%-2 前列腺特异性抗原和前列腺健康指数对前列腺癌的诊断性能：前瞻性、多机构研究。
Diagnostic Performance of %[-2]proPSA and Prostate Health Index for Prostate Cancer: Prospective, Multi-institutional Study.
机构信息
Department of Urology, Kangwon National University School of Medicine, Chuncheon, Korea.
Department of Urology, Wonju Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
出版信息
J Korean Med Sci. 2018 Mar 12;33(11):e94. doi: 10.3346/jkms.2018.33.e94.
BACKGROUND
We evaluated the clinical performance of [-2]proPSA (p2PSA) and its derivatives in predicting the presence and aggressiveness of prostate cancer (PCa) in Korean men.
METHODS
A total of 246 men with total prostate-specific antigen (tPSA) ≥ 3.5 ng/mL who underwent their first prostate biopsy were included in this prospective, multicenter, observational study. Diagnostic accuracy of tPSA, free-to-total PSA ratio (%fPSA), p2PSA, %p2PSA, and the Beckman Coulter prostate health index (PHI) was assessed by receiver operating characteristic curve analyses and logistic regression analyses.
RESULTS
Overall, PCa was detected in 125 (50.8%) subjects. In men with tPSA 3.5-10 ng/mL, the detection rate of PCa was 39.4% (61/155). In this group, PHI and %p2PSA were the most accurate predictors of PCa and significantly outperformed tPSA and %fPSA; area under the curve for tPSA, %fPSA, %p2PSA, and PHI was 0.56, 0.69, 0.74, and 0.76, respectively. PHI was also the strongest predictor of PCa with Gleason score ≥ 7.
CONCLUSION
This study demonstrates the superior clinical performance of %p2PSA and PHI in predicting the presence and aggressiveness of PCa in Korean men. The %p2PSA and PHI appear to improve detection of PCa and provide prognostic information.
背景
我们评估了 [-2] 前列腺特异性抗原（p2PSA）及其衍生物在预测韩国男性前列腺癌（PCa）的存在和侵袭性方面的临床性能。
方法
这项前瞻性、多中心、观察性研究共纳入了 246 名总前列腺特异性抗原（tPSA）≥3.5ng/mL 且首次接受前列腺活检的男性。通过受试者工作特征曲线分析和逻辑回归分析评估 tPSA、游离-总 PSA 比值（%fPSA）、p2PSA、%p2PSA 和贝克曼库尔特前列腺健康指数（PHI）的诊断准确性。
结果
总体而言，125 名（50.8%）患者检测出 PCa。在 tPSA 为 3.5-10ng/mL 的男性中，PCa 的检出率为 39.4%（61/155）。在该组中，PHI 和 %p2PSA 是 PCa 的最准确预测因子，明显优于 tPSA 和 %fPSA；tPSA、%fPSA、%p2PSA 和 PHI 的曲线下面积分别为 0.56、0.69、0.74 和 0.76。PHI 也是预测 Gleason 评分≥7 的 PCa 的最强预测因子。
结论
这项研究表明，%p2PSA 和 PHI 在预测韩国男性 PCa 的存在和侵袭性方面具有优越的临床性能。%p2PSA 和 PHI 似乎可以提高 PCa 的检出率，并提供预后信息。
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