Mazzucchelli R, Colanzi P, Pomante R, Muzzonigro G, Montironi R
Institutes of Pathological Anatomy, University of Ancona School of Medicine, Torrette, Ancona Italy.
Adv Clin Path. 2000 Jul;4(3):111-20.
Serum prostate specific antigen (PSA) is elevated beyond the arbitrary cut-off point of 4.0 ng/ml in the majority of patients with prostate cancer (PCa). It may also be greater than 4.0 ng/ml in some benign conditions, including benign prostatic hyperplasia (BPH). Therefore, serum PSA lacks high sensitivity and specificity for PCa. This problem has been partially overcome by calculating several PSA-related indices (such as PSA density, PSA velocity, percent free PSA) and/or evaluating other serum markers (such as human glandular kallikreins and prostate specific membrane antigen). Atypical small acinar proliferation (ASAP) often represents the underdiagnosis of cancer in biopsy material; patients with cancer on the repeat biopsy usually have an elevated serum PSA. Whether the determination of serum PSA can be of help in the identification of patients with isolated prostatic intraepithelial neoplasia (PIN), i.e., long before PCa develops, is still being debated
大多数前列腺癌（PCa）患者的血清前列腺特异性抗原（PSA）升高超过4.0 ng/ml这一任意临界值。在一些良性疾病中，包括良性前列腺增生（BPH），血清PSA也可能大于4.0 ng/ml。因此，血清PSA对PCa缺乏高敏感性和特异性。通过计算几种PSA相关指标（如PSA密度、PSA速率、游离PSA百分比）和/或评估其他血清标志物（如人腺体激肽释放酶和前列腺特异性膜抗原），这一问题已得到部分解决。非典型小腺泡增生（ASAP）在活检材料中常提示癌症诊断不足；再次活检确诊为癌症的患者血清PSA通常升高。血清PSA测定能否有助于识别孤立性前列腺上皮内瘤变（PIN）患者，即在PCa发生之前很久的患者，仍存在争议
