Influence of age on seven putative prostate tumor markers： a cohort study in Chinese men

The accuracy and sensitivity of prostate-specific antigen （PSA） for prostate cancer diagnosis is often poor; however, the reasons for its inaccuracy have rarely been investigated, especially with respect to age. In this study, 476 healthy males, aged 10-89 years, were stratified into eight age group...

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Published inAsian journal of andrology Vol. 19; no. 4; pp. 463 - 467
Main Authors Sun, Wei-Gui, Liang, Chao-Zhao, Zheng, Qi-Chuan, Hu, Xiao-Wu, Li, Zhi-Zhen, Wu, Ping
Format Journal Article
LanguageEnglish
Published China Medknow Publications and Media Pvt. Ltd 01.07.2017
Medknow Publications & Media Pvt. Ltd
Medknow Publications & Media Pvt Ltd
Subjects
Adolescent
Adult
Age
Age Factors
Aged
Aged, 80 and over
Antigens
Asian Continental Ancestry Group
Biomarkers
Biomarkers, Tumor - analysis
Child
China - epidemiology
Cohort analysis
Cohort Studies
Health aspects
Health Status
Humans
Male
Mens health
Middle Aged
Original
Physiological aspects
Prospective Studies
Prostate - physiopathology
Prostate cancer
Prostate specific antigen
Prostate-Specific Antigen - analysis
Prostatic Neoplasms - epidemiology
Risk Assessment
Studies
Urology
Young Adult
中国
健康指数
前列腺癌
年龄组
特异性抗原
男性
肿瘤标志物
队列研究
China
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Summary:The accuracy and sensitivity of prostate-specific antigen （PSA） for prostate cancer diagnosis is often poor; however, the reasons for its inaccuracy have rarely been investigated, especially with respect to age. In this study, 476 healthy males, aged 10-89 years, were stratified into eight age groups, and levels of seven markers were determined： total PSA （tPSA）, free PSA （fPSA）, %fPSA, isoform [-2]proPSA （p2PSA）, p2PSA/tPSA, %p2PSA, and the prostate health index （PHI）. Both tPSA and fPSA levels increased with age. The tPSA level was highest （1.39 ng m1-1） at 70-79 years; %fPSA was highest （0.57 ng ml-1） at 10-19 years; and %p2PSA was lowest （18.33 ng ml-1） at 40-49 years. Both p2PSA and p2PSA/tPSA had relatively flat curves and showed no correlation with age （P = 0.222）. PHI was a sensitive age-associated marker （P 〈 0.05）, with two peaks and one trough. The coverage rates and radiance graphs of PHI and %p2PSA were more distinctive than those of tPSA and the other markers. In subjects older than 69 years, PHI and %p2PSA both began to decrease, approximately 10 years earlier than the decrease in tPSA. Our results suggest that the clinical diagnosis of prostate cancer using PSA should be investigated more comprehensively based on patient age. Moreover, %p2PSA and PHI could be considered as earlier markers that may be more suitable than PSA alone.
Bibliography:age factors; diagnosis; prostate cancer; tumor marker
The accuracy and sensitivity of prostate-specific antigen （PSA） for prostate cancer diagnosis is often poor; however, the reasons for its inaccuracy have rarely been investigated, especially with respect to age. In this study, 476 healthy males, aged 10-89 years, were stratified into eight age groups, and levels of seven markers were determined： total PSA （tPSA）, free PSA （fPSA）, %fPSA, isoform [-2]proPSA （p2PSA）, p2PSA/tPSA, %p2PSA, and the prostate health index （PHI）. Both tPSA and fPSA levels increased with age. The tPSA level was highest （1.39 ng m1-1） at 70-79 years; %fPSA was highest （0.57 ng ml-1） at 10-19 years; and %p2PSA was lowest （18.33 ng ml-1） at 40-49 years. Both p2PSA and p2PSA/tPSA had relatively flat curves and showed no correlation with age （P = 0.222）. PHI was a sensitive age-associated marker （P 〈 0.05）, with two peaks and one trough. The coverage rates and radiance graphs of PHI and %p2PSA were more distinctive than those of tPSA and the other markers. In subjects older than 69 years, PHI and %p2PSA both began to decrease, approximately 10 years earlier than the decrease in tPSA. Our results suggest that the clinical diagnosis of prostate cancer using PSA should be investigated more comprehensively based on patient age. Moreover, %p2PSA and PHI could be considered as earlier markers that may be more suitable than PSA alone.
31-1795/R
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ISSN:1008-682X
1745-7262
DOI:10.4103/1008-682X.175787