Kamiyama Yuki, Somiya Shinya, Fujikawa Shohei, Yamada Yuya, Tamaki Masahiro, Kanaoka Toshio, Hayashi Tadashi
The Department of Urology, Japanese Red Cross Society Wakayama Medical Center.
Hayashi Tadashi Urological Clinic.
Hinyokika Kiyo. 2017 Oct;63(10):435-437. doi: 10.14989/ActaUrolJap_63_10_435.
We described a 63-year-old man who was diagnosed with clinical T1c prostate cancer, with a Gleason score of 6 (3＋3), and a preoperative prostate-specific antigen (PSA) level of 5. 27 ng/ml. Radical prostatectomy(RP) was performed and final pathologyshowed Gleason score 3＋4, pT2c with negative surgical margin. In spite of suggested surgical radicality, PSA was 3.32, 4.78, 5.93 ng/ml, at 1, 2, and 3 months after RP, respectively. However, radiological investigation revealed no metastasis. Because of this clinical discrepancy, we checked the PSA-α1-antichemotrypsin level and found it to be ≦0.1 ng/ml. From these results, false PSA elevation caused byinterference of positive heterophilic antibodies was suggested and demonstrated byseveral immunoassays.
我们描述了一名63岁男性，其被诊断为临床T1c期前列腺癌，Gleason评分为6（3＋3），术前前列腺特异性抗原（PSA）水平为5.27 ng/ml。进行了根治性前列腺切除术（RP），最终病理显示Gleason评分为3＋4，pT2c，手术切缘阴性。尽管手术达到了根治性要求，但RP术后1、2和3个月时PSA分别为3.32、4.78和5.93 ng/ml。然而，影像学检查未发现转移。由于这种临床差异，我们检测了PSA-α1-抗糜蛋白酶水平，发现其≤0.1 ng/ml。根据这些结果，提示并通过多种免疫测定证实了由阳性嗜异性抗体干扰导致的假PSA升高。
