年龄≤50岁非前列腺癌男性初始PSA及PSA速度的分布特点分析

Distribution and characteristics of initial PSA and PSA velocity in men younger than 50 years without prostate cancer

目的探讨年龄≤50岁非前列腺癌男性初始PSA及PSA速度的分布特点。方法回顾性分析2001年1月至2009年11月初始PSA检测年龄≤50岁的非前列腺癌患者的PSA值，计算PSA检测≥2次者的PSA速度。研究不同年龄段初始PSA及PSA速度的分布范围，分析初始PSA、初始PSA年龄及PSA速度之间的相关性。用生存分析和log—rank检验比较初始PSA高于和低于中位数2组患者将来PSA≥2．5ng／ml风险的差异。结果4206例非前列腺癌者，初始PSA中位数为0．6ng／ml，其中≥1．0、≥2．5和≥4．0ng/ml者分别1026例（24．4％）、177例（4．2％）和90例（2．1％）。417例PSA检测≥2次者PSA速度的中位数为0．03ng·ml^-1·y^-1，其中≥0．35、≥0．75和≥2．00ng·ml^-1·y^-1者分别为25例（6．0％）、13例（3．1％）和8例（1．9％）。年龄与PSA、年龄与PSA速度、PSA与PSA速度之间均无明显相关性（r值分别为0．019、-0．015和-0．006，P值分别为0．218、0．754和0．897）。395例PSA检测≥2次且初始PSA〈2．5ng／ml者随访3个月～7．1年，中位时间2．0年，初始PSA高于和低于中位数2组患者将来PSA超过2．5ng／ml的风险差异有统计学意义（P〈0．01）。结论年龄≤50岁非前列腺癌男性的中位初始PSA和PSA速度分别为0．6ng／ml和0．03ng·ml^-1·y^-1。初始PSA高于中位数的患者将来PSA超过2．5ng／ml的风险明显增高。

Objective To explore the distribution and characteristics of initial PSA and PSA velocity in men younger than years without prostate cancer. Methods PSA in men younger than 50 years without prostate cancer from January 2001 to November 2009 were retrieved retrospectively from our computer center. PSA velocity was calculated if their PSA was measured twice or more. The distributions of initial PSA and PSA velocity were analyzed. The correlations between initial PSA, initial PSA age, and PSA velocity were also analyzed. Kaplan-meicr and log-rank tests were used to estimate the significant difference at the risk of PSA≥ 2.5 ng/ml after initial PSA measurement, stratified by median initial PSA （0.6 ng/ml）. Results A total of 4206 men without prostate cancer were included. The median initial PSA value in these men was0.6 ng/ml. Of these men, 1026 （24.4%）, 177 （4.2%）, and 90 （2.1%） had an initialPSA≥ 1.0, ≥2.5, and ≥4.0 ng/ml, respectively. A total of 417 men had their PSA measured twice or more. The median PSA velocity in these men was 0.03 ng · ml^-1· year^-1 Of these men, 25 （6.0%）, 13 （3.1%）, and8 （1.9%） had a PSA velocity ≥0.35, ≥0.75, ≥2.00 ng· ml^-1· year^-1, respectively. There were no direct correlations between initial PSA age and initial PSA, initial PSA age and PSA velocity, and initial PSA and PSA velocity （ correlation coefficient r = 0. 019, - 0. 015, and - 0. 006, respectively; P=0. 218, 0. 754, and 0. 897, respectively）. After a follow-up of up to 7. 1 years from baseline PSA measurement, the risk of PSA ≥2.5 ng/ml, stratified by median initial PSA （0.6 ng/ml） was significantly different （log-rank test, P 〈 0. 001 ）. Conclusions The median baseline PSA and PSA velocity in men younger than 50 years old without prostate cancer are 0.6 ng/ml and 0.03 ng· ml^-1· year^-1, respectively. Men younger than 50 years old without prostate cancer with an initial PSA higher than median （0.6 ng/ml） have a subsequently higher risk of PSA value ≥2.5 ng/ml.