Tanaka Nobumichi, Fujimoto Kiyohide, Yoshikawa Motokiyo, Tanaka Masahiro, Hirao Yoshihiko, Kondo Hideaki, Saito Isao
Department of Urology, Nara Medical University.
Hinyokika Kiyo. 2007 Jul;53(7):459-65.
We examined the usefulness of the volume-adjusted prostate-specific antigen (PSA) parameters for prediction of T1c prostate cancer on 210 patients who had abnormal PSA levels but no abnormal findings in digital transrectal examination (DRE) or transrectal ultrasonography (TRUS). PSA, prostate volume (PV), transition zone volume (TZV), PSAD (PSA/PV) and PSATZD (PSA/TZV) were assessed with the receiver operating characteristic (ROC) curve and the area under the curve (AUC). Simple and stepwise logistic regression models were used to calculate the odds ratios of these parameters. Fifty-three (25.2%) of all 210 patients and 31 (19.9%) of 156 patients with intermediate PSA levels had biopsy-proved prostate cancer. The ROC curves of all patients revealed that PSA, PV, TZV, PSAD and PSATZD had significant predictive values, while AUCs of PV, PSAD and PSATZD had significant predictive values as compared to that of PSA. In the patients with intermediate PSA levels, the ROC curves revealed that PV, TZV, PSAD and PSATZD had significant predictive values, but there were no significant differences in AUCs among these parameters. The stepwise logistic regression analysis showed that PV and PSATZD were significant predictive parameters in all patients and that PSATZD was the only significant predictive parameter in the patients with intermediate PSA levels. In conclusion, not only PSAD and PSATZD but also PV and TZV had significant predictive values in discriminating prostate cancer. However, the multivariate analysis showed that PSATZD had the strongest predictive value in all patients and in those with intermediate PSA levels.
我们对210例前列腺特异抗原（PSA）水平异常但经直肠指检（DRE）和经直肠超声检查（TRUS）均无异常发现的患者，研究了体积校正后的PSA参数对T1c期前列腺癌的预测价值。采用受试者工作特征（ROC）曲线及曲线下面积（AUC）评估PSA、前列腺体积（PV）、移行区体积（TZV）、PSAD（PSA/PV）和PSATZD（PSA/TZV）。使用简单和逐步逻辑回归模型计算这些参数的比值比。210例患者中有53例（25.2%）、156例PSA水平处于中间值的患者中有31例（19.9%）经活检证实患有前列腺癌。所有患者的ROC曲线显示，PSA、PV、TZV、PSAD和PSATZD均具有显著的预测价值，而PV、PSAD和PSATZD的AUC与PSA相比具有显著的预测价值。在PSA水平处于中间值的患者中，ROC曲线显示PV、TZV、PSAD和PSATZD具有显著的预测价值，但这些参数的AUC之间无显著差异。逐步逻辑回归分析显示，PV和PSATZD是所有患者的显著预测参数，而PSATZD是PSA水平处于中间值患者的唯一显著预测参数。总之，在鉴别前列腺癌方面，不仅PSAD和PSATZD，而且PV和TZV都具有显著的预测价值。然而，多变量分析显示，PSATZD在所有患者及PSA水平处于中间值的患者中具有最强的预测价值。
