Ercole C J, Lange P H, Mathisen M, Chiou R K, Reddy P K, Vessella R L
Department of Urologic Surgery, University of Minnesota Health Sciences Center, Minneapolis.
J Urol. 1987 Nov;138(5):1181-4. doi: 10.1016/s0022-5347(17)43543-9.
Serum prostatic specific antigen and prostatic acid phosphatase levels were measured retrospectively and evaluated in 357 men with benign prostatic hypertrophy and in 209 men with various stages of prostatic carcinoma. Although prostatic specific antigen values were elevated in 21 per cent of the patients with benign prostatic hypertrophy, the elevations usually were low and did not interfere with clinical interpretation. Prostatic specific antigen was elevated in 98 per cent of 86 men with active stage D2 disease; in 22 per cent of the men prostatic specific antigen was the only elevated marker. In contrast, prostatic acid phosphatase was the only elevated marker in 1 per cent of the patients with stage D2 disease and neither marker was elevated in 2 per cent. Among 74 patients in whom prostatic specific antigen and prostatic acid phosphatase determinations were made before radical prostatectomy, prostatic specific antigen was elevated substantially (greater than 10 ng. per ml.) in 59 per cent (26 of 44) with extracapsular disease and in only 7 per cent (2 of 30) without extracapsular disease. More importantly, of those 28 patients with substantially elevated prostatic specific antigen levels 26 (93 per cent) had extracapsular disease. Serial serum measurements showed that prostatic specific antigen either reflected or predicted clinical status in more than 97 per cent of the patients. We conclude that prostatic specific antigen is an excellent serum tumor marker for monitoring patients with prostatic carcinoma and that it surpasses prostatic acid phosphatase in this regard. Prostatic specific antigen also may be useful in staging prostatic carcinoma and it may change our attitudes significantly about the therapeutic responses to this cancer.
回顾性测量了357例良性前列腺增生男性患者和209例不同阶段前列腺癌男性患者的血清前列腺特异性抗原（PSA）和前列腺酸性磷酸酶（PAP）水平，并进行了评估。虽然21%的良性前列腺增生患者PSA值升高，但升高幅度通常较小，不影响临床判断。86例处于D2活动期疾病的男性患者中，98%的患者PSA升高；22%的男性患者中，PSA是唯一升高的标志物。相比之下，D2期疾病患者中1%的患者PAP是唯一升高的标志物，2%的患者两种标志物均未升高。在74例前列腺癌根治术前测定PSA和PAP的患者中，59%（44例中的26例）有包膜外侵犯的患者PSA显著升高（大于10 ng/ml），而无包膜外侵犯的患者中只有7%（30例中的2例）升高。更重要的是，在那些PSA水平显著升高的28例患者中，26例（93%）有包膜外侵犯。系列血清检测显示，PSA在97%以上的患者中反映或预测了临床状况。我们得出结论，PSA是监测前列腺癌患者的优秀血清肿瘤标志物，在这方面它优于PAP。PSA也可能有助于前列腺癌的分期，并且可能会显著改变我们对这种癌症治疗反应的态度。
