Re: Longitudinal PSA changes in men with and without prostate cancer: assessment of prostate cancer risk.

摘要

Berger and coworkers assessed prostate-specific antigen (PSA) values in men with and without prostate cancer up to 10 yr before the diagnosis. The study population consisted of 2462 men selected from those screened (>76,000 up to 1999) and 535 men selected from those diagnosed with cancer (2363 in the Innsbruck region, with uncertainty how many were detected by screening) . Of all men without evidence of prostate cancer, PSA values over a 10-yr period were available {median age of 66.2 yr; range: 40-94). Of the men with the diagnosis of prostate cancer PSA values were available over 10 yr in 25 men; 178 men had PSA values available for 6 yr prior to diagnosis. The main conclusion was that longitudinal changes in men with and without prostate cancer are significantly different and that annual testing in men with baseline total PSA levels of <=1.0 ng/ml may not be necessary. Along with this the authors concluded that PSA velocity was significantly increased in men with prostate cancer (mean PSA velocity,0.409 ng/ml/yr) as compared to the men without prostate cancer (mean PSA velocity, 0.03 ng/ml/yr). When looking at tumor characteristics of the cancers detected there was a significant difference in PSA velocity values of prostate cancer cases with Gleason scores <6 as compared to those cases those Gleason scores of >=7. The authors concluded that PSA velocity may be a useful parameter to predict a positive biopsy in screening for prostate cancer.