Guillet J, Role C, Duc A T, François H
Department of Nuclear Medicine, St. Esprit Hospital, Agen, France.
Am J Clin Oncol. 1988;11 Suppl 2:S61-2. doi: 10.1097/00000421-198801102-00013.
Blood samples from 500 patients with clinical prostatic symptoms were radioimmunoassayed with prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) kits. On the basis of histological data, directed by PSA results and other investigations, 200 prostatic cancers (adenocarcinomas), 276 benign prostatic hypertrophy (BPH), 16 cases of prostatitis, 5 cancers of the bladder, and 3 prostatodynias were diagnosed. All of the serum samples from prostatic cancer patients showed elevated PSA levels at diagnosis, whereas about 70% of these showed normal PAP values. The sensitivity of the PSA assay is 100% when 2.5 ng/ml is taken as the upper limit of normal. However, the specificity and the positive predictive value are better at 10 ng/ml: 99 and 79%, respectively. High PSA values alerted the clinician when diagnosing a cancer without symptoms on rectal or ultrasonographic examination (3%). In BPH, when the PSA level is between 2.5 and 10 ng/ml, a PSA control must be performed within 2 months. If PSA increases above 10 ng/ml, the risk of cancer has to be considered. In the follow-up, PSA is a better marker than PAP to detect disease progression and seems to constitute an evolutive tumor mass index. PSA is the most sensitive, the earliest, and the most prognostically reliable marker for diagnosis and follow-up of prostate cancer patients.
采用前列腺特异性抗原（PSA）和前列腺酸性磷酸酶（PAP）试剂盒，对500例有前列腺临床症状的患者的血样进行放射免疫分析。根据组织学数据，在PSA结果及其他检查的指导下，诊断出200例前列腺癌（腺癌）、276例良性前列腺增生（BPH）、16例前列腺炎、5例膀胱癌和3例前列腺痛。所有前列腺癌患者的血清样本在诊断时PSA水平均升高，而其中约70%的患者PAP值正常。以2.5 ng/ml作为正常上限时，PSA检测的灵敏度为100%。然而，在10 ng/ml时特异性和阳性预测值更佳，分别为99%和79%。在直肠或超声检查无症状的癌症诊断中，高PSA值会给临床医生提示（3%）。在BPH中，当PSA水平在2.5至10 ng/ml之间时，必须在2个月内进行PSA复查。如果PSA升高超过10 ng/ml，则必须考虑癌症风险。在随访中，PSA是检测疾病进展比PAP更好的标志物，似乎构成了一个动态的肿瘤体积指标。PSA是前列腺癌患者诊断和随访中最敏感、最早且预后最可靠的标志物。
