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Lin HY, Zhu X, Aucoin AJ, Fu Q, Park JY, Tseng TS. Dietary and Serum Antioxidants Associated with Prostate-Specific Antigen for Middle-Aged and Older Men. Nutrients 2023; 15:3298. [PMID: 37571238 PMCID: PMC10420876 DOI: 10.3390/nu15153298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 07/22/2023] [Accepted: 07/22/2023] [Indexed: 08/13/2023] Open
Abstract
High prostate-specific antigen (PSA) levels can indicate potential prostate problems and are a warning sign of prostate cancer. The impact of antioxidants on the PSA of generally healthy men is understudied. This study aims to evaluate 14 dietary and endogenous antioxidants associated with PSA levels for United States (US) men. We assessed 7398 men using the 2003-2010 US population-based National Health and Nutrition Examination Survey (NHANES). The PSA levels were categorized into three groups: Normal, borderline, and elevated levels. We performed analyses for middle-aged and older groups aged 40-64.9 and ≥65, respectively. The weighted multinomial regressions were performed to evaluate antioxidants associated with the PSA status. For results, 0.3% and 3.4% of middle-aged and older men, respectively, had elevated PSA (>10 ng/mL). Men with a higher serum albumin level had a lower risk of an elevated PSA, adjusting for age. The magnitude of albumin's impact on PSA is larger in middle-aged men than in older men (OR of elevated PSA = 0.82 and 0.90, respectively, interaction p = 0.002). Other antioxidants are not associated with PSA. Our findings support men with low serum albumin tend to have an elevated PSA level, so related interventions can be considered to decrease PSA for maintaining prostate health.
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Affiliation(s)
- Hui-Yi Lin
- Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Xiaodan Zhu
- Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Alise J. Aucoin
- School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA;
| | - Qiufan Fu
- Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Jong Y. Park
- Department of Cancer Epidemiology, Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA;
| | - Tung-Sung Tseng
- Behavior and Community Health Sciences Program, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA;
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Tsai TH, Chu TW, Lin TH, Hsieh TF, Chen CC, Liu HH, Chuang YC, Lin CW, Lee SS. Ethnic differences in the age-related distribution of serum prostate-specific antigen values: A study in a Taiwanese male population. PLoS One 2023; 18:e0283040. [PMID: 36928100 PMCID: PMC10019637 DOI: 10.1371/journal.pone.0283040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 03/01/2023] [Indexed: 03/18/2023] Open
Abstract
This study investigates age-specific prostate-specific antigen (PSA) distributions in Taiwanese men and recommends reference ranges for this population after comparison with other studies. From January 1999 to December 2016, a total of 213,986 Taiwanese men aged above 19 years old without history of prostate cancer, urinary tract infection, or prostate infection were recruited from the Taiwan MJ cohort, an ongoing prospective cohort of health examinations conducted by the MJ Health Screening Center in Taiwan. Participants were divided into seven age groups. Simple descriptive statistical analyses were carried out and quartiles and 95th percentiles were calculated for each group as reference ranges for serum PSA in screening for prostate cancer in Taiwanese men. Serum PSA concentration correlated with age (r = 0.274, p<0.001). The median serum PSA concentration (5th to 95th percentile) ranged from 0.7 ng/ml (0.3 to 1.8) for men 20-29 years old (n = 6,382) to 1.6 ng/ml (0.4 to 8.4) for men over 79 years old (n = 504). The age-specific PSA reference ranges are as follows: 20-29 years, 1.80 ng/ml; 30-39 years, 1.80 ng/ml; 40-49 years, 2.0 ng/ml; 50-59 years, 3.20 ng/ml; 60-69 years, 5.60 ng/ml; 70-79 years, 7.40 ng/ml; over 80 years, 8.40 ng/ml. Almost no change occurred in the median serum PSA value in men 50 years old or younger, while a gradual increase was observed in men over 50. Taiwanese men aged 60 years above showed higher 95th percentile serum PSA values compared to Caucasian men and men in other Asian countries but were closer to those of Asian American and African American men. Results indicate significantly different PSA levels correlating to different ethnicities, suggesting that Oesterling's age-specific PSA reference ranges might not be appropriate for Taiwanese men. Our results should be further studied to validate the age-specific PSA reference ranges for Taiwanese men presented in this study.
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Affiliation(s)
- Tsung-Hsun Tsai
- Department of Urology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
- School of Medicine, Tzu Chi University, Hualian, Taiwan
| | - Ta-Wei Chu
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- MJ Health Screening Center, Taipei, Taiwan
| | - Tien-Huang Lin
- Department of Urology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
- School of Medicine, Tzu Chi University, Hualian, Taiwan
| | - Teng-Fu Hsieh
- Department of Urology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
- School of Medicine, Tzu Chi University, Hualian, Taiwan
| | - Chi-Cheng Chen
- Department of Urology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
- School of Medicine, Tzu Chi University, Hualian, Taiwan
| | - Hsin-Ho Liu
- Department of Urology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | | | | | - Shang-Sen Lee
- Department of Urology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
- School of Medicine, Tzu Chi University, Hualian, Taiwan
- Department of Urology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- * E-mail:
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Age-Adjusted Reference Values for Prostate Specific Antigen - A Systematic Review and Meta-Analysis. Clin Genitourin Cancer 2021; 20:e114-e125. [PMID: 34969631 DOI: 10.1016/j.clgc.2021.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 11/26/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To systematically evaluates the evidence on ethnic differences in age-adjusted reference values of PSA. MATERIALS AND METHODS In concordance with the Preferred Reporting Items for Systematic Review and Meta-analysis statement, a review of English articles using Medline, Embase and Cochrane databases, from inception to December 2019 was conducted. Studies that reported the PSA upper reference value as 95th percentile of the cohort distribution, in healthy men aged 40 to 79, were included. Methodological quality was assessed with a modified version of the Agency for Healthcare Research and Quality checklist for cross-sectional studies. RESULTS Forty-three studies examining 325,514 participants were included in the analysis. These were published between 1993 and 2018. Majority were prospective observational studies and reported the reference values in ten-year age intervals. Only five reports directly compared ethnic differences in PSA values. Due to missing data, six studies were not considered in the quantitative synthesis. For the remainder (37/43), heterogeneity in PSA reference values was considerable (Higgin's index = 99.2%), with age and ethnicity being the sole identified significant contributors. Accordingly, the pooled upper limits for PSA reference values were 2.1, 3.2, 4.9 and 6.5 ng/ml for men in their 40 s, 50 s, 60 s, and 70 s, respectively. CONCLUSION Moderate quality evidence suggest that upper PSA reference limits increased with age and significant ethnic differences were present.
