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【Objective】 To explore the application value of free prostate specific antigen density(fPSAD) based on rectal ultrasound in the prediction of prostate biopsy results. 【Methods】 Data of 578 patients undergoing transrectal ultrasound guided prostate biopsy during Jan.2014 and Jul.2021 were retrospectively analyzed, including prostate specific antigen(PSA) level, free prostate specific antigen(fPSA) level, fPSA/total prostate specific antigen(tPSA), prostate specific antigen density(PSAD), combined prostate specific antigen density(cPSAD), fPSAD, prostate volume and other clinical parameters. 【Results】 There were 253 cases of prostate cancer and 325 cases of prostatic hyperplasia. The positive puncture rate was 43.8%. The critical value of fPSAD was 0.05, the corresponding area under receiver operating characteristic (ROC) curve was 0.830, and the Yoeden index was 0.539. The sensitivity, specificity, diagnosis accordance rate and Kappa value of fPSAD to predict prostate cancer were 0.76, 0.77, 76.7% and 0.529, respectively. Compared with PSA, fPSA/tPSA and PSAD, PSA had the highest sensitivity (92.5%), fPSAD had the highest specificity (77.2%), and fPSAD had the highest diagnostic accordance rate (76.7%). 【Conclusion】 When transrectal prostate volume measurement is used to predict prostate cancer, fPSAD has relatively high specificity and diagnosis accordance rate, which is obviously better than using PSA, fPSA/tPSA ratio and PSAD alone in the differential diagnosis and prediction of prostate cancer and prostatic hyperplasia.
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A standard modality for prostate cancer detection in men 75 years and older has not been established. A simple screening method for elderly patients is needed to avoid unnecessary biopsies and to effectively diagnose prostate cancer. A retrospective study was conducted on elderly patients who had prostate biopsy at Kanazawa University Hospital (Kanazawa, Japan) between 2000 and 2017. Of the 2251 patients who underwent prostate biopsy, 254 had clinically significant prostate cancer (CSPC) with a Gleason score (GS) of≥7 and 273 had a GS of <7 or no malignancy. In this study, patients aged 75 years or older were classified as elderly patients. GS ≥ 7 was characterized by a prostate-specific antigen (PSA) of the maximum area under the curve of 12 ng ml
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Objective To investigate the clinical value of serum lipoprotein associated phospholipase A 2 (Lp-PLA2)as a biomarker for benign prostatic hyperplasia(BPH).Methods A total of 65 serum samples of BPH patients were selected as BPH group,64 serum samples of healthy male as control group.The serum lev-el of Lp-PLA2,total prostate specific antigen(tPSA)and free prostate specific antigen(fPSA)in both groups were detected,and the specificity and sensitivity of Lp-PLA2,F/T ratio and combine both were analyzed by ROC curve.Results The serum level of Lp-PLA2,tPSA and fPSA in BPH group were significantly higher than those in control group,the different were significant(P<0.05).ROC curve analyze shown that the area under the curve(AUC)of Lp-PLA2 was 0.763,95% confidence interval(CI)was 0.680-0.833;AUC of F/T ratio was 0.715,95% CI 0.633 -0.795;AUC of Lp-PLA2 combined with F/T ratio was 0.832,95% CI 0.756-0.892.Conclusion The serum level of Lp-PLA2 could be used as a potential diagnostic marker for BPH,and the diagnostic value of Lp-PLA2 combined with F/T ratio was better than ther single indicator. Key words:benign prostatic hyperplasia; lipoprotein associated phospholipase A 2; total prostate spe-cific antigen; free prostate specific antigen; F/T ratio
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Objective To explore the clinical value of combined application of bone imaging and prostate specific antigen(t -PSA),free prostate specific antigen(f -PSA)and alkaline phosphatase(ALP)in the diagnosis and treatment of prostate cancer bone metastasis.Methods The data of 372 patients diagnosed of prostate cancer were reviewed,and the results of the whole body bone scan and t -PSA,f -PSA,ALP were analyzed retrospectively. Results 282 cases in 372 cases of prostate cancer were diagnosed as bone metastasis.The t -PSA,f -PSA and ALP of prostate cancer patients with metastasis were significantly higher than those of prostate cancer patients without metastasis,the difference was statistically significant (P <0.05).The sensitivity of bone imaging in the diagnosis of bone metastases was 91.84%,the specificity was 76.67%,the accuracy was 88.17%,the positive predictive value was 92.50%,the negative predictive value was 75.00%.The combined application of bone scan and serum t -PSA, f -PSA,ALP detection,the sensitivity of the diagnosis of bone metastasis of prostate cancer was 95.71%,specificity was 87.69%,accuracy was 94.36%,the positive predictive value was 87.56%,the negative predictive value was 92.22%.Conclusion Combined application of whole body bone scan and serum t -PSA,f -PSA,ALP detection has high sensitivity and accuracy in diagnosis of bone metastasis of prostate cancer,and it can provide reliable basis for early diagnosis,treatment and prognosis of prostate cancer.
