The Accuracy of f/t-PSA for Diagnosing Prostate Cancer with a t-PSA Level of 4-10ng/mL: A Systematic Review and Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

GUO Xiaofan ^1,2 , XU Hainan ^1,2 , ZHANG Xiaoyu ^1,3 ,  WANG Hailong ¹ , SHI Jingpu ¹

1. Department of Clinical Epidemiology, The First Hospital of China Medical University, Shenyang 110001, China;2. Department of Clinical Medicine (Seven-Year System), China Medical University, Shenyang 110001, China;3. Department of Laboratory Medicine, Dalian Medical University, Dalian 116001, China;

Corresponding author：

WANG Hailong, Email: whl604@sohu.com

Keywords：

PSA; f/t-PSA; Prostate cancer; Meta-analysis; Diagnosis

DOI：

10.7507/1672-2531.20100564

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective 　To systemically evaluate the accuracy of f/t-PSA for diagnosing prostate cancer with a t-PSA level of 4-10ng/mL through meta-analysis.
Methods 　A literature search of CBM, VIP, CNKI and Wanfang Data from 1999 to 2009 was performed. Related journals were also searched manually. Two reviewers independently assessed trial quality according to QUADAS items. Heterogenous studies and meta-analysis were conducted by Meta-Disc1.4 software. The analysis was based on different critical values of f/t-PSA (0.1, 0.15, 0.2, 0.25, and 0.3).
Results 　Total 18 studies involving 2217 subjects were included. No threshold effect was found. But there was heterogeneity due to other factors. The meta–analysis showed that, the sensitivity of f/t-PSA with the critical value of 0.15 for the diagnosis of prostate cancer with a t-PSA level of 4-10ng/mL was 75% (95%CI 70%-79%), and the specificity was 81% (95%CI 78%-84%). The area under SROC curve was 0.883 5, and the Q index was 0.814 0.
Conclusion 　The f/t-PSA is a better index for diagnosing prostate cancer with t-PSA levels between 4 and 10ng/mL. And it is reasonable to consider 0.15 as a more suitable critical value.

Citation： GUO Xiaofan,XU Hainan,ZHANG Xiaoyu,WANG Hailong,SHI Jingpu. The Accuracy of f/t-PSA for Diagnosing Prostate Cancer with a t-PSA Level of 4-10ng/mL: A Systematic Review and Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2010, 10(10): 1164-1168. doi: 10.7507/1672-2531.20100564 Copy

