存率在对照组为68%，在筛查组为89%（p<0.0001）。偶发前列腺癌占对照组所有检测到癌症的比例为9.3%。
尽管筛查组中晚期前列腺癌男性的数量略高，但与对照组相比，筛查组中具有良好特征的前列腺癌比例有所增加。
