Oesterling J E, Kumamoto Y, Tsukamoto T, Girman C J, Guess H A, Masumori N, Jacobsen S J, Lieber M M
Division of Urology, University of Michigan, Ann Arbor, USA.
Br J Urol. 1995 Mar;75(3):347-53. doi: 10.1111/j.1464-410x.1995.tb07347.x.
To determine whether the age-specific reference ranges for serum prostate-specific antigen (PSA) concentration generated for white men are applicable to other races.
Three-hundred and thirty-five healthy Japanese men, aged 40-79 years, residing in the small fishing village of Shimamaki-mura, Japan, agreed to enter this prospective, community-based study. All underwent a detailed clinical evaluation that included a serum PSA determination, a digital rectal examination and a transrectal ultrasound. Two-hundred and eighty-six (85%) completed the prostatic evaluation and had no evidence of prostate cancer by any one of the three diagnostic tests; these men formed the study population on which all analyses were performed.
The serum PSA concentration correlated directly with patient age (r = 0.33; P < 0.001) and prostatic volume (r = 0.57; P < 0.001). PSA density (PSAD) also was directly proportional to age (r = 0.30; P < 0.001). Adjusting for age, the serum PSA concentration was lower for Japanese men than for white men (P < 0.001). Thus, the recommended age-specific reference ranges (95th percentile) for serum PSA for Japanese were lower as well: 0.0-2.0 ng/mL for 40-49 years; 0.0-3.0 ng/mL for 50-59 years; 0.0-4.0 ng/mL for 60-69 years; and 0.0-5.0 ng/mL for 70-79 years. Based on transrectal ultrasound-volume determinations, the lower serum PSA concentrations in Japanese men are due in large part to their smaller prostate glands as compared with white men (P < 0.001).
These findings confirm the earlier observations that serum PSA, prostatic volume and PSAD are age-dependent. However, because of physiological differences among the two races, partly due to the size of the prostate gland, the age-specific reference ranges for serum PSA are lower for Japanese men than for white men. Because of these racial differences, it is now crucial to conduct a similar investigation among black men.
确定为白人男性制定的血清前列腺特异性抗原（PSA）浓度的年龄特异性参考范围是否适用于其他种族。
居住在日本岛牧村这个小渔村的335名40 - 79岁健康日本男性同意参加这项基于社区的前瞻性研究。所有人都接受了详细的临床评估，包括血清PSA测定、直肠指检和经直肠超声检查。286名（85%）完成了前列腺评估，并且通过这三项诊断测试中的任何一项都没有前列腺癌的证据；这些男性构成了进行所有分析的研究人群。
血清PSA浓度与患者年龄直接相关（r = 0.33；P < 0.001）以及前列腺体积直接相关（r = 0.57；P < 0.001）。PSA密度（PSAD）也与年龄成正比（r = 0.30；P < 0.001）。校正年龄后，日本男性的血清PSA浓度低于白人男性（P < 0.001）。因此，日本男性血清PSA的推荐年龄特异性参考范围（第95百分位数）也较低：40 - 49岁为0.0 - 2.0 ng/mL；50 - 59岁为0.0 - 3.0 ng/mL；60 - 69岁为0.0 - 4.0 ng/mL；70 - 79岁为0.0 - 5.0 ng/mL。基于经直肠超声测定的体积，与白人男性相比，日本男性较低的血清PSA浓度很大程度上是由于他们较小的前列腺（P < 0.001）。
这些发现证实了早期的观察结果，即血清PSA、前列腺体积和PSAD与年龄相关。然而，由于两个种族之间的生理差异，部分原因是前列腺的大小，日本男性血清PSA的年龄特异性参考范围低于白人男性。由于这些种族差异，现在对黑人男性进行类似调查至关重要。
