前列腺特异性抗原水平较低的前列腺癌患者中前列腺特异性抗原与TNM分期或 Gleason评分的关系。

The relationship between prostate-specific antigen and TNM classification or Gleason score in prostate cancer patients with low prostate-specific antigen levels.

作者信息

Izumi Kouji, Ikeda Hiroko, Maolake Aerken, Machioka Kazuaki, Nohara Takahiro, Narimoto Kazutaka, Ueno Satoru, Kadono Yoshifumi, Kitagawa Yasuhide, Konaka Hiroyuki, Mizokami Atsushi, Namiki Mikio

机构信息

Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.

Division of Pathology, Kanazawa University Hospital, Kanazawa, Japan.

出版信息

Prostate. 2015 Jul 1;75(10):1034-42. doi: 10.1002/pros.22985. Epub 2015 Mar 8.

DOI:10.1002/pros.22985

PMID:25753899

Abstract

BACKGROUND

Prostate-specific antigen (PSA) is a useful biomarker for risk classification in patients with prostate cancer. However, it is unclear whether a correlation exists between low PSA levels (<10 ng/ml) at diagnosis and prognosis.

METHODS

Of the 642 Japanese patients who underwent prostate biopsy and were diagnosed with prostate cancer at Kanazawa University Hospital from 2000 to 2010, 406 patients with a PSA level <20 ng/ml were retrospectively reviewed.

RESULTS

PSA levels in 275 (68%) patients were <10 ng/ml. Although the percentage of Gleason score 8-10 in patients with a PSA level of <3.5 ng/ml was higher than that in patients with a PSA level between 3.5 and 10 ng/ml, it was not statistically significant. On the other hand, the percentage of higher stage (T3 and T4) patients with a PSA level <3.5 ng/ml was significantly greater than that in patients with a PSA level between 3.5 and 10 ng/ml (P < 0.0001). The percentage of metastases (N1 and M1) in patients with a PSA level <3.5 ng/ml was also significantly higher than that in patients with a PSA level between 3.5 and 10 ng/ml (P = 0.0112).

CONCLUSIONS

Patients with prostate cancer with a PSA level <3.5 ng/ml at diagnosis had a more advanced stage of cancer compared with those with a PSA level between 3.5 and 10 ng/ml. Therefore, risk classification using PSA levels at diagnosis may need to take into consideration this specific PSA range in order to better predict survival.

摘要

背景

前列腺特异性抗原（PSA）是前列腺癌患者风险分类的一种有用生物标志物。然而，目前尚不清楚诊断时低PSA水平（<10 ng/ml）与预后之间是否存在相关性。

方法

回顾性分析了2000年至2010年在金泽大学医院接受前列腺活检并被诊断为前列腺癌的642例日本患者，其中406例PSA水平<20 ng/ml。

结果

275例（68%）患者的PSA水平<10 ng/ml。虽然PSA水平<3.5 ng/ml的患者中Gleason评分8 - 10分的比例高于PSA水平在3.5至10 ng/ml之间的患者，但差异无统计学意义。另一方面，PSA水平<3.5 ng/ml的更高分期（T3和T4）患者的比例显著高于PSA水平在3.5至10 ng/ml之间的患者（P < 0.0001）。PSA水平<3.5 ng/ml的患者中转移（N1和M1）的比例也显著高于PSA水平在3.5至10 ng/ml之间的患者（P = 0.0112）。