Shao Qiang, Song Jian, Zhou Zhen-Jun, Du Lin-Dong
Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
Zhonghua Nan Ke Xue. 2008 Jul;14(7):597-601.
To investigate the possibility of differentiating prostate cancer (PCa) from benign prostatic disease by total prostate specific antigen (T-PSA) dynamic profiles following transrectal prostate biopsy, and to determine the cutoff value of the T-PSA ratio between pre- and post-biopsy.
A total of 36 men at the mean age of 69.89 years with increased serum PSA underwent prostate biopsy guided by transrectal ultrasound, followed by measurement of T-PSA at 10, 30, 60 and 90 min, plotting of T-PSA dynamic profiles and calculation of the pre- and post-biopsy T-PSA ratio at different time points. The patients were divided into a PCa and a non-PCa group according to the pathological results and compared for the difference in T-PSA ratios. The cutoff value of the pre- and post-biopsy T-PSA ratio was determined for the differentiation of PCa from benign prostatic diseases.
The post-biopsy T-PSA ratio was obviously higher in the non-PCa than in the PCa group (P < 0.05). With the ROC curve applied, the cutoff value of the T-PSA ratio was 1.5 and the best time for blood sampling was 30 minutes after the biopsy, with a 75% sensitivity and a 93% specificity.
Evaluation of the T-PSA ratio 30 minutes after biopsy might help screen the high-risk PCa population. Biopsy should be repeated for those with a lower T-PSA ratio in spite of initial benign results. The results are to be further supported by more prospective studies.
探讨经直肠前列腺穿刺活检后,通过总前列腺特异性抗原(T-PSA)动态曲线鉴别前列腺癌(PCa)与良性前列腺疾病的可能性,并确定穿刺活检前后T-PSA比值的临界值。
对36例平均年龄69.89岁、血清PSA升高的男性患者进行经直肠超声引导下的前列腺穿刺活检,随后在10、30、60和90分钟时测量T-PSA,绘制T-PSA动态曲线,并计算不同时间点穿刺活检前后的T-PSA比值。根据病理结果将患者分为PCa组和非PCa组,比较两组T-PSA比值的差异。确定穿刺活检前后T-PSA比值的临界值,以区分PCa与良性前列腺疾病。
非PCa组穿刺活检后的T-PSA比值明显高于PCa组(P<0.05)。应用ROC曲线,T-PSA比值的临界值为1.5,最佳采血时间为活检后30分钟,灵敏度为75%,特异度为93%。
活检后30分钟评估T-PSA比值可能有助于筛查高危PCa人群。对于T-PSA比值较低的患者,尽管初始结果为良性,也应重复活检。本研究结果有待更多前瞻性研究进一步证实。