This study investigated whether free prostate-specific antigen (fPSA) performs better than total PSA (tPSA) in predicting prostate volume (PV) in Chinese men with different PSA levels. A total of 5463 men with PSA levels of <10 ng ml^-1 and without prostate cancer diagnosis were included in this study. Patients were classified into four groups: PSA <2.5 ng ml^-1, 2.5-3.9 ng ml^-1, 4.0-9.9 ng ml^-1, and 2.5-9.9 ng ml^-1. Pearson/Spearman's correlation coefficient (r) and receiver operating characteristic (ROC) curves were used to evaluate the ability of tPSA and fPSA to predict PV. The correlation coefficient between tPSA and PV in the PSA <2.5 ng ml^-1 cohort (r = 0.422; P < 0.001) was markedly higher than those of the cohorts with PSA levels of 2.5-3.9 ng ml^-1, 4.0-9.9 ng ml^-1, and 2.5-9.9 ng ml^-1 (r = 0.114, 0.167, and 0.264, respectively; all P ≤ 0.001), while fPSA levels did not differ significantly among different PSA groups. Area under ROC curve (AUC) analyses revealed that the performance of fPSA in predicting PV ≥40 ml (AUC: 0.694, 0.714, and 0.727) was better than that of tPSA (AUC = 0.545, 0.561, and 0.611) in men with PSA levels of 2.5-3.9 ng ml^-1, 4.0-9.9 ng ml^-1, and 2.5-9.9 ng ml^-1, respectively, but not at PSA levels of <2.5 ng ml^-1 (AUC: 0.713 vs 0.720). These findings suggest that the relationship between tPSA and PV may vary with PSA level and that fPSA is more powerful at predicting PV only in the ''gray zone'' (PSA levels of 2.5-9.9 ng ml^-1), but its performance was similar to that of tPSA at PSA levels of <2.5 ng ml^-1.
Male ; Humans ; Prostate-Specific Antigen ; Prostate ; East Asian People ; Prostatic Neoplasms/diagnosis* ; ROC Curve

Male ; Humans ; Prostatic Neoplasms/diagnosis* ; Quality Control ; China

The morbidity and mortality of prostate cancer ascend yearly, which seriously threatens the health of the male population. Bone is the main metastasis site of prostate cancer, with bone metastases and skeletal-related events (SREs) occuring in more than 70% of patients with advanced prostate cancer. Bone metastases and the resulting SREs, such as spinal cord compression and pathological fracture, seriously affect the life quality of the patients. Although the active treatments of the primary disease is important, the application of bone-modifying agents to prevent SREs cannot be overlooked. However, there is no standard treatment procedure for the bone metastasis of prostate cancer at present. According to the clinical status, the Genitourinary Oncology Committee of Chinese Anti-cancer Association formulated this consensus, which integrated clinical evidence and real world clinical practices in China and abroad, to help clinicians make more accurate diagnosis and treatment for the bone metastases of prostate cancer with multidisciplinary strategies.
Bone Neoplasms ; Bone and Bones ; Consensus ; Humans ; Male ; Prostatic Neoplasms/diagnosis* ; Spinal Cord Compression/etiology*

With the rapid development of artificial intelligence technology, researchers have applied it to the diagnosis of various tumors in the urinary system in recent years, and have obtained many valuable research results. The article sorted the research status of artificial intelligence technology in the fields of renal tumors, bladder tumors and prostate tumors from three aspects: the number of papers, image data, and clinical tasks. The purpose is to summarize and analyze the research status and find new valuable research ideas in the future. The results show that the artificial intelligence model based on medical data such as digital imaging and pathological images is effective in completing basic diagnosis of urinary system tumors, image segmentation of tumor infiltration areas or specific organs, gene mutation prediction and prognostic effect prediction, but most of the models for the requirement of clinical application still need to be improved. On the one hand, it is necessary to further improve the detection, classification, segmentation and other performance of the core algorithm. On the other hand, it is necessary to integrate more standardized medical databases to effectively improve the diagnostic accuracy of artificial intelligence models and make it play greater clinical value.
Algorithms ; Artificial Intelligence ; Humans ; Male ; Prognosis ; Prostatic Neoplasms/diagnosis* ; Technology

