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首页> 外文期刊>Urology >Prostate-specific antigen cutoff of 2.6 ng/mL for prostate cancer screening is associated with favorable pathologic tumor features.
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Prostate-specific antigen cutoff of 2.6 ng/mL for prostate cancer screening is associated with favorable pathologic tumor features.

机译：用于前列腺癌筛查的前列腺特异性抗原截止值为2.6 ng / mL与良好的病理性肿瘤特征相关。

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OBJECTIVES: To evaluate the pathologic characteristics of clinical Stage T1c (nonpalpable, prostate-specific antigen [PSA]-detected) prostate cancers detected in the 2.6 to 4.0-ng/mL PSA range and compare them with Stage T1c cancers concurrently detected in the 4.1 to 10.0-ng/mL PSA range. All cancers were detected in a prostate cancer screening study. METHODS: We studied 94 patients with clinical Stage T1c prostate cancer diagnosed by four or six-sector ultrasound-guided needle biopsy who underwent radical prostatectomy between June 1995 and December 1996. We included all men whose prostatectomy specimens were processed with complete embedding of all prostatic tissue. Of these, 42 had a PSA level of 2.6 to 4.0 ng/mL and 52 a PSA level 4.1 to 10.0 ng/mL at the time of cancer detection. We determined the tumor volume by complete embedding and grid morphometry, pathologic stage, Gleason sum, and surgical margin status and compared the cancer volume and pathologic tumor stages for each group. RESULTS: Men with cancer detected at the 2.6 to 4.0 ng/mL PSA range had significantly smaller cancer volumes (1.1 +/- 1.1 cm(3) versus 1.8 +/- 1.5 cm(3), P = 0.02); however, no difference was found in the proportion (11.9% versus 11.5%, P = 0.9, and 23.8% versus 26.9%, P = 0.7, respectively) of tumors that met previously published criteria of clinically insignificant volume, Gleason sum 6 or less) or "clinically unimportant" (organ confined, less than 0.5 cm(3) tumor volume, and Gleason sum 6 or less) tumors. Using the lower PSA cutoff point resulted in the detection of a significantly higher percentage of organ-confined tumors (88% versus 63%, P = 0.01). CONCLUSIONS: The use of a 2.6-ng/mL PSA threshold for screening resulted in the more frequent detection of small, organ-confined tumors without overdetecting possibly clinically insignificant ones.
机译：目的：评估在2.6至4.0 ng / mL PSA范围内检测到的临床T1c期（不可触及的前列腺特异性抗原[PSA]检测）前列腺癌的病理特征，并将其与在4.1中同时检测到的T1c期癌症进行比较至10.0-ng / mL PSA范围。在前列腺癌筛查研究中检测到所有癌症。方法：我们研究了1995年6月至1996年12月间经四或六段超声引导穿刺活检诊断为临床T1c期前列腺癌的94例患者，这些患者均接受了前列腺切除术标本并全部包埋所有前列腺的男性组织。其中有42例在癌症检测时的PSA水平为2.6至4.0 ng / mL，52例为PSA水平为4.1至10.0 ng / mL。我们通过完全包埋和网格形态，病理分期，格里森总和和手术切缘状态确定肿瘤体积，并比较每组的癌症体积和病理肿瘤分期。结果：在2.6至4.0 ng / mL PSA范围内检测到的癌症患者的癌症体积明显较小（1.1 +/- 1.1 cm（3）对1.8 +/- 1.5 cm（3），P = 0.02）;但是，符合先前发表的临床上无意义的体积标准（格里森总和为6以下）的肿瘤比例（分别为11.9％对11.5％，P = 0.9和23.8％对26.9％，P = 0.7）没有差异）或“临床上不重要”（器官受限，小于0.5 cm（3）的肿瘤体积，格里森总数不超过6个）的肿瘤。使用较低的PSA临界点可检测到明显更高的器官限制肿瘤百分比（88％比63％，P = 0.01）。结论：使用2.6 ng / mL PSA阈值进行筛查可导致更频繁地发现较小的器官受限肿瘤，而不会过度检测可能对临床无影响的肿瘤。

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