Deptartment of Pathology, University of Ulsan College of Medicine, Ulsan University Hospital, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan 682-714, Korea.
Yonsei Med J. 2013 Sep;54(5):1202-6. doi: 10.3349/ymj.2013.54.5.1202.
To investigate the relationship between prostate volume and the increased risk for being diagnosed with prostate cancer (PCa) in men with slowly increasing prostate specific antigen (PSA).
A cohort of 1035 men who visited our hospital's health promotion center and were checked for serum PSA levels more than two times between January 2001 and November 2011 were included. Among them, 116 patients had a change in PSA levels from less than 4 ng/mL to more than 4 ng/mL and underwent transrectal ultrasound guided prostate biopsy. Median age was 55.9 years and 26 (22.4%) had PCa. We compared the initial PSA level, the last PSA level, age, prostate volume, PSA density (PSAD), PSA velocity, and follow-up period between men with and without PCa. The mean follow- up period was 83.7 months.
Significant predictive factors for the detection of prostate cancer identified by univariate analysis were prostate volume, follow-up period and PSAD. In the multivariate analysis, prostate volume (p<0.001, odds ratio: 0.890) was the most significant factor for the detection of prostate cancer. In the receiver operator characteristic curve of prostate volume, area under curve was 0.724. At the cut-off value of 28.8 mL for prostate volume, the sensitivity and specificity were 61.1% and 73.1% respectively.
In men with PSA values more than 4 ng/mL during the follow-up period, a small prostate volume was the most important factor in early detection of prostate cancer.
研究前列腺体积与前列腺特异抗原（PSA）缓慢升高的男性患前列腺癌（PCa）风险增加之间的关系。
本研究纳入了 2001 年 1 月至 2011 年 11 月期间在我院健康促进中心就诊并两次以上检查血清 PSA 水平的 1035 例男性。其中 116 例 PSA 水平从<4ng/ml 升高至>4ng/ml，并接受经直肠超声引导下前列腺活检。中位年龄为 55.9 岁，26 例（22.4%）患有 PCa。我们比较了 PCa 患者和非 PCa 患者的初始 PSA 水平、最后 PSA 水平、年龄、前列腺体积、PSA 密度（PSAD）、PSA 速度和随访时间。平均随访时间为 83.7 个月。
单因素分析确定的前列腺癌检测的显著预测因素是前列腺体积、随访时间和 PSAD。多因素分析显示，前列腺体积（p<0.001，优势比：0.890）是检测前列腺癌的最显著因素。在前列腺体积的受试者工作特征曲线中，曲线下面积为 0.724。在前列腺体积的截断值为 28.8ml 时，灵敏度和特异性分别为 61.1%和 73.1%。
在随访期间 PSA 值>4ng/ml 的男性中，前列腺体积较小是早期检测前列腺癌的最重要因素。