Objective: To evaluate the prostate health index (PHI) as a tool for the diagnosis of PCa with a PSA level of 4－10 μg/L and determine the best cut-off value of PHI. METHODS: Fifty-eight patients with a PSA level of 4－10 μg/L underwent transrectal ultrasound-guided prostatic biopsy in our hospital between April 2017 and June 2019. We constructed receiver operating characteristic (ROC) curves for the relationship of the biopsy results with the level of PSA, the ratio of ［－2］ proPSA to fPSA and PHI, and calculated the area under the ROC curves (AUC). RESULTS: Prostatic biopsy revealed 18 cases of PCa in the 58 patients (31.0%). Statistically significant differences were observed between the PCa and non-PCa groups in ［－2］ proPSA, %［－2］ proPSA and PHI, but not in tPSA, % fPSA and PSA-density. The AUCs of PSA, % fPSA, PSA-density, ［－2］ proPSA, %［－2］ proPSA and PHI were 0.556, 0.407, 0.533, 0.746, 0.751 and 0.774, respectively. The specificity of PHI was 27.50% (95% CI: 14.6%－43.9%), the highest among the above predictors at 90% sensitivity. By applying PHI to this cohort, 13 cases (22.4%) of unnecessary biopsy could be avoided. CONCLUSIONS The application of PHI can increase the accuracy of PCa prediction and reduce unnecessary prostatic biopsy.、.
Asians ; Humans ; Macau ; Male ; Prostate ; Prostate-Specific Antigen ; Prostatic Neoplasms/diagnosis*

diagnosis with all diseases were significant.CONCLUSION: Our complete enumeration of the Korean Pca population shows that ADT is not associated with increased risks of cardiovascular disease.]]>
Antineoplastic Agents ; Cardiovascular Diseases ; Cohort Studies ; Comorbidity ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Gonadotropin-Releasing Hormone ; Humans ; Incidence ; Male ; Morinda ; Multivariate Analysis ; Myocardial Ischemia ; National Health Programs ; Observational Study ; Passive Cutaneous Anaphylaxis ; Prostate ; Prostatic Neoplasms ; Social Class

Prostate cancer (PCa) risk calculators (RCs) with prostate-specific antigen (PSA) and other risk factors can greatly improve the accurate prediction of potential risk of PCa compared to PSA. The European Randomized Study of Screening for PCa Risk Calculator (ERSPC-RC) and the Prostate Cancer Prevention Trial Risk Calculator (PCPT-RC) are developed on the Western population. However, the Western RCs showed limited diagnostic efficacy in the Eastern Asian population, mainly due to racial differences between the two populations. We aimed to review the application of Western RCs and Eastern Asian RCs in Eastern Asian cohorts and to identify the characteristics and efficacy of these RCs.
Aged ; Early Detection of Cancer ; Asia, Eastern ; Humans ; Male ; Middle Aged ; Models, Theoretical ; Prostate-Specific Antigen/blood* ; Prostatic Neoplasms/diagnosis* ; Risk Assessment ; Risk Factors

Prostate cancer (CaP) is the most common cancer diagnosed among men in the United States and the fifth most common cancer among men in Korea. Unfortunately, the early stages of CaP may have no symptoms. Thus, early detection is very important and physicians managing voiding dysfunction must have awareness about CaP. The traditional tests used for early detection of CaP are the prostate-specific antigen (PSA) blood test and digital rectal examination. However, a high PSA level is not specific for CaP. Benign prostatic hyperplasia, prostatitis, urinary tract infection, and urinary retention can all cause a high PSA level. Thus, no test shows sufficient accuracy to truly be useful for screening men for CaP. A prostate biopsy is the only method that yields a definitive diagnosis of CaP; however, this test is invasive and uncomfortable. Recently, new biomarkers for CaP detection have been proposed to improve the accuracy of the PSA test. In this review, we summarize our knowledge of various new biomarkers, including PSA-associated biomarkers (the prostate health index and 4Kscore), molecular biomarkers (PCA3, TMPRSS2: ERG fusion gene, and various miRNAs), and proteomics-associated biomarkers, and the ways in which they may improve the detection rate of CaP. Accordingly, this review can raise awareness about CaP to physicians managing voiding dysfunction and be a good reference for them.
Biomarkers ; Biopsy ; Diagnosis ; Digital Rectal Examination ; Discrimination (Psychology) ; Early Detection of Cancer ; Hematologic Tests ; Humans ; Korea ; Male ; Mass Screening ; Methods ; Prostate ; Prostate-Specific Antigen ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Prostatitis ; United States ; Urinary Retention ; Urinary Tract Infections

