前列腺特异性抗原质量在日本良性前列腺增生患者前列腺体积估计中的性能。

Performance of prostate-specific antigen mass in estimation of prostate volume in Japanese men with benign prostate hyperplasia.

机构信息

Department of Urology, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan.

出版信息

Int J Urol. 2012 Oct;19(10):929-35. doi: 10.1111/j.1442-2042.2012.03069.x. Epub 2012 Jun 14.

DOI:10.1111/j.1442-2042.2012.03069.x

PMID:22694207

Abstract

OBJECTIVES

Obese men with benign prostate hyperplasia might have lower serum prostate-specific antigen because of hemodilution, resulting in underestimation of total prostate volume by serum prostate-specific antigen. The aim of this study was to compare the performance of prostate-specific antigen mass as the absolute amount of prostate-specific antigen protein secreted into circulation with that of serum prostate-specific antigen in the prediction of total prostate volume.

METHODS

A total of 1517 men with serum prostate-specific antigen up to 10 ng/mL, including 1425 with biopsy-proven benign prostate hyperplasia, were enrolled in this study. Height and weight were used to estimate body mass index, body surface area and plasma volume. Prostate-specific antigen mass was calculated as serum prostate-specific antigen multiplied by plasma volume. The association between serum prostate-specific antigen or prostate-specific antigen mass and transrectal ultrasound-measured total prostate volume were evaluated by Pearson's correlation coefficient (Υ), linear regression analyses and receiver operating characteristic curves.

RESULTS

Serum prostate-specific antigen had an inverse relationship with plasma volume, decreasing as plasma volume increased, after adjustment of total prostate volume. Larger total prostate volume per serum prostate-specific antigen was found in men with higher body mass index or plasma volume. Among all participants, the correlation (Υ = 0.456) between prostate-specific antigen mass and total prostate volume was apparently stronger than that (Υ = 0.442) between serum prostate-specific antigen and total prostate volume. Prostate-specific antigen mass outperformed serum prostate-specific antigen at estimating total prostate volume cut-off values of 30 and 40 mL. These findings were more significant in men aged ≥60 years.

CONCLUSIONS

Prostate-specific antigen mass performs better than serum prostate-specific antigen in estimating TPV, especially in men aged ≥60 years.

摘要

目的

由于血液稀释，良性前列腺增生的肥胖男性的血清前列腺特异性抗原（PSA）可能较低，从而导致通过 PSA 低估总前列腺体积。本研究的目的是比较 PSA 质量（即循环中分泌的 PSA 蛋白的绝对量）与血清 PSA 在预测总前列腺体积方面的性能。

方法

本研究共纳入 1517 名血清 PSA 达 10ng/mL 的男性，其中 1425 名经活检证实为良性前列腺增生。身高和体重用于估计体重指数、体表面积和血浆体积。PSA 质量计算为血清 PSA 乘以血浆体积。通过 Pearson 相关系数（Υ）、线性回归分析和受试者工作特征曲线评估血清 PSA 或 PSA 质量与经直肠超声测量的总前列腺体积之间的关系。

结果

血清 PSA 与血浆体积呈负相关，在调整总前列腺体积后，随着血浆体积的增加而降低。在更高的体重指数或血浆体积的男性中，每单位血清 PSA 的总前列腺体积更大。在所有参与者中，PSA 质量与总前列腺体积之间的相关性（Υ=0.456）明显强于血清 PSA 与总前列腺体积之间的相关性（Υ=0.442）。PSA 质量在估计 30 和 40mL 的总前列腺体积截断值方面优于血清 PSA。这些发现对于年龄≥60 岁的男性更为显著。