[The detection rate of prostate cancer in different prostate-specific antigen (PSA) levels in Chinese men]

Abstract

Objective: To investigate the detection rate of prostate cancer in different PSA values and evaluate the importance of free PSA/total PSA in the diagnosis of prostate cancer in Chinese men.

Methods: We have analyzed 1244 patients who were submitted to needle biopsy since Jan 2000 to June 2005 in the Institute of Urology, Peking University. Systematic 12- or 13-core biopsies were taken transrectally under ultrasound (TRUS) guide for all of the patients.

Results: The prostate cancer detection rates in the tPSA ranges of < 4 ng/ml with positive DRE; 4 - 10 ng/ml with f/tPSA > 0.16; 4 - 10 ng/ml with f/tPSA < 0.16; 10.1 - 20 ng/ml and > 20 ng/ml. The positive biopsy rates were 18.1% (13/72), 11.6% (10/86), 17.4% (45/258), 24.9% (110/442), 56.7% (219/386) respectively. The higher levels of the PSA, the higher percentage of high grade (Gleason score > or = 8) prostate cancer. In conclusion, patients with PSA > 10 ng/ml or positive digital rectal examination (DRE) were strongly recommended to biopsy for detecting prostate cancer because of high positive rate. For the patients with PSA 4 - 10 ng/ml, the free PSA (fPSA/t PSA < 0.16) will play an important role to improve cancer detection rate.