Department of Urology, Stellenbosch University and Tygerberg Hospital.
S Afr Med J. 2011 Sep 5;101(9):642-4.
We aimed to evaluate the presenting features and treatment outcome of prostate cancer in men aged <50 years, in a region where prostate specific antigen (PSA) screening is not readily available and most men present with symptoms.
We analysed the data of 1 571 men with prostatic adenocarcinoma treated between January 1997 and December 2008 at out institution, a tertiary level public secotr hospital serving a largely indigent population. Statistical analysis was performed using Student's, the Mann-Whitney and Fisher's exact tests where appropriate (p<0.05 accepted as statistically significant).
Of 1 571 men, 47 (3%) were aged < 50 years. The group aged <50 years compared with that aged >50 years, had a siginificantly greater proportion with poorly differentiated adenocarcinoma (53%), locally advanced (stage T3-4) tumours (56%), haematogenous metastases (75%), significantly higher serum PSA at diagnosis (mean 621, median 74 ng/ml) and shorter survival.
Men aged <50 years presenting with symptoms owing to prostate cancer had significantly higher risk disease, higher mean PSA, and poorer prognosis than men aged >50 years. To diagnose prostate cancer at a potentially curable stage in men aged <50 years, it is necessary to initiate asleine PSA testing at age 40 and 45 years, and to select high-risk men for PSA surveillance in order to diagnose potentially curable cancer in those with a life expectancy >20-25 years.
本研究旨在评估在前列腺特异性抗原（PSA）筛查不普及且大多数患者因症状就诊的地区，50 岁以下男性前列腺癌的临床表现和治疗结局。
我们分析了 1997 年 1 月至 2008 年 12 月期间在我们机构（一家为贫困人口服务的三级公立医院）接受治疗的 1571 例前列腺腺癌男性患者的数据。统计分析采用学生 t 检验、Mann-Whitney 检验和 Fisher 确切概率法（p<0.05 为统计学显著）。
1571 例男性患者中，年龄<50 岁的有 47 例（3%）。与年龄>50 岁的患者相比，年龄<50 岁的患者中分化不良腺癌（53%）、局部晚期（T3-4 期）肿瘤（56%）、血液转移（75%）的比例显著更高，诊断时血清 PSA 水平更高（平均 621，中位数 74ng/ml），生存时间更短。
因前列腺癌出现症状就诊的年龄<50 岁男性，其疾病风险显著更高，PSA 均值更高，预后更差。为了在年龄<50 岁的男性中在可能治愈的阶段诊断前列腺癌，有必要在 40 岁和 45 岁时单独进行 PSA 检测，并选择高危男性进行 PSA 监测，以便在预期寿命>20-25 年的男性中诊断潜在可治愈的癌症。
