准则的指导方针:对PSA重复测试间隔的证据进行批判性评估
Kiana K Collins1, Pradeep S Virdee1, Nia Roberts2
1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
BJU international
|July 4, 2025
概括
大多数指导方针建议无症状男性每2-4年进行一次前列腺特异性抗原 (PSA) 检测. 然而,目前关于PSA重复测试间隔的建议缺乏直接支持的证据.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 临床指南 临床指南
- 基于证据的医学基于证据的医学.
背景情况:
- 前列腺特异性抗原 (PSA) 测试对于前列腺癌查至关重要.
- 确定最佳的PSA再检测间隔对于患者管理至关重要.
- 临床实践指南为PSA重复测试间隔提供了建议.
研究的目的:
- 总结前列腺特异性抗原 (PSA) 重复测试间隔的建议.
- 在临床实践指南中评估支持这些建议的证据.
主要方法:
- 2013-2024年间发表的临床实践指南的系统审查.
- 在PubMed和TRIP数据库中搜索相关指南.
- 使用AGREE II工具评估指南质量并进行叙事综合.
主要成果:
- 包括11条指导方针,其中91%建议PSA重复测试间隔为2至4年.
- 在37项参考研究中,只有14%的研究直接涉及PSA重复测试间隔.
- 一半的指南建议与引用的证据部分或完全不符合.
结论:
- 大多数指导方针建议每两到四年对50岁以上的无症状男性进行一次PSA检测,PSA为1-3 ng/mL.
- 对于PSA<1 ng/mL,间隔可能延长至4-10年.
- 目前关于PSA再检测间隔的指导方针缺乏直接证据,需要临床医生和患者共同做出决定.
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