Berger Andreas P, Deibl Martina, Strasak Alexander, Bektic Jasmin, Pelzer Alexandre, Steiner Hannes, Spranger Robert, Fritsche Gernot, Bartsch Georg, Horninger Wolfgang
Department of Urology, Medical University of Innsbruck, Innsbruck, Austria.
Urology. 2006 Nov;68(5):1067-71. doi: 10.1016/j.urology.2006.06.020. Epub 2006 Nov 7.
To evaluate, in a screening population, the impact of tumor volume and prostate volume on prostate-specific antigen (PSA) velocity (PSAV) and to find predictors of biochemical failure after radical prostatectomy. Longitudinal PSA changes in men with prostate cancer have been reported to be significantly different from those without prostate cancer.
PSAV was assessed in 102 men undergoing radical retropubic prostatectomy. The pathologic findings of specimens obtained at radical retropubic prostatectomy and pelvic lymph node dissection were analyzed separately for all patients.
The median preoperative PSA in the 102 patients was 6.4 ng/mL, the median prostate volume was 32.8 cm3, and the median tumor volume was 1.27 cm3. The PSAV correlated significantly with tumor volume (P <0.05) but not with prostate volume (P = 0.142). The median tumor volume in men with biochemical progression after radical retropubic prostatectomy was 2.55 cm3 versus 0.94 cm3 in men who were free of disease 5 years after surgery. The median PSAV in the year before diagnosis in men with relapse after radical prostatectomy was 1.98 ng/mL/yr versus 1.05 ng/mL/yr in men who had no evidence of disease.
The results of our study have shown that the main factor contributing to the PSAV in patients with prostate cancer is cancer load and that prostate volume is not significantly associated with the PSAV. Men with a PSAV of more than 2 ng/mL/yr in the year before cancer diagnosis are at a high risk of relapse. The PSAV may be helpful in identifying patients with small tumors and thus increase the detection rate of potentially curable prostate cancers.
在筛查人群中评估肿瘤体积和前列腺体积对前列腺特异性抗原（PSA）速率（PSAV）的影响，并找出根治性前列腺切除术后生化复发的预测因素。据报道，前列腺癌男性患者的PSA纵向变化与无前列腺癌男性患者的显著不同。
对102例行根治性耻骨后前列腺切除术的男性患者进行PSAV评估。对所有患者分别分析根治性耻骨后前列腺切除术和盆腔淋巴结清扫术中获取标本的病理结果。
102例患者术前PSA中位数为6.4 ng/mL，前列腺体积中位数为32.8 cm³，肿瘤体积中位数为1.27 cm³。PSAV与肿瘤体积显著相关（P<0.05），但与前列腺体积无关（P = 0.142）。根治性耻骨后前列腺切除术后出现生化进展的男性患者的肿瘤体积中位数为2.55 cm³，而术后5年无疾病的男性患者为0.94 cm³。根治性前列腺切除术后复发的男性患者在诊断前一年的PSAV中位数为1.98 ng/mL/年，而无疾病证据的男性患者为1.05 ng/mL/年。
我们的研究结果表明，前列腺癌患者PSAV的主要影响因素是肿瘤负荷，而前列腺体积与PSAV无显著关联。癌症诊断前一年PSAV超过2 ng/mL/年的男性复发风险高。PSAV可能有助于识别小肿瘤患者，从而提高潜在可治愈前列腺癌的检出率。
