Department of Pathology and Laboratory Medicine, St Vincent's University Hospital, Dublin, Ireland.
Ann Clin Biochem. 2011 Jul;48(Pt 4):310-6. doi: 10.1258/acb.2011.010273. Epub 2011 Apr 27.
Although widely used, the value of prostate-specific antigen (PSA) in screening asymptomatic men for prostate cancer is controversial. Reasons for the controversy relate to PSA being less than an ideal marker in detecting early prostate cancer, the possibility that screening for prostate cancer may result in the overdetection and thus overtreatment of indolent disease and the lack of clarity as to the definitive or best treatment for men diagnosed with localized prostate cancer. Although the results from some randomized prospective trials suggest that screening with PSA reduces mortality from prostate cancer, the overall benefit was modest. It is thus currently unclear as to whether the modest benefit of reduced mortality outweighs the harms of overdetection and overtreatment. Thus, prior to undergoing screening for prostate cancer, men should be informed of the risks and benefits of early detection. Newly emerging markers that may complement PSA in the early detection of prostate cancer include specific isoforms of PSA and PCA3.
虽然被广泛应用，但前列腺特异性抗原（PSA）在无症状男性前列腺癌筛查中的价值仍存在争议。争议的原因包括 PSA 作为早期前列腺癌检测指标的效果并不理想、前列腺癌筛查可能导致惰性疾病的过度检出和过度治疗、以及对被诊断为局限性前列腺癌的男性的最佳治疗方案不明确。虽然一些随机前瞻性试验的结果表明，PSA 筛查可降低前列腺癌的死亡率，但总体获益较小。因此，目前尚不清楚死亡率降低的适度获益是否超过过度检出和过度治疗的危害。因此，在进行前列腺癌筛查之前，男性应该被告知早期检测的风险和益处。可能在早期检测前列腺癌方面与 PSA 互补的新出现的标志物包括 PSA 和 PCA3 的特定同工型。
