Fosså S D, Waehre H, Paus E
Department of Medical Oncology, Norwegian Radium Hospital, Oslo.
Br J Cancer. 1992 Jul;66(1):181-4. doi: 10.1038/bjc.1992.239.
Twenty-seven of 152 patients (18%) with progressing hormone resistant prostate cancer had normal serum levels of prostate specific antigen (PSA less than or equal to 10 micrograms l-1), when referred for secondary treatment. PSA was significantly correlated with the extent of skeletal metastases (R: 0.35) and the levels of hemoglobin (R: -0.19) and serum alkaline phosphatase (R: 0.30). In a multivariate Cox regression analysis the survival of the 152 patients was not correlated with the PSA level but with the patients performance status, the level of hemoglobin, and the time between primary hormone treatment and relapse. The lack of serum PSA to predict survival may be explained by a heterogenous composition of hormone resistant prostate cancer as regards differentiated and/or PSA producing vs undifferentiated and/or PSA non-producing cells.
152例激素抵抗性前列腺癌进展患者中有27例(18%)在接受二线治疗时血清前列腺特异性抗原(PSA)水平正常(PSA≤10μg/L)。PSA与骨转移程度(R:0.35)、血红蛋白水平(R:-0.19)及血清碱性磷酸酶水平(R:0.30)显著相关。在多因素Cox回归分析中,152例患者的生存情况与PSA水平无关,而与患者的身体状况、血红蛋白水平以及初次激素治疗与复发之间的时间有关。激素抵抗性前列腺癌在分化和/或产生PSA的细胞与未分化和/或不产生PSA的细胞方面组成不均一,这可能解释了血清PSA无法预测生存情况的原因。