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Okuja M, Ameda F, Dabanja H, Bongomin F, Bugeza S. Relationship between serum prostate-specific antigen and transrectal prostate sonographic findings in asymptomatic Ugandan males. AFRICAN JOURNAL OF UROLOGY 2021. [DOI: 10.1186/s12301-021-00162-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
AbstractBackgroundProstate disorders are among the leading causes of morbidity and mortality in men above the age of 40 years globally. Serum prostate-specific antigen (PSA) levels may be used to screen men at risk of prostate cancer and determine choice of medical treatment in benign prostatic hyperplasia (BPH) and evaluation of patients with prostatitis, while prostate sonography determines prostate volume (PV) and detects nodules. BPH may exhibit distinct hypoechoic, isoechoic, or hyperechoic nodules in the transition zone, whereas hypoechoic nodules in the peripheral zone are diagnostic for prostate cancer in over 50% of cases. In this study, we aimed at determining the relationship between serum PSA levels and transrectal prostate sonographic findings among asymptomatic Ugandan males.MethodsUgandan males above 30 years of age or older without lower urinary tract symptoms were cross-sectionally enrolled into the study. Serum PSA determination and transrectal ultrasound were performed. Association between PSA levels and PV was assessed using Spearman’s correlation coefficients (ρ).ResultsA total of 277 men were studied. The median serum PSA level was 1 (95% CI: 1–2). Most (n = 217, 78.3%) participants had serum PSA levels ≤ 4 ng/ml. The median sonographic PV was 26 (95% CI: 26–29) mls. One hundred and fifty-five (56.0%) participants had PV between 25 and 50 mls. Both PSA levels and PV progressively increased with age from 0.9 ng/ml and 22 mls in the 30–39 year age group to 7 ng/ml and 38 mls in the 60–69 year age group, respectively. PSA levels weakly correlated with PV (ρ = 0.27) (p < 0.0001). One hundred and thirty (47%) participants had prostatic nodules. Of these, 100 (77%) had features of benign nodules and 23% had suspicious nodules for prostate cancer. The median (range) serum PSA level in those with nodules was 2.0 (0.1–16.0) ng/ml and for those without nodules was 1.1 (0.1–8.0) ng/ml (p < 0.0001).ConclusionsSerum PSA has a weak direct correlation with PV and not a reliable marker for the prediction of presence or absence of prostatic nodules in asymptomatic adult males.
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de Lima MM, Filho SSJ, Tobias-Machado M. Association between PSA and age in Macuxi ethnic population of the Brazilian Amazon forest region. Res Rep Urol 2018; 10:159-168. [PMID: 30349813 PMCID: PMC6186899 DOI: 10.2147/rru.s149836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Prostate cancer is one of the most common cancers in men, with higher prevalence in developed countries. Nothing much is known regarding the incidence and mortality of prostate cancer in Brazilian population or among the indigenous groups in Brazil. Therefore, this study aimed to correlate prostate-specific antigen (PSA) level and age in the tribe with Macuxi ethnicity, from the jungles of Amazon (between Brazil and Venezuela). Patients and methods This was an epidemiological cross-sectional study aimed to find the correlation between age and PSA in the 110 Brazilian Indian tribal men of Macuxi ethnicity. Serum PSA levels (total and free PSA [tPSA and fPSA]) were screened and analyzed considering age groups. Results We found that there was a significant correlation between the age and either tPSA (p=0.016) or fPSA (p=0.036). Interestingly, there was no correlation between tPSA and fPSA with any of the age groups, but we found a significant correlation between fPSA and tPSA in only the age groups 60-69 years and 70-80 years (p=0.008). Conclusion In this study, we found a significant correlation between tPSA, fPSA, and the age of patients. However, the age-specific correlation was insignificant. From our current findings, we found that the levels of PSA may be considered as an important determinant in determining this correlation and specificity, even though more work needs to be done to verify this. Although PSA screening is a valuable research tool for male patients, the low specificity of the screening might provide false-positive results leading to overtreatment.
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Affiliation(s)
| | | | - Marcos Tobias-Machado
- Section of Urologic Oncology, Department of Urology, ABC Medical School, Sao Paulo, Brazil
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Tahmasebi H, Trajcevski K, Higgins V, Adeli K. Influence of ethnicity on population reference values for biochemical markers. Crit Rev Clin Lab Sci 2018; 55:359-375. [DOI: 10.1080/10408363.2018.1476455] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Houman Tahmasebi
- CALIPER Program, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
- Department of Laboratory Medicine & Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Karin Trajcevski
- CALIPER Program, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
| | - Victoria Higgins
- CALIPER Program, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
- Department of Laboratory Medicine & Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Khosrow Adeli
- CALIPER Program, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, Canada
- Department of Laboratory Medicine & Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Canada
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Age-specific reference ranges for prostate-specific antigen among healthy Syrian men. Int J Biol Markers 2018; 27:e152-9. [DOI: 10.5301/jbm.2012.9304] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2012] [Indexed: 01/22/2023]
Abstract
Prostate-specific antigen (PSA) has become the most useful serum tumor marker in adjunct to digital rectal examination (DRE) for the management of prostate cancer (PC). The currently cited reference range of normal PSA levels (between 0 and 4.0 ng/mL) is deficient in terms of both sensitivity and specificity. Age-adjusted PSA have been proposed as an alternative to serum PSA. The primary objective of the present study is to determine the age-specific PSA and the percentage of free PSA (%FPSA) in healthy Syrian men. A total of 3,000 healthy Syrian men over 40 years old participated in this study. All men were asked to have total serum (TPSA) and free PSA (FPSA) tested, a DRE, and, when recommended, a prostate biopsy. Serum TPSA levels correlated with age (r=0.30, p<0.001). The 95th percentile TPSA values ranged from 1.7 ng/mL in the age group 40–49 years to 5.8 ng/mL in the group 70–80 years. The general pattern for medians and the percentile values for FPSA across age groups were similar to those seen for TPSA concentrations (r=0.37, p<0.001). However, the %FPSA was fairly constant across age groups except for the higher ratios in the youngest age group. These findings confirm that the serum TPSA and FPSA levels correlate with age. Interestingly, however, Syrian men have lower PSA values compared with other races. Racial differences of PSA concentrations were observed. Our results may help increasing the sensitivity and specificity of PSA measurements in the diagnosis of prostate cancer in Syria and probably in the surrounding regions.
