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Volume 7, Issue 2 (March 2005) 7, 159–163; 10.1111/j.1745-7262.2005.00029.x
Mass screening of prostate cancer in a Chinese population: the relationship between pathological features of prostate cancer and serum prostate specific antigen
Hong-Wen Gao, Yu-Lin Li, Shan Wu, Yi-Shu Wang, Hai-Feng Zhang, Yu-Zhuo Pan, Ling Zhang, Hiroo Tateno, Ikuro Sato, Masaaki Kuwahara and Xue-Jian Zhao
1.Department of Pathology, Jilin University Second Hospital, Changchun 130041, China
2.Department of Pathology, Basic Medical College, Jilin University, Changchun 130021, China
3.Prostate Diseases Prevention and Treatment Research Center, Jilin University, Changchun 130021, China
4.Department of Pathology, Miyagi Cancer Center, Miyagi Prefecture, Japan
5.Department of Urology, Miyagi Cancer Center, Miyagi Prefecture, Japan
Received: 2004-02-24 Accepted: 2004-12-06
| Abstract |
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Aim: To investigate the pathological features of the prostate biopsy through mass screening for prostate cancer in a Chinese cohort and their association with serum prostate specific antigen (PSA).
Methods: A total of 12 027 Chinese men in Changchun were screened for prostate cancer by means of the serum total prostate specific antigen (tPSA) test (by Elisa assay). Transrectal ultrasound-guided systematic six-sextant biopsies were performed on those whose serum tPSA value was >4.0 ng/mL and those who had obstructive symptoms (despite their tPSA value) and were subject to subsequent pathological analysis with the aid of the statistic software SPSS 10.0 (SPSS. Inc., Chicago. USA).
Results: Of the 12 027 cases, 158 (including 137 patients whose serum tPSA values were >4.0 ng/mL and 21 patients [serum tPSA <4.0 ng/mL] who had obstructive symptoms) undertook prostate biopsy. Of the 158 biopsies, 41 cases of prostatic carcinoma were found (25.9 %, 41/158). The moderately differentiated carcinoma and poorly differentiated carcinoma accounted for 61 % and 34 %, respectively. A significant linear positive correlation between the serum tPSA and the Gleason scores in the 41 cases of prostatic carcinoma (r= 0.312, P < 0.01) was established. A significant linear positive correlation between the serum tPSA value of the 41 prostatic carcinoma and the positive counts of carcinoma in sextant biopsies was established (r= 0.406, P < 0.01), indicating a significant linear relationship between serum tPSA and the size of tumor.
Conclusion: This study was the first to conduct mass screening for prostate cancer by testing for serum tPSA values and the first to investigate the pathological features of prostate cancer in a cohort of Chinese men. Our results reveal that the moderately differentiated carcinoma is the most common type of prostate cancer. This study also has shown that the serum tPSA value in prostate cancer is associated with the Gleason score and the size of tumor.
Keywords: prostate cancer, mass screening, prostate specific antigen, pathomorphology
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