Ramírez Michelle L, Nelson Eric C, Devere White Ralph W, Lara Primo N, Evans Christopher P
Department of Urology and Cancer Center, University of California at Davis, Sacramento, CA 95817, USA.
Eur Urol. 2008 Aug;54(2):291-300. doi: 10.1016/j.eururo.2008.04.003. Epub 2008 Apr 11.
To review the current status of prostate-specific antigen doubling time (PSADT) as it pertains to the evolution of prostate cancer (PCa), specifically assessing its role in the following four stages: before diagnosis, prior to definitive treatment, following treatment including salvage therapy after recurrence, and lastly, after onset of androgen-insensitive PCa.
We searched PubMed literature for current articles on PSADT using the key words listed for this review and, where possible, selected those with significant levels of evidence that were deemed relevant, seminal, or controversial. We summarized the data regarding PSADT as a marker for diagnosis and disease characterization, as well as a predictor of progression, response to treatment, and mortality.
PSADT may offer an advantage in providing a more dynamic picture of tumor behavior, providing clues regarding the relative aggressiveness of the underlying pathology. Evidence points toward a role for PSADT in the management of PCa, specifically in active surveillance, disease recurrence after treatment, and in androgen-independent PCa. PSADT is an important prognostic factor that may serve as an auxiliary end point for cancer-specific survival; however, optimal cut-off points denoting risk remain debatable.
PCa management requires risk stratification with a combination of variables, PSADT being one of the most reliable predictors. It is now a parameter included in many predictive nomograms and in treatment guidelines for expectant management and salvage therapy.
回顾前列腺特异性抗原倍增时间（PSADT）与前列腺癌（PCa）进展相关的现状，特别评估其在以下四个阶段的作用：诊断前、确定性治疗前、包括复发后挽救性治疗在内的治疗后，以及最后雄激素非敏感性PCa发病后。
我们在PubMed文献中使用本次综述列出的关键词搜索关于PSADT的当前文章，并在可能的情况下选择那些具有显著证据水平且被认为相关、具有开创性或有争议的文章。我们总结了关于PSADT作为诊断和疾病特征标志物的数据，以及作为疾病进展、治疗反应和死亡率预测指标的数据。
PSADT在提供肿瘤行为更动态的情况方面可能具有优势，提供有关潜在病理相对侵袭性的线索。有证据表明PSADT在PCa管理中发挥作用，特别是在主动监测、治疗后疾病复发以及雄激素非依赖性PCa方面。PSADT是一个重要的预后因素，可作为癌症特异性生存的辅助终点；然而，表示风险的最佳临界值仍存在争议。
PCa管理需要结合多种变量进行风险分层，PSADT是最可靠的预测指标之一。它现在是许多预测列线图以及期待性管理和挽救性治疗的治疗指南中包含的一个参数。