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Cheng HH, Pritchard CC, Montgomery B, Lin DW, Nelson PS. Prostate Cancer Screening in a New Era of Genetics. Clin Genitourin Cancer 2017; 15:625-628. [PMID: 28697982 DOI: 10.1016/j.clgc.2017.05.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 05/17/2017] [Accepted: 05/23/2017] [Indexed: 12/24/2022]
Abstract
Men who inherit pathogenic germline mutations in BRCA2 and BRCA1 are at increased risk of developing aggressive prostate cancer, and those with germline mutations in other DNA repair genes such as ATM, CHEK2, and MSH2/MSH6 may also have increased risks. Although clinically important, there is lack of specific guidance regarding management strategies for men at increased risk owing to germline mutation status or family history of aggressive prostate cancer. We review prostate cancer genetic risk factors and the ongoing IMPACT (Identification of Men with a genetic predisposition to ProstAte Cancer: Targeted screening in BRCA1/2 mutation carriers and controls) screening study. Pending results of IMPACT and unified guidelines, there are areas of uncertainty and need for further study. Ongoing and future research will be critical for optimizing prostate cancer screening approaches for men at the highest risk for aggressive prostate cancer. In the interim, we propose a practical approach to prostate cancer screening for men with a germline mutation in a known/suspected moderate to high-penetrance cancer predisposition gene (eg, BRCA1/2), and/or men with a first- or second-degree relative with metastatic prostate cancer (regardless of genetic testing): baseline prostate-specific antigen and digital rectal exam by experienced providers at age 40 years or 5 years earlier than age of diagnosis of the youngest first- or second-degree relative with metastatic prostate cancer, whichever is earlier. Then, based on age, digital rectal exam, and prostate-specific antigen, we suggest consideration of magnetic resonance imaging, biopsy, and/or continued monitoring.
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Affiliation(s)
- Heather H Cheng
- Department of Medicine, University of Washington, Seattle, WA; Fred Hutchinson Cancer Research Center, Seattle, WA.
| | - Colin C Pritchard
- Department of Laboratory Medicine, University of Washington, Seattle, WA
| | | | - Daniel W Lin
- Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Urology, University of Washington, Seattle, WA
| | - Peter S Nelson
- Department of Medicine, University of Washington, Seattle, WA; Fred Hutchinson Cancer Research Center, Seattle, WA
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Ho Lee S, Kon Lee S. Does Race/Ethnicity Have a Role in a Link Between Lower Urinary Tract Symptoms and Metabolic Syndrome? EUROPEAN MEDICAL JOURNAL 2017. [DOI: 10.33590/emj/10313733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023] Open
Abstract
Metabolic syndrome (MS) is a highly prevalent disease related to the risk of cardiovascular disease and diabetes. A large body of evidence has suggested a link between MS and the components of MS with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) complex. The pathogenesis of MS is complex and not fully understood. Furthermore, recent results from epidemiological studies, including multiple Asian reports, have not been consistent. The risk of BPH is lower in Asian men compared with white men and the prevalence of MS varies by race and ethnicity. An elevated risk of Type 2 diabetes mellitus, hypertension, and dyslipidaemia is closely related to MS and is observed in Asian men even if their body mass index is low. However, the role of race and ethnic disparity in the link between MS and LUTS secondary to BPH is not elucidated. It has been suggested that the pathogenesis of LUTS is multifactorial rather than developing from BPH, which is the traditional concept. Lifestyle and genetic factors may substantially modify the risk of MS and LUTS/BPH. This comprehensive literature review summarises the scientific evidence of the racial/ethnic disparity regarding the association between MS and LUTS/BPH in order to improve current understanding of this controversial issue.
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Affiliation(s)
- Seong Ho Lee
- Department of Urology, School of Medicine, Hallym University, Chuncheon, South Korea
| | - Sang Kon Lee
- Department of Urology, School of Medicine, Hallym University, Chuncheon, South Korea
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Chien TM, Lu YM, Geng JH, Huang TY, Ke HL, Huang CN, Li CC, Chou YH, Wu WJ, Huang SP. Predictors of Positive Bone Metastasis in Newly Diagnosed Prostate Cancer Patients. Asian Pac J Cancer Prev 2017; 17:1187-91. [PMID: 27039746 DOI: 10.7314/apjcp.2016.17.3.1187] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The prevalence of prostate cancer (PCa) has been increasing in recent years. Treatment strategies are largely based on the results of bone scan screening. Therefore, our aim was to investigate predictors of positive bone metastasis in newly diagnosed PCa patients. MATERIALS AND METHODS After extensive review, 336 consecutive patients newly diagnosed with PCa between April 2010 and November 2013 at our institution were enlisted in the study. Patients were divided into two groups according to bone scan results. Univariate analyses (Chi-square test for discrete variables and independent t-test for continuous variables) were applied to determine the potentially significant risk factors associated with distant bone metastasis. Binary logistic regression analyses were used to further investigate the influence of these factors on bone metastasis. RESULTS The patient mean age was 71.9 ± 8.6 years (range: 48 to 94 years). The mean prostate specific antigen (PSA) level and biopsy Gleason score were 260.2 ± 1107.8 ng/mL and 7.4 ± 1.5, respectively. The body mass index (BMI) for the series was 24.5 ± 3.4 kg/m2. Sixty-four patients (19.0%) had a positive bone scan result. Patients with positive bone scan results had a significantly lower BMI (23.3 ± 3.5 vs. 24.8 ± 3.3; p=0.003), a higher Gleason score (8.5 ± 1.1 vs. 7.1 ± 1.5; p < 0.001), and a higher PSA level (1071.3 ± 2337.1 vs. 69.4 ± 235.5; p < 0.001) than those without bone metastasis. Multivariate logistic regression analysis employing the above independent predictors demonstrated that a Gleason score of ≥7, clinical stage ≥T3, BMI ≤22 kg/m2, and an initial PSA level of ≥20 ng/mL were all independent predictors of bone metastasis. CONCLUSIONS A bone scan might be necessary in newly diagnosed PCa patients with any of the following criteria: clinical stage T3 or higher, a Gleason score of 7 or higher, BMI equal to or less than 22, and a PSA level of 20 or higher.
