与 PSA 相比，在 PSA<20ng/ml 的台湾男性中，分区调整 PSA 密度可提高前列腺癌的检出率。
Zonal adjusted PSA density improves prostate cancer detection rates compared with PSA in Taiwanese males with PSA < 20 ng/ml.
机构信息
Department of Urology, MacKay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Zhongshan Dist, 10449, Taipei, Taiwan.
Mackay Medical College, No.46, Sec. 3, Zhongzheng Rd., Sanzhi Dist., Taipei, Taiwan.
出版信息
BMC Urol. 2020 Oct 7;20(1):151. doi: 10.1186/s12894-020-00717-z.
BACKGROUND
The current study aimed to compare the efficacy of transition zone PSA density (TZPSAD) with traditional PSA and PSA density (PSAD), for the diagnosis of prostate cancer (PCa) in Taiwanese males.
METHODS
Men with PSA between 4.0 and 20.0 ng/ml who underwent a transrectal ultrasound (TRUS) guided prostate biopsy between the studied period were retrospectively identified. The demographic data, PSAD and TZPSAD were calculated in all patients. Receiver operating characteristic (ROC) curves were used to analyze the accuracy of a positive PCa diagnosis.
RESULTS
The area under the ROC (AUC) was 0.615, 0.748 and 0.746 for PSA, PSAD and TZPSAD, respectively. The best cut-off of value for TZPSAD in predicting PCa in men with a PSA of 4.0-10.0 ng/ml was 0.367 ng/ml/ml with a sensitivity of 50% and a specificity of 77.5%. In men with a PSA of 10.1-20.0 ng/ml, the best cut-off value was 0.454 ng/ml, with a sensitivity of 74.8% and specificity of 70.9%.
CONCLUSION
The use of TZPSAD can improve the efficiency and specificity of PSA for the diagnosis of PCa in Taiwanese men with PSA 4.0-20.0 ng/ml. TZPSAD efficiency was similar to PSAD but TZPSAD had better cancer specificity.
背景
本研究旨在比较过渡带 PSA 密度（TZPSAD）与传统 PSA 和 PSA 密度（PSAD）在诊断台湾男性前列腺癌（PCa）方面的疗效。
方法
回顾性分析了研究期间 PSA 介于 4.0 至 20.0ng/ml 之间且接受经直肠超声（TRUS）引导下前列腺活检的男性患者。所有患者均计算了人口统计学数据、PSAD 和 TZPSAD。使用受试者工作特征（ROC）曲线分析阳性 PCa 诊断的准确性。
结果
ROC 曲线下面积（AUC）分别为 0.615、0.748 和 0.746，用于 PSA、PSAD 和 TZPSAD。PSA 在 4.0-10.0ng/ml 之间的男性中，预测 PCa 的最佳 TZPSAD 截断值为 0.367ng/ml/ml，其灵敏度为 50%，特异性为 77.5%。在 PSA 为 10.1-20.0ng/ml 的男性中，最佳截断值为 0.454ng/ml，其灵敏度为 74.8%，特异性为 70.9%。
结论
在 PSA 为 4.0-20.0ng/ml 的台湾男性中，使用 TZPSAD 可提高 PSA 诊断 PCa 的效率和特异性。TZPSAD 的效率与 PSAD 相似，但 TZPSAD 具有更好的癌症特异性。
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