Ten-year real-world data analysis of clinical characteristics in treatment-naive patients with highly suspected prostate cancer and PSA level ≥20 ng/mL
10.3969/j.issn.1009-8291.2025.01.004
- VernacularTitle:初诊未治PSA≥20 ng/mL高度可疑前列腺癌患者临床特征的10年真实世界数据分析
- Author:
Baolong PENG
1
;
Mingzhe CHEN
1
;
Junxin WANG
1
;
Ranlu LIU
1
,
2
;
Baojie MA
1
,
3
;
Shanqi GUO
4
;
Xingkang JIANG
1
Author Information
1. Department of Urology, Tianjin Medical University Second Hospital, Tianjin 300211
2. Department of Urology, Tianjin Medical University General Hospital, Tianjin 300000
3. Department of Urology, Huai'an Hospital, Huai'an 223200
4. Department of Oncology, The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin 300381, China
- Publication Type:Journal Article
- Keywords:
prostate cancer;
prostate-specific antigen;
localized prostate cancer;
metastatic prostate cancer;
early screening
- From:
Journal of Modern Urology
2025;30(1):13-21
- CountryChina
- Language:Chinese
-
Abstract:
[Objective] To analyze the clinicopathological characteristics of treatment-naive patients with highly suspected prostate cancer (PCa) with prostate-specific antigen (PSA) level ≥20 ng/mL, to provide reference for promoting early screening of PCa. [Methods] A retrospective analysis was conducted on the clinical data of treatment-naive patients with PSA level ≥20 ng/mL, undergoing prostate biopsy for highly suspected PCa at the Department of Urology, Tianjin Medical University Second Hospital during Jan.2013 and Jun.2023. The correlation between patients' age, body mass index (BMI), PSA, prostate volume (PV), prostate cancer-specific antigen density (PSAD), prostate imaging reporting and data system (PI-RADS) score, and International Society of Urological Pathology (ISUP) grade with highly suspected PCa metastasis and PSA stratification were analyzed. [Results] A total of 1778 suspected patients were enrolled. Pathological findings confirmed PCa in 1465 cases (82.4%), with 487(33.2%) diagnosed as metastatic PCa. Over the past decade, the number of patients undergoing prostate biopsy for highly suspected PCa and being confirmed has been increasing annually, with the proportion of metastatic cases remaining at around 30%. Compared with those with PSA level being 20-50 ng/mL, patients with PSA level >50 ng/mL had older age, lower BMI, higher PSAD, higher PI-RADS, higher ISUP, more diverse pathological types, and a higher incidence of metastasis (P<0.05) with lower proportion of urban residents. Additionally, analysis of metastatic PCa cases showed that 46.8%(228/487) had oligometastasis (≤5 metastatic lesions), including 99.0% bone metastasis, 4.1% extraregional lymph node metastasis, and 4.3% other organ metastasis. [Conclusion] Over the past 10 years, there has been a continuous increase in the number of treatment-naive biopsied cases and newly diagnosed cases of highly suspicious PCa with PSA level ≥20 ng/mL, while the proportion of metastatic cases remains high. Therefore, proactive efforts should be made to promote early screening of high-risk suspected cases.
