Yang Wenjun, Liu Sirong, Hu Cheng, Xie Keji, Wei Xinghua, Zeng Weiwei, Tang Ping
Department of Urology, Guangzhou First People's Hospital, the Second Affiliated Hospital of South China University of Technology, Guangzhou, China.
J BUON. 2019 Mar-Apr;24(2):832-837.
To analyze the distributions and characteristics of initial prostate-specific antigen (PSA) and PSA velocity in Chinese men aged 50 years and younger without prostate cancer.
The initial PSA test of men aged 50 years and younger, taken from January 2008 to December 2018 in two medical centers, was retrospectively analyzed. Cases with prostate cancer were excluded. The distributions of initial PSA and PSA velocity, and the correlations between these two values were estimated. Kaplan-Meier and log-rank test were used to estimate significant difference on the risk of PSA≥2.5 ng/mL after initial PSA measurement, stratified by median initial PSA (0.6 ng/mL).
A total of 9461 men with non-prostate cancer were included in this study. The median initial PSA value was 0.7 ng/mL. A total of 853 men had their PSA measured two times or more and the median PSA velocity was 0.026 ng·mL-1·yr-1. There was no two-two direct correlation between initial PSA testing age, initial PSA, and PSA velocity. After a follow-up of up to 10 years from the baseline PSA test, the risk of PSA ≥ 2.5 ng/mL, stratified by median initial PSA (0.7 ng/mL), was significantly different (log-rank test, p<0.001).
More than 25% of the men aged ≤ 50 years should have regularly PSA screening based on current guidelines. However, the subsequent risk of being diagnosed with prostate cancer in these men is unknown. Men aged 50 years and younger with an initial PSA higher than the median (0.7 ng/mL) have a subsequent higher risk of abnormal PSA value.
分析50岁及以下无前列腺癌中国男性的初始前列腺特异性抗原（PSA）及PSA速率的分布情况和特征。
回顾性分析2008年1月至2018年12月在两个医疗中心进行的50岁及以下男性的初始PSA检测。排除前列腺癌患者。评估初始PSA和PSA速率的分布情况以及这两个值之间的相关性。采用Kaplan-Meier法和对数秩检验评估初始PSA测量后PSA≥2.5 ng/mL风险的显著差异，按初始PSA中位数（0.6 ng/mL）分层。
本研究共纳入9461例非前列腺癌男性。初始PSA值中位数为0.7 ng/mL。共有853名男性进行了两次或以上的PSA检测，PSA速率中位数为0.026 ng·mL-1·yr-1。初始PSA检测年龄、初始PSA和PSA速率之间不存在两两直接相关性。从基线PSA检测开始随访长达10年后，按初始PSA中位数（0.7 ng/mL）分层，PSA≥2.5 ng/mL的风险存在显著差异（对数秩检验，p<0.001）。
根据现行指南，超过25%的50岁及以下男性应定期进行PSA筛查。然而，这些男性随后被诊断为前列腺癌的风险尚不清楚。初始PSA高于中位数（0.7 ng/mL）的50岁及以下男性，其后续PSA值异常的风险更高。
