Kosaka Takeo, Mizuno Ryuichi, Shinojima Toshiaki, Miyajima Akira, Kikuchi Eiji, Tanaka Nobuyuki, Shinoda Kazunobu, Morita Shinya, Mikami Shuji, Oya Mototsugu
Department of Urology, Keio University School of Medicine Tokyo, Japan.
Department of Pathology, Keio University School of Medicine Tokyo, Japan.
Am J Clin Exp Urol. 2014 Dec 25;2(4):332-6. eCollection 2014.
To investigate the appropriate cut-off level of PSA or other clinical parameters at aged ≤ 50 years. The rate of detection of PCa in young men will continue to rise associated with the advancement of the current and evolving practices of screening and detection. In this study, we determined whether to investigate the appropriate cut-off level of PSA or other clinical parameters at aged ≤ 50 years. The study population included 106 patients aged ≤ 50 years who had prostate biopsy at our institute. The differences of clinical variables including various PSA related parameters between the patients with significant PCa and insignificant PCa were analyzed. Receiver operating characteristics (ROC) curves and the corresponding areas under the ROC curves (AUC) were calculated. There were no significant differences between no-PCa and PCa patients regarding PSA value, prostate volume (P vol), PSA density (PSAD), transition zone volume (TZ vol), PSATZ density (PSATZD). When the patients meeting the following criteria, Gleason score was ≤ 6 with less than 2 positive biopsy cores, were classified as having insignificant prostate cancer, PSAD could become a useful predictor of significant PCa in men. The AUC was significantly greater in PSAD (0.801) than for the other parameters. The sensitivity and specificity of a PSAD threshold of 0.32 were 85.7% and 77.8%, respectively. In conclusion, PSAD can be a useful and very effective predictor in a man aged ≤ 50 and we can counsel patients with discretion regarding the likelihood of significant PCa.
研究年龄≤50岁人群中前列腺特异性抗原（PSA）或其他临床参数的合适临界值。随着当前筛查和检测实践的不断发展，年轻男性中前列腺癌（PCa）的检出率将持续上升。在本研究中，我们决定是否研究年龄≤50岁人群中PSA或其他临床参数的合适临界值。研究人群包括在我院接受前列腺活检的106例年龄≤50岁的患者。分析了具有显著PCa和非显著PCa患者之间临床变量的差异，包括各种与PSA相关的参数。计算了受试者工作特征（ROC）曲线及相应的ROC曲线下面积（AUC）。在无PCa和PCa患者之间，PSA值、前列腺体积（P vol）、PSA密度（PSAD）、移行区体积（TZ vol）、PSATZ密度（PSATZD）方面无显著差异。当符合以下标准（Gleason评分≤6且阳性活检核心小于2个）的患者被归类为患有非显著前列腺癌时，PSAD可成为男性显著PCa的有用预测指标。PSAD的AUC（0.801）显著大于其他参数。PSAD阈值为0.32时的敏感性和特异性分别为85.7%和77.8%。总之，PSAD对于年龄≤50岁的男性可能是一个有用且非常有效的预测指标，我们可以酌情为患者提供关于显著PCa可能性的咨询。
