Pound C R, Partin A W
Department of Urology, The University of Tennessee College of Medicine, 1211 Union Avenue, Suite 340, Memphis, TN 38104, USA.
Curr Urol Rep. 2000 May;1(1):28-35. doi: 10.1007/s11934-000-0032-2.
The return of the prostate-specific antigen (PSA) to a detectable serum level (PSA recurrence) is usually the first sign of recurrent disease after radical prostatectomy. PSA recurrence generally occurs in men who are otherwise asymptomatic and may occur as late as 5 to 10 years after surgery. Men in this situation want to know what this means regarding the likelihood of clinical disease recurrence and, ultimately, survival. An evaluation for recurrent disease is warranted but generally does not reveal objective signs of clinical disease in the majority of men. Although select men may benefit from salvage local therapy, a PSA recurrence is most often an early sign of distant disease present since the time of surgery. The decision whether or not to initiate systemic therapy in these men is difficult and controversial. Fortunately, recent developments in determining the significance of a PSA recurrence may help the patient and his physician to make a more informed decision regarding treatment options.
前列腺特异性抗原（PSA）恢复到可检测的血清水平（PSA复发）通常是根治性前列腺切除术后疾病复发的首个迹象。PSA复发一般发生在原本无症状的男性身上，且可能在手术后5至10年才出现。处于这种情况的男性想知道这对于临床疾病复发的可能性以及最终的生存意味着什么。对复发性疾病进行评估是有必要的，但在大多数男性中，评估通常不会揭示临床疾病的客观迹象。虽然部分男性可能从挽救性局部治疗中获益，但PSA复发最常是自手术时起就已存在远处疾病的早期迹象。决定是否对这些男性启动全身治疗既困难又存在争议。幸运的是，近期在确定PSA复发的意义方面取得的进展可能有助于患者及其医生就治疗方案做出更明智的决定。
