Li Ming, Na Yan-Qun
Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing 100036, China.
Zhonghua Yi Xue Za Zhi. 2008 Jan 1;88(1):16-8.
To investigate the detection rate of prostate cancer in different PSA values and evaluate the importance of free PSA/total PSA in the diagnosis of prostate cancer in Chinese men.
We have analyzed 1244 patients who were submitted to needle biopsy since Jan 2000 to June 2005 in the Institute of Urology, Peking University. Systematic 12- or 13-core biopsies were taken transrectally under ultrasound (TRUS) guide for all of the patients.
The prostate cancer detection rates in the tPSA ranges of < 4 ng/ml with positive DRE; 4 - 10 ng/ml with f/tPSA > 0.16; 4 - 10 ng/ml with f/tPSA < 0.16; 10.1 - 20 ng/ml and > 20 ng/ml. The positive biopsy rates were 18.1% (13/72), 11.6% (10/86), 17.4% (45/258), 24.9% (110/442), 56.7% (219/386) respectively. The higher levels of the PSA, the higher percentage of high grade (Gleason score > or = 8) prostate cancer. In conclusion, patients with PSA > 10 ng/ml or positive digital rectal examination (DRE) were strongly recommended to biopsy for detecting prostate cancer because of high positive rate. For the patients with PSA 4 - 10 ng/ml, the free PSA (fPSA/t PSA < 0.16) will play an important role to improve cancer detection rate.
探讨不同前列腺特异性抗原（PSA）值下前列腺癌的检出率，并评估游离PSA与总PSA比值在中国男性前列腺癌诊断中的重要性。
我们分析了2000年1月至2005年6月期间在北京大学泌尿外科研究所接受穿刺活检的1244例患者。所有患者均在超声引导下经直肠进行系统的12或13针穿刺活检。
在tPSA范围为<4 ng/ml且直肠指检（DRE）阳性；4 - 10 ng/ml且f/tPSA>0.16；4 - 10 ng/ml且f/tPSA<0.16；10.1 - 20 ng/ml和>20 ng/ml时的前列腺癌检出率。阳性活检率分别为18.1%（13/72）、11.6%（10/86）、17.4%（45/258）、24.9%（110/442）、56.7%（219/386）。PSA水平越高，高级别（Gleason评分≥8）前列腺癌的比例越高。总之，由于阳性率高，强烈建议PSA>10 ng/ml或直肠指检（DRE）阳性的患者进行活检以检测前列腺癌。对于PSA为4 - 10 ng/ml的患者，游离PSA（fPSA/t PSA<0.16）在提高癌症检出率方面将发挥重要作用。
