Combination of serum PSA assay, multi-parametric MRi and targeted prostate biopsy for prostate cancer screening in Nanjing
Liang, J.; Zhao, X.-Z.; Shi, J.-Y.; Qiu, X.-F.; Zhang, Q.; Zhuang, J.-L.; Wang, W.; Deng, Y.-M.; Huang, H.-F.; Zhang, C.-W.; Guo, H.-Q.
Zhonghua Nan Ke Xue 25(9): 815-822
2019
ISSN/ISBN: 1009-3591 PMID: 32233209 Document Number: 699151
To investigate the exact prevalence of PCa among males in Nanjing and search for a mode of PCa screening suitable for the specific conditions. From January to December 2018, we collected serum samples and clinical information from 6 903 men aged ≥50 years taking physical examination in 16 community health service centers in Nanjing. We proposed multi-parametric MRI (mpMRI) for those with serum PSA ≥4 μg/L, transperineal systematic biopsy and MRI/ultrasound fusion targeted prostate biopsy for those who scored ≥3 points on the Prostate Imaging-Reporting and Data System Version 2 (PI-RADS v2), transperineal systematic biopsy only for those with a PI-RADS v2 score of <3 and serum PSA ≥10 μg/L, and follow-up examinations every 6 months for those with a PI-RADS v2 score of <3 and serum PSA <4 μg/L. Among the 6 903 male subjects, 835 (12.1%) were found with serum PSA≥4 μg/L; 229 (77.4%) of the 296 men that received mpMRI scored ≥3 points on PI-RADS v2; and 79 (53.4%) of the 148 males that underwent prostate biopsy were diagnosed with PCa, with a total detection rate of 1.14% in all the subjects. Of the 77 patients with complete pathological data, 73 (94.8%) were found with clinically significant PCa, 30 (39.0%) with localized, 41 (53.2%) with locally advanced and 6 (7.8%) with metastatic malignancy, 6 (7.8%) in stage Ⅰ, 21 (27.3%) in stage Ⅱ, 34 (44.2%) in stage Ⅲ and 16 (20.8%) in stage Ⅳ. There were 47 (66.2%) high-risk, 18 (25.4%) moderate-risk and 6 (8.5%) low-risk cases among those with localized or locally advanced PCa. The prevalence of PCa in Nanjing deserves considerable attention, and PCa screening is highly necessary in the high-risk population, for which the combination of serum PSA assay, mpMRI and targeted prostate biopsy may be an ideal method.