放射性核素骨显像联合血清PSA、fPSA、ALP及BAP在评价内分泌疗法治疗前列腺癌

目的 探讨放射性核素骨显像联合前列腺特异性抗原（PSA）、游离前列腺特异性抗原（fPSA）、碱性磷酸酶（ALP）及骨特异性碱性磷酸酶（BAP）在评价内分泌疗法治疗前列腺癌疗效中的应用价值。 方法 选取2016年1月至2017年12月于随州市中心医院接受内分泌疗法治疗的64例前列腺癌患者作为研究对象。接受内分泌治疗后1年，进行PSA、fPSA、ALP、BAP水平检测以及放射性核素骨显像检查，根据检查结果评估放射性核素骨显像在评价前列腺癌内分泌疗法治疗效果中的应用。 结果 内分泌治疗后的64例患者经放射性核素骨显像检查结果显示共发生51例骨转移；放射性核素骨显像转移灶数目＞2个骨转移灶的患者的血清PSA、fPSA水平高于骨转移灶≤2个患者的的血清PSA、fPSA水平（均P＜005）；随着骨显像分型的增高，前列腺癌骨转移患者血清PSA、ALP与BAP水平均增高，呈正相关（均P＜005）。 结论 放射性核素骨显像联合PSA、fPSA、ALP、BAP能够实现内分泌疗效的准确评价与骨转移瘤的早期诊断。     

血清铁蛋白联合前列腺特异性抗原检测对前列腺癌的诊断价值

目的探讨血清铁蛋白(Ferr)、总前列腺特异性抗原(tPSA)、游离前列腺特异性抗原(f PSA)、fPSA/tPSA联合检测对前列腺癌(PCa)的诊断价值。方法选择90例PCa患者、84例前列腺良性病变患者和50例健康男性体检者分别作为PCa组、良性组和对照组,检测3组研究对象的血清Ferr、tPSA、fPSA水平并计算fPSA/tPSA,分析Ferr、tPSA、fPSA、fPSA/tPSA联合检测对PCa的诊断价值。结果PCa组患者的血清Ferr、tPSA、fPSA水平均高于良性组和对照组,fPSA/tPSA低于良性组和对照组,差异均有统计学意义(P﹤0.05)。良性组患者的血清Ferr、tPSA、fPSA水平均高于对照组,fPSA/tPSA低于对照组,差异均有统计学意义(P﹤0.05)。PCa患者的血清Ferr与tPSA、fPSA均呈正相关,tPSA与f PSA呈正相关,tPSA与fPSA/tPSA呈负相关(P﹤0.05)。血清Ferr、tPSA、fPSA、fPSA/tPSA联合检测诊断PCa的灵敏度、特异度、曲线下面积均高于四个指标的三联、两联、单独检测。结论PCa患者的血清Ferr、t PSA、fPSA水平均高于前列腺良性病变患者,fPSA/tPSA低于前列腺良性病变患者。血清Ferr、tPSA、f PSA、f PSA/tPSA联合检测对PCa具有较高的诊断价值,值得在临床中推广应用。     

89Sr联合内分泌治疗前列腺癌多发骨转移的临床研究

[目的]探讨^89Sr（^89锶）联合内分泌治疗前列腺癌多发骨转移的疗效。[方法]52例确诊前列腺癌多发骨转移患者,手术去势后随机分为两组：单纯内分泌治疗组20例。口服抗雄激素内分泌治疗;其余32例采用^89Sr联合内分泌治疗。治疗后3个月随访,观察两组镇痛效果、骨转移病灶数目、前列腺特异性抗原（PSA）变化。[结果]20例内分泌治疗患者,15例疼痛缓解,止痛率为75％,骨转移病灶和PSA不同程度下降,PSA下降55．35±18．23ng／ml;32例患者行^89Sr联合内分泌治疗,30例疼痛缓解,止痛率为93．8％,骨转移病灶和PSA明显下降,PSA下降68．77±20．35ng／ml。较单纯内分泌治疗,联合治疗镇痛效果、骨转移病灶数目减少及PSA降低均有显著性意义（P〈0．05）。[结论]对前列腺癌多发骨转移患者,采用^89Sr联合内分泌治疗,可明显提高止痛疗效,减少骨转移病灶数目、缩小病灶范围及降低血清PSA浓度,疗效优于单纯内分泌治疗。     

