PROSTATE SPECIFIC ANTIGEN DENSITY - A MEANS OF DISTINGUISHING BENIGN PROSTATIC HYPERTROPHY AND PROSTATE-CANCER
PROSTATE SPECIFIC ANTIGEN DENSITY - A MEANS OF DISTINGUISHING BENIGN PROSTATIC HYPERTROPHY AND PROSTATE-CANCER
复制标题
DOI：
10.1016/s0022-5347(17)37393-7
复制
发表时间：
1992-03-01
影响因子：
6.6
通讯作者：
COONER, WH
中科院分区：
文献类型：
--
作者：
BENSON, MC;WHANG, IS;COONER, WH
在无症状个体中分离的前列腺特异性抗原（PSA）测定尚未显示出足够的敏感性和特异性，无法用于前列腺疾病的常规评估。为了提高血清PSA的准确性，我们使用了血清PSA和前列腺体积的商数，我们称之为前列腺特异性抗原密度（PSAD）。本研究的前列腺体积是根据良性前列腺肥大（BPH）的磁共振成像结果或肿瘤手术标本的尺寸计算的，计算公式为：长x宽x深x 0.5 =体积。共61例临床局限于前列腺的前列腺疾病患者（41例行根治性前列腺切除术的前列腺癌患者和20例BPH患者）进行评估。前列腺癌的PSAD平均值为0.581，前列腺增生症的PSAD平均值为0.044 （p < 0.002）。没有BPH患者的PSAD大于0.117，只有1例患者的密度大于或等于0.1。在34名PSAD大于等于0.1的患者中，有33名患有前列腺癌。41例前列腺癌患者中仅有2例PSAD低于0.05，BPH患者中有14例PSAD低于0.05。PSAD大于0.05小于0.1的患者11例，其中前列腺癌6例（P0病1例），BPH 5例。6例前列腺癌患者中5例PSA≤4.0,5例BPH患者中4例PSA大于4.0,1例PSA大于10。这些结果提示PSAD可能有助于区分BPH和前列腺癌。
Isolated prostate specific antigen (PSA) determinations in asymptomatic individuals have not demonstrated sufficient sensitivity and specificity to be useful in the routine evaluation of prostate disease. To enhance the accuracy of serum PSA we have used a quotient of serum PSA and prostate volume, which we refer to as prostate specific antigen density (PSAD). Prostate volume in this study was calculated from magnetic resonance imaging determinations of benign prostate hypertrophy (BPH) or from the dimensions of the surgical specimen of cancer using the formula, length x width x depth x 0.5 = volume. A total of 61 patients with prostatic disease clinically confined to the prostate glands (41 with prostate cancer undergoing radical prostatectomy and 20 with BPH) was evaluated. The mean PSAD for prostate cancer was 0.581 while that for BPH was 0.044 (p < 0.002). No patient with BPH had a PSAD of greater than 0.117 and only 1 patient had a density of 0.1 or greater. Of 34 patients with a PSAD of 0.1 or greater 33 had prostate cancer. Only 2 of the 41 prostate cancer patients and 14 of the BPH patients had a PSAD of 0.05 or less. There were 11 patients with a PSAD of greater than 0.05 and less than 0.1, including 6 with prostate cancer (1 with P0 disease) and 5 with BPH. Of the 6 prostate cancer patients 5 had a PSA of 4.0 or less and among the 5 patients with BPH 4 had a serum PSA of greater than 4.0 and 1 had a PSA of greater than 10. These results suggest that PSAD may be useful in distinguishing BPH and prostate cancer.