Walz P H, Schoppmann T, Büscher C, Ennen J, Schriewer H
Department of Urology, District Hospital, Lüdenscheid, FRG.
Eur Urol. 1992;22(1):20-6. doi: 10.1159/000474716.
We examined the influence of different factors [benign prostatic hyperplasia (BPH), prostatic carcinoma (PCA), organ volume, weight of resected tissue, transurethral catheter] on the serum prostate-specific antigen (PSA) levels in 253 patients with BPH (n = 138; 54%) and PCA (n = 115; 46%). Only in 57.2% of the BPH patients, PSA values were < 4 ng/ml, in 74.6% < 7 ng/ml. In 108 patients with BPH, a transurethral prostatectomy was performed. PSA values correlated significantly with the sonographically determined prostatic volumes and less precisely with the weight of the resected tissue. The PSA concentration per milliliter of prostatic volume was 0.12 ng/ml, per gram of resected tissue it was 0.21 ng/ml. An incidental PCA was found in 12/108 patients (11%). The PSA values were identical with those of the total collective in regard to volume and tissue weight. In 11 patients, we examined possible alterations of the PSA values before and until 24 h after prostatic massage. Only insignificant alterations were seen, a massive increase was not found in any patient. Searching for an absolutely valid 'normal value' appears hardly appropriate. However, the usefulness of PSA is increased when the sonographically determined prostatic volume is included. A rectal examination of the prostate has no influence on the PSA value.
我们研究了不同因素[良性前列腺增生（BPH）、前列腺癌（PCA）、器官体积、切除组织重量、经尿道导管]对253例BPH患者（n = 138；54%）和PCA患者（n = 115；46%）血清前列腺特异性抗原（PSA）水平的影响。仅57.2%的BPH患者PSA值< 4 ng/ml，74.6%的患者< 7 ng/ml。108例BPH患者接受了经尿道前列腺切除术。PSA值与超声测定的前列腺体积显著相关，与切除组织重量的相关性稍弱。每毫升前列腺体积的PSA浓度为0.12 ng/ml，每克切除组织为0.21 ng/ml。12/108例患者（11%）发现了偶然的PCA。就体积和组织重量而言，这些患者的PSA值与总体人群相同。我们对11例患者在前列腺按摩前及按摩后24小时内的PSA值变化进行了检查。仅发现了不显著的变化，未在任何患者中发现大幅升高。寻找一个绝对有效的“正常值”似乎不太合适。然而，当纳入超声测定的前列腺体积时，PSA的实用性会增加。直肠指检前列腺对PSA值没有影响。
