通过超敏检测法测得的血清前列腺特异性抗原最低点值作为临床局限性前列腺癌根治性前列腺切除术后生化复发预测指标的实用性。

Usefulness of the nadir value of serum prostate-specific antigen measured by an ultrasensitive assay as a predictor of biochemical recurrence after radical prostatectomy for clinically localized prostate cancer.

作者信息

Sakai Iori, Harada Ken-ichi, Kurahashi Toshifumi, Muramaki Mototsugu, Yamanaka Kazuki, Hara Isao, Inoue Taka-aki, Miyake Hideaki

机构信息

Department of Urology, Hyogo Medical Center for Adults, Akashi, and Kobe University School of Medicine, Japan.

出版信息

Urol Int. 2006;76(3):227-31. doi: 10.1159/000091624.

DOI:10.1159/000091624

PMID:16601384

Abstract

INTRODUCTION

The objective of this study was to determine whether the nadir value of serum prostate-specific antigen (PSA) measured by an ultrasensitive assay could be a useful predictor of biochemical recurrence after radical prostatectomy for clinically localized prostate cancer.

MATERIALS AND METHODS

This study included 127 patients who underwent radical prostatectomy for clinically localized prostate cancer without neoadjuvant hormonal therapy and were pathologically diagnosed as negative for lymph node metastasis. The serum PSA value was measured using an ultrasensitive PSA assay system (Roche Diagnostics, Mannheim, Germany), and the findings were analyzed with respect to several clinicopathological factors. In this series, biochemical recurrence was defined as PSA persistently >0.2 ng/ml.

RESULTS

Based on the nadir PSA value, we divided 127 patients into three groups as follows: group A (n=99):<or=0.01 ng/ml; group B (n=16): 0.01-0.05 ng/ml, and group C (n=12): >or=0.05 ng/ml. The nadir PSA value was significantly associated with preoperative PSA value, but not other conventional clinicopathological prognostic parameters. During the observation period (median 31 months, range 6-75 months), biochemical recurrence occurred in 16 patients, that is, 1 in group A (6.3%), 4 in group B (25.0%), and 11 in group C (91.7%). Multivariate analysis using the Cox proportional hazards regression model indicated that the nadir PSA value was an independent predictor for biochemical recurrence after radical prostatectomy.

CONCLUSION

These findings suggest that the nadir serum PSA value measured by an ultrasensitive assay could be a useful predictor of biochemical recurrence after radical prostatectomy for clinically localized prostate cancer, and that careful follow-up should be considered in cases demonstrating a nadir PSA value>0.01 ng/ml because of the significantly higher probability of biochemical recurrence in such cases.

摘要

引言

本研究的目的是确定通过超敏检测法测得的血清前列腺特异性抗原（PSA）最低点值是否可作为临床局限性前列腺癌根治性前列腺切除术后生化复发的有用预测指标。

材料与方法

本研究纳入了127例接受临床局限性前列腺癌根治性前列腺切除术且未接受新辅助激素治疗、病理诊断为淋巴结转移阴性的患者。使用超敏PSA检测系统（德国曼海姆罗氏诊断公司）测定血清PSA值，并就多种临床病理因素对结果进行分析。在本系列研究中，生化复发定义为PSA持续>0.2 ng/ml。

结果

根据PSA最低点值，我们将127例患者分为以下三组：A组（n = 99）：≤0.01 ng/ml；B组（n = 16）：0.01 - 0.05 ng/ml；C组（n = 12）：≥0.05 ng/ml。PSA最低点值与术前PSA值显著相关，但与其他传统临床病理预后参数无关。在观察期（中位时间31个月，范围6 - 75个月）内，16例患者发生生化复发，即A组1例（6.3%），B组4例（25.0%），C组11例（91.7%）。使用Cox比例风险回归模型进行多因素分析表明，PSA最低点值是根治性前列腺切除术后生化复发的独立预测指标。