Clinical Utility of Prostate Specific Antigen in the Management of Prostatic Cancer
Clinical Utility of Prostate Specific Antigen in the Management of Prostatic Cancer
复制标题
前列腺特异性抗原在前列腺癌治疗中的临床应用
DOI：
10.1080/00365518809168499
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发表时间：
1988
影响因子：
2.1
通讯作者：
E. Cooper
中科院分区：
文献类型：
--
作者：
E. Cooper
45 在缓解期间通常低于 1 0 ng/ml。然而。该水平可以稳定在较高水平，精确的反应取决于个体患者。随着 PSA 平台水平的升高，未来几个月内病情进展的可能性也会增加。转移性疾病中 PSA 水平升高的进展预测。相比之下，通过免疫化学测量的 PAP 水平提供了一种不太敏感的监测治疗反应的方法，该水平主要反映了较大的肿瘤负荷。对 120 名患者进行了一项研究，调查是否可以使用连续 PSA 或 PAP 测量来代替重复的骨闪烁扫描来确定临床试验中的进展情况。在 5-4 名骨扫描阴性的患者中，有 1-0 名出现骨骼转移，其中 5 名和 9 名患者的 PAP 和 PSA 水平分别上升。另外 9 名患者出现局部进展，其中 8 名 PAP 上升，所有 9 名 PSA 上升。在 66 名既往有骨转移记录的患者中，骨扫描显示有 36 名进展证据。在首次出现进展证据时，2 名患者 PAP 上升（55%），26 名患者（72%）PSA 上升。在 4 名患者中，在首次出现进展证据时，两种标志物均未升高。这些研究表明，虽然对患者进行骨闪烁扫描很有用，但重复 PSA 测量可能是监测患者进展的一种更具成本效益的方法。现状 PSA 的使用在欧洲正在建立，并且可能会复发 PAP 的免疫学测量。该测试尚未获得人口监测所需的特异性。然而，在常规实践中，前列腺肥大且 PSA > 10 ng/ml 的患者极有可能患有前列腺癌。患有与低血清 PSA 相关的前列腺癌的患者往往会在多年内保持无进展，而那些血清 PSA 水平 > 20 ng/ml 的患者往往会在两年内出现进展。最后，PSA 提供了前列腺癌对治疗的反应和最终进展的敏感指标。
45 are usually below 1 0 ng/ml during the period of remission. However. thelevelscanplateauat ahigherlevel, theprecise response being dependent on the individual patient. The probability of progression within the next few months is increased as the plateau level of PSA rises. The prediction of progression from a rising PSA levelin metastatic disease. By contrastthe levels of PAP, measured immunochemically, provided a less sensitive method of monitoring response to treatment, the levels mainly reflecting the larger tumour burdens. A study was made in 120 patients to investigate whether serial PSA or PAP measurements could be used instead of repeated bone scintigraphytoidentif yprogressionin clinicaltrials. Of 5 4 patients who presented with negative bone scans 1 0 developed skeletal metastases, the PAP and PSA levels were rising in 5 and 9 of these patients, respectively. Local progression occurred in a further 9 patientsin whom PAP was risingin 8 and PSA in all 9. In the 66 patients with previously documented skeletal metastases bone scanevidence of progression was seenin 36. A tthetime of thefirstevidenceof progression PAP was rising in 2 0 (55%) and PSA was rising in 26 (72%). In 4 patients neither marker was raised at the time of first evidence of progression. These studies suggest that whilst it is useful to undertake a bone scintigraphyinapatien tatpresentation, repeated PSA measurements may be a more cost effective way of monitoring the patient’s progress.Current status The use of PSA is becoming established in Europe and is likely to relapse the immunological measurement of PAP. The test has not gat the specificity needed for population monitoring. however in routine practice a patient with an enlarged prostate and PSA> 10 ng/ml raises a strong possibility of prostatic cancer. Patients presenting with prostatic cancer associated with a low serum PSA tend to remain without progression for many years, those with levels> 20 ng/ml tend to progress in two years. Finally PSA provides a sensitive indicator of the response of prostatic cancer to treatment and the eventual development of progression.