Chun Felix K-H, Hutterer Georg C, Perrotte Paul, Gallina Andrea, Valiquette Luc, Benard Francois, McCormack Michael, Briganti Alberto, Ionescu Constantin, Jeldres Claudio, Guay Jean-Pierre, Saad Fred, Karakiewicz Pierre I
Department of Urology, University Medical Centre Eppendorf, Hamburg, Germany.
BJU Int. 2007 Jul;100(1):37-41. doi: 10.1111/j.1464-410X.2007.06923.x. Epub 2007 May 4.
To explore the distribution of total prostate specific antigen (PSA) and percentage free/total PSA (%f/tPSA) in healthy volunteers with no clinical evidence of prostate cancer, who participated in prostate cancer screening.
PSA and %f/tPSA values from 2323 men, who participated in one of three annual prostate cancer screening events between 2004 and 2006, were tabulated according to age strata of 40-49, 50-59, 60-69 and 70-79 years. Local regression smoothing plots provided a graphical display of the relation between age and PSA or %f/tPSA, respectively. All PSA and %f/tPSA analyses were repeated for each age category after excluding, respectively, the top and the bottom 10% of PSA and %f/tPSA values.
Within the entire cohort, the median PSA level was 1.0 ng/mL and the median %f/tPSA was 25%. According to the age categories the PSA level and %f/tPSA medians within the entire cohort were, respectively, 0.7, 0.9, 1.3, 1.8 ng/mL and 28.0, 26.0, 24.0 and 25.0%. Of the 2323 men, 438 (18.9%) had a PSA level of >2.5 ng/mL and 1172 (50.5%) had a %f/tPSA of < or = 25%. When either a PSA level of >2.5 ng/mL or a %f/tPSA of < or = 25% were considered, 1235 (53.2%) had one or two abnormal values. Finally, if either a PSA level of >2.5 ng/mL or %f/tPSA of < or = 15% was used, 617 (26.6%) were considered abnormal.
Half of men with no clinical evidence of prostate cancer should have PSA levels of <1.0 ng/mL and a %f/tPSA of >25%. A PSA level threshold of 2.5 ng/mL would require a biopsy in 20% of men and a %f/tPSA threshold of < or = 25% in half of the men. Alternatively, a %f/tPSA threshold of < or = 15% would decrease the probability to 15%.
探讨参与前列腺癌筛查且无前列腺癌临床证据的健康志愿者中总前列腺特异性抗原（PSA）及游离/总PSA百分比（%f/tPSA）的分布情况。
将2004年至2006年间参加三项年度前列腺癌筛查活动之一的2323名男性的PSA及%f/tPSA值，按照40 - 49岁、50 - 59岁、60 - 69岁和70 - 79岁的年龄分层进行列表。局部回归平滑图分别直观显示了年龄与PSA或%f/tPSA之间的关系。在分别排除PSA和%f/tPSA值最高和最低的10%后，对每个年龄组重复进行所有PSA和%f/tPSA分析。
在整个队列中，PSA水平中位数为1.0 ng/mL，%f/tPSA中位数为25%。按年龄组划分，整个队列中PSA水平和%f/tPSA中位数分别为0.7、0.9、1.3、1.8 ng/mL以及28.0、26.0、24.0和25.0%。在2323名男性中，438名（18.9%）PSA水平>2.5 ng/mL，1172名（50.5%）%f/tPSA≤25%。当将PSA水平>2.5 ng/mL或%f/tPSA≤25%视为异常时，1235名（53.2%）有一项或两项异常值。最后，如果将PSA水平>2.5 ng/mL或%f/tPSA≤15%视为异常，则617名（26.6%）被认为异常。
无前列腺癌临床证据的男性中，一半人的PSA水平应<1.0 ng/mL且%f/tPSA>25%。PSA水平阈值为2.5 ng/mL时，20%的男性需要进行活检；%f/tPSA阈值≤25%时，一半男性需要活检。或者，%f/tPSA阈值≤15%时，概率会降至15%。