BACKGROUND: Cancer is one of the leading causes of morbidity and mortality worldwide. Yet, limited is known about patterns of cancer and risk factors for advanced stage cancers in Ethiopia. METHODS: A cross-sectional study was conducted on 919 patients with biopsy-confirmed cancers at Tikur Anbessa Hospital in Ethiopia, 2010 to 2014. Pearson chi-square test, t-test, analysis of variance and multivariate logistic regression analyses were performed. RESULTS: The majority of the patients were females (72.4%). The commonest malignancies among males were bone and soft tissue (16.5%), colorectal (12.2%), and esophageal (9.1%). Among females, the most common cancers were cervical (39.7%), breast (18.3%), and ovarian (7.1%); of these, 41.7%, 59.0%, and 42.6% were diagnosed at advanced stages, respectively. Females had more advanced stage cancers at diagnosis than males (37.6% vs. 24.8%, P < 0.01). Among males, 46.7% of prostate and 29.0% of colorectal cancers were in advanced stages at the time of diagnosis. Delay in presentation from onset of symptoms was associated with advanced cancer among females (OR = 3.21; 95% CI = 1.69–6.10). Prostate cancer among males (OR = 5.22; 95% CI = 1.26–21.60) and breast cancer among females (OR = 1.93; 95% CI = 1.23–3.03) were more likely to be diagnosed at advanced stages. CONCLUSIONS: Cancers with effective screening tests are common in Ethiopia and significant proportions of these were diagnosed at advanced stages, typically several months after onset of symptoms. Timely access to preventive care along with effective educational and screening strategies is needed in Ethiopia for early detection and treatment of common malignancies, such as cervical, breast and colorectal cancers.
Breast ; Breast Neoplasms ; Colorectal Neoplasms ; Cross-Sectional Studies ; Diagnosis ; Ethiopia ; Female ; Humans ; Logistic Models ; Male ; Mass Screening ; Mortality ; Neoplasm Staging ; Prostate ; Prostatic Neoplasms ; Risk Factors

BACKGROUND: Prostate cancer (PC) is the second most common type of cancer in men worldwide and the fifth most common cancer among Korean men. Although most PCs grow slowly, it is unclear whether a longer time interval from diagnosis to treatment causes worse outcomes. This study aimed to investigate whether the time interval from diagnosis to radical prostatectomy (RP) in men with clinically localized PC affects postoperative oncologic outcomes. METHODS: We retrospectively analyzed data of 427 men who underwent RP for localized PC between January 2005 and June 2016. The patients were divided into two groups based on the cutoff median time interval (100 days) from biopsy to surgery. The associations between time interval from biopsy to surgery (< 100 vs. ≥ 100 days) and adverse pathologic outcomes such as positive surgical margin, pathologic upgrading, and upstaging were evaluated. Biochemical recurrence (BCR)-free survival rates were analyzed and compared based on the time interval from biopsy to surgery. RESULTS: Pathologic upgrading of Gleason score in surgical specimens was more frequent in the longer time interval group and showed marginal significance (38.8% vs. 30.0%; P = 0.057). Based on multivariable analysis, an association was observed between time interval from biopsy to surgery and pathologic upgrading (odds ratio, 2.211; 95% confidence interval [CI], 1.342–3.645; P = 0.002). BCR-free survival did not differ based on time interval from biopsy to surgery, and significant association was not observed between time interval from biopsy to surgery and BCR on multivariable analysis (hazard ratio, 1.285; 95% CI, 0.795–2.077; P = 0.305). CONCLUSION: Time interval ≥ 100 days from biopsy to RP in clinically localized PC increased the risk of pathologic upgrading but did not affect long-term BCR-free survival rates in Korean men.
Biopsy ; Diagnosis ; Humans ; Male ; Neoplasm Grading ; Prostate ; Prostatectomy ; Prostatic Neoplasms ; Recurrence ; Retrospective Studies ; Survival Rate ; Time Factors ; Treatment Outcome