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頁籤選單縮合
題名 | 臺北市攝護腺癌之篩檢分析=Screening for Prostate Cancer in Taipei City |
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作者 | 盧星華; 張彰琦; 邱文祥; 劉志光; 柯明中; 陳修聖; 郭育成; 陳證文; | 書刊名 | 北市醫學雜誌 |
卷期 | 9:4 2012.12[民101.12] |
頁次 | 頁359-373 |
分類號 | 415.863 |
關鍵詞 | 攝護腺特異抗原; 身體質量指數; 年齡; 攝護腺癌; PSA; BMI; Age; Prostate cancer; |
語文 | 中文(Chinese) |
中文摘要 | 本研究針對臺北市各社區健康男性PSA的分析以建立不同年齡層健康男性PSA之標準參考值及了解BMI 對其PSA值之影響。方法:本研究於2009年9月至2011年6月在臺北市舉辨免費攝護腺癌篩檢,以居住本市40歲以上男性為對象,對同意參與研究之民眾收集其過往病史、攝護腺癌家族史、IPSS(International Prostate Symptom Score)、血液、測量BMI值及進行肛診。同意參與本研究者共4947位,其PSA大於2.5 ng/ml 或肛診有異狀(攝護腺有硬塊或表面不平整)都轉介至醫院泌尿科,接受進一步診斷與治療。排除資料不全、重複篩檢、有下泌尿道感染者、有攝護腺癌病史者及回診後診斷為攝護腺癌者,最後納入分析個案共3,976位。結果:本研究對象平均年齡為57.3歲(年齡範圍為40至94歲),BMI平均為24.6kg/m2,PSA 中位數為1.20ng/mL。各年齡層PSA的第95百分位數分別為:40-49歲為2.51ng/mL;50-59歲為4.40ng/mL;60-69歲為6.86ng/mL;70-79歲為10.6ng/mL;80歲以上為13.2ng/mL。PSA與年齡達統計上顯著相關(p<0.01),有攝護腺癌家族史者之PSA值與無攝護腺癌家族史者之PSA值達統計上顯著差異;在校正年齡後BMI≥30kg/m2者與18.5-<22kg/m2者的PSA平均值達統計上顯著差異。結論:本研究結果顯示較高BMI者的PSA較低,也依資料建立台北市男性不同年齡層之PSA參考值,對於年齡較高者若考量以較高PSA值作為參考值,也許可以避免一些非必要的檢查,但仍需由臨床醫師視情形診療決定,以免造成病情延誤。 |
英文摘要 | The purpose of this study was to establish reference ranges for age specific PSA levels and identify any correlation between BMI and serum PSA levels using a community based survey of healthy males from Taipei City. Methods: From September 2009 to June 2011, 4,947 male (mean age 57.3 year-old, range between 40 and 94 yearold), who are older than 40 years old and lived in Taipei City were enrolled. The dataset related to 3,976 male subjects was subject to the statistical analysis. Past medical history, family history related to prostate cancer, serum PSA level, BMI and the results of a digital rectal examination (DRE) were recorded. The male participants with a PSA level greater than 2.5 ng/ml or AN abnormal DRE were referred to the hospital for further diagnosis and treatment. Those subjects with a history of prostate cancer, missing data, or who underwent a repeat examination were excluded. Finally, the dataset related to 4,010 participants was analyzed statistically. Results: The mean BMI value was 24.6kg/m^2 and the median PSA value was 1.20 ng/mL. The age-specific PSA reference value (95% percentile) were 2.51 ng/mL, 4.40 ng/mL, 6.68 ng/ mL, 10.6 ng/mL and 13.2 ng/mL for the age groups 40-49.9, 50-59.9, 60-69.9, 70-79.9, and over 80 years old, respectively, and there were found to be significant differences in PSA values across the different age groups (p<0.01). The participants with a family history of prostate cancer had higher PSA values compared to those without a family history of prostate cancer. The participants with a BMI ≥30kg/ m2 had significantly lower PSA values compared with those with a BMI 18.5-<22kg/m^2. Conclusions: Males with a higher BMI tend to have a lower PSA value. The reference ranges for age-specific PSA values in Taipei City have been established. The adoption of a higher PSA values for the older age groups may be beneficial to the policy makers as it will avoid unnecessary investigations in elderly men who have higher PSA values. However, in order to avoid any delay in diagnosis, clinicians should make decisions depending on the individual's specific condition. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。