Chung Byung Ha, Hong Sung Joon, Cho Jin Seon, Seong Do Hwan
Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
BJU Int. 2006 Apr;97(4):742-6. doi: 10.1111/j.1464-410X.2006.06016.x.
To evaluate the relationship between prostate specific antigen (PSA) and prostate volume (PV) in Korean men, as PV is a key predictor of both disease progression and response to medical therapy in patients with benign prostatic hyperplasia (BPH), and PSA has been suggested as a proxy marker to estimate the total PV, mainly in Caucasians.
From 1999 to 2004, men aged 50-79 years with lower urinary tract symptoms (LUTS) and BPH were enrolled into this multicentre study. The analyses included 5716 patients presenting to 11 medical centres with LUTS (International Prostate Symptom Score >8, peak urinary flow rate <15 mL/s); they had a mean age of 64.3 years, mean baseline PV of 36.9 mL, and mean baseline PSA level of 2.2 ng/mL. Men with a baseline PSA of >10 ng/mL were excluded, to reduce the likelihood of including occult prostate cancer. A biopsy was taken in those with suspicious findings on a digital rectal examination or serum PSA level of >4 ng/mL, to exclude prostate cancer. Receiver operating characteristic (ROC) curves were constructed to evaluate the ability of serum PSA to predict threshold PV in men with BPH.
The PV and serum PSA level had an age-dependent log-linear relationship, the strength of which increased with age. The ROC curve analysis showed that PSA had good predictive value for various prostate volume thresholds (30, 40 and 50 mL).
The PSA-PV relationship in Korean men is similar to that in Caucasians, but Korean men have a slightly lower PSA level and a smaller PV than Caucasians. The approximate age-specific criteria for detecting Korean men with a PV of >40 mL were a PSA level of >1.3 ng/mL, >1.7 ng/mL and >2.0 ng/mL for men with BPH in their sixth, seventh and eighth decade, respectively.
评估韩国男性前列腺特异性抗原（PSA）与前列腺体积（PV）之间的关系，因为前列腺体积是良性前列腺增生（BPH）患者疾病进展和药物治疗反应的关键预测指标，并且主要在白种人中，PSA已被建议作为估计总前列腺体积的替代标志物。
1999年至2004年，年龄在50 - 79岁、有下尿路症状（LUTS）且患有BPH的男性被纳入这项多中心研究。分析纳入了5716名到11个医疗中心就诊的有LUTS的患者（国际前列腺症状评分>8，最大尿流率<15 mL/s）；他们的平均年龄为64.3岁，平均基线前列腺体积为36.9 mL，平均基线PSA水平为2.2 ng/mL。基线PSA>10 ng/mL的男性被排除，以降低纳入隐匿性前列腺癌的可能性。对直肠指检有可疑发现或血清PSA水平>4 ng/mL的患者进行活检，以排除前列腺癌。构建受试者工作特征（ROC）曲线以评估血清PSA预测BPH男性阈值前列腺体积的能力。
前列腺体积与血清PSA水平呈年龄依赖性对数线性关系，其强度随年龄增加而增强。ROC曲线分析表明，PSA对各种前列腺体积阈值（30、40和50 mL）具有良好的预测价值。
韩国男性中PSA与前列腺体积的关系与白种人相似，但韩国男性的PSA水平略低于白种人，前列腺体积也小于白种人。检测前列腺体积>40 mL的韩国男性的大致年龄特异性标准分别为，60多岁、70多岁和80多岁患有BPH的男性PSA水平>1.3 ng/mL、>1.7 ng/mL和>2.0 ng/mL。
