Falsaperla M, Morgia G, Giammusso B, Condorelli S V, Saita A, Marchese F, Spampinato A, Motta M
Department of Urology II, University Of Catania, Catania, Italy.
Prostate Cancer Prostatic Dis. 2003;6(1):45-9. doi: 10.1038/sj.pcan.4500615.
Ca 15-3 is an aspecific tumor marker characteristic of cancer proliferation. Elevated serum levels seem to be closely correlated with cancer progression in non-urological tumors. This study assessed the role of Ca 15-3 as an aspecific tumor marker in patients with borderline prostate-specific antigen (PSA) biochemically suspected of prostate cancer (PCa) and with multiple negative prostate biopsies. The study is based on prospective analysis of 103 patients: (a) 33 patients (group A) presented lower urinary tract symptoms secondary to BPH with normal serum PSA values, DRE and TRUS negative for suspected PCa; (b) 31 patients (group B) with histologically diagnosed PCa; (c) 39 patients (group C) with borderline serum PSA values, DRE and TRUS normal, two ultrasound (US)-guided random prostate biopsies negative for PCa. Ca 15-3 was determined in the entire study series by the IRMA method, using as range the values proposed for the investigated non-urological tumors (38 UI/l).Ca 15-3 was within normal range in all group A patients (control), while the values were elevated in 27/31 of group B patients (PCa) and in 11/39 of group C (PCa suspected) patients. A third biopsy was performed in all 39 group C patients with borderline PSA and it was PCa-positive in 13 patients (33.3%, subgroup C3). In this series Ca 15-3 was increased in 9 of 13 patients (subgroup C3alpha), while the remaining four patients (subgroup C3beta) presented values within the normal range. On 26 group C patients who were negative for PCa to third biopsy (subgroup C4), 24 patients had Ca 15-3 levels within normal range (subgroup C4alpha) with histologic findings of BPH in 23 cases and granulomatous chronic prostatitis in one case, while two patients (subgroup C4beta) had elevated Ca 15-3 concentrations associated with lymphoplasmacytic chronic prostatitis. We hypothesize that Ca 15-3, as a specific tumor marker, could be an interesting and inexpensive second step diagnostic tool for PCa in patients with borderline PSA and multiple negative prostate biopsies, as it could indicate whether a repeated biopsy should be performed in a short time, having excluded other concomitant tumors. However, further prospective studies will be necessary to confirm this hypothesis.
癌抗原15-3（Ca 15-3）是一种反映癌症增殖的非特异性肿瘤标志物。血清水平升高似乎与非泌尿系统肿瘤的癌症进展密切相关。本研究评估了Ca 15-3作为非特异性肿瘤标志物在生化检查怀疑患有前列腺癌（PCa）但前列腺活检多次阴性且前列腺特异性抗原（PSA）处于临界值的患者中的作用。该研究基于对103例患者的前瞻性分析：（a）33例患者（A组）因良性前列腺增生（BPH）出现下尿路症状，血清PSA值正常，直肠指检（DRE）和经直肠超声检查（TRUS）未发现可疑PCa；（b）31例组织学诊断为PCa的患者（B组）；（c）39例血清PSA值处于临界值、DRE和TRUS正常、经超声（US）引导的两次随机前列腺活检均未发现PCa的患者（C组）。在整个研究系列中，采用免疫放射分析（IRMA）法测定Ca 15-3，参考范围采用针对所研究的非泌尿系统肿瘤提出的值（38 UI/l）。A组所有患者（对照组）的Ca 15-3均在正常范围内，而B组31例患者（PCa组）中有27例的值升高，C组39例（疑似PCa组）患者中有11例的值升高。对所有39例PSA处于临界值的C组患者进行了第三次活检，其中13例患者（33.3%，C3亚组）的活检结果为PCa阳性。在该系列中，13例C3亚组患者中有9例Ca 15-3升高，其余4例患者（C3β亚组）的值在正常范围内。在26例第三次活检PCa阴性的C组患者（C4亚组）中，24例患者的Ca 15-3水平在正常范围内（C4α亚组），其中23例组织学表现为BPH，1例为肉芽肿性慢性前列腺炎，而2例患者（C4β亚组）的Ca 15-3浓度升高，伴有淋巴细胞性慢性前列腺炎。我们假设，Ca 15-3作为一种特异性肿瘤标志物，对于PSA处于临界值且前列腺活检多次阴性的PCa患者可能是一种有趣且廉价的第二步诊断工具，因为它可以在排除其他伴随肿瘤后，指示是否应在短时间内进行重复活检。然而，需要进一步的前瞻性研究来证实这一假设。
