Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
Prostate. 2013 Jan;73(1):42-7. doi: 10.1002/pros.22537. Epub 2012 May 14.
To assess whether the severity of lower urinary tract symptoms (LUTS) is associated with the risk of prostate cancer (PCa) detection via a multi (≥12)-core prostate biopsy.
From January 2004 to May 2011, 3,107 patients underwent transrectal ultrasound (TRUS) prostate biopsies due to elevated PSA levels ranging between 3 and 20 ng/ml or abnormal digital rectal exams (DREs). Multivariate logistic analysis was used to assess the potential association of LUTS and PCa detection via biopsy. The predictive accuracy of the multivariate model was assessed based on the receiver operating characteristics-derived area under the curve.
The median International Prostate Symptom Score (IPSS) was 11, and the mean PSA was 6.81 ng/ml. Of the total subjects, PCa was detected from biopsy in 931 (30.0%) patients. In a comparison of 1,465 patients with IPSS ≥ 11 and 1,642 patients with IPSS <11, those with a higher IPSS were older, had higher PSA and had a larger prostate, but there were no significant differences in the PCa detection rates. However, in multivariate analysis incorporating other associated variables, a higher IPSS was significantly associated with lower odds of PCa detection (P = 0.016). Nevertheless, addition of the IPSS did not significantly increase the accuracy of the multivariate model devised for the detection of PCa (P = 0.098).
Although PCa was detected less commonly among men with higher LUTS, LUTS may not provide additional prognostic information beyond that which can be obtained via previously established prognostic factors.
评估下尿路症状（LUTS）的严重程度是否与通过多（≥12）芯前列腺活检检测前列腺癌（PCa）的风险相关。
2004 年 1 月至 2011 年 5 月，由于 PSA 水平在 3 至 20ng/ml 之间升高或直肠指检（DRE）异常，3107 例患者接受了经直肠超声（TRUS）前列腺活检。采用多变量逻辑分析评估 LUTS 与通过活检检测 PCa 的潜在相关性。基于受试者工作特征曲线下面积评估多变量模型的预测准确性。
中位国际前列腺症状评分（IPSS）为 11，平均 PSA 为 6.81ng/ml。在所有受试者中，931 例（30.0%）患者的活检中检测到 PCa。在 IPSS≥11 的 1465 例患者和 IPSS<11 的 1642 例患者的比较中，IPSS 较高的患者年龄较大，PSA 较高，前列腺较大，但 PCa 检出率无显著差异。然而，在纳入其他相关变量的多变量分析中，较高的 IPSS 与 PCa 检出率较低的几率显著相关（P=0.016）。然而，IPSS 的加入并没有显著提高用于检测 PCa 的多变量模型的准确性（P=0.098）。
尽管 LUTS 较高的男性中 PCa 的检出率较低，但 LUTS 可能无法提供超出先前确定的预后因素所能获得的额外预后信息。