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Affiliation(s)
- Tsu-Ming Chien
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan E-mail :
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Fang D, Zhao C, Ren D, Yu W, Wang R, Wang H, Li X, Yin W, Yu X, Yang K, Liu P, Shan G, Li S, He Q, Wang X, Xin Z, Zhou L. Could Magnetic Resonance Imaging Help to Identify the Presence of Prostate Cancer Before Initial Biopsy? The Development of Nomogram Predicting the Outcomes of Prostate Biopsy in the Chinese Population. Ann Surg Oncol 2016; 23:4284-4292. [PMID: 27464612 DOI: 10.1245/s10434-016-5438-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Indexed: 12/15/2022]
Abstract
PURPOSE This study was designed to investigate the effectiveness of magnetic resonance imaging (MRI) in diagnosing prostate cancer (PCa) and high-grade prostate cancer (HGPCa) before transrectal ultrasound (TRUS)-guided biopsy. METHODS The clinical data of 894 patients who received TRUS-guided biopsy and prior MRI test from a large Chinese center was reviewed. Based on Prostate Imaging Reporting and Data System (PI-RADS) scoring, all MRIs were re-reviewed and assigned as Grade 0-2 (PI-RADS 1-2; PI-RADS 3; PI-RADS 4-5). We constructed two models both in predicting PCa and HGPCa (Gleason score ≥ 4 + 3): Model 1 with MRI and Model 2 without MRI. Other clinical factors include age, digital rectal examination, PSA, free-PSA, volume, and TRUS. RESULTS PCa and HGPCa were present in 434 (48.5 %) and 218 (24.4 %) patients. An MRI Grade 0, 1, and 2 were assigned in 324 (36.2 %), 193 (21.6 %) and 377 (42.2 %) patients, which was associated with the presence of PCa (p < 0.001) and HGPCa (p < 0.001). Particularly in patients aged ≤55 years, the assignment of MRI Grade 0 was correlated with extremely low rate of PCa (1/27) and no HGPCa. The c-statistic of Model 1 and Model 2 for predicting PCa was 0.875 and 0.841 (Z = 4.2302, p < 0.001), whereas for predicting HGPCa was 0.872 and 0.850 (Z = 3.265, p = 0.001). Model 1 exhibited higher sensitivity and specificity at same cutoffs, and decision-curve analysis also suggested the favorable clinical utility of Model 1. CONCLUSIONS Prostate MRI before biopsy could predict the presence of PCa and HGPCa, especially in younger patients. The incorporation of MRI in nomograms could increase predictive accuracy.
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Affiliation(s)
- Dong Fang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China
| | - Chenglin Zhao
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Da Ren
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China
| | - Wei Yu
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China
| | - Rui Wang
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Huihui Wang
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Xuesong Li
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China
| | - Wenshi Yin
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China
| | - Xiaoteng Yu
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China
| | - Kunlin Yang
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China
| | - Pei Liu
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China
| | - Gangzhi Shan
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China
| | - Shuqing Li
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China
| | - Qun He
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China
| | - Xiaoying Wang
- Department of Radiology, Peking University First Hospital, Beijing, China
| | - Zhongcheng Xin
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China.
| | - Liqun Zhou
- Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer Centre, Beijing, China.
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Putra IBO, Hamid AR, Mochtar CA, Umbas R. Relationship of age, prostate-specific antigen, and prostate volume in Indonesian men with benign prostatic hyperplasia. Prostate Int 2016; 4:43-8. [PMID: 27358842 PMCID: PMC4916066 DOI: 10.1016/j.prnil.2016.03.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 03/04/2016] [Accepted: 03/07/2016] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND To investigate the relationship between age, prostate specific antigen (PSA), and prostate volume (PV) in Indonesian men with histologically proven benign prostatic hyperplasia. METHODS Data were generated from our BPH database from June 1994 until December 2013. Subjects were men with a minimum age of 40 years with chief complaint of LUTS or urinary retention, diagnosed with BPH. All patients underwent TRUS-guided prostate biopsy. Patients with PSA level >10 ng/mL were excluded from the study to exclude the possibility of occult prostate cancer. PV was measured with TRUS. Appropriate statistical tests were employed for data analysis. RESULTS In all, 1638 patients were enrolled in our study. There was a statistically significant difference in PSA (P = 0.03) and PV (P < 0.0001) between age groups. Overall correlation between age, PSA, and PV were: i). Age and PV (r = 0.12, P < 0.0001); ii). Age and PSA (r = 0.07, P = 0.008); iii). PSA and PV (r = 0.26, P < 0.0001). Subgroup analysis in terms of indwelling catheter use versus without: i). Age 66.09 ± 8 years versus 65.38 ± 7.66 years (P = 0.158); ii). PSA 4.93 ± 2.62 ng/mL versus 4.68 ± 2.82 ng/mL (P = 0.038); iii). PV 47.58 ± 21.33 mL versus 41.43 ± 20.55 mL (P < 0.0001). Correlation between age, PSA, and PV in patients were similar in patients with and without indwelling catheter. CONCLUSION In Indonesian men with biopsy-proven BPH, both PV and PSA increased with ageing. Prostate volume was significantly correlated with PSA. Even though the results were weaker, these results are consistent with results in other sets of population. The results vary between different countries and thus, ethnicities. Indonesia is a populous a sociocultural and ethnically diverse country. Therefore, aside from PSA, age, and PV, when investigating men with BPH, ethnicity may also need to be taken into account.