PSA、FPSA检测和骨显像对前列腺癌骨转移的诊断价值

目的:探讨联合应用前列腺特异性抗原(PSA)、游离PSA(FPSA)检测和全身骨显像诊断前列腺癌骨转移的意义.方法:回顾性分析70例经临床确诊的前列腺癌患者,全部行血清PSA、FPSA测定,并作全身骨显像.结果:PSA<4ng/ml在14例病人中,发生骨转移者7例,诊断阳性率为50%;PSA 4ng/ml～20ng/ml共7例,发生骨转移者6例,诊断阳性率为87%;PSA＞20ng/ml组49例,发生骨转移45例,阳性率为92%.结论:PSA、FPSA检测结合全身骨显像,可尽早、全面地发现前列腺癌患者全身骨转移.     

PSA、FPSA检测和骨显像对前列腺癌骨转移的诊断价值

目的：探讨联合应用前列腺特异性抗原（PSA）、游离PSA（FPSA）检测和全身骨显像诊断前列腺癌骨转移的意义。方法：回顾性分析70例经临床确诊的前列腺癌患者，全部行血清PSA、FPSA测定，并作全身骨显像。结果：PSA〈4ng／ml在14例病人中，发生骨转移者7例，诊断阳性率为50％；PSA4ng／ml～20ng／ml共7例，发生骨转移者6例、诊断阳性率为87％；PSA〉20ng／ml组49例，发生骨转移45例，阳性率为92％。结论：PSA、FPSA检测结合全身骨显像，可尽早、全面地发现前列腺癌患者全身骨转移。     

放射性核素骨显像联合血清PSA、fPSA、ALP及BAP在评价内分泌疗法治疗前列腺癌疗效中的应用价值

目的探讨放射性核素骨显像联合前列腺特异性抗原(PSA)、游离前列腺特异性抗原(fPSA)、碱性磷酸酶(ALP)及骨特异性碱性磷酸酶(BAP)在评价内分泌疗法治疗前列腺癌疗效中的应用价值。方法选取2016年1月至2017年12月于随州市中心医院接受内分泌疗法治疗的64例前列腺癌患者作为研究对象。接受内分泌治疗后1年,进行PSA、fPSA、ALP、BAP水平检测以及放射性核素骨显像检查,根据检查结果评估放射性核素骨显像在评价前列腺癌内分泌疗法治疗效果中的应用。结果内分泌治疗后的64例患者经放射性核素骨显像检查结果显示共发生51例骨转移;放射性核素骨显像转移灶数目2个骨转移灶的患者的血清PSA、fPSA水平高于骨转移灶≤2个患者的的血清PSA、fPSA水平(均P0. 05);随着骨显像分型的增高,前列腺癌骨转移患者血清PSA、ALP与BAP水平均增高,呈正相关(均P0. 05)。结论放射性核素骨显像联合PSA、fPSA、ALP、BAP能够实现内分泌疗效的准确评价与骨转移瘤的早期诊断。     

前列腺癌实验室诊断指标的ROC曲线分析

目的应用ROC曲线分析血清游离前列腺特异性抗原（fPSA）,总前列腺特异性抗原（tPSA）及其比值（fP-SA/tPSA）在前列腺癌中的诊断价值。方法应用受试者工作特征曲线（ROC）对健康男性组,前列腺增生组及前列腺癌组血清tPSA,fPSA及fPSA/tPSA结果进行分析。结果前列腺癌组血清的tPSA、fPSA及f/t与其余两组比较均有差异。经ROC曲线分析,tPSA、fPSA及f/t的阈值分别为7.14μg/L、1.31μg/L及0.235。三者分别及联合检测的ROC曲线下面积分别为0.905、0.770、0.352与0.968。结论 tPSA、fPSA及f/t三者联合检测可以提高对前列腺癌的诊断。     

