We investigated the prostate cancer detection rates upon transrectal ultrasound(TRUS)-guided biopsy in relation to digital rectal examination(DRE)and prostate-specific antigen(PSA),and risk factors of prostate cancer ...We investigated the prostate cancer detection rates upon transrectal ultrasound(TRUS)-guided biopsy in relation to digital rectal examination(DRE)and prostate-specific antigen(PSA),and risk factors of prostate cancer detection in the Chinese population.Data from all consecutive Chinese men who underwent first TRUS-guided prostate biopsy from year 2000 to 2013 was retrieved from our database.The prostate cancer detection rates with reference to DRE finding and PSA level of〈4,4-10,10.1-20,20.1-50 and〉50 ng ml^-1 were investigated.Multivariate logistic regression analyses were performed to investigate for potential risk factors of prostate cancer detection.A total of 2606 Chinese men were included.In patients with normal DRE,the cancer detection rates were 8.6%,13.4%,21.8%,41.7%and 85.2%in patients with PSA〈4,4-10,10.1-20,20.1-50 and〉50 ng ml^-1 respectively.In patients with abnormal DRE,the cancer detection rates were 12.4%,30.2%,52.7%,80.6%and 96.4%in patients with PSA〈4,4-10,10.1-20,20.1-50 and〉50 ng m1-1 respectively.Older age,smaller prostate volume,larger number of biopsy cores,presence of abnormal DRE finding and higher PSA level were associated with increased risk of prostate cancer detection upon multivariate logistic regression analyses(P〈0.001).Chinese men appeared to have lower prostate cancer detection rates when compared to the Western population.Taking the different risk factors into account,an individualized approach to the decision of TRUS-guided biopsy can be adopted.展开更多
We investigated the performance characteristics of prostate-specific antigen (PSA) and PSA density (PSAD) in Chinese men. All Chinese men who underwent transrectal ultrasound-guided prostate biopsy (TRUS-PB) fro...We investigated the performance characteristics of prostate-specific antigen (PSA) and PSA density (PSAD) in Chinese men. All Chinese men who underwent transrectal ultrasound-guided prostate biopsy (TRUS-PB) from year 2000 to 2013 were included. The receiver operating characteristic (ROC) curves for both PSA and PSAD were analyzed. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) at different cut-off levels were calculated. A total of 2606 Chinese men were included. For the ROC, the area under curve was 0.770 for PSA (P〈 0.001) and 0.823 for PSAD (P〈 0.001). PSA of 4.5 ng ml^-1 had sensitivity of 94.4%, specificity of 14.1%, PPV of 29.5%, and NPV of 86.9%; PSAD of 0.12 ng ml^-1cc^-1 had sensitivity of 94.5%, specificity of 26.6%, PPV of 32.8%, and NPV of 92.7%. On multivariate logistic regression analyses, PSA cut-off at 4.5 ng ml^-1 (OR 1.61, 95% CI 1.05-2.45, P = 0.029) and PSAD cut-off at 0.12 ng ml^-1 cc^-1 (OR 6.22, 95% CI 4.20-9.22, P 〈 0.001) were significant predictors for prostate cancer detection on TRUS-PB. In conclusion, the performances of PSA and PSAD at different cut-off levels in Chinese men were very different from those in Caucasians. PSA of 4.5 ng ml^-1 and PSAD of O. 12 ng ml^-1 cc^-1 had near 95% sensitivity and were significant predictors of prostate cancer detection in Chinese men.展开更多
Dear Editor, The current standard 12-core systematic transrectal ultrasound (TRUS)-guided biopsy in prostate cancer diagnosis has the disadvantages of overdetecting indolent tumors, while failing to identify clinica...Dear Editor, The current standard 12-core systematic transrectal ultrasound (TRUS)-guided biopsy in prostate cancer diagnosis has the disadvantages of overdetecting indolent tumors, while failing to identify clinically significant cancers in up to 35%.1 Advances in imaging techniques, notably the multiparametric magnetic resonance imaging (mpMRI), allow clinically significant prostate cancers to be detected with more precise localization) Fusion of MRI and real-time TRUS enables targeted biopsy of suspicious lesions, overcoming human error, and inability of biopsy site tracking in cognitive fusion? Multiple Western series have suggested a higher detection rate, higher specificity, and better risk stratification with fusion biopsy.展开更多
