Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto-City, Kyoto, 602-8566, Japan.
Department of Biostatistics, Kyoto Prefectural University of Medicine, Kyoto-City, Kyoto, Japan.
Sci Rep. 2023 Apr 21;13(1):6579. doi: 10.1038/s41598-023-33725-8.
To define a normal range for PSA values (ng/mL) by age and create a prediction model for prostate cancer incidence. We conducted a retrospective analysis using 263,073 observations of PSA values in Japanese men aged 18-98 years (2007-2017), including healthy men and those diagnosed with prostate cancer. Percentiles for 262,639 PSA observations in healthy men aged 18-70 years were calculated and plotted to elucidate the normal fluctuation range for PSA values by age. Univariable and multivariable logistic regression analyses were performed to develop a predictive model for prostate cancer incidence. PSA levels and PSA velocity increased with age in healthy men. However, there was no difference in PSA velocity with age in men diagnosed with prostate cancer. Logistic regression analysis showed an increased risk of prostate cancer for PSA slopes ranging from 0.5 to 3.5 ng/mL/year. This study provides age-specific normal fluctuation ranges for PSA levels in men aged 18-75 years and presents a novel and personalized prediction model for prostate cancer incidence. We found that PSA slope values of > 3.5 ng/mL/year may indicate a rapid increase in PSA levels caused by pathological condition such as inflammation but are unlikely to indicate cancer risk.
定义 PSA 值（ng/mL）的正常范围并建立前列腺癌发病的预测模型。我们对 2007-2017 年间 263073 例年龄在 18-98 岁的日本男性（包括健康男性和前列腺癌患者）的 PSA 值进行了回顾性分析。计算了年龄在 18-70 岁的健康男性中 262639 例 PSA 观察值的百分位数，并绘制图表以阐明 PSA 值随年龄的正常波动范围。对前列腺癌发病的预测模型进行了单变量和多变量逻辑回归分析。在健康男性中，PSA 水平和 PSA 速度随年龄的增长而增加。然而，在诊断患有前列腺癌的男性中，PSA 速度随年龄的变化没有差异。逻辑回归分析显示，PSA 斜率在 0.5 至 3.5ng/mL/年之间，前列腺癌发病的风险增加。本研究为年龄在 18-75 岁的男性提供了特定年龄的 PSA 水平正常波动范围，并提出了一种新的、个性化的前列腺癌发病预测模型。我们发现，PSA 斜率值>3.5ng/mL/年可能表示 PSA 水平因炎症等病理状况而快速升高，但不太可能表示癌症风险。
