Shigemura Katsumi, Arakawa Soichi, Yamanaka Kunito, Yasui Nobuo, Matsubara Shigeji, Iwamoto Takahiro, Kataoka Nobuo, Yuien Keiji, Fujisawa Masato
Department of Urology, Nishiwaki Municipal Hospital, Nishiwaki, Japan.
Int Urol Nephrol. 2008;40(1):91-6. doi: 10.1007/s11255-007-9219-5. Epub 2007 Jul 4.
There are numerous arguments for the predictive factors of positive prostate biopsies, differing according to race and region. This study aimed to determine predictive factors for a positive prostate biopsy in East Asian, especially Japanese men, using clinical, laboratory, and transrectal ultrasound (TRUS) findings.
Data were collected from 466 men who underwent a prostate biopsy for suspected prostate cancer. Variables analyzed including age, digital rectal examination (DRE) findings, prostate-specific antigen (PSA) level, PSA density, prostate volume, and TRUS findings. Logistic regression analysis and the Mann-Whitney U test were used for this study.
Logistic regression analysis showed that significant predictors for a positive prostate biopsy for all patients were positive DRE results, prostate volume, and hypoechoic lesions on TRUS. Especially in the patients with PSA levels <10 ng/ml, the significant predictor for positive biopsy was prostate volume. The Mann-Whitney U test showed that significant predictors for a positive prostate biopsy in all patients were PSA density >0.15, positive DRE results, and prostate volume <25 cm(3). Especially in patients with PSA levels <10 ng/ml, significant predictors for a positive prostate biopsy were prostate volume <25 cm(3) and PSA density >0.15. Additionally, even if the data were confined to those patients with seven or more core biopsies, all the predictive factors shown in all patients were significant predictors in this category.
This study investigated potential predictors for positive prostate biopsy and demonstrated that prostate volume was an independent predictive factor for positive prostate biopsy in patients with PSA levels <10 ng/ml. In the future, we may be able to use our findings to create a nomogram for predicting positive prostate biopsy in Japanese men.
关于前列腺活检阳性的预测因素存在众多观点,这些观点因种族和地区而异。本研究旨在利用临床、实验室及经直肠超声(TRUS)检查结果,确定东亚地区尤其是日本男性前列腺活检阳性的预测因素。
收集了466例因疑似前列腺癌接受前列腺活检的男性患者的数据。分析的变量包括年龄、直肠指检(DRE)结果、前列腺特异性抗原(PSA)水平、PSA密度、前列腺体积及TRUS检查结果。本研究采用逻辑回归分析和曼-惠特尼U检验。
逻辑回归分析显示,所有患者前列腺活检阳性的显著预测因素为DRE结果阳性、前列腺体积及TRUS上的低回声病变。尤其是在PSA水平<10 ng/ml的患者中,活检阳性的显著预测因素为前列腺体积。曼-惠特尼U检验显示,所有患者前列腺活检阳性的显著预测因素为PSA密度>0.15、DRE结果阳性及前列腺体积<25 cm³。尤其是在PSA水平<10 ng/ml的患者中,前列腺活检阳性的显著预测因素为前列腺体积<25 cm³及PSA密度>0.15。此外,即使将数据局限于那些进行了7针或更多针穿刺活检的患者,所有患者中显示的所有预测因素在该类别中均为显著预测因素。
本研究调查了前列腺活检阳性的潜在预测因素,并证明前列腺体积是PSA水平<10 ng/ml患者前列腺活检阳性的独立预测因素。未来,我们或许能够利用我们的研究结果创建一个列线图,用于预测日本男性前列腺活检阳性情况。