摘要We investigated the prostate cancer detection rates upon transrectal ultrasound(TRUS)-guided biopsy in relation to digital rectal examination(DRE)and prostate-specific antigen(PSA),and risk factors of prostate cancer detection in the Chinese population.Data from all consecutive Chinese men who underwent first TRUS-guided prostate biopsy from year 2000 to 2013 was retrieved from our database.The prostate cancer detection rates with reference to DRE finding and PSA level of〈4,4-10,10.1-20,20.1-50 and〉50 ng ml^-1 were investigated.Multivariate logistic regression analyses were performed to investigate for potential risk factors of prostate cancer detection.A total of 2606 Chinese men were included.In patients with normal DRE,the cancer detection rates were 8.6%,13.4%,21.8%,41.7%and 85.2%in patients with PSA〈4,4-10,10.1-20,20.1-50 and〉50 ng ml^-1 respectively.In patients with abnormal DRE,the cancer detection rates were 12.4%,30.2%,52.7%,80.6%and 96.4%in patients with PSA〈4,4-10,10.1-20,20.1-50 and〉50 ng m1-1 respectively.Older age,smaller prostate volume,larger number of biopsy cores,presence of abnormal DRE finding and higher PSA level were associated with increased risk of prostate cancer detection upon multivariate logistic regression analyses(P〈0.001).Chinese men appeared to have lower prostate cancer detection rates when compared to the Western population.Taking the different risk factors into account,an individualized approach to the decision of TRUS-guided biopsy can be adopted.
摘要We investigated the performance characteristics of prostate-specific antigen (PSA) and PSA density (PSAD) in Chinese men. All Chinese men who underwent transrectal ultrasound-guided prostate biopsy (TRUS-PB) from year 2000 to 2013 were included. The receiver operating characteristic (ROC) curves for both PSA and PSAD were analyzed. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) at different cut-off levels were calculated. A total of 2606 Chinese men were included. For the ROC, the area under curve was 0.770 for PSA (P〈 0.001) and 0.823 for PSAD (P〈 0.001). PSA of 4.5 ng ml^-1 had sensitivity of 94.4%, specificity of 14.1%, PPV of 29.5%, and NPV of 86.9%; PSAD of 0.12 ng ml^-1cc^-1 had sensitivity of 94.5%, specificity of 26.6%, PPV of 32.8%, and NPV of 92.7%. On multivariate logistic regression analyses, PSA cut-off at 4.5 ng ml^-1 (OR 1.61, 95% CI 1.05-2.45, P = 0.029) and PSAD cut-off at 0.12 ng ml^-1 cc^-1 (OR 6.22, 95% CI 4.20-9.22, P 〈 0.001) were significant predictors for prostate cancer detection on TRUS-PB. In conclusion, the performances of PSA and PSAD at different cut-off levels in Chinese men were very different from those in Caucasians. PSA of 4.5 ng ml^-1 and PSAD of O. 12 ng ml^-1 cc^-1 had near 95% sensitivity and were significant predictors of prostate cancer detection in Chinese men.
摘要Dear Editor, The current standard 12-core systematic transrectal ultrasound (TRUS)-guided biopsy in prostate cancer diagnosis has the disadvantages of overdetecting indolent tumors, while failing to identify clinically significant cancers in up to 35%.1 Advances in imaging techniques, notably the multiparametric magnetic resonance imaging (mpMRI), allow clinically significant prostate cancers to be detected with more precise localization) Fusion of MRI and real-time TRUS enables targeted biopsy of suspicious lesions, overcoming human error, and inability of biopsy site tracking in cognitive fusion? Multiple Western series have suggested a higher detection rate, higher specificity, and better risk stratification with fusion biopsy.