Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA.
J Natl Compr Canc Netw. 2010 Feb;8(2):265-70. doi: 10.6004/jnccn.2010.0017.
Prostate-specific antigen (PSA) in combination with digital rectal examination forms the basis for current prostate cancer (CaP) screening programs. Although PSA screening was recently shown to reduce CaP-specific mortality in the European randomized trial, its limitations include the risk for unnecessary prostate biopsy and the diagnosis and treatment of some CaP that might never have caused suffering or death. A potential way to minimize these pitfalls is through the use of derivatives of PSA, particularly PSA kinetics, to increase the specificity for clinically relevant CaP. CaP is the second-leading cause of cancer death in men in the United States and many other westernized countries; accordingly, judicious screening of healthy men allows for diagnosis sufficiently early that all options (i.e., treatment or surveillance) are still available in most cases.
前列腺特异性抗原（PSA）联合直肠指检是当前前列腺癌（CaP）筛查计划的基础。尽管最近的欧洲随机试验表明 PSA 筛查可降低 CaP 特异性死亡率，但它也存在局限性，包括不必要的前列腺活检风险，以及诊断和治疗一些可能永远不会导致痛苦或死亡的 CaP。一种潜在的方法是通过使用 PSA 的衍生物，特别是 PSA 动力学，来提高对临床相关 CaP 的特异性，从而最小化这些陷阱。在美国和许多其他西方国家，CaP 是男性癌症死亡的第二大原因；因此，对健康男性进行明智的筛查可以使大多数情况下的诊断足够早，从而使所有选择（即治疗或监测）仍然可用。
