Percent free prostatic-specific antigen （%fPSA） has been introduced as a tool to avoid unnecessary biopsies in patients with a serum PSA level of 4.0-10.0 ng ml^-1, however, it remains controversial whether %fPSA is...Percent free prostatic-specific antigen （%fPSA） has been introduced as a tool to avoid unnecessary biopsies in patients with a serum PSA level of 4.0-10.0 ng ml^-1, however, it remains controversial whether %fPSA is effective in PSA range of 10.1-20.0 ng ml^-1 in both Chinese and Western population. In this study, the diagnostic performance of %fPSA and serum PSA in predicting prostate cancer （PCa） and high-grade PCa （HGPCa） was analyzed in a multi-center biopsy cohort of 5915 consecutive Chinese patients who underwent prostate biopsy in 22 hospitals across China from January 1, 2010 to December 31, 2013. The indication for biopsy was PSA〉4.0 ng ml^-1 or/and suspicious digital rectal examination. Total and free serum PSA determinations were performed by three types of electrochemiluminescence immunoassays with recalibration to the World Health Organization standards. The diagnostics accuracy of PSA, %fPSA and %fPSA in combination with PSA （%fPSA ＋ PSA） was determined by the area under the receivers operating characteristic curve （AUC）. %fPSA was more effective than PSA in men aged ≥60 years old. The AUC was 0.584 and 0.635 in men aged ≥60 years old with a PSA of 4.0-10.0 ng ml^-1 and 10.1-20.0 ng ml^-1, respectively. The AUC of %fPSA was superior to that of PSA in predicting HGPCa in patients ≥60 years old in these two PSA range. Our results indicated that %fPSA is both statistically effective and clinical applicable to predict prostate biopsy outcome in Chinese patients aged ≥60 years old with a PSA of 4.0-10.0 ng ml^-1 and 10.1-20.0 ng ml^-1.展开更多
This study aimed to establish nomograms to preoperatively predict the possibility of testicular salvage(TS)in patients with testicular torsion.The clinical data of 204 patients with testicular torsion diagnosed at Xij...This study aimed to establish nomograms to preoperatively predict the possibility of testicular salvage(TS)in patients with testicular torsion.The clinical data of 204 patients with testicular torsion diagnosed at Xijing Hospital and Tangdu Hospital(Xi'an,China)between August 2008 and November 2019 were retrospectively analyzed.Univariate and multivariate logistic regression analyses were used to determine the independent predictors of TS.Based on multivariate regression coefficients,nomograms to predict possibility of TS were established.The predictive ability of the nomograms was internally validated by receiver operating characteristic(ROC)curves and calibration plots.The duration of symptoms ranged from 2 h to 1 month,with a median of 3.5 days.Thirty(14.7%)patients underwent surgical reduction and contralateral orchiopexy,while the remaining 174(85.3%)underwent orchiectomy and contralateral orchiopexy.Finally,long symptom duration was an independent risk predictor for TS,while visible intratesticular blood flow and homogeneous testicular echotexture under color Doppler ultrasound were independent protective predictors.Internal validation showed that the nomograms,which were established by integrating these three predictive factors,had good discrimination ability in predicting the possibility of TS(areas under the ROC curves were 0.851 and 0.828,respectively).The calibration plots showed good agreement between the nomogram-predicted possibility of TS and the actual situation.In conclusion,this brief preoperative prediction tool will help clinicians to quickly determine the urgency of surgical exploration.展开更多
文摘Percent free prostatic-specific antigen （%fPSA） has been introduced as a tool to avoid unnecessary biopsies in patients with a serum PSA level of 4.0-10.0 ng ml^-1, however, it remains controversial whether %fPSA is effective in PSA range of 10.1-20.0 ng ml^-1 in both Chinese and Western population. In this study, the diagnostic performance of %fPSA and serum PSA in predicting prostate cancer （PCa） and high-grade PCa （HGPCa） was analyzed in a multi-center biopsy cohort of 5915 consecutive Chinese patients who underwent prostate biopsy in 22 hospitals across China from January 1, 2010 to December 31, 2013. The indication for biopsy was PSA〉4.0 ng ml^-1 or/and suspicious digital rectal examination. Total and free serum PSA determinations were performed by three types of electrochemiluminescence immunoassays with recalibration to the World Health Organization standards. The diagnostics accuracy of PSA, %fPSA and %fPSA in combination with PSA （%fPSA ＋ PSA） was determined by the area under the receivers operating characteristic curve （AUC）. %fPSA was more effective than PSA in men aged ≥60 years old. The AUC was 0.584 and 0.635 in men aged ≥60 years old with a PSA of 4.0-10.0 ng ml^-1 and 10.1-20.0 ng ml^-1, respectively. The AUC of %fPSA was superior to that of PSA in predicting HGPCa in patients ≥60 years old in these two PSA range. Our results indicated that %fPSA is both statistically effective and clinical applicable to predict prostate biopsy outcome in Chinese patients aged ≥60 years old with a PSA of 4.0-10.0 ng ml^-1 and 10.1-20.0 ng ml^-1.
基金This work was supported by the Military Medicine Research Projects of Xijing Hospital(XJZT18D05).
文摘This study aimed to establish nomograms to preoperatively predict the possibility of testicular salvage(TS)in patients with testicular torsion.The clinical data of 204 patients with testicular torsion diagnosed at Xijing Hospital and Tangdu Hospital(Xi'an,China)between August 2008 and November 2019 were retrospectively analyzed.Univariate and multivariate logistic regression analyses were used to determine the independent predictors of TS.Based on multivariate regression coefficients,nomograms to predict possibility of TS were established.The predictive ability of the nomograms was internally validated by receiver operating characteristic(ROC)curves and calibration plots.The duration of symptoms ranged from 2 h to 1 month,with a median of 3.5 days.Thirty(14.7%)patients underwent surgical reduction and contralateral orchiopexy,while the remaining 174(85.3%)underwent orchiectomy and contralateral orchiopexy.Finally,long symptom duration was an independent risk predictor for TS,while visible intratesticular blood flow and homogeneous testicular echotexture under color Doppler ultrasound were independent protective predictors.Internal validation showed that the nomograms,which were established by integrating these three predictive factors,had good discrimination ability in predicting the possibility of TS(areas under the ROC curves were 0.851 and 0.828,respectively).The calibration plots showed good agreement between the nomogram-predicted possibility of TS and the actual situation.In conclusion,this brief preoperative prediction tool will help clinicians to quickly determine the urgency of surgical exploration.
