保守治疗的良性前列腺增生症患者的前列腺特异性抗原变化率：它能否预测与良性前列腺增生症相关的侵入性治疗需求？

PSA velocity in conservatively managed BPH: can it predict the need for BPH-related invasive therapy?

作者信息

Mochtar Chaidir A, Kiemeney Lambertus A L M, Laguna M Pilar, Debruyne Frans M J, de la Rosette Jean J M C H

机构信息

Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

出版信息

Prostate. 2006 Sep 15;66(13):1407-12. doi: 10.1002/pros.20436.

DOI:10.1002/pros.20436

PMID:16741919

Abstract

OBJECTIVE

To study the value of PSA velocity (PSAV) to predict benign prostatic hyperplasia (BPH) progression in patients managed with alpha(1)-blockers or watchful waiting (WW).

METHODS

Nine hundred and forty two BPH patients treated with alpha(1)-blocker or WW were reviewed. PSAV was defined as: (PSA(t)-PSA(b))/(t/12); where PSA(t) = PSA at time of follow-up (t, in months), PSA(b) = PSA at baseline. PSA(t) was taken from the 1 year follow-up visit or, if not present, from the next available visit with a maximum of 24 months.

RESULTS

Five hundred and ninety five patients (234 alpha(1)-blocker, 361 WW) were included in the analyses. PSAV range was -5.24 to 43.06 ng/ml/year in alpha(1)-blocker patients and -6.11 to 19.55 ng/ml/year in WW patients (median: 0.01 ng/ml/year). PSAV was stratified into tertiles (Stable/Decrease/Increase). There were no significant differences in retreatment-free survival and the risk of BPH-related invasive therapy between the tertiles in both treatment groups.

CONCLUSIONS

PSAV did not predict BPH progression in either alpha(1)-blocker treated patients or WW group.

摘要

目的

研究前列腺特异性抗原速率（PSAV）在预测接受α1受体阻滞剂治疗或密切观察等待（WW）的良性前列腺增生（BPH）患者病情进展中的价值。

方法

回顾了942例接受α1受体阻滞剂或密切观察等待治疗的BPH患者。PSAV定义为：（PSA(t)-PSA(b)）/（t/12）；其中PSA(t)为随访时（t，以月为单位）的PSA，PSA(b)为基线时的PSA。PSA(t)取自1年随访时的值，若没有该值，则取下次可获得的值，最长为24个月。

结果

595例患者（234例接受α1受体阻滞剂治疗，361例接受密切观察等待）纳入分析。接受α1受体阻滞剂治疗的患者PSAV范围为-5.24至43.06 ng/ml/年，接受密切观察等待的患者为-6.11至19.55 ng/ml/年（中位数：0.01 ng/ml/年）。PSAV被分为三分位数（稳定/下降/上升）。两个治疗组的三分位数在无再次治疗生存期和BPH相关侵入性治疗风险方面均无显著差异。