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Resumen: El cáncer de próstata es una enfermedad clínicamente caracterizada por un periodode latencia largo y un crecimiento tumoral lento. En la actualidad, es un problema de granimportancia para la salud pública, pues es el segundo cáncer más frecuentemente diagnosticadoy corresponde a la sexta causa de muerte por cáncer en hombres en el mundo. Se caracteriza poruna gran heterogeneidad clínica y molecular. Su diagnóstico se basa en el uso de tres pruebasfundamentales: el examen del tacto rectal y la medición de los niveles séricos del antígenoespecífico de próstata (AEP), los cuales se usan frecuentemente en el tamizaje, y la biopsiaprostática, mediante la cual se confirma el diagnóstico de cáncer de próstata. Actualmente, el AEPse ha constituido en la principal herramienta tamiz para el cáncer de próstata; no obstante, existeuna gran controversia en torno a su uso. Por ello, están siendo ampliamente estudiados nuevosbiomarcadores, a fin de disponer de pruebas diagnósticas más sensibles y específicas. Dado queel AEP es una prueba ampliamente utilizada internacionalmente y que han surgido biomarcadoresadicionales para el diagnóstico temprano del cáncer de próstata, es de fundamental importanciaque el personal de la salud en general y el personal de laboratorio en particular puedan contarcon información con respecto al uso de éstas y su relación con otras herramientas diagnósticas,además de otros aspectos generales del cáncer de próstata.
Abstract: Prostate cancer is a disease clinically characterized by a long latency period and slow tumorgrowth rate. Prostate cancer is currently a major public health problem because it is the second mostcommonly diagnosed cancer, and the sixth major cause of cancer-related death in men in the world.It is characterized by clinical and molecular heterogeneity. Diagnosis is based on the use of threebasic tests: digital rectal examination, measurement of prostate-specific antigen (PSA) serum levels,frequently used in screening, and prostate biopsy, which confirms the diagnosis of prostate cancer.Nowadays, PSA has become the main testing way for prostate cancer screening, although there ismuch controversy about its use. Therefore, new biomarkers are being widely researched, in order toprovide more sensitive and more specific diagnostic tests. Provided that PSA is a globally used test,and additional tests for early diagnosis of prostate cancer have aroused, is it essential that healthpersonnel, and particularly laboratory personnel, are granted with information about their use, andtheir relationship with further diagnostic techniques, besides other general aspects of prostate cancer.
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Humans , Biopsy , Prostate , Prostatic NeoplasmsABSTRACT
A cross sectional pilot study was carried out to look into the usefulness of percent free prostate specific antigen (fPSA) in the diagnosis of prostatic cancer in HUSM patients. All patients who attended surgical clinic and admitted to surgical wards with signs and symptoms of prostate problems during the study period were taken as the study subjects. Total prostate specific antigen (tPSA) was estimated by immunoassay technique and those values of 4 ng/mL or more were proceeded for estimation of fPSA. Using the cut-off value of less than 25% fPSA for diagnosing patients with prostate cancer, our study showed that majority of the prostate cancer patients have a ratio of fPSA:tPSA more than 25% and a significantly higher level of total prostate specific antigen (P<0.005) when compared with patients with benign prostatic hyperplasia (BPH). Unexpectedly, the fPSA values were high in patients diagnosed as prostate cancer compared to BPH. Ratio of percent fPSA to tPSA was found not to be sensitive and specific, in diagnosing prostate cancer at the cut-off value of 25%. In conclusion, total PSA is a more useful biochemical test for diagnosing prostate cancer in our patients.