Ratio of free-to-total prostate specific antigen correlates with tumor volume in patients with increased prostate specific antigen
Ratio of free-to-total prostate specific antigen correlates with tumor volume in patients with increased prostate specific antigen
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DOI：
10.1097/00005392-200102000-00024
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发表时间：
2001-02-01
影响因子：
6.6
通讯作者：
Cookson, MS
中科院分区：
文献类型：
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作者：
Grossklaus, DJ;Shappell, SB;Cookson, MS
目的：我们评估了游离前列腺特异性抗原（PSA）和前列腺病理学，包括等级，阶段和肿瘤体积之间的关系，前列腺癌患者进行根治性arterectomy.Materials和方法：我们前瞻性分析了54例连续前列腺癌患者进行根治性arterectomy，并在其中冷冻血清可用于评估游离总PSA比。病理学检查采用整体切片，肿瘤总体积由面积测量法确定。结果：54例患者的总PSA均值为5.81 ng，游离PSA均值为14.2 ng。毫升，游离PSA/总PSA比值与前列腺体积直接相关（p = 0.037），与Gleason评分（p = 0.012）和囊外疾病（p = 0.0074）呈负相关。此外，39例患者的游离PSA/总PSA比值与病理分期pT 2a/B显著相关，而15例患者的pT 3a/B显著相关（p = 0.005）。总的来说，游离PSA与总PSA的比值与肿瘤体积之间没有相关性。然而，在37例PSA升高（定义为大于4.0 ng）的患者中，毫升，游离PSA与总PSA的比值与肿瘤体积之间存在显著的负相关关系（p = 0.01）。在这个子集中，只有一个弱的相关性与前列腺体积（p = 0.049）。结论：我们的研究结果表明，游离总PSA的比例可能是预测肿瘤生物学在这些患者的总PSA大于4 ng。ml.如与肿瘤等级和体积的良好相关性所证明的。这一发现似乎与前列腺体积无关。这些初步结果表明，需要在PSA升高的患者中进行额外的研究，以评估游离PSA与总PSA比值结合传统临床变量在预测前列腺癌病理学中的潜在作用。
Purpose: We evaluated the relationship between the ratio of free-to-total prostate specific antigen (PSA) and prostate pathology, including grade, stage and tumor volume, among patients with prostate cancer who underwent radical prostatectomy.Materials and Methods: We prospectively analyzed 54 consecutive patients with prostate cancer who underwent radical prostatectomy and in whom frozen serum was available for assessment of free-to-total PSA ratio. Pathological review was done with whole mount sections, and total tumor volume was determined by planimetry. Comparison between free-to-total PSA ratio and pathological parameters was performed using the Pearson correlation coefficient.Results: Among the 54 patients mean total and free-to-total PSA ratio were 5.81 and 14.2 ng./ml., respectively, and free-to-total PSA ratio directly correlated with prostate volume (p = 0.037), and inversely correlated with Gleason score (p = 0.012) and extracapsular disease (p = 0.0074). Furthermore, there was a significant relationship between free-to-total PSA ratio and pathological stage pT2a/b in 39 cases versus pT3a/b in 15 (p = 0.005). Overall, there was no correlation between free-to-total PSA ratio and tumor volume. However, among 37 patients with an increased PSA, defined as greater than 4.0 ng./ml., a significant inverse relationship between free-to-total PSA ratio and tumor volume was identified (p = 0.01). Among this subset there was only a weak correlation with prostate volume (p = 0.049).Conclusions: Our findings suggest that free-to-total PSA ratio may be predictive of tumor biology among those patients with a total PSA of greater than 4 ng./ml. as evidenced by good correlation with tumor grade and volume. This finding appears to be independent of prostate volume. These preliminary results suggest the need for additional studies among patients with an increased PSA designed to evaluate the potential role of free-to-total PSA ratio in combination with traditional clinical variables in the prediction of prostate cancer pathology.