60岁时的前列腺特异性抗原水平和致命前列腺癌的终身风险
Emily A Vertosick1, Andrew Vickers1, Anders Dahlin2
1Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States.
Journal of the National Cancer Institute
|September 20, 2025
概括
60岁前列腺特异性抗原 (PSA) 水平预测了一生中致命的前列腺癌风险. 60岁时PSA低于1-2ng/ml的男性的风险较低,可能不需要进一步查.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 预防医学 预防医学
背景情况:
- 研究了60岁前列腺特异性抗原 (PSA) 与致命前列腺癌的终身风险之间的长期关系.
- 研究了无百分比PSA对低PSA水平的男性风险分层的有用性.
- 在马尔默预防项目中使用了从未查的队列中获取的数据,在马尔默预防项目中追踪了40年.
研究的目的:
- 确定PSA在60岁时的预测值,以确定致命前列腺癌的终身风险.
- 评估百分比自由的PSA是否可以改善低PSA水平的男性的风险分层.
- 根据基线PSA水平,为前列腺癌的查指南提供信息.
主要方法:
- 分析了1162名基线年龄为58-62岁的男性的数据,到2020年12月31日记录了1151例死亡.
- 在130名前列腺癌患者和517名没有前列腺癌患者中测量了总和自由PSA.
- 根据基线PSA计算洛伦茨曲线来评估由于前列腺癌而丧失的生命年数.
主要成果:
- 60岁时的PSA总量是终身致命前列腺癌风险的强有力的预测指标 (C指数=0.87).
- 超过一半的前列腺癌死亡发生在60岁时PSA>4.0 ng/ml的男性中;PSA>2.0 ng/ml和>1.0 ng/ml的男性也有显著比例.
- 无百分比的PSA并没有提高PSA水平较低的男性的风险分层.
结论:
- 60岁时PSA<1-2ng/ml的男性患致命前列腺癌的风险较低,可能不需要进一步查.
- 在60岁时PSA<2ng/ml的男性中,无百分比PSA对于指导查决策并不有用.
- 60岁时的PSA基线水平对于评估长期致命前列腺癌风险至关重要.
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