PMID- 23825670
OWN - NLM
STAT- MEDLINE
DCOM- 20140207
LR  - 20221207
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 8
IP  - 6
DP  - 2013
TI  - Age-specific prostate specific antigen cutoffs for guiding biopsy decision in 
      Chinese population.
PG  - e67585
LID - 10.1371/journal.pone.0067585 [doi]
LID - e67585
AB  - BACKGROUND: Age-specific prostate specific antigen (PSA) cutoffs for prostate 
      biopsy have been widely used in the USA and European countries. However, the 
      application of age-specific PSA remains poorly understood in China. METHODS: 
      Between 2003 and 2012, 1,848 men over the age of 40, underwent prostate biopsy 
      for prostate cancer (PCa) at Huashan Hospital, Shanghai, China. Clinical 
      information and blood samples were collected prior to biopsy for each patient. 
      Men were divided into three age groups (</=60, 61 to 80, and >80) for analyses. 
      Digital rectal examination (DRE), transrectal ultrasound (prostate volume and 
      nodule), total PSA (tPSA), and free PSA (fPSA) were also included in the 
      analyses. Logistic regression was used to build the multi-variate model. RESULTS: 
      Serum tPSA levels were age-dependent (P = 0.008), while %fPSA (P = 0.051) and 
      PSAD (P = 0.284) were age-independent. At a specificity of 80%, the sensitivities 
      for predicting PCa were 83%, 71% and 68% with tPSA cutoff values of 19.0 ng/mL 
      (age</=60),21.0 ng/mL (age 61-80), and 23.0 ng/mL (age>/=81). Also, sensitivities at 
      the same tPSA levels were able to reach relatively high levels (70%-88%) for 
      predicting high-grade PCa. Area (AUC) under the receive operating curves (ROCs) 
      of tPSA, %fPSA, PSAD and multi-variate model were different in age groups. When 
      predicting PCa, the AUC of tPSA, %fPSA, PSAD and multi-variate model were 0.90, 
      0.57, 0.93 and 0.87 respectively in men </=60 yr; 0.82, 0.70, 0.88 and 0.86 
      respectively in men 61-80 yr; 0.79, 0.78, 0.87 and 0.88 respectively in men>80 
      yr. When predicting Gleason Score >/=7 or 8 PCa, there were no significant 
      differences between AUCs of each variable. CONCLUSION: Age-specific PSA cutoff 
      values for prostate biopsy should be considered in the Chinese population. 
      Indications for prostate biopsies (tPSA, %fPSA and PSAD) should be considered 
      based on age in the Chinese population.
FAU - Na, Rong
AU  - Na R
AD  - Department of Urology, Huashan Hospital, Fudan University, Shanghai, China.
FAU - Wu, Yishuo
AU  - Wu Y
FAU - Xu, Jianfeng
AU  - Xu J
FAU - Jiang, Haowen
AU  - Jiang H
FAU - Ding, Qiang
AU  - Ding Q
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130625
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
RN  - EC 3.4.21.77 (Prostate-Specific Antigen)
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - *Asian People
MH  - Biopsy/*standards
MH  - *Decision Making
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Prostate/pathology
MH  - Prostate-Specific Antigen/*blood
MH  - Prostatic Neoplasms/blood/pathology
MH  - ROC Curve
MH  - Reference Standards
PMC - PMC3692456
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2013/07/05 06:00
MHDA- 2014/02/08 06:00
PMCR- 2013/06/25
CRDT- 2013/07/05 06:00
PHST- 2013/02/23 00:00 [received]
PHST- 2013/05/19 00:00 [accepted]
PHST- 2013/07/05 06:00 [entrez]
PHST- 2013/07/05 06:00 [pubmed]
PHST- 2014/02/08 06:00 [medline]
PHST- 2013/06/25 00:00 [pmc-release]
AID - PONE-D-13-08243 [pii]
AID - 10.1371/journal.pone.0067585 [doi]
PST - epublish
SO  - PLoS One. 2013 Jun 25;8(6):e67585. doi: 10.1371/journal.pone.0067585. Print 2013.