Kurita Y, Ushiyama T, Suzuki K, Fujita K, Kawabe K
Department of Urology, Hamamatsu University School of Medicine, Japan.
Int J Urol. 1996 Sep;3(5):367-72. doi: 10.1111/j.1442-2042.1996.tb00555.x.
The aim of the present study was to improve the accuracy of the prostate-specific antigen (PSA) density for detecting prostate cancer by using the transition zone (TZ) volume instead of the total prostate volume.
From April 1994 to October 1995, we examined 164 consecutive patients (52-88 years old), with an elevated PSA and/or abnormal digital rectal examination. All patients underwent a transrectal ultrasound-guided biopsy. The PSA density for total prostate volume (PSAD) and for TZ volume (PSAT) were calculated from the transrectal ultrasound measurements.
Forty-four of the 162 patients (27.2%) had histological confirmation of prostate cancer on biopsy. The area under the receiver-operator characteristic curve was 0.667 for PSA, 0.663 for PSAD, and 0.826 for PSAT. These areas were not significantly different for PSA and PSAD. However, PSAT was significantly superior to PSAD in differentiating benign hyperplasia from prostate cancer (P < 0.01).
The TZ volume-adjusted PSA density (PSAT) is useful for selecting patients for prostate biopsy from those with suspected prostate cancer.
本研究的目的是通过使用移行区（TZ）体积而非前列腺总体积来提高前列腺特异性抗原（PSA）密度检测前列腺癌的准确性。
1994年4月至1995年10月，我们对164例连续患者（52 - 88岁）进行了检查，这些患者PSA升高和/或直肠指检异常。所有患者均接受经直肠超声引导下活检。根据经直肠超声测量结果计算前列腺总体积的PSA密度（PSAD）和TZ体积的PSA密度（PSAT）。
162例患者中有44例（27.2%）经活检组织学确诊为前列腺癌。受试者操作特征曲线下面积，PSA为0.667，PSAD为0.663，PSAT为0.826。PSA和PSAD的这些面积无显著差异。然而，在区分良性增生和前列腺癌方面，PSAT显著优于PSAD（P < 0.01）。
经TZ体积调整的PSA密度（PSAT）有助于从疑似前列腺癌患者中选择进行前列腺活检的患者。