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Affiliation(s)
| | | | | | - Rainy Umbas
- Department of Urology, Faculty of Medicine University of Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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Lim J, Bhoo-Pathy N, Sothilingam S, Malek R, Sundram M, Hisham Bahadzor B, Ong TA, Ng KL, Sivalingam S, Razack AHA. Ethnicity is an independent determinant of age-specific PSA level: findings from a multiethnic Asian setting. PLoS One 2014; 9:e104917. [PMID: 25111507 PMCID: PMC4128728 DOI: 10.1371/journal.pone.0104917] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Accepted: 07/13/2014] [Indexed: 01/27/2023] Open
Abstract
Objectives To study the baseline PSA profile and determine the factors influencing the PSA levels within a multiethnic Asian setting. Materials and Methods We conducted a cross-sectional study of 1054 men with no clinical evidence of prostate cancer, prostate surgery or 5α-reductase inhibitor treatment of known prostate conditions. The serum PSA concentration of each subject was assayed. Potential factors associated with PSA level including age, ethnicity, height, weight, family history of prostate cancer, lower urinary tract voiding symptoms (LUTS), prostate volume and digital rectal examination (DRE) were evaluated using univariable and multivariable analysis. Results There were 38 men (3.6%) found to have a PSA level above 4 ng/ml and 1016 (96.4%) with a healthy PSA (≤4 ng/ml). The median PSA level of Malay, Chinese and Indian men was 1.00 ng/ml, 1.16 ng/ml and 0.83 ng/ml, respectively. Indians had a relatively lower median PSA level and prostate volume than Malays and Chinese, who shared a comparable median PSA value across all 10-years age groups. The PSA density was fairly similar amongst all ethnicities. Further analysis showed that ethnicity, weight and prostate volume were independent factors associated with age specific PSA level in the multivariable analysis (p<0.05). Conclusion These findings support the concept that the baseline PSA level varies between different ethnicities across all age groups. In addition to age and prostate volume, ethnicity may also need to be taken into account when investigating serum PSA concentrations in the multiethnic Asian population.
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Affiliation(s)
- Jasmine Lim
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nirmala Bhoo-Pathy
- Julius Center University of Malaya, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Rohan Malek
- Department of Urology, Selayang Hospital, Selangor, Malaysia
| | - Murali Sundram
- Department of Urology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
| | - Badrul Hisham Bahadzor
- Department of Surgery, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
| | - Teng Aik Ong
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Keng Lim Ng
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Centre for Kidney Disease Research, School of Medicine, University of Queensland, Translational Research Institute, Brisbane, Australia
| | | | - Azad Hassan Abdul Razack
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- * E-mail:
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15
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Walser-Domjan E, Richard A, Eichholzer M, Platz EA, Linseisen J, Rohrmann S. Association of urinary phytoestrogen concentrations with serum concentrations of prostate-specific antigen in the National Health and Nutrition Examination Survey. Nutr Cancer 2014; 65:813-9. [PMID: 23909724 DOI: 10.1080/01635581.2013.801999] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Some clinical trials have shown that high phytoestrogen intake may decrease serum concentrations of prostate-specific antigen (PSA), and phytoestrogens may also lower prostate cancer risk. It was the aim of this study to examine the relationship between the serum PSA level and urine phytoestrogen concentration in generally healthy U.S. men. Eight hundred twenty-four men, 40+ yr old without prostate cancer, who participated in the 2001-2004 NHANES surveys, were included in the analysis. The association of total PSA, free PSA, and PSA ratio [free PSA/total PSA * 100] with concentrations of isoflavones and lignans (standardized for urinary creatinine concentration) was examined using multivariable-adjusted linear and logistic regression models. The linear regression analyses showed no clear association between creatinine-standardized urinary phytoestrogen concentrations and serum total or free PSA levels or PSA ratio. However, the odds of having a PSA ratio <15% rose from Quartile 1 to Quartile 4 of isoflavone excretion (odds ratio = 2.82, 95% confidence interval 1.28-6.22 for top vs. bottom quartile), but there were no associations with having a PSA ratio <25%. In generally healthy U.S. men, 40+ yr old without a diagnosis of prostate cancer, urinary isoflavone, and lignan concentrations were not associated with serum PSA level.
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Affiliation(s)
- Esther Walser-Domjan
- Division of Cancer Epidemiology and Prevention, Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland
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Yu J, Vexler A, Hutson AD, Baumann H. Empirical Likelihood Approaches to Two-Group Comparisons of Upper Quantiles Applied to Biomedical Data. Stat Biopharm Res 2014; 6:30-40. [PMID: 24660050 PMCID: PMC3959985 DOI: 10.1080/19466315.2013.826597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In many biomedical studies, a difference in upper quantiles is of specific interest since the upper quantile represents the upper range of biomarkers and/or is used as the cut-off value for a disease classification. In this article, we investigate two-group comparisons of an upper quantile based on the empirical likelihood methodology. Two approaches, the classical empirical likelihood and 'plug-in' empirical likelihood are used to construct the test statistics and their properties are theoretically investigated. Although the plug-in method is developed by the frame work of the empirical likelihood, the test statistic is not based on the maximization of the empirical likelihood, and is simplified by using indicator function in its construction, making it a unique test to investigate. Extensive simulation results demonstrate that the 'plug-in' empirical likelihood approach performs better to compare upper quantiles across various underlying distributions and sample sizes. For the actual application, we employ the developed methods to test the differences in upper quantiles in two different studies, the oral colonization of pneumonia pathogens for intensive care unit patients treated by two different oral treatments, and the biomarker expressions of normal and abnormal bronchial epithelial cells.
