Establishment of two new predictive models for prostate cancer to determine whether to require prostate biopsy when the PSA level is in the diagnostic gray zone (4-10 ng ml-1) / 亚洲男科学杂志(英文版)

Our goal was to establish two new predictive models of prostate cancer to determine whether to require a prostate biopsy when the prostate-specific antigen level is in the diagnostic gray zone. A retrospective analysis of 197 patients undergoing prostate biopsy with prostate-specific antigens between 4 and 10 ng ml-1 was conducted. Of these, 47 patients were confirmed to have cancer, while the remaining 150 patients were diagnosed with benign prostate disease after examining biopsy pathology. Two multivariate logistic regression models were established including age, prostate volumes, free/total prostate-specific antigen ratio, and prostate-specific antigen density using SPSS 19.0 to obtain the predicted probability and Logit P, and then, two receiver operating characteristic (ROC) curves were drawn to obtain the best cutoff value for prostate biopsy: one for the group of all the prostate cancers and one for the group of clinically significant prostate cancers. The best cutoff value for prostate biopsy was 0.25 from the multivariate logistic regression ROC curve model of all the prostate cancers, which gave a sensitivity of 75.4% and a specificity of 75.8%. The best cutoff value for prostate biopsy was 0.20 from the multivariate logistic regression model of clinically significant prostate cancers, which gave a sensitivity of 76.7% and a specificity of 80.1%. We identified the best cutoff values for prostate biopsy (0.25 for all prostate cancers and 0.20 for clinically significant prostate cancers) to determine whether to require prostate biopsy when the PSA level is in the diagnostic gray zone.

Prostate Cancer Prevention Trial risk calculator for evaluating the risk of prostate cancer in the high-risk Chinese population / 中华男科学杂志

Objective@#The Prostate Cancer Prevention Trial risk calculator (PCPT-RC) is an online tool for assessing the risk of prostate cancer (PCa) based on age, race, serum PSA, biopsy history, family history, and other factors. This study aimed to investigate the value, sensitivity and specificity of the PCPT-RC 2.0 in assessing the risk of PCa in the Chinese high-risk population.@*METHODS@#This study included 622 patients with the high risk of PCa characterized by high serum PSA (PSA >3 μg/L) or abnormality in digital rectal examination or imaging of the prostate. According to the results of prostate biopsy, we divided the patients into a PCa and a non-PCa group and used the PCPT-RC 2.0 for evaluation of all the cases followed by statistical analysis.@*RESULTS@#PCa was detected in 264 (42.4%) of the 622 patients, including 126 cases of high-grade malignancy. Compared with the non-PCa group, the PCa patients showed a significantly older age (［68.40 ± 7.30］ vs ［72.80 ± 7.20］ yr, P 0.05).@*CONCLUSIONS@#The PCPT risk score is valuable in predicting the risk of PCa in China, which may play a better role than the serum PSA level in screening PCa and avoid unnecessary prostate biopsy, though its advantage is not so obvious in identifying high-grade malignancy. A prediction tool needs to be established for evaluating the risk of PCa in the Chinese population.

Quantitative analysis by real-time elastosonography for the differential diagnosis of azoospermia: preliminary application / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the quantitative analysis by real-time elastosonography in the differential diagnosis of obstructive azoospermia (OA) and non-obstructive azoospermia (NOA).</p><p><b>METHODS</b>We evaluated the elastosonographic images of 200 cases of OA, 300 cases of NOA and 100 normal healthy controls, calculated the strain ratio of the testis to the scrotal skin and the median strain ratio among the three groups, and analyzed the best cut-off point for differentiating OA and NOA by the receiver operation characteristic (ROC) curve.</p><p><b>RESULTS</b>The median strain ratio of NOA was 0.49 +/- 0.43, while that of OA was 0.35 +/- 0.31, with significant difference between the two groups (Z = - 19.173, P = 0.000 < 0.017). According to the results of ROC curve analysis, the area under the curve was 0.857 +/- 0.012 and the best cut-off point for differentiating OA and NOA was 0.395 (sensitivity = 84.5%, specificity = 74.5%, accuracy = 80.5%).</p><p><b>CONCLUSION</b>Quantitative analysis by real-time elastosonography is a new valuable technique for the differential diagnosis of azoospermia.</p>

Ultrasonographic features of epididymides in obstructive azoospermia / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the ultrasonographic features of epididymides in congenital obstructive azoospermia (COA) and acquired obstructive azoospermia (AOA).</p><p><b>METHODS</b>A total of 211 infertile men with obstructive azoospermia were observed by scrotal ultrasonography, and the features of the epididymal ultrasonograms were compared between COA and AOA.</p><p><b>RESULTS</b>COA exhibited significantly higher rates of ectasia in the epididymal head, cord-like changes, abrupt tapering and absence of the epididymal body and tail than AOA (P < 0.05), while AOA showed markedly higher rates of epididymal body and tail duct ectasia and epididymal inflammatory mass than COA (P < 0.01). Tubular ectasia of the epididymal duct in the head, body and tail were markedly higher in the COA (14 [5.9%], 41 [17.2%] and 20 [8.4%] cases in 236 epididymides) than in the AOA (P < 0.05). Retiform ectasia were markedly higher in the AOA (119 [64.0%], 142 [76.3%] and 109 [58.6%] cases in 186 epididymides) than in the COA (P < 0.05), with statistically significant differences between the two groups (P < 0.05). Ultrasonographically, the epididymides of the COA patients were characterized by irregular ectasia of the epididymal tube with decreased and unclear wall echoes (P < 0.05), and those of the AOA patients by regular ectasia with enhanced wall echoes (P < 0.01).</p><p><b>CONCLUSION</b>The ultrasonographic epididymal features of COA are obviously different from those of AOA, which is of important clinical application value for distinguishing the two conditions from each other.</p>