Park Seung Chol, Rim Joung Sik, Choi Han Yong, Kim Choung Soo, Hong Sung Joon, Kim Wun Jae, Lee Sang Eun, Song Jae Mann, Yoon Jin Han
Department of Urology, Wonkwang University, Iksan, Republic of Korea.
Int J Urol. 2009 Aug;16(8):670-5. doi: 10.1111/j.1442-2042.2009.02329.x. Epub 2009 Jul 13.
To determine the optimal cut-off of a nadir prostate-specific antigen (PSA) for prediction of progression within 24 months after combined androgen blockade (CAB) and to analyze predictive factors of failing to achieve the nadir PSA.
We retrospectively reviewed the medical records of 343 patients with prostate cancer treated with CAB from 2000 to 2005. We determined the nadir PSA level that predicts progression to hormone refractory prostate cancer (HRPC) at 24 months after CAB. Predictive factors for failing to achieve a determined nadir PSA were analyzed.
Mean age was 74.0 years. Mean follow up was 42.1 month. Seventy-seven patients experienced progression to HRPC. A nadir PSA of 1.0 ng/mL predicts progression to HRPC at 24 months. Predictive factors for failing to achieve a nadir PSA of 1.0 ng/mL or less include pretreatment PSA, percentage positive biopsy core, Gleason score, serum hemoglobin, stage, and extent of bone metastasis in univariate analysis. Pretreatment PSA (>50 ng/mL) and serum hemoglobin (<12 g/dL) were significant factors to predict failing to achieve a nadir PSA of 1.0 ng/mL or less in logistic regression analysis.
A nadir PSA of 1.0 ng/mL can predict progression to HRPC after CAB. Pretreatment PSA and serum hemoglobin are significant predictors of failing to achieve a nadir PSA of 1.0 ng/mL or less.
确定最低点前列腺特异性抗原（PSA）的最佳临界值，以预测联合雄激素阻断（CAB）后24个月内的疾病进展，并分析未能达到最低点PSA的预测因素。
我们回顾性分析了2000年至2005年接受CAB治疗的343例前列腺癌患者的病历。我们确定了可预测CAB后24个月进展为激素难治性前列腺癌（HRPC）的最低点PSA水平。分析了未能达到既定最低点PSA的预测因素。
平均年龄为74.0岁。平均随访时间为42.1个月。77例患者进展为HRPC。最低点PSA为1.0 ng/mL可预测24个月时进展为HRPC。单因素分析中，未能达到最低点PSA为1.0 ng/mL或更低的预测因素包括治疗前PSA、活检阳性核心百分比、Gleason评分、血清血红蛋白、分期和骨转移范围。在逻辑回归分析中，治疗前PSA（>50 ng/mL）和血清血红蛋白（<12 g/dL）是预测未能达到最低点PSA为1.0 ng/mL或更低的重要因素。
最低点PSA为1.0 ng/mL可预测CAB后进展为HRPC。治疗前PSA和血清血红蛋白是未能达到最低点PSA为1.0 ng/mL或更低的重要预测指标。
