在扩大前列腺活检方案时代，前列腺特异性抗原及前列腺特异性抗原密度检测结果的种族差异

Racial variations in the performance of prostate specific antigen and prostate specific antigen density in the era of extended prostate biopsy schemes.

作者信息

Elliott Christopher S, Shinghal Rajesh, Presti Joseph C

机构信息

Department of Urology, Stanford University School of Medicine, California 94305-5118, USA.

出版信息

J Urol. 2008 Oct;180(4):1318-23; discussion 1323-4. doi: 10.1016/j.juro.2008.06.031. Epub 2008 Aug 15.

DOI:10.1016/j.juro.2008.06.031

PMID:18707710

Abstract

PURPOSE

The incidence of prostate cancer is known to vary as a function of race. To date few studies have evaluated the performance of the prostate specific antigen test and its indexes in unique racial populations. We examined the performance of prostate specific antigen, prostate specific antigen density and transition zone density in racial groups undergoing an extended prostate biopsy scheme.

MATERIALS AND METHODS

A retrospective review was performed of prospectively collected data on 1,115 white, 288 black and 161 Asian/Pacific Islander men referred for prostate needle biopsy. All participants had not undergone previous biopsy. ROC curves stratified by race were ascertained for prostate specific antigen, prostate specific antigen density and transition zone density for detecting cancer and high grade cancer (Gleason 3 + 4 or greater).

RESULTS

Across all races prostate specific antigen density outperformed prostate specific antigen for detecting any prostate cancer and high grade cancer. Prostate specific antigen and prostate specific antigen density performed best for diagnosing high grade cancer and diagnosing cancer in men with an abnormal digital rectal examination. When comparing differing races, prostate specific antigen density performed the best in Asian/Pacific Islander men for high grade cancer detection. The performance of transition zone density was inferior to that of prostate specific antigen density.

CONCLUSIONS

Racial variations exist in the performance of prostate specific antigen and prostate specific antigen density. In men of Asian/Pacific Islander descent prostate specific antigen and prostate specific antigen density perform better than in white men, especially for diagnosing clinically significant, high grade prostate cancer. In general prostate specific antigen and prostate specific antigen density perform equally well in white and black populations.

摘要

目的

已知前列腺癌的发病率因种族而异。迄今为止，很少有研究评估前列腺特异性抗原检测及其指标在独特种族人群中的表现。我们研究了前列腺特异性抗原、前列腺特异性抗原密度和移行区密度在接受扩展前列腺活检方案的种族群体中的表现。

材料与方法

对前瞻性收集的1115名白种人、288名黑种人和161名亚太岛民男性的前列腺穿刺活检数据进行回顾性分析。所有参与者此前均未接受过活检。确定按种族分层的前列腺特异性抗原、前列腺特异性抗原密度和移行区密度检测癌症和高级别癌症（Gleason 3 + 4或更高）的ROC曲线。

结果

在所有种族中，前列腺特异性抗原密度在检测任何前列腺癌和高级别癌症方面均优于前列腺特异性抗原。前列腺特异性抗原和前列腺特异性抗原密度在诊断高级别癌症以及诊断直肠指检异常男性的癌症方面表现最佳。在比较不同种族时，前列腺特异性抗原密度在亚太岛民男性中检测高级别癌症的表现最佳。移行区密度的表现不如前列腺特异性抗原密度。