Morgan W R, Zincke H, Rainwater L M, Myers R P, Klee G G
Department of Urology, Mayo Clinic, Rochester, Minnesota 55905.
J Urol. 1991 Feb;145(2):319-23. doi: 10.1016/s0022-5347(17)38327-1.
Prostate specific antigen (PSA) levels were obtained before and after radical retropubic prostatectomy in 192 patients: 78 (41%) had pathological stage B2 cancer or less, 83 (43%) had stage C or C+ and 31 (16%) had stage D1 disease. Of those with stages B2 or less, C, C+ and D1 disease 82, 86, 65 and 90%, respectively, had postoperative PSA values of 0.2 ng./ml. or less (when first evaluated 30 or more days postoperatively). At 1 year postoperatively 94% of the stages C and C+ cancer patients treated with adjuvant radiation had PSA levels of 0.2 ng./ml. or less, which was significantly different from those not treated adjuvantly (p = 0.02). This effect of adjuvant radiation on PSA was temporary in the small number of patients with longer followup. Adjuvant orchiectomy for stage D1 lesions resulted in female PSA levels in virtually all cases. This decrease may be misleading and may reflect a direct hormonal effect rather than a decrease in tumor volume. Positive surgical margins did not significantly affect postoperative PSA levels, possibly because of the frequent use of adjuvant treatment.
对192例患者在耻骨后根治性前列腺切除术前和术后测定了前列腺特异性抗原（PSA）水平：78例（41%）为病理分期B2期或更低期别的癌症，83例（43%）为C期或C+期，31例（16%）为D1期疾病。在B2期或更低期别、C期、C+期和D1期疾病的患者中，分别有82%、86%、65%和90%在术后（首次评估为术后30天或更长时间）PSA值为0.2 ng./ml或更低。术后1年，接受辅助放疗的C期和C+期癌症患者中94%的PSA水平为0.2 ng./ml或更低，这与未接受辅助治疗的患者有显著差异（p = 0.02）。在少数随访时间较长的患者中，辅助放疗对PSA的这种作用是暂时的。对D1期病变进行辅助睾丸切除术在几乎所有病例中都导致了女性化的PSA水平。这种降低可能会产生误导，可能反映的是直接的激素效应而非肿瘤体积的减小。手术切缘阳性对术后PSA水平没有显著影响，可能是因为频繁使用辅助治疗。
