基于血液的S2,3PSA%检测在前列腺癌筛查中的作用:一种减少MRI和不必要活检的新方法。

IF 2.5 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM
Prostate Pub Date : 2025-08-01 Epub Date: 2025-05-22 DOI:10.1002/pros.24917
Hikari Miura, Tomoko Hamaya, Tohru Yoneyama, Tadashi Shimoyama, Fumiyasu Tsushima, Kyo Togashi, Yuki Miura, Anna Yoneyama, Hiroyuki Sato, Sosuke Omizo, Kazuyuki Mori, Hirotake Kodama, Naoki Fujita, Teppei Okamoto, Hayato Yamamoto, Shingo Kakeda, Chikara Ohyama, Shingo Hatakeyama
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引用次数: 0

摘要

目的:基于前列腺特异性抗原(PSA)的筛查降低了前列腺癌(PCa)的死亡率,但与过度诊断/过度治疗有关。我们开发并评估了一种基于血液的S2,3PSA%测试,以解决基于psa筛查PCa的局限性。方法:这项回顾性研究包括年龄≤75岁的男性,他们在2022年4月至2023年3月期间接受了机会性PSA和S2,3PSA%筛查。推荐对PSA≥2.0 ng/mL和S2、3PSA%≥38.0%或PSA≥4.0 ng/mL的参与者进行二次筛查。主要结局是基于S2,3PSA%临界值≥38.0%的MRI利用率降低。次要结果包括前列腺癌的检出率,以及前列腺活检和医疗费用的减少。结果:在808名接受PSA和S2,3PSA%筛查的参与者中,190名符合二次筛查标准。其中72人接受了进一步的评估,包括65名参与者的MRI。MRI结果排除了22名(33.8%)参与者不需要前列腺活检。最终,25名参与者进行了前列腺活检,17人(68.0%)被诊断为前列腺癌,其中12人患有临床显著的前列腺癌。PSA、S2、3PSA%和MRI的联合使用使MRI的使用减少44%,不必要的活检减少63%,医疗费用减少72%。研究的局限性包括样本量小,缺乏对S2、3PSA%阴性或MRI结果的参与者的评估。结论:S2,3PSA%筛查可能有潜力作为一种工具,以减少对MRI的需求,不必要的活检和医疗费用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Effects of the Blood-Based S2,3PSA% Test on Prostate Cancer Screening: A Novel Approach to Reduce the Need for MRI and Unnecessary Biopsies.

Objective: Prostate-specific antigen (PSA)-based screening has reduced prostate cancer (PCa) mortality but is associated with overdiagnosis/overtreatment. We developed and evaluated a blood-based S2,3PSA% test to address the limitations of PSA-based screening for PCa.

Methods: This retrospective study included men aged ≤ 75 years who underwent opportunistic PSA and S2,3PSA% screening between April 2022 and March 2023. Secondary screening was recommended for participants with PSA ≥ 2.0 ng/mL and S2,3PSA% ≥ 38.0%, or PSA ≥ 4.0 ng/mL. The primary outcome was the reduction in MRI utilization based on an S2,3PSA% cutoff of ≥ 38.0%. Secondary outcomes included the PCa detection rate, as well as reductions in prostate biopsies and medical costs.

Results: Among 808 participants who underwent PSA and S2,3PSA% screening, 190 met the criteria for secondary screening. Of these, 72 underwent further evaluation, including MRI in 65 participants. MRI findings excluded 22 (33.8%) participants from requiring prostate biopsy. Ultimately, 25 participants underwent prostate biopsy, and PCa was diagnosed in 17 (68.0%), including 12 with clinically significant PCa. The combined use of PSA, S2,3PSA%, and MRI resulted in a 44% reduction in MRI use, a 63% reduction in unnecessary biopsies, and a 72% reduction in medical costs. Study limitations include the small sample size and lack of evaluation of participants with negative S2,3PSA% or MRI findings.

Conclusions: S2,3PSA% screening may have potential as a tool to reduce the need for MRI, unnecessary biopsies, and medical costs.

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来源期刊
Prostate
Prostate 医学-泌尿学与肾脏学
CiteScore
5.10
自引率
3.60%
发文量
180
审稿时长
1.5 months
期刊介绍: The Prostate is a peer-reviewed journal dedicated to original studies of this organ and the male accessory glands. It serves as an international medium for these studies, presenting comprehensive coverage of clinical, anatomic, embryologic, physiologic, endocrinologic, and biochemical studies.
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