Eastham J A, May R A, Whatley T, Crow A, Venable D D, Sartor O
Department of Urology, Louisiana State University Medical Center, Overton Brooks Veterans Affairs Medical Center, Shreveport 71130-3932, USA.
J Natl Cancer Inst. 1998 May 20;90(10):756-60. doi: 10.1093/jnci/90.10.756.
The reported incidence of prostate cancer is higher among African-American men than among white men. We conducted a study of African-American and white men without prostate cancer to determine whether clinical and histologic findings might be associated with racial differences in serum prostate-specific antigen (PSA) levels.
From January 1990 through March 1997, 493 (59.5%) of 829 African-American men and 736 (74.1%) of 993 white men who had elevated serum PSA levels (> or = 4.0 ng/mL) and/or abnormal digital rectal examinations and who underwent transrectal ultrasound-guided prostate biopsies were found to be without prostate cancer. Also reviewed were patients' age and race, indication for biopsy, histologic features of the prostate biopsy specimen, ultrasound-measured prostate volume, PSA density (i.e., the PSA level divided by the prostate volume), and (in some cases) serum testosterone levels.
Among these men without prostate cancer, there were no statistically significant differences by race in the ages of the patients, their prostate volumes, or their serum testosterone levels; however, the mean serum PSA levels and PSA densities were significantly higher in African-American men than in white men (two-sided P values of .00003 and .000009, respectively). A higher proportion of African-American men than white men had inflammation in their prostate biopsy specimen, and men of both races with prostate inflammation had higher PSA values than those without inflammation. African-American men without inflammation had higher PSA values than white men without inflammation.
In this study, African-American men without histologic evidence of prostate cancer had significantly higher PSA levels and PSA densities than similarly aged white men. This finding was not accounted for by racial differences in patients' age, serum testosterone level, or prostate volume.
据报道，非裔美国男性前列腺癌的发病率高于白人男性。我们对无前列腺癌的非裔美国男性和白人男性进行了一项研究，以确定临床和组织学发现是否可能与血清前列腺特异性抗原（PSA）水平的种族差异相关。
从1990年1月至1997年3月，829名血清PSA水平升高（≥4.0 ng/mL）和/或直肠指检异常且接受经直肠超声引导下前列腺活检的非裔美国男性中有493名（59.5%）被发现没有前列腺癌，993名白人男性中有736名（74.1%）被发现没有前列腺癌。还回顾了患者的年龄和种族、活检指征、前列腺活检标本的组织学特征、超声测量的前列腺体积、PSA密度（即PSA水平除以前列腺体积），以及（在某些情况下）血清睾酮水平。
在这些无前列腺癌的男性中，患者年龄、前列腺体积或血清睾酮水平在种族上没有统计学显著差异；然而，非裔美国男性的平均血清PSA水平和PSA密度显著高于白人男性（双侧P值分别为0.00003和0.000009）。非裔美国男性前列腺活检标本中有炎症的比例高于白人男性，且两个种族有前列腺炎症的男性的PSA值均高于无炎症者。无炎症的非裔美国男性的PSA值高于无炎症的白人男性。
在本研究中，无前列腺癌组织学证据的非裔美国男性的PSA水平和PSA密度显著高于年龄相仿的白人男性。这一发现不能用患者年龄、血清睾酮水平或前列腺体积的种族差异来解释。
