Littrup P J, Kane R A, Williams C R, Egglin T K, Lee F, Torp-Pedersen S, Church P A
Department of Radiology, New England Deaconess Hospital, Harvard Medical School, Boston, MA 02215.
Radiology. 1991 Feb;178(2):537-42. doi: 10.1148/radiology.178.2.1702894.
To investigate whether radiologists can objectively define a high-risk group for prostate cancer, the researchers measured gland volume and compared it with results of a screening blood test, prostate-specific antigen (PSA) assay. A total of 768 men, aged 55-71 years, were self-referred to two prostate cancer screening programs using transrectal ultrasound (US) and digital rectal examination. In patients with no evidence of cancer, statistically significant increases in mean PSA values were noted with increasing gland volume ranges (P less than .05). PSA values in patients with cancer were more likely to exceed the volume-adjusted 95th percentile (mean + [1.65.standard deviation]) than those in patients with negative biopsy results (P less than .005). Patients with PSA values above the volume-adjusted 95th percentile have an estimated risk for prostate cancer up to nine times that of the general screening population. The researchers conclude that knowledge of transrectal US gland volume and prostate-specific antigen assay type are important objective variables for future prostate cancer screening programs. The volume-adjusted 95th percentiles presented may help guide cost-effective management of current early detection efforts.
为了研究放射科医生能否客观地界定前列腺癌高危人群，研究人员测量了腺体体积，并将其与筛查血液检测结果（前列腺特异性抗原[PSA]检测）进行比较。共有768名年龄在55至71岁之间的男性自行前往两个使用经直肠超声（US）和直肠指检的前列腺癌筛查项目。在没有癌症证据的患者中，随着腺体体积范围的增加，平均PSA值有统计学意义的显著升高（P小于0.05）。与活检结果为阴性的患者相比，癌症患者的PSA值更有可能超过体积调整后的第95百分位数（平均值 + [1.65×标准差]）（P小于0.005）。PSA值高于体积调整后第95百分位数的患者患前列腺癌的估计风险高达一般筛查人群的九倍。研究人员得出结论，经直肠超声腺体体积和前列腺特异性抗原检测类型的知识是未来前列腺癌筛查项目的重要客观变量。所呈现的体积调整后第95百分位数可能有助于指导当前早期检测工作的成本效益管理。