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Affiliation(s)
- Jihnhee Yu
- Department of Biostatistics, University at Buffalo, State University of New York, USA
| | - Albert Vexler
- Department of Biostatistics, University at Buffalo, State University of New York, USA
| | - Alan D. Hutson
- Department of Biostatistics, University at Buffalo, State University of New York, USA
| | - Heinz Baumann
- Department of Molecular and Cellular Biology, Roswell Park Cancer Institute, USA
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17
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Song J, Park H, Lee G. Contribution of genetic variation rs266882 to prostate-specific antigen levels in healthy controls with serum PSA below 2.0 ng/ml. Biochem Genet 2013; 51:264-74. [PMID: 23315126 DOI: 10.1007/s10528-012-9561-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Accepted: 11/15/2012] [Indexed: 12/01/2022]
Abstract
We evaluated the impact of genetic variation in the prostate-specific antigen (PSA) gene (rs266882) on serum PSA levels in healthy men as well as risk factors for benign prostate hypertrophy (BPH) and prostate cancer. The study population comprised 91 men with PSA levels below 2.0 ng/ml as healthy controls, 78 men with PSA 2-10 ng/ml as a BPH group, and 128 prostate cancer patients, all in Korea. DNA was amplified by polymerase chain reaction and the product was sequenced. We found that PSA levels were associated with a G/A polymorphism only in healthy controls. The transition, however, was not associated with PSA levels of BPH and cancer patients, nor was it a risk factor. In conclusion, this genetic factor is important for determining serum PSA levels in the naive group, whereas the disruption of prostatic architecture in BPH or prostate cancer may be a major determining factor for PSA levels.
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Affiliation(s)
- Jaeman Song
- Department of Urology, Yonsei University Wonju College of Medicine, Wonju, South Korea
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Casey RG, Hegarty PK, Conroy R, Rea D, Butler MR, Grainger R, McDermott T, Thornhill JA. The Distribution of PSA Age-Specific Profiles in Healthy Irish Men between 20 and 70. ISRN ONCOLOGY 2012; 2012:832109. [PMID: 22919517 PMCID: PMC3412100 DOI: 10.5402/2012/832109] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Accepted: 06/10/2012] [Indexed: 11/26/2022]
Abstract
Background. Ireland is estimated to have the highest European incidence rate of prostate cancer (Pca) in 2006 which will increase by 275% by 2025. This study aimed to determine PSA cutoff values in different age groups of healthy male patients without Pca. Methods. 660 men in a pilot men's health programme, aged 18–67, had PSA assayed. Men were grouped into 8 age groups at 5-year intervals: 30–34, 35–39, 40–44, 45–49, 50–54, 55–59, 60–64, and 64–70. Results. Linear regression demonstrates a PSA velocity of 0.024 ng/ml/year. The 95% confidence interval demonstrates a near flat line of PSA values from age 20 to 50 and rises after. When transformed logarithmically, PSA correlates highly with expected values from the normal distribution (0.98). A fractional polynomial quantile regression model was used to predict median and 95th percentile for PSA as follows: 30–34 (0.73, 1.57), 35–39 (0.71, 1.65), 40–44 (0.73, 1.85), 45–49 (0.78, 2.17), 50–54 (0.88, 2.63), 55–59 (1.01, 3.25), 60–64 (1.20, 4.02), and 64–70 (1.43, 4.96). Conclusions. PSA levels are similar to other racial groups but not as high as US Caucasians until 65 years. These data define the predicted PSA for the Irish population and provide a reference for future screening programmes.
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Affiliation(s)
- R G Casey
- The Adelaide and Meath Hospital-Dublin, Incorporating The National Children's Hospital, Tallaght, Dublin 24, Ireland
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Park SG, Choi HC, Cho B, Kwon YM, Kwon HT, Park JH. Effect of Central Obesity on Prostate Specific Antigen Measured by Computerized Tomography: Related Markers and Prostate Volume. J Urol 2012; 187:1589-93. [DOI: 10.1016/j.juro.2011.12.067] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Indexed: 11/16/2022]
Affiliation(s)
- Seung-Guk Park
- Department of Family Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Pusan, South Korea
| | - Ho-Chun Choi
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Belong Cho
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Young-Min Kwon
- Department of Family Medicine, Sam Yook Medical Center, Seoul, South Korea
| | - Hyuk-Tae Kwon
- Department of Family Medicine, Healthcare System Gangnam Center of Seoul National University Hospital, Seoul, South Korea
| | - Jin-ho Park
- Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
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Sutcliffe S, Pakpahan R, Sokoll LJ, Elliott DJ, Nevin RL, Cersovsky SB, Walsh PC, Platz EA. Prostate-specific antigen concentration in young men: new estimates and review of the literature. BJU Int 2012; 110:1627-35. [DOI: 10.1111/j.1464-410x.2012.11111.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Litchfield MJ, Cumming RG, Smith DP, Naganathan V, Le Couteur DG, Waite LM, Blyth FM, Handelsman DJ. Prostate‐specific antigen levels in men aged 70 years and over: findings from the CHAMP study. Med J Aust 2012; 196:395-8. [DOI: 10.5694/j.1326-5377.2012.tb04214.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Melisa J Litchfield
- Centre for Education and Research on Ageing, Concord Hospital and University of Sydney, Sydney, NSW
| | | | - David P Smith
- Cancer Epidemiology Research Unit, Cancer Council NSW, Sydney, NSW
| | - Vasi Naganathan
- Centre for Education and Research on Ageing, Concord Hospital and University of Sydney, Sydney, NSW
| | - David G Le Couteur
- Centre for Education and Research on Ageing, Concord Hospital and University of Sydney, Sydney, NSW
| | - Louise M Waite
- Centre for Education and Research on Ageing, Concord Hospital and University of Sydney, Sydney, NSW
| | - Fiona M Blyth
- Centre for Education and Research on Ageing, Concord Hospital and University of Sydney, Sydney, NSW
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Tang P, Du W, Xie K, Fu J, Chen H, Yang W, Moul JW. Characteristics of baseline PSA and PSA velocity in young men without prostate cancer: Racial differences. Prostate 2012; 72:173-80. [PMID: 21538426 DOI: 10.1002/pros.21418] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Accepted: 04/12/2011] [Indexed: 11/11/2022]
Abstract
BACKGROUND Baseline prostate specific antigen (PSA) and PSA velocity used to stratify subsequent prostate cancer risk in young men may not directly applicable to all populations. We sought to compare the baseline PSA and PSA velocity among ethnic groups. PATIENTS AND METHODS Chinese, African-American (AA), and Caucasian-American (CA) men aged ≤50 years old without prostate cancer were used to identify baseline PSA and PSA velocity. The differences of baseline PSA and PSA velocity between races were assessed. The important cutoffs of baseline PSA and PSA velocity were used to stratify patients among races. RESULTS Four thousand two hundred six Chinese, 997 AA, and 2,030 CA were included. The rates of baseline PSA of ≥1.0, ≥2.5, and ≥4.0 ng/ml was 24.4%, 4.2%, and 2.1% in Chinese, 30.7%, 5.2%, and 1.8% in AA, 29.7%, 5.3%, and 2.8% in CA, respectively. The rates of PSA velocity of ≥0.35, ≥0.75, and ≥1.0 ng/ml/year was 6.0%, 3.1%, and 2.6% in Chinese, 5.3%, 2.3%, and 1.7% in AA, 5.4%, 3.5%, and 3.3% in CA, respectively. Chinese had a lower baseline PSA and higher PSA velocity as compared to AA and CA. Baseline PSA and PSA velocity in AA had no statistical differences as compared to CA. CONCLUSIONS The distributions of baseline PSA and PSA velocity in young men among Chinese, AA, and CA races are different. These characteristics shall be taken into account when using these variables to stratify risk of prostate cancer in young men.
