Rubens D J, Gottlieb R H, Maldonado C E, Frank I N
Department of Radiology, University of Rochester School of Medicine and Dentistry, New York, NY 14642-8648, USA.
Radiology. 1996 Apr;199(1):159-63. doi: 10.1148/radiology.199.1.8633140.
To determine whether excess prostate-specific antigen (PSA) improves the accuracy of predicting positive biopsy results.
Results of prostate biopsy in 130 consecutive patients were correlated with transrectal ultrasound (TRUS) findings, digital rectal examination results, serum PSA level, and excess PSA (serum PSA level minus predicted PSA level [prostate volume x 0.12]), alone and in combination. Random sextant biopsy was performed in all patients, as well as directed biopsy of any suspicious lesion seen at TRUS.
Excess PSA alone was most accurate in the prediction of positive biopsy results. Use of an excess PSA of > or = 0 ng/mL instead of a serum PSA level of > 4 ng/mL to initiate prostate biopsy increased the positive yield from 49% to 56% and accuracy from 51% to 62%, eliminating 21% of biopsies while maintaining sensitivity at 94% (vs 95% with serum PSA level).
Use of only excess PSA of > or = 0 ng/mL to initiate prostate biopsy results in the best combination of sensitivity and specificity compared with the other standard parameters.
确定前列腺特异性抗原（PSA）升高是否能提高预测活检阳性结果的准确性。
连续130例患者的前列腺活检结果与经直肠超声（TRUS）检查结果、直肠指诊结果、血清PSA水平以及额外PSA（血清PSA水平减去预测PSA水平[前列腺体积×0.12]）进行单独及联合相关性分析。所有患者均进行随机六分区活检以及对TRUS检查发现的任何可疑病变进行靶向活检。
单独使用额外PSA对预测活检阳性结果最为准确。采用额外PSA≥0 ng/mL而非血清PSA水平＞4 ng/mL来启动前列腺活检，使活检阳性率从49%提高至56%，准确性从51%提高至62%，减少了21%的活检，同时保持敏感性在94%（血清PSA水平时为95%）。
与其他标准参数相比，仅使用额外PSA≥0 ng/mL来启动前列腺活检可获得敏感性和特异性的最佳组合。
