Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.
Int Neurourol J. 2013 Jun;17(2):73-7. doi: 10.5213/inj.2013.17.2.73. Epub 2013 Jun 30.
To investigate the efficacy of total prostate-specific antigen (tPSA) and free prostate-specific antigen (fPSA) for the estimation of prostate volume (PV) in pathologically-proven benign prostatic hyperplasia (BPH) patients.
From January 2010 to March 2013, 165 Korean men with a PSA less than 10 ng/mL who were diagnosed without prostate cancer by prostate biopsy were enrolled. Patients were classified into three age groups: ≤60, 61-70, and >70 years old. The results were organized to estimate and compare the ability of serum tPSA and fPSA to assess the PV.
Enrolled patients had a median age of 63.5 years (44 to 80), a median tPSA of 5.72 ng/mL, a median fPSA of 0.98 ng/mL and a median PV of 53.68 mL, respectively. Among the associations between tPSA, fPSA, age, and PV, the highest correlation was verified between fPSA and PV (r=0.377, P<0.0001); the correlation coefficient between tPSA and PV was much lower (r=0.262, P<0.001). All stratified age cohorts showed the same findings. The ROC curves (for PV greater than 30, 40, and 50 mL) showed that fPSA (area under the curve [AUC]=0.781, 0.718, and 0.700) outperformed tPSA (AUC=0.657, 0.583, and 0.67) in its ability to predict clinically significant PV enlargement.
Both tPSA and fPSA significantly correlated with PV in Korean men, while the correlation efficiency between fPSA and PV was more powerful. fPSA may be a useful tool in making therapeutic decisions and follow-up management in BPH patients.
研究总前列腺特异性抗原（tPSA）和游离前列腺特异性抗原（fPSA）在经病理证实的良性前列腺增生（BPH）患者中估算前列腺体积（PV）的疗效。
2010 年 1 月至 2013 年 3 月，纳入了 165 名前列腺特异性抗原（PSA）小于 10ng/ml 且经前列腺活检诊断无前列腺癌的韩国男性患者。患者分为三组年龄：≤60 岁、61-70 岁和>70 岁。将结果组织起来，以评估和比较血清 tPSA 和 fPSA 评估 PV 的能力。
纳入患者的中位年龄为 63.5 岁（44 至 80 岁），中位 tPSA 为 5.72ng/ml，中位 fPSA 为 0.98ng/ml，中位 PV 为 53.68ml。在 tPSA、fPSA、年龄和 PV 之间的相关性中，fPSA 与 PV 之间的相关性最高（r=0.377，P<0.0001）；tPSA 与 PV 的相关性系数则较低（r=0.262，P<0.001）。所有分层年龄组均显示出相同的发现。ROC 曲线（针对 PV 大于 30、40 和 50ml）显示，fPSA（曲线下面积[AUC]=0.781、0.718 和 0.700）在预测临床上显著的 PV 增大方面优于 tPSA（AUC=0.657、0.583 和 0.67）。
tPSA 和 fPSA 均与韩国男性的 PV 显著相关，而 fPSA 与 PV 之间的相关性效率更高。fPSA 可能是 BPH 患者在做出治疗决策和随访管理方面的有用工具。
