Zhu Xiao-Dong, Zheng An, Wang Zhi-Qian, Shao Qiang
Department of Urology, Beijing Electric Power Hospital, Capital Medical University, Beijing 100073, China.
Zhonghua Nan Ke Xue. 2018 Feb;24(2):142-146.
The Prostate Cancer Prevention Trial risk calculator (PCPT-RC) is an online tool for assessing the risk of prostate cancer (PCa) based on age, race, serum PSA, biopsy history, family history, and other factors. This study aimed to investigate the value, sensitivity and specificity of the PCPT-RC 2.0 in assessing the risk of PCa in the Chinese high-risk population.
This study included 622 patients with the high risk of PCa characterized by high serum PSA (PSA >3 μg/L) or abnormality in digital rectal examination or imaging of the prostate. According to the results of prostate biopsy, we divided the patients into a PCa and a non-PCa group and used the PCPT-RC 2.0 for evaluation of all the cases followed by statistical analysis.
PCa was detected in 264 (42.4%) of the 622 patients, including 126 cases of high-grade malignancy. Compared with the non-PCa group, the PCa patients showed a significantly older age (［68.40 ± 7.30］ vs ［72.80 ± 7.20］ yr, P <0.001), higher serum PSA level (［11.20 ± 7.76］ vs ［15.06 ± 10.65］, P <0.001), and higher PCPT risk score (［37.0 ± 10.8］% vs ［44.4 ± 12.6］%, P <0.001). The PCPT risk score exhibited a greater area under the ROC curve than the level of serum PSA in evaluating the risk of PCa (0.67 vs 0.61, P <0.05), but no statistically significant difference between the two in predicting the risk of high-grade malignancy (0.67 vs 0.66, P >0.05).
The PCPT risk score is valuable in predicting the risk of PCa in China, which may play a better role than the serum PSA level in screening PCa and avoid unnecessary prostate biopsy, though its advantage is not so obvious in identifying high-grade malignancy. A prediction tool needs to be established for evaluating the risk of PCa in the Chinese population.
前列腺癌预防试验风险计算器（PCPT-RC）是一种基于年龄、种族、血清前列腺特异抗原（PSA）、活检史、家族史及其他因素评估前列腺癌（PCa）风险的在线工具。本研究旨在探讨PCPT-RC 2.0在中国高危人群中评估PCa风险的价值、敏感性和特异性。
本研究纳入622例以血清PSA升高（PSA>3μg/L）或直肠指检或前列腺影像学异常为特征的PCa高危患者。根据前列腺活检结果，将患者分为PCa组和非PCa组，应用PCPT-RC 2.0对所有病例进行评估，随后进行统计分析。
622例患者中264例（42.4%）检测到PCa，其中126例为高级别恶性肿瘤。与非PCa组相比，PCa患者年龄显著更大（［68.40±7.30］岁 vs ［72.80±7.20］岁，P<0.001），血清PSA水平更高（［11.20±7.76］ vs ［15.06±10.65］，P<0.001），PCPT风险评分更高（［37.0±10.8］% vs ［44.4±12.6］%，P<0.001）。在评估PCa风险方面，PCPT风险评分的ROC曲线下面积大于血清PSA水平（0.67 vs 0.61，P<0.05），但在预测高级别恶性肿瘤风险方面两者无统计学显著差异（0.67 vs 0.66，P>0.05）。
PCPT风险评分在预测中国人群PCa风险方面具有价值，在筛查PCa方面可能比血清PSA水平发挥更好的作用，可避免不必要的前列腺活检。不过，其在识别高级别恶性肿瘤方面优势不明显。需要建立一种预测工具来评估中国人群PCa风险。
