Prostate Cancer Prevention Trial risk calculator for evaluating the risk of prostate cancer in the high-risk Chinese population

ZHU Xiao-dong; ZHENG An; WANG Zhi-qian; SHAO Qiang

doi:10.13263/j.cnki.nja.2018.02.009

Abstract：Objective:The Prostate Cancer Prevention Trial risk calculator (PCPT-RC) is an online tool for assessing the risk of prostate cancer (PCa) based on age,race,serum PSA,biopsy history,family history,and other factors.This study aimed to investigate the value,sensitivity and specificity of the PCPT-RC 2.0 in assessing the risk of PCa in the Chinese high-risk population.Methods:This study included 622 patients with the high risk of PCa characterized by high serum PSA (PSA ＞ 3 μg/L) or abnormality in digital rectal examination or imaging of the prostate.According to the results of prostate biopsy,we divided the patients into a PCa and a non-PCa group and used the PCPT-RC 2.0 for evaluation of all the cases followed by statistical analysis.Results:PCa was detected in 264 (42.4％) of the 622 patients,including 126 cases of high-grade malignancy.Compared with the non-PCa group,the PCa patients showed a significantly older age ([68.40 ± 7.30] vs [72.80 ± 7.20] yr,P ＜0.001),higher serum PSA level ([11.20 ± 7.76] vs [15.06 ± 10.65],P ＜0.001),and higher PCPT risk score ([37.0 ± 10.8]％ vs [44.4 ± 12.6]％,P ＜ 0.001).The PCPT risk score exhibited a greater area under the ROC curve than the level of serum PSA in evaluating the risk of PCa (0.67 vs 0.61,P ＜ 0.05),but no statistically significant difference between the two in predicting the risk of high-grade malignancy (0.67 vs 0.66,P ＞ 0.05).Conclusion:The PCPT risk score is valuable in predicting the risk of PCa in China,which may play a better role than the serum PSA level in screening PCa and avoid unnecessary prostate biopsy,though its advantage is not so obvious in identifying high-grade malignancy.A prediction tool needs to be established for evaluating the risk of PCa in the Chinese population.