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RISS 인기검색어
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- 저자 : Ja Yoon Ku(구자윤) (검색결과 2 건)
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구자윤(Ja Yoon Ku),전태경(Tae Kyung Jern),하홍구(Hong Koo Ha) 대한비뇨기종양학회 2014 대한비뇨기종양학회지 Vol.12 No.2
The prevalence of prostate cancer is stiffly increasing in Korea. In contrasts to the frequency of occurrence, there is no definite guideline for the cut off value of serum PSA. So, we reviewed the usefulness of serum PSA and recently reported guidelines in the prostate cancer detection. Nowadays, the cut off value of PSA continued to change, moreover, it is difficult to satisfied both sensitivity and specificity, at the same time. Also, the value of PSA relies on the assay method or laboratory. Various methods such as the percent of free PSA, PSA velocity and PSA doubling time have been used to enhance the detection rate during prostate biopsy. However, these methods did not make certainty in deciding whether performing the prostate biopsy. To complement the uncertainty of PSA and its derivatives, the new ways such as proPSA, PCA3 and gene fusion have been recently documented. Currently, the clearly indication of prostate biopsy is placed in controversy. Therefore, in the future, new methods to overcome non-specificity of PSA should be considered.
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Kyung Hwan Kim(김경환),Ja Yoon Ku(구자윤),Won Young Park(박원영),Seung Baek Hong(홍승백),Suk Kim(김석),Hong Koo Ha(하홍구) 대한비뇨기종양학회 2020 대한비뇨기종양학회지 Vol.18 No.2
Purpose: Our study aimed to evaluate the predictive value of multiparametric magnetic resonance imaging (mpMRI) to assess the capsular extension of prostate cancer. Risk factors for extraprostatic invasion or microscopic invasion of bladder neck (pT3a stage) in the cases showing localized disease findings on MRI scan were also identified. Materials and Methods: We identified 198 patients who underwent robot-assisted or conventional laparoscopic radical prostatectomy in our institute between June, 2016 and May, 2018. Altogether, 170 patients with preoperational mpMRI scans and complete pathologic data were included. Positive and negative predictive values of mpMRI to detect capsular extension were estimated. Chi-square test was performed for ratio variables. Logistic regression analysis was performed to identify capsular invasion risk factors. Results: Median age and prostate-specific antigen level were 68 years and 7.5 ng/mL, respectively. Based on findings, 16 patients (9.4%) were identified as cT3a stage (unilateral or bilateral extraprostatic extension), whereas 37 patients (21.8%) as pT3a stage. Positive and negative predictive values of mpMRI to detect capsular extension were 75.0% and 73.9%, respectively. In the logistic regression analysis, positive biopsy core rate was the significant predictor for pT3a disease in the patients with negative capsular invasion findings on mpMRI (p<0.001). According to receiver-operating characteristic curve (area under the curve=0.691, p=0.001), the positive biopsy core rate of 0.275 was the best threshold. Conclusions: Multiparametric MRI is an appropriate test to predict pT3a disease preoperatively. The patients with positive core rate over 0.275 may have pT3a diseases despite negative image findings.
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