Brändle E, Hautmann O, Bachem M, Kleinschmidt K, Gottfried H W, Grünert A, Hautmann R E
Department of Urology, University of Ulm, Germany.
Urology. 1999 Apr;53(4):722-30. doi: 10.1016/s0090-4295(98)00593-7.
All studies investigating the elimination kinetics of serum total (tPSA) and free (fPSA) prostate-specific antigen (PSA) were carried out in men undergoing radical prostatectomy. Radical prostatectomy itself could, however, have a major influence on the serum concentration of these tumor markers (e.g., perioperative fluid shift or blood loss). The purpose of our study was to determine the half-life time of fPSA and tPSA with special regard to the influence of the radical prostatectomy on the serum concentration of these tumor markers.
Eleven men (mean age 63.2+/-7.2 years) with organ-confined prostate cancer who underwent radical prostatectomy were investigated (final pathologic Stage pT2pN0 or lower). Serum samples were obtained preoperatively and 0.25, 0.5, 1, 2, 4, 8, 12, 16, 24, 48, 72, 120, 168, and 240 hours after removal of the prostate. fPSA and tPSA and albumin and total protein serum concentrations were determined in all samples.
During the first 120 minutes after removal of the prostate, albumin and total protein serum concentrations continuously declined, with a half-life time of -104.5+/-28 minutes and -129.7+/-32 minutes, respectively. Serum decline of fPSA and tPSA followed a biphasic kinetic. During the initial alpha-phase, fPSA and tPSA serum concentrations decreased, with a half-life time of -69+/-10.3 minutes and -87.3+/-18.1 minutes, respectively. During the terminal beta-phase, the half-life time of fPSA and tPSA was -1152.2 minutes (0.8 days) and -3916.1 minutes (2.7 days), respectively. Between the alpha-phase half-life time of fPSA or tPSA and the half-life time of the total protein or albumin concentration decline, significant correlations were found.
These correlations indicate that the rapid decline of fPSA and tPSA directly after removal of the prostate (alpha-phase half-life time) is caused by the radical prostatectomy itself. The half-life time of the beta-phase reflects the biologic clearance of PSA. Therefore, the half-life time determination of PSA after radical prostatectomy is of limited value if the influence of the operation itself on the serum PSA concentration is not taken into account.
所有研究血清总前列腺特异性抗原（tPSA）和游离前列腺特异性抗原（fPSA）消除动力学的研究均在接受根治性前列腺切除术的男性中进行。然而，根治性前列腺切除术本身可能会对这些肿瘤标志物的血清浓度产生重大影响（例如围手术期液体转移或失血）。我们研究的目的是确定fPSA和tPSA的半衰期，特别关注根治性前列腺切除术对这些肿瘤标志物血清浓度的影响。
对11名患有局限性前列腺癌且接受了根治性前列腺切除术的男性（平均年龄63.2±7.2岁）进行了研究（最终病理分期为pT2pN0或更低）。术前以及前列腺切除术后0.25、0.5、1、2、4、8、12、16、24、48、72、120、168和240小时采集血清样本。测定所有样本中的fPSA、tPSA以及白蛋白和总蛋白血清浓度。
在前列腺切除术后的前120分钟内，白蛋白和总蛋白血清浓度持续下降，半衰期分别为-104.5±28分钟和-129.7±32分钟。fPSA和tPSA的血清下降遵循双相动力学。在初始的α期，fPSA和tPSA血清浓度下降，半衰期分别为-69±10.3分钟和-87.3±18.1分钟。在终末的β期，fPSA和tPSA的半衰期分别为-1152.2分钟（0.8天）和-3916.1分钟（2.7天）。在fPSA或tPSA的α期半衰期与总蛋白或白蛋白浓度下降的半衰期之间发现了显著相关性。
这些相关性表明，前列腺切除术后fPSA和tPSA的快速下降（α期半衰期）是由根治性前列腺切除术本身引起的。β期的半衰期反映了PSA的生物清除率。因此，如果不考虑手术本身对血清PSA浓度的影响，根治性前列腺切除术后PSA半衰期的测定价值有限。
