Benecchi L
Department of Urology, Fidenza Hospital, Parma, Italy.
Prostate Cancer Prostatic Dis. 2006;9(2):169-72. doi: 10.1038/sj.pcan.4500866. Epub 2006 Mar 28.
The aim of this study is to compare different tools for evaluating prostate-specific antigen (PSA) increase or decrease, such as PSA velocity and PSA slope. This study was conducted on 312 male patients evaluated with transrectal ultrasound-guided biopsy of prostate with six or more cores. Patients with at least three consecutive PSA measurements in at least 18 months entered the study. Prostate-specific antigen slope was estimated by the slope of the least-square regression line fit to PSA versus time in years; PSA velocity was calculated with 3 or more PSA arrays. Median age was 66 years (range 45-86). Overall 67 patients were affected by primary prostate cancer, 245 were controls without prostate cancer. Prostate-specific antigen slope and PSA velocity were significantly higher in patients with prostate cancer than in controls. At the ROC analysis, PSA slope evidenced better results than PSA velocity (area under the curve (AUC) 0.743 for PSA slope; AUC 0.663 for PSA velocity; P=0.037). At PSA slope (calculated with the least-square fit) equal to zero, the sensitivity resulted as being 94% with a specificity of 38.8%. In conclusion prostate-specific antigen slope calculated with three or more PSA assays permits longitudinal evaluation of PSA for prostate diagnosis. Prostate-specific antigen slope improves both sensitivity and specificity in prostate cancer diagnosis, compared with PSA velocity.
本研究的目的是比较评估前列腺特异性抗原（PSA）升高或降低的不同工具，如PSA速率和PSA斜率。本研究对312例接受经直肠超声引导下前列腺六针或更多针穿刺活检评估的男性患者进行。在至少18个月内有至少连续三次PSA测量值的患者进入研究。前列腺特异性抗原斜率通过拟合PSA与时间（年）的最小二乘回归线的斜率来估计；PSA速率用3次或更多次PSA检测值来计算。中位年龄为66岁（范围45 - 86岁）。总体上，67例患者患有原发性前列腺癌，245例为无前列腺癌的对照。前列腺癌患者的前列腺特异性抗原斜率和PSA速率显著高于对照组。在ROC分析中，PSA斜率的结果优于PSA速率（PSA斜率的曲线下面积（AUC）为0.743；PSA速率的AUC为0.663；P = 0.037）。当PSA斜率（用最小二乘法拟合计算）等于零时，敏感性为94%，特异性为38.8%。总之，用三次或更多次PSA检测计算的前列腺特异性抗原斜率可对PSA进行纵向评估以用于前列腺诊断。与PSA速率相比，前列腺特异性抗原斜率在前列腺癌诊断中提高了敏感性和特异性。
