[The detection rate of prostate cancer in different prostate-specific antigen (PSA) levels in Chinese men].

OBJECTIVE

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.

METHODS

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.

RESULTS

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.