游离前列腺特异性抗原与总前列腺特异性抗原比值在前列腺癌鉴别诊断中的应用

 目的 探讨游离前列腺特异性抗原（fPSA）与总前列腺特异性抗原（tPSA）比值在前列腺癌（PCa）鉴别诊断中的意义。方法 采用电化学免疫发光技术对86例前列腺良性增生（BPH）45例PCa患者和60例健康男性体检者（正常对照组）血清fPSA和tPSA同时进行测定，并计算出fPSA／tPSA，进行统计分析。结果 BPH、PCa组tPSA水平明显高于正常对照组（P＜0.05）。PCa组和BPH组的血清tPSA差异亦有统计学意义，但当tPSA在4.0 ~ 10.0 μg／L范围时，PCa组血清fPSA／tPSA比值却明显低于BPH组（P＜0.01）。把fPSA／tPSA比值划分成8个区间，当fPSA／tPSA比值15 ％作为诊断灰区PCa诊断的临界值时，诊断的敏感性、特异性、阳性预测值、阴性预测值及正确诊断指数分别为72.8 %、67.5 %、62.5 %、82.2 %、50.2 %。结论 当血清tPSA处于诊断灰区时，联合检测fPSA／tPSA比值可明显提高tPSA对PCa早期诊断的特异性。     

游离和总前列腺特异性抗原比值、外周血中性粒细胞和淋巴细胞比值、白细胞介素6、前列腺健康指数密度检测在前列腺癌早期诊断中的应用

目的探讨游离和总前列腺特异性抗原比值(f/tPSA)、外周血中性粒细胞和淋巴细胞比值(NLR)、白细胞介素6(IL-6)、前列腺健康指数密度(PHID)检测在前列腺癌早期诊断中的临床应用。方法回顾性分析2020年1月至2022年1月徐州医科大学第二附属医院收治住院的160例前列腺特异性抗原(PSA)异常患者临床资料, 根据前列腺穿刺活组织检查或电切手术病理结果分为前列腺癌组68例、良性前列腺增生组92例;选取同期徐州医科大学第二附属医院男性健康体检者50名为健康对照组。3组均检测总前列腺特异性抗原(tPSA)、游离前列腺特异性抗原(fPSA)、前列腺特异性抗原同源异构体2(p2PSA)、IL-6等指标, 计算f/tPSA、前列腺健康指数(PHI)、PHID和NLR等。绘制受试者工作特征曲线(ROC), 比较各指标诊断和鉴别诊断前列腺癌、良性前列腺增生的效能。结果前列腺癌组患者血清tPSA、fPSA、p2PSA、PHI、PHID水平均高于良性前列腺增生组和健康对照组(均P<0.05);血清f/tPSA水平均低于良性前列腺增生组和健康对照组(均P<0.05)。PHID诊断早期前...     

分析血清PSA系列及Gleason评分在前列腺癌分期中的预测价值

目的：探讨血清前列腺特异性抗原（prostate specific antigen,PSA）系列及穿刺活检Gleason评分对前列腺癌病理分期的预测价值。方法：回顾性分析根治术后病理证实为前列腺腺癌的92例患者资料,具备术前总前列腺特异抗原（total pros-tate specific antigen,tPSA）、游离PSA（free prostate specific antigen,fPSA）、fPSA/tPSA、前列腺特异抗原密度（prostate specific antigen density,PSAD）及穿刺活检Gleason评分。比较器官局限组和包膜外侵犯组之间以上指标的差异,运用工作特征曲线（ROC曲线）比较各指标的预测价值,并通过多因素logistic回归分析筛选器官局限最主要的影响因素。结果：包膜外侵犯组PSAD、tPSA、fPSA/tPSA和穿刺活检Gleason评分值均高于器官局限组（P〈0.05）;ROC曲线对器官局限性前列腺癌的单因素预测比较,仅PSAD、tPSA预测价值较好[工作特征曲线下面积（areaunder ROC,AUC）〉0.7,P〈0.05];多因素分析中仅PSAD、穿刺活检Gleason评分为器官局限最主要的影响因素（P〈0.05）,AUC达0.8（P=0.000）。结论：PSAD比tPSA对病理分期显示了更好的预测价值,病理分期预测模型可考虑以PSAD替代tPSA,结合其他因素,有望提高预测准确度。     

