Song Cheryn, Ahn Hanjong, Lee Moo-Song, Park Jongyeon, Kwon Tae Gyun, Kim Hyung-Jin, Choi Han-Yong
Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
J Urol. 2008 Nov;180(5):1949-52; discussion 1952-3. doi: 10.1016/j.juro.2008.07.041. Epub 2008 Sep 17.
We investigated the detection rate of prostate cancer in Korean men through a population based mass screening test.
In June 2007 serum prostate specific antigen was examined in 3,943 residents in the Gangneung (1,429), Daegu (1,396) and Jeonju (1,118) areas who were 55 years or older with prostate specific antigen 3.0 ng/ml or greater considered the criterion for 12-site transrectal biopsy recommendation. The serum prostate specific antigen distribution and the cancer detection rate were analyzed according to participant regions and age groups.
Mean +/- SD serum prostate specific antigen in the entire cohort was 2.4 +/- 8.6 ng/ml. It significantly increased with increasing age, that is 1.2, 2.2, 3.4 and 4.7 ng/ml in the groups 55 to 64, 65 to 74, 75 to 84 and 85 years or older, respectively (p <0.0001). However, no regional differences were noted among Gangneung, Daegu and Jeonju (2.2, 2.7 and 2.3 ng/ml, respectively, p = 0.290). Biopsy candidates represented 7.3% (48 men), 17.7% (395), 25.5% (240) and 32.7% (36) of the 55 to 64, 65 to 74, 75 to 84 and 85 years or older groups, respectively, or 18.2% of the entire cohort of 719. Of biopsy candidates 268 (37.3%) had undergone biopsy, of whom cancer was detected in 76 (28.4%) for a cancer detection rate and estimated cancer detection rate of 1.93% and 5.17%, respectively. The age adjusted estimated cancer detection rate (55 years or older) was 3.36%. Cancer detection increased significantly with increasing prostate specific antigen, that is 12.3% at 3.0 to 4.0 ng/ml, 27.3% at 4.1 to 10.0 and 64.1% at greater than 10.0. The Gleason score was 2-6 in 41 men (53.9%), 7 in 14 (18.4%) and 8-10 in 21 (27.6%).
The estimated cancer detection rate in Korean men 55 years or older was 3.36%. The significance of the high rate in this population should be determined through repeat screening and further surveillance in the future.
我们通过基于人群的大规模筛查试验，调查韩国男性前列腺癌的检出率。
2007年6月，对江原道（1429人）、大邱（1396人）和全州（1118人）地区55岁及以上居民进行血清前列腺特异性抗原检测，前列腺特异性抗原≥3.0 ng/ml被视为推荐12位点经直肠活检的标准。根据参与者所在地区和年龄组分析血清前列腺特异性抗原分布及癌症检出率。
整个队列的平均±标准差血清前列腺特异性抗原为2.4±8.6 ng/ml。其随年龄增长显著升高，55至64岁、65至74岁、75至84岁和85岁及以上组分别为1.2、2.2、3.4和4.7 ng/ml（p<0.0001）。然而，江原道、大邱和全州之间未发现地区差异（分别为2.2、2.7和2.3 ng/ml，p = 0.290）。活检候选者在55至64岁、65至74岁、75至84岁和85岁及以上组中分别占7.3%（48人）、17.7%（395人）、25.5%（240人）和32.7%（36人），占整个719人队列的18.2%。在活检候选者中，268人（37.3%）接受了活检，其中76人（28.4%）检测出癌症，癌症检出率和估计癌症检出率分别为1.93%和5.17%。年龄调整后的估计癌症检出率（55岁及以上）为3.36%。癌症检出率随前列腺特异性抗原升高而显著增加，3.0至4.0 ng/ml时为12.3%，4.1至10.0 ng/ml时为27.3%，大于10.0 ng/ml时为64.1%。Gleason评分2至6分的有41人（53.9%），7分的有14人（18.4%），8至10分的有21人（27.6%）。
55岁及以上韩国男性的估计癌症检出率为3.36%。该人群中这一高检出率的意义应通过未来的重复筛查和进一步监测来确定。
