Age-Specific Cutoff Value for the Application of Percent Free Prostate-Specific Antigen (PSA) in Chinese Men with Serum PSA Levels of 4.0-10.0 Ng/ml

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2015 Jun 20

PMID 26091007

Citations 10

Authors

Rui Chen

Yiran Huang

Xiaobing Cai

Liping Xie

Dalin He

Liqun Zhou

Chuanliang Xu

Xu Gao

Shancheng Ren

Fubo Wang

Lulin Ma

Qiang Wei

Changjun Yin

Ye Tian

Zhongquan Sun

Qiang Fu

Qiang Ding

Junhua Zheng

Zhangqun Ye

Dingwei Ye

Danfeng Xu

Jianquan Hou

Kexin Xu

Jianlin Yuan

Xin Gao

Chunxiao Liu

Tiejun Pan

Yinghao Sun

Affiliations

Soon will be listed here.

Abstract

Objective: The influence of age on the performance of percent free prostate-specific antigen (%fPSA) in diagnosing prostate cancer (PCa) in East Asians is controversial. We tested the diagnostic performance of %fPSA in a multi-center biopsy cohort in China and identified the proper age-specific cutoff values to avoid unnecessary biopsies.

Methods: Consecutive patients with a prostate-specific antigen (PSA) level of 4.0-10.0 ng/ml or 10.1-20.0 ng/ml who underwent transrectal ultrasound-guided or transperineal prostate biopsy were enrolled from 22 Chinese medical centers from Jan 1, 2010 to Dec 31, 2013. The diagnostic accuracy of PSA and %fPSA was determined using the area under the receiver operating characteristic (ROC) curve (AUC). Age-specific cutoff values were calculated using ROC curve analysis.

Results: The median %fPSA was much lower in younger patients compared with older patients with a PSA level of 4.0-10.0 ng/ml or 10.1-20.0 ng/ml. The AUC of %fPSA was higher than PSA only in older patients. In patients aged 50 to 59 years, %fPSA failed to improve the diagnosis compared with PSA in these two PSA ranges. Age-specific cutoff values were 24%, 27% and 32% for patients aged 60-69, 70-79 and ≥80 years, respectively, to reduce unnecessary biopsies in men with PSA levels of 4.0-10.0 ng/ml to detect 90% of all PCa.

Conclusions: The effectiveness of %fPSA is correlated with age in the Chinese population. Age-specific cutoff values would help avoid unnecessary biopsies in the Chinese population.

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