机构：[1]Department of Urology, Shanghai Changhai Hospital, Second Military Medical University, No. 168 Changhai Road, Shanghai, 200433, China,[2]Renji Hospital, Shanghai Jiao Tong University, School of Medicine, No.1630 Dongfang Road, Shanghai, 200127, China,[3]Department of Health Care, PLA Headquarters of the General Staff Guard Bureau, Beijing 100017, China,[4]Department of Urology, First Affiliated Hospital, School of Medicine, Zhejiang University, Qingchun Road 79, Hangzhou 310003, Zhejiang Province, China,浙江大学医学院附属第一医院[5]Department of Urology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, No.277 west Yanta Road, Xi'an 710061, China,[6]Department of Urology, Peking University First Hospital, Institute of Urology, Peking University, National Urological Cancer center, 8 Xishiku Street, Xicheng District, Beijing 100034, China,[7]Department of Urology, Peking University Third Hospital, No 49,North Garden Road, Haidian Dist, Beijing, China,[8]Department of Urology, West China Hospital, Sichuan University, Guoxuexiang 37# 610041, Chengdu Sichuan, China,四川大学华西医院[9]State Key Laboratory of Reproductive Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China江苏省人民医院[10]No.300 Guangzhou Road, Nanjing, Jiangsu Province, China,[10]Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China江苏省人民医院[12]No.300 Guangzhou Road, Nanjing, Jiangsu Province, China,[11]Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China,首都医科大学附属北京友谊医院[12]Department of Urology, Huadong Hospital, Fudan University, #221 West Yan’an Road, Shanghai 20040, China,[13]Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Yishan Rd.600 Shanghai, China,[14]Huashan Hospital, Fudan University, No. 12, WuLuMuQi Middle Road, Shanghai, 200040, China,[15]Department of Urology, Tenth People's Hospital[18]Tongji University, Shanghai, China,[16]Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave. Wuhan, 430030, China,华中科技大学同济医学院附属同济医院[17]Fudan University Shanghai Cancer Center and Department of Oncology, #270 Dong An Road, Shanghai, 200032, China,[18]Department of Urology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, China,[19]The First Affiliated Hospital of Soochow University, 188 ShiZhi Road, Suzhou, 215006, China,[20]Peking University People's Hospital, 11 Xizhomen South Street, Beijing, 100044, China,[21]Department of Urology, Xijing Hospital, The Fourth Military Medical University, 127 Changlexi Road, Xi'an, 710032 China,[22]Department of Urology, 3rd Hospital of Sun Yat-Sen University, Tiehe Road 600#, Guangzhou, 510630, China,中山大学附属第三医院[23]Department of Urology, Zhujiang Hospital, Southern Medical University, No. 253 Industrial Road, Haizhu District, Guangzhou, Guangdong, 510282, China,[24]Department of Urology, Wuhan General Hospital of Guangzhou Military Command, No. 627 Wuluo Rd, Wuhan, Hubei 430070, China
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.
基金：
Program for Changjiang Scholars and Innovative Research Team in University scheme of the Ministry of Education of China [IRT1111]; National Basic Research Program of ChinaNational Basic Research Program of China [2012CB518300, 2012CB518306]
第一作者机构：[1]Department of Urology, Shanghai Changhai Hospital, Second Military Medical University, No. 168 Changhai Road, Shanghai, 200433, China,
共同第一作者：
通讯作者：
推荐引用方式(GB/T 7714)：
Rui Chen,Yiran Huang,Xiaobing Cai,et al.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[J].PLOS ONE.2015,10(6):doi:10.1371/journal.pone.0130308.
APA：
Rui Chen,Yiran Huang,Xiaobing Cai,Liping Xie,Dalin He...&Chinese Prostate Cancer Consortium.(2015).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.PLOS ONE,10,(6)
MLA：
Rui Chen,et al."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".PLOS ONE 10..6(2015)