Diagnostic Role of Serum Free-to-Total Prostate Specific Antigen (PSA) Ratio in Prostate Cancer with Serum Total Concentration of PSA below 4 ng/mL

Purpose: To examine the effectiveness of serum free-to-total prostate specific antigen ratio (%fPSA) forthe detection of prostate cancer (PCa) in men with different serum total PSA (tPSA) categories. Materials andMethods: From January 2010 to December 2013, a total of 225 patients with lower urinary tract symptoms(LUTS) underwent tPSA and %fPSA measurements. Histological examination with calculation of Gleasonscore and whole body bone scans were performed in identified cases of PCa. Results: PCa was diagnosed in 44(19.6%) patients and the remaining 181 patients had benign prostate disease. PCa was detected in 5 (23.8%),13 (8.7%) and 26 (47.3%) cases with tPSA level ranges ≤4 ng/ml, 4 to 10 ng/ml and >10 ng/ml, respectively. Theaverage Gleason score was 7.2±0.2. Some 6 (13.6%) out of 44 PCa patients had bone metastases. The sensitivitywas 80% and specificity was 81.3% at the cut-off %fPSA of 15% in PCa patients with a tPSA level below 4 ng/mL. A lower %fPSA was associated with PCa patients with Gleason score ≥7 than those with Gleason score≤6 (11.7±0.98 vs. 16.5±2.25%, P=0.029). No obvious relation of %fPSA to the incidence of bone metastasis wasapparent in this study. Conclusions: The clinical application of %fPSA could help to discriminate PCa frombenign prostate disease in men with a tPSA concentration below 4 ng/mL.     

Risk assessment for biochemical recurrence prior to radical prostatectomy: significant enhancement contributed by human glandular kallikrein 2 (hK2) and free prostate specific antigen (PSA) in men with moderate PSA-elevation in serum

Most models to predict biochemical recurrence (BCR) of prostate cancer use pretreatment serum prostate-specific antigen (PSA), clinical stage and prostate biopsy Gleason grade. We investigated whether human glandular kallikrein 2 (hK2) and free prostate-specific antigen (fPSA) measured in pretreatment serum enhance prediction. We retrospectively measured total PSA (tPSA), fPSA and hK2 in preoperative serum samples from 461 men with localized prostate cancer treated with radical prostatectomy between 1999 and 2001. We developed a regression model to predict BCR using preoperative tPSA, clinical stage and biopsy Gleason grade. We then compared the predictive accuracy of this "base" model with a model with fPSA and hK2 as additional predictors. BCR was observed in 90 patients (20%), including 48 patients with a pretreatment tPSA < or = 14 ng/ml (13%), and 28 patients (10%) with a pretreatment tPSA < or = 10 ng/ml. Overall, the predictive accuracy of the base model (bootstrap-corrected concordance index of 0.813) was not improved after the addition of fPSA or hK2 (0.818). However, for men with moderate tPSA-elevation (tPSA < or = 10 ng/ml), addition of fPSA and hK2 data increased predictive accuracy (from a base model concordance index of 0.756-0.815, p = 0.005). The improvement in accuracy was not sensitive to the threshold for "moderately elevated" PSA. For patients with a moderate tPSA-elevation (tPSA < or = 10 ng/ml), which closely corresponds to concurrent disease demographics, BCR-prediction was enhanced when fPSA and hK2 were added to the conventional model. Measurements of fPSA and hK2 improve on our ability to counsel patients prior to treatment as to their risk of BCR.     