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Affiliation(s)
- Ping Tang
- Department of Urology, Guangzhou First Municipal People's Hospital, Guangzhou Medical College, Guangdong, China
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23
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Is it suitable to eliminate bone scan for prostate cancer patients with PSA ≤ 20 ng/mL? World J Urol 2011; 30:265-9. [PMID: 21779835 PMCID: PMC3321272 DOI: 10.1007/s00345-011-0728-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Accepted: 06/30/2011] [Indexed: 10/27/2022] Open
Abstract
PURPOSE We evaluated the relationship between bone metastasis (BM) and clinical or pathological variables, including the serum prostate-specific antigen (PSA) concentration. METHODS This retrospective study included 579 consecutive patients with newly diagnosed prostate cancer (Pca) who underwent a bone scan study at our institution between 2002 and 2010. We used receiver operating characteristics curves to evaluate accuracy of bone metastasis between serum PSA 10 and 20 ng/mL. RESULTS A positive bone scan result was found in 83 men (14.3%) with PCa. However, 27 men (4.6%) with serum PSA between 10 and 20 ng/mL, 29/579 men (5.0%) with GS ≤ 7, and 21/83 (25.3%) with serum PSA ≤ 20 ng/mL and Gleason score (GS) ≤ 7 had positive bone scans. In the logistic regression analyses, clinical T stage (odds ratio [OR] = 3.26; 95% CI, 2.29-4.33; P = 0.021), GS (OR = 3.41; 95% CI, 2.91-4.63; P = 0.019), and serum PSA (OR = 8.37; 95% CI, 3.91-19.21; P < 0.001) were predictive factors of detecting the BM. When the serum PSA concentration ≤20 ng/mL and GS ≤ 7, AUC value of bone scans for the detection of BM was 0.640 (P = 0.020; 95% CI, 0.563-0.717). With serum PSA at 10 ng/mL and GS ≤ 7, the AUC values of bone scans were 0.828 (P < 0.001; 95% CI, 0.773-0.883). CONCLUSIONS Bone scans might be necessary in men with serum PSA between 10 and 20 ng/mL. New guidelines for eliminating bone scans in patients with newly diagnosed Pca are needed, especially in Asians.
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Park SY, Lee HM. What Are Some New Developments in Prostate Cancer Diagnosis? JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2010. [DOI: 10.5124/jkma.2010.53.2.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Seo Yong Park
- Department of Urology, Sungkyunkwan University School of Medicine, Korea.
| | - Hyun Moo Lee
- Department of Urology, Sungkyunkwan University School of Medicine, Korea.
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Khoo EM, Tan HM, Low WY. Erectile Dysfunction and Comorbidities in Aging Men: An Urban Cross‐Sectional Study in Malaysia. J Sex Med 2008; 5:2925-34. [DOI: 10.1111/j.1743-6109.2008.00988.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Jeong H, Jeong BC, Kwak C, Lee E, Lee SE, Kim TB. A comparison of prostate cancer detection rates by 12 or 6 core biopsy at different prostate-specific antigen densities in Korean men. World J Urol 2008; 26:395-400. [PMID: 18438670 DOI: 10.1007/s00345-008-0264-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2007] [Accepted: 04/02/2008] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES To evaluate the diagnostic value of 12 core biopsy versus sextant biopsy at different prostatic-specific antigen densities (PSAD). METHODS We retrospectively analyzed the records of 1,463 patients who underwent transrectal ultrasound-guided prostate biopsies at our institution. 995 patients underwent 12 core biopsy and 468 sextant biopsy of the prostate. The cancer detection rates achieved by these two methods were analyzed at different PSAD levels. RESULTS All patients were stratified into 5 groups according to PSAD level; group A: PSAD < 0.1 (n = 290), group B: 0.1 < or = PSAD < 0.2 (n = 572), group C: 0.2 < or = PSAD < 0.3 (n = 248), group D: 0.3 < or = PSAD < 0.4 (n = 122), and group E: PSAD > or = 0.4 (n = 231). In group B, 12 core biopsy had a higher detection rate than 6 core biopsy (P = 0.017). CONCLUSIONS These results demonstrate 12 core biopsy is better able to detect cancer than 6 core biopsy in patients with a PSAD in the range 0.1-0.2, which suggests that PSAD be considered when deciding on the number of prostate biopsy cores required.