1.	Ferlay J, Bray F, Pisani P, et al. Globocan 2000: Cancer Incidence, Mortality and PrevalenceWorldwide,Version1.0..Lyon: IARCPress; 2001. http://www.iarc.fr/globocan/globocan.html (accessed June 2003).
2.	Finne P, Zhang WM, Auvinen A, et al. Use of the complexed between prostate specific antigen and alpha1-protease inhibitor for screening prostate cancer. J Urol, 2000, 164: 1956-1960.
3.	Andiole GL, Levin DL, Crawford ED, et al. Prostate cancer screening in the prostate, lung, colorectal and ovarian(PLCO) cancer screening trial: findings from the initial screening round of a randomized trial. JNCI Cancer Spectrum, 2005, 97: 433-438.
4.	Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3: 25.
5.	Zamora J, AbrairaV, Muriel A, et al. Meta-DiSc: A software for meta-analysis of test accuracy data. BMC Med Res Methodology, 2006, 6: 31.
6.	葛京平, 高建平, 许宏, 等. F/TPSA比值对T-PSA 4～10 ng/ml之间前列腺癌鉴别诊断的意义. 江苏医药杂志, 1999, 25(6): 420-421.
7.	张耀平, 李皇. f -PSA/t -PSA 比值诊断前列腺疾病的临床意义. 右江民族医学院学报, 2005, 2: 189-190.
8.	粱丽, 王肄辉, 杨波, 等. fPSA/tPSA比值在前列腺癌和前列腺增生鉴别中的意义. 现代泌尿外科杂志, 2002, 7(2): 67-69.
9.	周蕾, 王海, 陈刚, 等. TPSA、FPSA、及其比值F/TPSA联合检测对前列腺癌诊断的意义. 实验与检验医学, 2008, 26(2): 185-186.
10.	李付军, 白安平. F-PSA/T-PSA 比值在前列腺病患者灰区内的诊断价值. 中国误诊学杂志, 2006, 6(5): 868-869.
11.	田连芳. 血清 f-PSA及f-PSA/t-PSA比值诊断前列腺疾病的临床意义. 放射免疫学杂志, 2007, 20(3): 287-288.
12.	谢克俭, 潘芙蓉, 管瑜. t-PSA为 4.0～10.0 ng/ml时f-PSA百分率对前列腺疾病的鉴别诊断价值. 临床榆验杂志, 2001, 19(5): 299-300.
13.	史硕达, 张丹. 两种抗原比值在前列腺疾病诊断中的意义. 检验医学与临床, 2009, 6(11): 875-876.
14.	韦平宣. 血清 F/T比值对诊断前列腺癌的应用价值. 广西医科大学学报, 2006, 23(5): 816-817.
15.	白安平, 李启忠. 血清F-PSA/T-PSA检测在前列腺增生及前列腺癌患者诊断中的临床价值. 实用诊断与治疗杂志, 2006, 20(2): 126-127.
16.	蒋莹, 范秀琴. 血清 T-PSA、F-PSA、F-PSA /T-PSA在前列腺癌诊断中的应用. 中国煤炭工业医学杂志, 2008, 11(10): 1563-1564.
17.	唐超美, 沈晓萍, 曹颖平. 血清游离/总前列腺特异抗原比值在前列腺癌鉴别诊断中的意义. 福建医药杂志, 1999, 21(4): 85-87.
18.	邱宁岩, 张静馨, 吴锦昌, 等. 血清游离 PSA和游离／总 PSA在前列腺癌诊断中的价值. 标记免疫分析与临床, 2005, 12(4): 200-203.
19.	田玉玲, 陈耀宇, 雷力民. 游离PSA总 PSA在前列腺增生与前列腺癌诊断中的意义. 实用医技杂志, 2007, 14(12): 1563-1564.
20.	张灵, 计国义, 李晓萌, 等. fPSA/tPSA比值优化前列腺癌早期诊断作用的研究. 中华男科学杂志, 2004, 10(8): 582-585.
21.	吴登龙, 金重睿, 张炯, 等. 血清游离前列腺特异性抗原百分率在前列腺癌诊断盲区的价值评价. 上海医学, 2002, 25: 39-40.
22.	吕晓娴, 王传兵, 刘冰. 游离和总前列腺特异抗原检测对诊断和鉴别前列腺癌的临床意义. 实用医技杂志, 2006, 13(21): 3781.
23.	黄伟刚, 赖建生, 林津, 等. F-PSA和 F/T比值在前列腺癌“诊断灰色带”中的临床应用. 现代检验医学杂志, 2004, 19(3): 33-34.
24.	Yamamoto S, Maruyama T, Kondoh N, et al. Diagnostic efficacy of free to total ratio of prostate—-specific antigen and prostate--specific antigen velocity，singly and in combination，in detecting prostate cancer in patients with total serum prostate—specific antigen between 4 and 10 ng/mL. Int Urol Nephrol, 2008, 40(1): 85-89.
25.	Thompson IM, Ankerst DP. Prostate-specific antigen in the early detectionof prostate cancer. CMAJ, 2007, 176(13): 1853-1858.
26.	Loeb S, Catalona WJ. Prostate-specific antigen in clinical practice. Cancer Lett, 2007, 249(1): 30-39.