复合PSA及相关指标在前列腺癌诊断中的应用

Objective:To study the diagnostic value of complex PSA(cPSA),the calculated free/total PSA(f/t PSA) raio and total PSA(tPSA)in the differentiation of prostate cancer from benign prostate hyperplasia.Methods:The tPSA,cPSA and fPSA were measured using the Bayer ACS-180 chemiluminescence immuno-assay.152 patients(21 with prostate cancer and 131 with benign prostate hyperplasia proven by tissue pathology)whose serum total PSA ranged from 0.2-20.0ng/ml were accessed from July 2001 to May 2002 consecutively.The correlation between tPSA and cPSA was analyzed.The re-ceiver operator characteristic curves(ROC curve)were generated by plotting the sensitivity versus specificity.Areas under the curve were calculated for each assay.Logistic regression analysis was used to evaluate the ability of the indices as independent varia-bles to predict prostate cancer.Results:In the experimental group,the areas under the ROC curve of cPSA ,tPSA and fPSA/tPSA ratio were 0.811,0.799 and 0.376 respectively.The specificity for tPSA,fPSA/tPSA ratio and cPSA were 62%,57% and 4.7%,respectively,at cotoff yield-ing 95% sensitivity.Serum cPSA concentration was determined to be the best index among the three through logistic regression analy-sis.Conclusion:The serum levels of cPSA and tPSA are better indices than f/tPSA in the differentiation of prostate cancer from benign prostate hyperplasia.At the same level of sensitivity,cPSA has a higher specificity than tPSA.Serum cPSA may be a better indicator in the prediction of prostate cancer of early stage.     

Comparative value of molecular forms of prostate-specific antigen in diagnosis of prostatic cancer

The aim of the study was to compare diagnostic significance of free PSA (fPSA)/total PSA (tPSA) versus PSA complex with alpha1-antichymotrypsin (cPSA) in tPSA level within 4-10 ng/ml in differential diagnosis of prostatic cancer (PC). A complete urological examination (digital rectal test, transrectal ultrasound investigation, serum assay for fPSA and tPSA, multifocal transperineal prostatic biopsy) was made in 108 patients with tPSA blood level 4-10 ng/ ml. Prostatic adenoma (PA) was histologically verified in 61 of 108 patients, fPSA/tPSA was normal. In the other 39 of 108 patients fPSA/tPSA was under 15% while cPSA was in the range 3.8-9.6 ng/ml. A course of etiotropic therapy of chronic prostatic inflammation produced no significant changes in fPSA/tPSA and cPSA in 28 out of 39 patients. Histologically, these 28 patients had PC. In the rest 11 of 39 patients chronic prostatitis treatment fPSA/tPSA significantly rose to 18.2%, on the average. CPSA decreased to 2.4 ng/ml. These 11 patients were found histologically to have PA and signs of chronic inflammation. In 8 of 108 patients fPSA/tPSA was not indicative of PC being 18,2% on the average while cPSA indicated the presence of PC and was 4.2 ng.ml, on the average. PC was verified histologically in these 8 patients. Thus, cPSA in PC suspects is more informative than fPSA/tPSA in PC diagnosis. CPSA in the serum depends on prostatic inflammation making difficult differential diagnosis of PC in interpretation of tPSA, fPSA/tPSA and cPSA. Therefore, estimation of PSA variants and molecular forms in PC suspects and prostatic inflammation should be made after etiotropic therapy.     

Bone scanning--who needs it among patients with newly diagnosed prostate cancer?

