Marszalek Martin, Wachter Johann, Ponholzer Anton, Leitha Thomas, Rauchenwald Michael, Madersbacher Stephan
Department of Urology and Andrology, Donauspital, Langobardenstrasse 122, A-1220 Vienna, Austria.
Eur Urol. 2005 Jul;48(1):34-9. doi: 10.1016/j.eururo.2005.03.020. Epub 2005 Apr 2.
Insulin-like growth factor 1 (IGF-1) and chromogranin A (CGA) are currently discussed as supplemental serum markers for prostate cancer (PC) diagnosis. To address this issue we determined serum levels of IGF-1, CGA and PSA in men with newly diagnosed PC and controls.
A consecutive series of 156 men (median age: 67 yrs) with newly diagnosed, untreated PC and 271 controls (69 yrs) were recruited. The diagnosis of PC was made by transrectal ultrasound guided biopsies only. In controls, the presence of PC was excluded by digito-rectal examination, serum prostate specific antigen (PSA) levels by using age-specific reference values and-if indicated-by transrectal ultrasound guided 12-core biopsies. Serum levels of IGF-1, CGA and PSA were compared between cases and controls and correlated to histopathological findings and age.
Serum PSA-levels were significantly higher in men with PC (49.6+/-13.9 ng/ml, mean+/-standard error of the mean; median: 7.0 ng/ml) than in controls (2.6+/-0.2 ng/ml; median: 1.3 ng/ml) (p<0.001). In contrast, serum levels of IGF-1 (PC: 166+/-6.1 ng/ml, median: 155 ng/ml; controls: 159+/-4.5 ng/ml, 153 ng/ml) and CGA (PC: 92+/-7.4 U/l, median: 67 U/l; controls: 117+/-12.0 U/l; median: 74 U/l) were identical in both groups (p>0.05). Serum levels of IGF-1 and CGA revealed no correlation to serum PSA, Gleason score and number of positive biopsy cores. In the PC-cohort all three serum markers did not correlate with age. In controls, PSA (p=0.018) and CGA (p<0.001) correlated positively and IGF-1 (p<0.001) negatively with age.
Our data suggest that quantification of IGF-1 and CGA-serum levels provides no useful information in the diagnosis of PC.
胰岛素样生长因子1（IGF-1）和嗜铬粒蛋白A（CGA）目前被作为前列腺癌（PC）诊断的补充血清标志物进行讨论。为解决这一问题，我们测定了新诊断的PC患者及对照者血清中IGF-1、CGA和前列腺特异抗原（PSA）的水平。
招募了连续的156例新诊断的未经治疗的PC患者（中位年龄：67岁）和271例对照者（69岁）。PC的诊断仅通过经直肠超声引导下的活检进行。在对照者中，通过直肠指检、使用年龄特异性参考值测定血清前列腺特异抗原（PSA）水平，必要时通过经直肠超声引导下的12针活检排除PC的存在。比较病例组和对照组血清中IGF-1、CGA和PSA的水平，并与组织病理学结果和年龄进行相关性分析。
PC患者的血清PSA水平（49.6±13.9 ng/ml，平均值±平均标准误；中位值：7.0 ng/ml）显著高于对照组（2.6±0.2 ng/ml；中位值：1.3 ng/ml）（p<0.001）。相比之下，两组的血清IGF-1水平（PC组：166±6.1 ng/ml，中位值：155 ng/ml；对照组：159±4.5 ng/ml，153 ng/ml）和CGA水平（PC组：92±7.4 U/l，中位值：67 U/l；对照组：117±12.0 U/l；中位值：74 U/l）相同（p>0.05）。血清IGF-1和CGA水平与血清PSA、Gleason评分及阳性活检针数均无相关性。在PC队列中，所有三种血清标志物均与年龄无相关性。在对照组中，PSA（p=0.018）和CGA（p<0.001）与年龄呈正相关，而IGF-1（p<0.001）与年龄呈负相关。
我们的数据表明，测定IGF-1和CGA的血清水平在PC诊断中并无有用信息。