1. Ferlay J, Bray F, Pisani P, et al. Globocan 2000: Cancer Incidence, Mortality and PrevalenceWorldwide,Version1.0..Lyon: IARCPress; 2001. http://www.iarc.fr/globocan/globocan.html (accessed June 2003).
2. Finne P, Zhang WM, Auvinen A, et al. Use of the complexed between prostate specific antigen and alpha1-protease inhibitor for screening prostate cancer. J Urol, 2000, 164: 1956-1960.
3. Andiole GL, Levin DL, Crawford ED, et al. Prostate cancer screening in the prostate, lung, colorectal and ovarian(PLCO) cancer screening trial: findings from the initial screening round of a randomized trial. JNCI Cancer Spectrum, 2005, 97: 433-438.
4. Whiting P, Rutjes AW, Reitsma JB, et al. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol, 2003, 3: 25.
5. Zamora J, AbrairaV, Muriel A, et al. Meta-DiSc: A software for meta-analysis of test accuracy data. BMC Med Res Methodology, 2006, 6: 31.
6. 葛京平, 高建平, 许宏, 等. F/TPSA比值对T-PSA 4～10 ng/ml之间前列腺癌鉴别诊断的意义. 江苏医药杂志, 1999, 25(6): 420-421.
7. 张耀平, 李皇. f -PSA/t -PSA 比值诊断前列腺疾病的临床意义. 右江民族医学院学报, 2005, 2: 189-190.
8. 粱丽, 王肄辉, 杨波, 等. fPSA/tPSA比值在前列腺癌和前列腺增生鉴别中的意义. 现代泌尿外科杂志, 2002, 7(2): 67-69.
9. 周蕾, 王海, 陈刚, 等. TPSA、FPSA、及其比值F/TPSA联合检测对前列腺癌诊断的意义. 实验与检验医学, 2008, 26(2): 185-186.
10. 李付军, 白安平. F-PSA/T-PSA 比值在前列腺病患者灰区内的诊断价值. 中国误诊学杂志, 2006, 6(5): 868-869.
11. 田连芳. 血清 f-PSA及f-PSA/t-PSA比值诊断前列腺疾病的临床意义. 放射免疫学杂志, 2007, 20(3): 287-288.
12. 谢克俭, 潘芙蓉, 管瑜. t-PSA为 4.0～10.0 ng/ml时f-PSA百分率对前列腺疾病的鉴别诊断价值. 临床榆验杂志, 2001, 19(5): 299-300.
13. 史硕达, 张丹. 两种抗原比值在前列腺疾病诊断中的意义. 检验医学与临床, 2009, 6(11): 875-876.
14. 韦平宣. 血清 F/T比值对诊断前列腺癌的应用价值. 广西医科大学学报, 2006, 23(5): 816-817.
15. 白安平, 李启忠. 血清F-PSA/T-PSA检测在前列腺增生及前列腺癌患者诊断中的临床价值. 实用诊断与治疗杂志, 2006, 20(2): 126-127.
16. 蒋莹, 范秀琴. 血清 T-PSA、F-PSA、F-PSA /T-PSA在前列腺癌诊断中的应用. 中国煤炭工业医学杂志, 2008, 11(10): 1563-1564.
17. 唐超美, 沈晓萍, 曹颖平. 血清游离/总前列腺特异抗原比值在前列腺癌鉴别诊断中的意义. 福建医药杂志, 1999, 21(4): 85-87.
18. 邱宁岩, 张静馨, 吴锦昌, 等. 血清游离 PSA和游离／总 PSA在前列腺癌诊断中的价值. 标记免疫分析与临床, 2005, 12(4): 200-203.
19. 田玉玲, 陈耀宇, 雷力民. 游离PSA总 PSA在前列腺增生与前列腺癌诊断中的意义. 实用医技杂志, 2007, 14(12): 1563-1564.
20. 张灵, 计国义, 李晓萌, 等. fPSA/tPSA比值优化前列腺癌早期诊断作用的研究. 中华男科学杂志, 2004, 10(8): 582-585.
21. 吴登龙, 金重睿, 张炯, 等. 血清游离前列腺特异性抗原百分率在前列腺癌诊断盲区的价值评价. 上海医学, 2002, 25: 39-40.
22. 吕晓娴, 王传兵, 刘冰. 游离和总前列腺特异抗原检测对诊断和鉴别前列腺癌的临床意义. 实用医技杂志, 2006, 13(21): 3781.
23. 黄伟刚, 赖建生, 林津, 等. F-PSA和 F/T比值在前列腺癌“诊断灰色带”中的临床应用. 现代检验医学杂志, 2004, 19(3): 33-34.
24. Yamamoto S, Maruyama T, Kondoh N, et al. Diagnostic efficacy of free to total ratio of prostate—-specific antigen and prostate--specific antigen velocity，singly and in combination，in detecting prostate cancer in patients with total serum prostate—specific antigen between 4 and 10 ng/mL. Int Urol Nephrol, 2008, 40(1): 85-89.
25. Thompson IM, Ankerst DP. Prostate-specific antigen in the early detectionof prostate cancer. CMAJ, 2007, 176(13): 1853-1858.
26. Loeb S, Catalona WJ. Prostate-specific antigen in clinical practice. Cancer Lett, 2007, 249(1): 30-39.

Chinese Journal of Evidence-Based Medicine

The Accuracy of f/t-PSA for Diagnosing Prostate Cancer with a t-PSA Level of 4-10ng/mL: A Systematic Review and Meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content