Rising PSA with a Negative Biopsy
Rising PSA with a Negative Biopsy
复制标题
活检阴性时 PSA 上升
DOI：
10.1159/000049878
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发表时间：
2001
期刊：
影响因子：
23.4
通讯作者：
L. Boccon‐Gibod
中科院分区：
文献类型：
--
作者：
L. Boccon‐Gibod
前列腺特异性抗原（PSA）作为诊断和筛查工具的使用导致了前列腺活检患者数量的显著增加。然而，PSA检测的特异性较低，大多数患者在诊断不确定的血清PSA范围为4-10 ng/ml时，活检结果为前列腺癌阴性。此外，目前的活检技术还不够理想。需要改进技术以提高肿瘤检出率并减少重复活检的次数。现在已经描述了几种活检技术，通过在已建立的六分仪活检岩心样本之外提取额外的岩心样本，更有效地对前列腺进行采样。腺体周围区域的采样结果显着提高了肿瘤检出率，而患者的发病率没有增加。前列腺上皮内瘤变（PIN）的存在是前列腺癌存在或可能出现的证据，但活检中未取样。在PSA升高和活检阴性的情况下，血清游离PSA /总PSA（游离PSA %）测量有助于区分癌症和其他可能引起PSA升高的原因，如良性前列腺增生。PIN与游离PSA百分比降低相关，是决定进行重复活检的有价值指标。
The use of prostate-specific antigen (PSA) as a diagnostic and screening tool has led to a significant rise in the numbers of patients undergoing prostate biopsy. However, the specificity of the PSA test is low, and the majority of patients in the diagnostically uncertain serum PSA range of 4–10 ng/ml will be negative for prostate cancer on biopsy. In addition, current biopsy techniques are sub-optimal. Improvements in technique are needed to increase the tumour detection rate and reduce the number of repeat biopsies. Several biopsy techniques have now been described that sample the prostate gland more effectively, by taking extra core samples in addition to the established sextant biopsy core samples. Sampling of peripheral areas of the gland results in significantly improved tumour detection rates while morbidity to the patient is not increased. The presence of prostatic intraepithelial neoplasia (PIN) is evidence that cancer is present, or is likely to appear, in the prostate, but has not been sampled in the biopsy. In the event of a rising PSA and negative biopsy, serum free/total PSA (% free PSA) measurement can be beneficial in discriminating between cancer and other possible causes of raised PSA, such as benign prostatic hyperplasia. PIN in association with reduced % free PSA is a valuable indicator in the decision to carry out a repeat biopsy.
DOI：
10.1001/jama.1995.03530150038031
发表时间：
1995-10
期刊：
JAMA
影响因子：
--
作者：
W. Catalona;Deborah S. Smith;R. Wolfert;T. J. Wang;H. Rittenhouse;T. Ratliff;R. B. Nadler
通讯作者：
W. Catalona;Deborah S. Smith;R. Wolfert;T. J. Wang;H. Rittenhouse;T. Ratliff;R. B. Nadler
DOI：
10.1001/jama.1993.03510070082041
发表时间：
1993-08
期刊：
JAMA
影响因子：
--
作者：
J. E. Oesterling;S. Jacobsen;C. Chute;H. Guess;C. Girman;Laurei A. Panser;M. Lieber
通讯作者：
J. E. Oesterling;S. Jacobsen;C. Chute;H. Guess;C. Girman;Laurei A. Panser;M. Lieber
作为前列腺癌检测方法的血清前列腺特异性抗原水平的变化率。
DOI：
10.1016/s0022-5347(17)32528-4
发表时间：
1994
期刊：
The Journal of urology
影响因子：
--
作者：
Smith,DS;Catalona,WJ
通讯作者：
Catalona,WJ