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Affiliation(s)
- Hyeon Jeong
- Department of Urology, Seoul Municipal Boramae Hospital, Seoul, Korea
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Ku JH. Race-specific reference ranges of serum prostate-specific antigen levels in countries with a low incidence of prostate cancer. BJU Int 2006; 97:69-72. [PMID: 16336331 DOI: 10.1111/j.1464-410x.2005.05866.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ja Hyeon Ku
- Department of Urology, Seoul Veterans Hospital, Seoul, Korea.
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Peyromaure M, Debré B, Mao K, Zhang G, Wang Y, Sun Z, Xu D, Jiang J, Sun Y. MANAGEMENT OF PROSTATE CANCER IN CHINA: A MULTICENTER REPORT OF 6 INSTITUTIONS. J Urol 2005; 174:1794-7. [PMID: 16217289 DOI: 10.1097/01.ju.0000176817.46279.93] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE In China the incidence of prostate cancer (PCa) is low and sparse data are available regarding its management. We analyzed the management of PCa at 6 Chinese urological institutions. MATERIALS AND METHODS A retrospective analysis was performed of 431 consecutive patients treated for PCa at 6 Chinese institutions, including 5 in the divisions of Shanghai and 1 in the province of Chongqing, between January 2000 and December 2004. Tumor characteristics, therapeutic options and patient outcomes were recorded. RESULTS At diagnosis median patient age was 72 years and median prostate specific antigen was 46.1 ng/ml. Most PCa cases were revealed by urinary symptoms (75.9%) or bone pain (12.8%). PCa was palpable on digital rectal examination in 74% of cases. At least 44 patients (10.2%) had metastases to lymph nodes at diagnosis and 112 (26%) had bone metastases. A total of 236 patients underwent bilateral orchiectomy and 100 received medical hormone therapy, which in 75% consisted of antiandrogen alone. At a median followup of 16.8 months 60% of these patients experienced biological recurrence. Radical prostatectomy was performed in 24 patients as monotherapy or in combination with bilateral orchiectomy. No patient with clinically localized PCa experienced biological recurrence after radical prostatectomy. CONCLUSIONS The management of PCa in China differs from that in Western countries. To date surgical castration represents standard treatment. Screening detection of PCa could help detect earlier stage tumors and improve the outcome in patients.
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Kehinde EO, Mojiminiyi OA, Sheikh M, Al-Awadi KA, Daar AS, Al-Hunayan A, Anim JT, Al-Sumait AA. Age-specific reference levels of serum prostate-specific antigen and prostate volume in healthy Arab men. BJU Int 2005; 96:308-12. [PMID: 16042719 DOI: 10.1111/j.1464-410x.2005.05620.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
UNLABELLED OBJECTIVE; To determine age-specific reference ranges for serum prostate-specific antigen (PSA) concentration and prostate volumes in a population of healthy Arab men. SUBJECTS AND METHODS Blood samples were taken from 396 healthy Arab men (from Kuwait and Oman) aged 15-79 years and from across the social spectrum. Men aged >40 years had a digital rectal examination and transrectal ultrasonography of the prostate to determine prostate volume. The serum PSA level was measured using commercial kits, and age-specific ranges for PSA levels and prostate volume determined. RESULTS The serum PSA ranges (ng/mL) for each age range in Arab men were: 40-49 years, 0-0.9; 60-69, 0-2.7; 70-79, 0-5.5 ng/mL; the respective prostate volumes were 8-22, 9-30 and 10-33 mL. The serum PSA level and prostate volume correlated with age (P < 0.001). Arab men had lower serum PSA levels and prostate volumes than those reported for Caucasians, but similar to those reported for Asians (Japanese and Chinese). CONCLUSION These results indicate that Arab men have lower PSA levels and prostate volumes than Caucasians. The levels are slightly lower than those reported in the Japanese and, as in the Japanese, low PSA levels and small prostate volumes might be related to the low incidence of clinical prostate cancer in Arab men.
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Affiliation(s)
- Elijah O Kehinde
- Department of Surgery, Division of Urology, Faculty of Medicine, Kuwait University, Kuwait.
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Cheillan D, Vercherat M, Chevalier-Porst F, Charcosset M, Rolland MO, Dorche C. False-positive results in neonatal screening for cystic fibrosis based on a three-stage protocol (IRT/DNA/IRT): Should we adjust IRT cut-off to ethnic origin? J Inherit Metab Dis 2005; 28:813-8. [PMID: 16435172 DOI: 10.1007/s10545-005-0067-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2004] [Accepted: 05/06/2005] [Indexed: 01/27/2023]
Abstract
Since 1979, newborn screening for cystic fibrosis (CF) has been possible by measuring immunoreactive tryspinogen (IRT) in blood spots. In France, a programme based on a three-stage strategy (IRT/DNA/IRT) started in 2002. In the Rhône-Alpes area, the positive screening rate (i.e. the proportion of samples sent for genotyping) observed after the first IRT measurement was higher than the expected rate (0.65% versus 0.50%), without a greater CF incidence. We hypothesized that the IRT reference range could differ according to the ethnic origin of the newborns. 35 141 newborns were studied and divided into two groups: European ethnic group 26 324 (75%) and North African ethnic group 8817 (25%). 243 positive newborns were identified: 146 (60%) in the European ethnic group and 97 (40%) in the North African ethnic group. Three CF patients and 11 unaffected heterozygotes were found in the European group, but no mutations were found in the North African group. Mean IRT values and the percentage of IRT values over the cut-off were significantly higher in the North African group than in the European group (mean IRT = 21.17 microg/L and 19.74 microg/L, p < 0.0001; %IRT > cut-off = 1.1% and 0.5%, respectively). For the positive screened newborns, term and IRT mean were comparable, whereas birth weight was higher in the North African ethnic group. These results lead us to conclude that (i) newborns from families of North African origin have higher IRT values and (ii) most of the positive screened newborns in this population could be considered as 'false positives'. These conclusions could explain, in part, the large variations seen in the positive screening rate in the French CF neonatal screening and raise the question whether it is relevant to adapt cut-off to ethnic origin of the newborns.
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Affiliation(s)
- D Cheillan
- Service de Biochimie Pédiatrique, Unité de Dépistage Néonatal - Hôpital Debrousse, 29 rue soeur Bouvier, 69005, Lyon, France.
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