血清（-5，-7）前列腺特异性抗原前体用于区分前列腺癌的分期和分级。
Serum (-5, -7) proPSA for distinguishing stage and grade of prostate cancer.
作者信息
Stephan Carsten, Meyer Hellmuth-Alexander, Paul Eva-Maria, Kristiansen Glen, Loening Stefan A, Lein Michael, Jung Klaus
机构信息
Departments of Neurology, Universitätsmedizin Charité Berlin, CCM, Germany.
出版信息
Anticancer Res. 2007 Jul-Aug;27(4A):1833-6.
BACKGROUND
ProPSA has been suggested for the detection of preferentially aggressive prostate cancer (PCa). We report on the use of proPSA and free PSA to enhance preoperative staging and grading.
PATIENTS AND METHODS
Serum samples from 376 PCa patients within the PSA range 1-25 microg/l who underwent radical prostatectomy were analysed for PSA, free PSA (fPSA) and (-5, -7) proPSA.
RESULTS
ProPSA was only significantly different between pT2 and pT3 PCa (p = 0.02) in the subgroup of patients with % fPSA < 10%. The ratio proPSA/% fPSA differed between G2 and G3 (p = 0.004), Gleason < 7 and Gleason > or =7 (p = 0.001), and pT2 and pT3 tumors (p < 0.0001) at PSA 1-25 microg/l. However, % fPSA improved differentiation only between Gleason < 7 and Gleason > or = 7 tumors, not between pT2 and pT3 or G2 and G3 tumors.
CONCLUSION
ProPSA as a single parameter did not improve the detection of non-organ confined or aggressive PCa whereas proPSA/% fPSA further improved staging and grading within all analysed PSA ranges.
背景
前列腺特异性抗原（ProPSA）已被建议用于检测侵袭性较强的前列腺癌（PCa）。我们报告了使用ProPSA和游离前列腺特异性抗原（fPSA）来加强术前分期和分级。
患者和方法
对376例接受根治性前列腺切除术、血清前列腺特异性抗原（PSA）水平在1-25μg/L之间的PCa患者的血清样本进行PSA、游离PSA（fPSA）和（-5，-7）ProPSA分析。
结果
在fPSA百分比<10%的患者亚组中，ProPSA仅在pT2和pT3期PCa之间有显著差异（p = 0.02）。在PSA为1-25μg/L时，ProPSA/fPSA百分比在G2和G3之间（p = 0.004）、Gleason评分<7和Gleason评分>或 =7之间（p = 0.001）以及pT2和pT3肿瘤之间（p < 0.0001）存在差异。然而，fPSA百分比仅在Gleason评分<7和Gleason评分>或 =7的肿瘤之间改善了分化，在pT2和pT3或G2和G3肿瘤之间未改善。
结论
ProPSA作为单一参数并不能改善非器官局限性或侵袭性PCa的检测，而ProPSA/fPSA百分比在所有分析的PSA范围内进一步改善了分期和分级。
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