| Objective:To investigate the relevance between the Series of Serum PSA and the positive rate in prostate biopsy. To evaluate value of t PSA,PSAD, fPSA/tPSA ratio,DRE,TURS in diagnosis of prostate cancer by ROC curve. To establish the Prediction model of the patient in grey-zone of the diagnosis in prostate cancer.Method:Analysis of the patient's case that was between 2007 and 2009. To contrast the discrimination in tPSA,DRE, TURS by sensitivity, specificity and positve rate. The patient was distinguished by tPSA, named 0-4ng/ml,4-10ng/ml,10-20ng/ml,>20ng/ml. To contrast the grops by positve rate in prostate biopsy. Define the grey-zone of the diagnosis in prostate cancer. The patients who were in the grey-zone, were distinguished by pathology, named prostate cancer and Not- prostate cancer. The series of Serum PSA were compared in the two grops. To evaluate value of tPSA,PSAD, fPSA/ tPSA ratio by ROC curve. To establish the Prediction model of the patient by Logistic regression.Result: Positve rate in prostate biopsy was 44.4% when tPSA was 4-10ng/ml. The rate was 48.3% when tPSA was 10-20ng/ml. PSAD and fPSA/tPSA were both significantly discriminating between prostate cancer and Not- prostate cancer (P<0.05).The area under ROC of these indexes in descending order is fPSA/tPSA ratio, PSAD. The fPSA/tPSA was 0.742 while the PSAD was 0.716. When tPSA was between 10ng/ml and 20ng/ml, the recommandation cut-off value of PSAD was 0.17,and the fPSA/tPSA was 0.15. To program the the Prediction model of patien in grey-zone.Conclusion:When tPSA was between 4ng/ml and 20ng/ml, the positive rate in prostate biopsy was low. So we can take the 4-20ng/ml as the the grey-zone of the diagnosis in prostate cancer.PSAD and fPSA/tPSA can improve the specificity of tPSA in prostate biopsy. When tPSA was between lOng/ml and 20ng/ml, the recommandation cut-off value of PSAD was 0.17, and the fPSA/tPSA was 0.15. To program the the prediction model of patien in grey-zone. prediction model:... |
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