BACKGROUND: We evaluated the relationship between serum PSA and clinical variables to eliminate bone scanning in patients with prostate cancer having a low probability of bone metastasis. METHODS: The study included 366 patients with newly diagnosed prostate cancer between 1999 and 2005. Bone metastasis was studied for its correlation with various clinical and pathological variables in these patients. RESULTS: Bone metastasis was found in 28 (7.7%) of 366 patients. Fourteen patients had skeletal symptoms related to bone metastasis. The risk for bone metastases increased considerably with increases of PSA level, clinical T stage and Gleason score. The metastasis was not found in 161 patients with serum PSA concentration of 10 ng/ml or lower. In 95 patients with the concentration between 10 and 20 ng/ml only two had the metastasis. These two patients had T2 disease and Gleason scores of 7 or greater. In 204 patients with clinical stage T1 disease, one (0.5%) had the metastasis. In 117 patients with Gleason scores of 6 or less, the metastasis was found in two (1.7%). CONCLUSIONS: For patients with serum PSA levels of 10 ng/ml or lower, bone scanning may be eliminated because of the negligible risk of bone metastases. In addition, scanning may not be necessary for those with PSA levels between 10 and 20 ng/ml, when they have T1 disease and Gleason scores of 6 or lower.     

Clinical usefulness of free PSA in early detection of prostate cancer.

OBJECTIVE: Measurement of serum prostate-specific antigen (PSA) is widely used as an aid in early detection of prostate cancer. Most patients with prostate cancer and a PSA level less than 10.0 ng/ml have early-stage disease. Thus, the detection of prostate cancer in its potentially curable stages requires the use of low PSA cutoffs, inevitably leading to many unnecessary biopsies. The combined use of free PSA and total PSA increases specificity of early detection. To develop risk assessment guidelines and a cutoff value of ratio of free (f) to total (t) PSA with a high predictive value for prostate cancer in men to whom the test would be applied in real life practice, a multicenter early detection trial was initiated. PATIENTS AND METHODS: In one week in November 1997, 963 urologists prospectively examined 11,644 men between 45 and 75 years by digital rectal examination (DRE) and prostate-specific antigen with 4.0 ng/ml as cutoff. Data of physical examination were collected by questionnaire. At this time participants were not aware of their PSA values. Suspicious findings were further investigated with sextant biopsy. Prostate volume was determined with transrectal ultrasound (TRUS). Different cutoff levels were correlated to age and detection rate. RESULTS: From1,115 biopsied men, the data of 633 men fulfilled the criteria DRE-negative, TRUS-estimated volume, and PSA 4.0-10.0 ng/ml. In that cohort 91 cancers were detected. Percentage of fPSA was significantly more predictive of cancer than tPSA (p < 0.001). The area under the ROC curve was 0.72 for percent fPSA (% fPSA) and 0.62 for total PSA. The cancer risk nearly doubled using a cutoff of 10% fPSA, the median %PSA level of the detected cancers. A better discrimination of cancer and noncancer especially in the age group above 70 years is possible. Using a cutoff of 16% fPSA increases positive predictive value (PPV) to 25% missing only 4% of cancers. Nearly 45% of the biopsies could be avoided. In the age group 45-69 years, a cutoff of 20% fPSA leads to PPV of 15%, missing 6% of cancers. Unnecessary biopsies could be avoided in 12%. CONCLUSIONS: Using % fPSA in early detection of prostate cancer reduces the number of unnecessary biopsies, especially in men with negative rectal examination in the PSA range of 4.0-10.0 ng/ml. In order to diminish biopsy rate in men 70 years or older a cutoff of 16% fPSA should be used. A cutoff of 20% fPSA in men younger than 70 years is recommended to increase sensitivity in that age group.     

