期刊
EUROPEAN UROLOGY
卷 49, 期 3, 页码 460-465出版社
ELSEVIER SCIENCE BV
DOI: 10.1016/j.eururo.2005.12.026
关键词
prostate cancer; screening; PSA; PSA velocity; tumour aggressiveness
PSA-driven screening has been applied to a large part of the male population in many countries. An elevated PSA in secondary screens may indicate benign enlargement of the prostate rather than prostate cancer. in such cases the yearly rate of increase of PSA (PSA velocity [PSAV]) may improve the test characteristics of PSA. Materials and Methods: Data from the European Randomized Study of Screening for Prostate Cancer Rotterdam are used to study the issue. Relative sensitivity, relative specificity, and positive predictive value (PPV) are calculated. Logistic regression analysis is used to compare odds ratios for positive biopsies. The relationship between PSAV and parameters of tumour aggressiveness is investigated. Results: Five hundred eighty-eight consecutive participants were identified who presented at their first screening with PSA,values < 4.0 and who progressed to PSA values > 4.0 ng/ml four years later. None were biopsied in round one, all were biopsied in round two. Relative sensitivity and specificity depend strongly on PSAV cut-offs of 0.25-1.0 ng/ml/yr. The use of PSAV cut-offs does not improve the PPV of the PSA cut-off of 4.0 ng/ml, nor do any of the PSAV cut-offs improve the odds ratio for identifying prostate cancer with respect to the cut-off value of 4.0 ng/ml. The rate of aggressive cancers seems to increase with increasing PSAV. Conclusions: PSAV does not improve the detection characteristics of a PSA cut-off of 4.0 ng/ml in secondary screening after four years. (c) 2006 Elsevier B.V. All rights reserved.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据