60세 미만 한국인의 전립선암 선별에 있어 전립선특이항원속도의 유용성 및 새로운 절단치
New Thresholds for Prostate-specific Antigen Velocity for Prostate Cancer Screening in Korean Patients Younger than 60 Years Old
이혜원, 곽경원, 최윤호, 최한용, 이현무,
소속 상세정보
이혜원 ( Lee Hye-Won )
성균관대학교 의과대학 비뇨기과학교실
곽경원 ( Kwak Kyung-Won )
성균관대학교 의과대학 비뇨기과학교실
최윤호 ( Choi Yoon-Ho )
성균관대학교 의과대학 삼성서울병원 건강검진센터
최한용 ( Choi Han-Yong )
성균관대학교 의과대학 비뇨기과학교실
이현무 ( Lee Hyun-Moo )
성균관대학교 의과대학 비뇨기과학교실
KMID : 0358320080490020113
Abstract
Purpose: We identified new thresholds for prostate-specific antigen velocity(PSAV) for screening of prostate cancer in Korean patients younger than 60 years old based on PSA serial data obtained from our hospital’s health promotion center.
Materials and Methods: The study population was retrieved from 10,011 patients, 40 to 79 years old, with 2 or more PSA values within five years who visited our hospital’s health promotion center between January 2002 and December 2006, including 100 patients with prostate cancer. These subjects were divided into 2 age groups, 40-59 years old and 60-79 years old, and their PSAV were calculated as the rate of PSA change using the first and last values only. A receiver operating characteristic(ROC) curve was used to analyze the performance of PSAV in the screening of prostate cancer, and we developed new PSAV thresholds by comparing sensitivity and specificity at different PSAV levels.
Results: Overall prostate cancer prevalence was 0.6%(45) in younger(40-59 years old) patients and 2.1%(55) in older(60 to 79 years old) patients. The median PSAV in the normal control group and the cancer group were 0.047ng/ml/year vs 0.877ng/ml/year in younger patients(p＜0.0001) and 0.067ng/ml/year vs 0.642ng/ml/year in older patients(p＜0.0001). For younger patients, the sensitivity and specificity were 55.6% and 99.2% at PSAV 0.75ng/ml/year, but decreasing the PSAV cut-points to 0.35ng/ ml/year improved sensitivity to 78% for cancer detection in this age group.
Conclusions: The previous PSAV threshold for prostate biopsy, 0.75 ng/ml/year or greater, probably underestimate cancer risk in younger Korean men. Decreasing PSAV thresholds to 0.35ng/ml/year would improve screening sensitivity. (Korean J Urol 2008;49:113-117)
키워드
Prostate cancer;Screening;Prostate-specific antigen velocity
원문 및 링크아웃 정보
등재저널 정보