比卡鲁胺联合戈舍瑞林间断性治疗前列腺癌临床研究

目的:观察比卡鲁胺联合戈舍瑞林间断性治疗对前列腺癌患者血清PSA、f-PSA的影响,及对排尿梗阻症状、骨转移灶和骨痛感的疗效。方法:将本院2005年7月-2012年7月收治的前列腺癌患者84例分为手术去势组20例,持续药物去势组32例和间歇药物去势组32例。手术去势组病例行双侧睾丸切除术,并口服比卡鲁胺治疗,持续药物去势组予比卡鲁胺合戈舍瑞林治疗,间歇药物去势组给药同持续药物去势组,当患者血清PSA值降至0.2ng/ml以下时停止给药,PSA值重新升至4ng/ml以上时,再给药治疗。分别在治疗前、治疗后1、3、6、12个月时观察三组患者的血清PSA、f-PSA变化,及有排尿梗阻症状、骨转移灶和骨痛感患者的变化。结果:三组患者治疗后血清PSA、f-PSA值较本组治疗前均有明显下降（P＜0.01）。三组治疗后血清PSA、f-PSA值同时间组间比较无显著差异（P＞0.05）。三组治疗后有自觉排尿梗阻症状、有骨转移灶及有骨痛感的患者数较本组治疗前均有明显减少（P＜0.05）。结论:比卡鲁胺联合戈舍瑞林间断性疗法对前列腺癌的控制治疗可与持续疗法和手术去势疗法收到同样疗效。     

Population-based screening for prostate cancer by measuring free and total serum prostate-specific antigen in Iran.

PURPOSE: To evaluate the natural background of prostate cancer in Iran a large population-based study of screening using total prostate-specific antigen (tPSA) and per cent free PSA (fPSA) as the initial test was performed. MATERIALS AND METHODS: For 9 years (1996 to 2004) in Tehran, Iran, 3670 Iranian men older than 40 years were mass checked by PSA-based screening. They were invited to have a digital rectal examination (DRE), serum PSA assay and transrectal ultrasonography (TRUS)-guided sextant prostate biopsy to see if the DRE was clinically suspicious of malignancy, the serum PSA was > or =2.1 ng/ml or free-to-total PSA (f/tPSA) ratio < or=15%. RESULTS: In 433 (11.8%) of screened males, tPSA levels exceeded the cut-off value of > or =2.1 ng/ml and 128 prostate cancers were diagnosed [positive predictive value (PPV) 29.6%] corresponding to an overall detection rate of 3.5%. Altogether 138 cancers were detected (detection rate 3.8%); none were stage M(1), three were stage N(+) and 4 stage T(3). A threshold tPSA of > or =2.1 ng/ml would have detected 128 cancers in 447 biopsied men (PPV 29%). There were 109 of 138 (79%) men with cancer who had an f/tPSA of < or =15%, while 152 of 305 (49.8%) with benign biopsies had a f/tPSA of < or =15%, which corresponds to a PPV of 30.8%. CONCLUSION: PSA-based screening with low PSA cut-off values increase the detection rate of clinically significant, organ confined and potentially curable prostate cancer. Further studies are warranted in order to determine the incidence and prevalence of prostate cancer in different ethnic groups.     

A new Model Consists of Intravesical Prostatic Protrusion,Prostate Volume and Serum Prostatic-Specific Antigen in the Evaluation of Prostate Cancer

The Prostate-specific antigen (PSA) level is largely used to diagnose prostate cancer (PCa) in last decades. However, its specificity is low in patients with a PSA level ranging from 4.0 to 10.0 ng/ml. This study aims to define the correlation between intravesical prostatic protrusion (IPP) and PSA and to establish a new model to predict PCa. A total of 339 patients order than 45 years examined between October 2010 and June 2012 were enrolled. Eligible patients were recommended for transrectal ultrasonography (TRUS)-guided prostate biopsies after measuring total prostate volume (TPV), tranzisional zone volume (TZV) and IPP. The levels of total PSA (tPSA), free PSA (fPSA) were analyzed by using Hybritech calibrated Access tPSA and fPSA assays. A new mathematical model, named IPP removed PCa predicting score (IRPPS), consists of tPSA, TZV and IPP was established. The predictive accuracy of IRPPS, PSA density (PSAD), %PSA and tPSA were compared using receiver-operator characteristic (ROC) analysis. Eighty-six patients had PSA levels of 4.0–10.0 ng/ml. Twenty of them were diagnosed as PCa. Using ROC curves, the areas under the curve for IRPPS, PSAD and %PSA and tPSA were 0.786, 0.768 and 0.664 and 0.585, respectively. We suggested IPP grade had a significant relationship with serum tPSA levels. The predictive accuracy of IRPPS was higher than the other 3 indictors.