Zheng Xiang-Yi, Zhang Peng, Xie Li-Ping, You Qi-Han, Cai Bo-Sen, Qin Jie
Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Asian Pac J Cancer Prev. 2012;13(11):5529-33. doi: 10.7314/apjcp.2012.13.11.5529.
To investigate the utility of prostate-specific antigen velocity (PSAV) and PSAV per initial volume (PSAVD) for early detection of prostate cancer (PCa) in Chinese men.
Between January 2009 and June 2012, a total of 193 men (aged 49-84 years, median 67 years) with at least 2 transrectal ultrasonography (TRUS) procedures and concurrent serum PSA measurements underwent prostate biopsy because of suspicion of PCa. The total group were classified into PCa and non-PCa groups, and the variables of the two groups were compared. Univariate and multivariate analyses were used to investigate which variables were predictove. The diagnostic values of PSAV, PSAVD and prostate-specific antigen density (PSAD) were compared using receiver operating characteristic (ROC) analysis.
Prostate cancer was diagnosed in 44 (22.8%) of the 193 men. There were significant differences between the groups in last and initial prostate volumes determined by TRUS, initial age, last serum PSA levels, PSAV, PSAD and PSAVD. After adjusting for confounding factors, the odds ratios of PCa across the quartile of PSAVD were 1, 4.06, 10.6, and 18.9 (P for trend <0.001).The area under the ROC curves (AUCs) of PSAD (0.779) and PSAVD (0.776) were similar and both significantly greater than that of PSA (AUC 0.667). PSAVD was a significantly better indicator of PCa than PSAV (AUC 0.736). There was no statistical significant difference between the AUC of PSAV and that of last serum PSA level. The sensitivity and specificity of PSAVD at a cutoff of 0.023ng in participants with last serum PSA levels of 4.0 ng/mL-10.0 ng was 73.7% and 70.7%, respectively.
The results of this study demonstrated PSAVD may be a useful tool in PCa detection, especially in those undergoing previous TRUS examination.
探讨前列腺特异性抗原速率（PSAV）及每初始体积的前列腺特异性抗原速率（PSAVD）在中国男性前列腺癌（PCa）早期检测中的应用价值。
2009年1月至2012年6月期间，共有193名男性（年龄49 - 84岁，中位年龄67岁）因怀疑患有PCa接受了至少两次经直肠超声检查（TRUS）并同时检测血清PSA，随后进行了前列腺活检。将全部研究对象分为PCa组和非PCa组，并比较两组的变量。采用单因素和多因素分析来研究哪些变量具有预测性。使用受试者工作特征（ROC）分析比较PSAV、PSAVD和前列腺特异性抗原密度（PSAD）的诊断价值。
193名男性中，44例（22.8%）被诊断为前列腺癌。两组在TRUS测定的末次和初始前列腺体积、初始年龄、末次血清PSA水平、PSAV、PSAD和PSAVD方面存在显著差异。校正混杂因素后，PSAVD四分位数范围内PCa的比值比分别为1、4.06、10.6和18.9（趋势P<0.001）。PSAD（0.779）和PSAVD（0.776）的ROC曲线下面积（AUC）相似，且均显著大于PSA的AUC（0.667）。PSAVD作为PCa的指标显著优于PSAV（AUC 0.736）。PSAV的AUC与末次血清PSA水平的AUC之间无统计学显著差异。在末次血清PSA水平为4.0 ng/mL - 10.0 ng的参与者中，PSAVD在截断值为0.023 ng时的敏感性和特异性分别为73.7%和70.7%。
本研究结果表明，PSAVD可能是PCa检测中的一种有用工具，尤其是在那些曾接受过TRUS检查的人群中。
