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首页> 外文期刊>BJU international >Associations of lower urinary tract symptoms with prostate-specific antigen levels, and screen-detected localized and advanced prostate cancer : a case-control study nested within the UK population-based ProtecT (Prostate testing for cancer and Treatment) study
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Associations of lower urinary tract symptoms with prostate-specific antigen levels, and screen-detected localized and advanced prostate cancer : a case-control study nested within the UK population-based ProtecT (Prostate testing for cancer and Treatment) study

机译：下尿路症状与前列腺特异性抗原水平，筛查发现的局部和晚期前列腺癌的关联：一项病例对照研究，嵌套在基于英国人群的ProtecT（前列腺癌和治疗方法）研究中

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OBJECTIVE: To determine associations of lower urinary tract symptoms (LUTS) with prostate-specific antigen (PSA) levels and screen-detected localized and advanced prostate cancer. SUBJECTS AND METHODS: A case-control study nested within the UK population-based ProtecT (Prostate testing for cancer and Treatment) study. Men aged 50-69 years were invited for PSA testing and those with a PSA level of >or=3.0 ng/mL were invited for biopsy. We determined whether LUTS were associated with a PSA level of >or=3.0 ng/mL and prostate cancer using logistic regression models adjusted for age, family history of prostate cancer and PSA level as appropriate. Areas under receiver operating characteristic curves (AUC) were compared between models with and without symptoms. RESULTS: In all, 65 871 men had a PSA test: 7251 had a PSA level of >or=3.0 ng/mL including 2467 subsequently diagnosed with prostate cancer (2119 localized, 348 advanced). LUTS were positively associated with a PSA level of >or=3.0 ng/mL: odds ratios(ORs) were 1.18 (95% confidence interval, CI 1.01-1.38), 1.69 (95% CI 1.32-2.16), and 1.60 (95% CI 1.33-1.93) for daytime urination frequency (hourly vs less frequent), urgency and hesitancy (most/all the time vs never), respectively. LUTS among men with a PSA level of >or=3 ng/mL were negatively associated with prostate cancer: ORs were 0.44 (95% CI 0.22-0.83), 0.74 (95% CI 0.63-0.87), and 0.83 (95% CI 0.73-0.94) for nocturia (4+ vs 0), leakage and hesitancy (occasionally/sometimes vs never), respectively. LUTS improved the prediction of a PSA level of >or=3.0 ng/mL (AUC 0.635 vs 0.606, P < 0.001) and prostate cancer (AUC 0.661 vs 0.638; P < 0.001). CONCLUSIONS: A history of LUTS before PSA testing marginally improves the prediction of an individual's risk for prostate cancer; men with a PSA level of >or=3 ng/mL and LUTS were more likely to be diagnosed with benign disease than prostate cancer.
机译：目的：确定下尿路症状（LUTS）与前列腺特异性抗原（PSA）水平以及筛查的局部和晚期前列腺癌的相关性。受试者与方法：一项病例对照研究，嵌套在基于英国人群的ProtecT（癌症和治疗前列腺测试）研究中。邀请年龄在50-69岁之间的男性进行PSA检测，并邀请PSA水平>或= 3.0 ng / mL的男性进行活检。我们使用对年龄，前列腺癌家族史和PSA水平进行了适当调整的逻辑回归模型，确定LUTS是否与PSA水平≥3.0 ng / mL和前列腺癌相关。在有症状和无症状的模型之间比较接收器工作特征曲线（AUC）下的面积。结果：总共有65871名男性进行了PSA检测：7251名患者的PSA水平大于或等于3.0 ng / mL，其中包括2467名随后被诊断患有前列腺癌的患者（2119名本地化，348名晚期）。 LUTS与PSA水平>或= 3.0 ng / mL呈正相关：优势比（OR）为1.18（95％置信区间，CI为1.01-1.38），1.69（95％CI为1.32-2.16）和1.60（95）的百分比CI为1.33-1.93），分别代表白天排尿频率（每小时vs较不频繁），尿急和犹豫（大多数/所有时间vs从来没有）。 PSA水平>或= 3 ng / mL的男性中的LUTS与前列腺癌呈负相关：OR为0.44（95％CI 0.22-0.83），0.74（95％CI 0.63-0.87）和0.83（95％CI夜尿症（4+ vs 0），渗漏和犹豫（偶尔/有时vs从不）分别为0.73-0.94）。 LUTS改善了PSA水平≥3.0 ng / mL（AUC 0.635 vs 0.606，P <0.001）和前列腺癌（AUC 0.661 vs 0.638; P <0.001）的预测。结论：PSA测试前的LUTS病史可稍微提高对个体患前列腺癌风险的预测; PSA≥3 ng / mL且LUTS的男性比前列腺癌更有可能被诊断为良性疾病。

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