Vicentini Fabio C, Botelho Luiz A A, Hisano Marcelo, Ebaid Gustavo X, Lucon Marcos, Lucon Antonio M, Srougi Miguel
Department of Urology, Clinics Hospital, University of São Paulo Medical School, São Paulo, Brazil.
Urology. 2009 May;73(5):1032-5. doi: 10.1016/j.urology.2009.01.015. Epub 2009 Mar 14.
To determine the serum total prostate-specific antigen (tPSA) levels in cirrhotic men and compare them with those in noncirrhotic men.
We prospectively evaluated 113 cirrhotic patients listed for liver transplantation using the serum tPSA, total testosterone level, and Child-Pugh liver function score according to age and severity of liver disease. The tPSA levels were compared with those of 661 healthy men. The Mann-Whitney U test was used for statistical analysis, with a significance level of .05.
The median age of the cirrhotic and noncirrhotic patients was 55 years (range 28-70) and 58 years (range 46-70), respectively (P < .01). However, when stratified by age group (<49, 50-59, and >60 years), this difference was not significant. The median serum tPSA level was 0.3 ng/mL (range 0.04-9.9) and 1.3 ng/mL (range 0.04-65.8) in the cirrhotic and noncirrhotic group, respectively (P < .0001). Stratifying both groups according to age, the cirrhotic patients had significantly lower tPSA levels than did the noncirrhotic patients. According to the Child-Pugh score (A, B, and C), Child-Pugh class C patients had significantly lower tPSA levels than did Child-Pugh class A patients and also had lower testosterone levels than did Child-Pugh class A and B patients. The tPSA levels correlated significantly with the testosterone levels in the cirrhotic patients (P = .028).
The results of our study have shown that cirrhotic patients have approximately 4 times lower serum tPSA levels than noncirrhotic men. Patients with more severe liver disease have lower tPSA and testosterone levels than patients less affected. The tPSA levels in cirrhotic men are affected by the total testosterone levels.
测定肝硬化男性的血清总前列腺特异性抗原（tPSA）水平，并与非肝硬化男性的进行比较。
我们前瞻性地评估了113例等待肝移植的肝硬化患者，根据年龄和肝病严重程度测定其血清tPSA、总睾酮水平及Child-Pugh肝功能评分。将tPSA水平与661例健康男性的进行比较。采用Mann-Whitney U检验进行统计学分析，显著性水平为0.05。
肝硬化患者和非肝硬化患者的中位年龄分别为55岁（范围28 - 70岁）和58岁（范围46 - 70岁）（P < 0.01）。然而，按年龄组（<49岁、50 - 59岁和>60岁）分层时，这种差异不显著。肝硬化组和非肝硬化组的血清tPSA中位水平分别为0.3 ng/mL（范围0.04 - 9.9）和1.3 ng/mL（范围0.04 - 65.8）（P < 0.0001）。按年龄对两组进行分层，肝硬化患者的tPSA水平显著低于非肝硬化患者。根据Child-Pugh评分（A、B和C），Child-Pugh C级患者的tPSA水平显著低于Child-Pugh A级患者，且睾酮水平也低于Child-Pugh A级和B级患者。肝硬化患者的tPSA水平与睾酮水平显著相关（P = 0.028）。
我们的研究结果表明，肝硬化患者的血清tPSA水平约比非肝硬化男性低4倍。肝病较严重的患者比受影响较小的患者tPSA和睾酮水平更低。肝硬化男性的tPSA水平受总睾酮水平影响。
