经多部位前列腺活检后血清总前列腺特异性抗原（PSA）和游离 PSA 的动力学：活检、经尿道前列腺电切术（TURP）和活检加 TURP 的比较。

Kinetics of serum total and free prostate-specific antigen (PSA) after extended multisite prostate biopsy: Comparison among biopsy, transurethral resection of the prostate (TURP), and biopsy plus TURP.

机构信息

Division of Urology, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.

出版信息

Urol Oncol. 2010 Jul-Aug;28(4):355-9. doi: 10.1016/j.urolonc.2008.10.014. Epub 2008 Dec 25.

DOI:10.1016/j.urolonc.2008.10.014

PMID:19110451

Abstract

BACKGROUND

The kinetics and reproducibility of serum prostate-specific antigen (PSA) following extended multisite biopsies are unknown. The aim of this study was to examine the kinetics of hematogenous leakage of PSA molecules by comparing the postintervention PSA manner among extended biopsies, transurethral resection of the prostate (TURP) and biopsy plus TURP.

METHODS

Total and free PSA values were examined before and sequentially after intervention (at 1 hour, 24 hours, 2 days, 14 days, and 28 days), in patients who underwent 14-core prostate biopsy (Biopsy, n = 53), TURP (TURP, n = 21), or prostate biopsy plus TURP (Biopsy+TURP, n = 18).

RESULTS

Ten patients in the Biopsy group were histologically diagnosed as having prostate cancer, and all other patients were diagnosed with non-malignant disorders. One hour after intervention, the increase in total PSA in the Biopsy group (mean 19.58 +/- 24.78-fold) and Biopsy+TURP group (mean 14.00 +/- 10.52-fold) was higher than that of the TURP group (mean 6.189 +/- 7.567-fold) (P = 0.0207 and 0.0119, respectively). The increase in total PSA in the Biopsy+TURP group was not different from that of the Biopsy group. The increase in free PSA in the Biopsy group (mean 36.52 +/- 21.18-fold or more) was greater than that of the TURP group (mean 15.57 +/- 18.17-fold) (P = 0.0002 or less). Both total and free PSA values in the Biopsy group recovered to the initial levels 28 days after intervention (P = 0.380 and P = 0.0873, respectively). The course of both total and free PSA values in the Biopsy group was not different between prostate cancer and non-malignant disorders.

CONCLUSIONS

Extended multisite biopsies caused marked elevation of both total and free PSA compared with ordinary sextant protocol or TURP, and they reduced to the preoperative levels in about 4 weeks. The postintervention increase of PSA and its manner of recovery were comparable between the Biopsy and Biopsy+TURP groups, suggesting that the hematogenous leakage of PSA by biopsies occurs in an early phase just after biopsy and rapidly reduces also in the early phase.

摘要

背景

目前尚不清楚经扩展多部位活检后血清前列腺特异性抗原（PSA）的动力学和可重复性。本研究旨在通过比较扩展活检、经尿道前列腺切除术（TURP）和活检加 TURP 后干预后的 PSA 方式，来检查 PSA 分子血源漏出的动力学。

方法

对 14 核前列腺活检（活检组，n=53）、TURP（TURP 组，n=21）或前列腺活检加 TURP（活检+TURP 组，n=18）患者进行术前和术后（1 小时、24 小时、2 天、14 天和 28 天）的总 PSA 和游离 PSA 值检查。

结果

活检组 10 例患者组织学诊断为前列腺癌，其余患者均诊断为非恶性疾病。干预后 1 小时，活检组（平均增加 19.58±24.78 倍）和活检+TURP 组（平均增加 14.00±10.52 倍）的总 PSA 增加量高于 TURP 组（平均增加 6.189±7.567 倍）（P=0.0207 和 0.0119）。活检+TURP 组的总 PSA 增加量与活检组无差异。活检组游离 PSA 增加量（平均增加 36.52±21.18 倍或更高）大于 TURP 组（平均增加 15.57±18.17 倍）（P=0.0002 或更低）。活检组术后 28 天总 PSA 和游离 PSA 均恢复至术前水平（P=0.380 和 P=0.0873）。活检组中前列腺癌与非恶性疾病的总 PSA 和游离 PSA 值的变化过程无差异。