Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease.
Longitudinal evaluation of prostate-specific antigen levels in men with and without prostate disease.
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DOI：
10.1001/jama.1992.03480160073037
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发表时间：
1992-04
期刊：
影响因子：
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通讯作者：
H. Carter;J. Pearson;E. Metter;L. Brant;L. Brant;Daniel W. Chan;Reubin Andres;Reubin Andres;J. Fozard;P. Walsh
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文献类型：
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作者：
H. Carter;J. Pearson;E. Metter;L. Brant;L. Brant;Daniel W. Chan;Reubin Andres;Reubin Andres;J. Fozard;P. Walsh
目的评价前列腺特异性抗原（PSA）水平在有无前列腺疾病的男性中的纵向变化。设计：病例对照研究，以前列腺疾病和非前列腺疾病的男性为研究对象，进行前瞻性老龄化研究。国家老龄研究所老年学研究中心;巴尔的摩（马里兰州）老龄化纵向研究。16名无前列腺疾病的男性（对照组），20名组织学诊断为良性前列腺增生（BPH）的男性，18名组织学诊断为前列腺癌的男性。观察指标：在组织学诊断或排除前列腺疾病前7 - 25年，对血清样本进行多次PSA和雄激素测定。结果雄激素水平随年龄的变化在两组之间没有差异。对照组受试者的PSA水平未随年龄发生显著变化。两组之间年龄校正的PSA水平变化率有显著差异（前列腺癌大于BPH大于对照组; P <0.01）。在诊断前5年，当BPH和前列腺癌受试者之间的PSA水平没有差异时，前列腺癌受试者的PSA水平变化率（每年0.75微克/L）显著高于对照受试者和BPH受试者。此外，PSA水平的变化率将前列腺癌受试者与BPH受试者和对照受试者区分开来，特异性分别为90%和100%。结论：随着年龄的增长，影响血清PSA水平的最重要因素是前列腺疾病的发展。PSA水平的变化率可能是前列腺癌发展的敏感和特异的早期临床标志物。
OBJECTIVE To evaluate longitudinal changes in prostate-specific antigen (PSA) levels in men with and without prostate disease. DESIGN Case-control study of men with and without prostate disease who were participants in a prospective aging study. SETTING Gerontology Research Center of the National Institute on Aging; the Baltimore (Md) Longitudinal Study of Aging. PATIENTS Sixteen men with no prostate disease (control group), 20 men with a histologic diagnosis of benign prostatic hyperplasia (BPH), and 18 men with a histologic diagnosis of prostate cancer. OUTCOME MEASURES Multiple PSA and androgen determinations on serum samples obtained from 7 to 25 years prior to histologic diagnosis or exclusion of prostate disease. RESULTS Changes in androgen levels with age did not differ between groups. Control subjects did not show a significant change in PSA levels with age. There was a significant difference in the age-adjusted rate of change in PSA levels between groups (prostate cancer greater than BPH greater than control; P less than .01). At 5 years before diagnosis when PSA levels did not differ between subjects with BPH and prostate cancer, rate of change in PSA levels (0.75 micrograms/L per year) was significantly greater in subjects with prostate cancer compared with control subjects and subjects with BPH. Also, rate of change in PSA levels distinguished subjects with prostate cancer from subjects with BPH and control subjects with a specificity of 90% and 100%, respectively. CONCLUSIONS The most significant factor affecting serum PSA levels with age is the development of prostate disease. Rate of change in PSA levels may be a sensitive and specific early clinical marker for the development of prostate cancer.