Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.
Department of Oncology, Sundsvall County Hospital, 851 86, Sundsvall, Sweden.
BMC Urol. 2019 Jul 12;19(1):66. doi: 10.1186/s12894-019-0493-1.
The prostate-specific antigen (PSA) -value is often used during the prostate cancer trajectory as a marker of progression or response to treatment. Concerns about PSA-values are often expressed by patients in clinical situations. Today there is a lack of larger studies that have investigated the association between PSA-value and distress. The aim was to investigate the association between PSA-values and distress adjusted for sociodemographic factors, hormonal therapy and quality of life (QoL), among men with prostate cancer.
In this cross-sectional survey of 3165 men with prostate cancer, members of the Swedish Prostate Cancer Federation, answered questions about sociodemographic factors, PSA, distress, QoL and treatments. Descriptive statistics, and bivariate and multivariable analyses were performed. The result was presented based on four PSA-value groups: 0-19, 20-99, 100-999, and ≥ 1000 ng/ml.
Of the men, 53% experienced distress. An association between distress and PSA-values was found where higher PSA-values were associated with higher OR:s for experiencing distress in the different PSA-groups: 0-19 ng/ml (ref 1), 20-99 ng/ml (OR 1.25, 95% CI 1.01-1.55), 100-999 ng/ml (OR 1.47, 95% CI 1.12-1.94), ≥1000 ng/ml (OR 1.77, 95% CI 1.11-2.85). These associations were adjusted for sociodemographic factors and hormonal therapy. In the multivariable analyses, beside PSA-values, higher levels of distress were associated with being without partner or hormonal therapy. When adding QoL in the multivariable analysis, the association between PSA and distress did not remain significant.
These results indicate that the PSA-values are associated with distress, especially for those with higher values. However, to be able to support these men, continued research is needed to gain more knowledge about the mechanisms behind the association between emotional distress and PSA-values.
前列腺特异性抗原（PSA）值常被用于前列腺癌进程中，作为进展或治疗反应的标志物。在临床情况下，患者常常对 PSA 值表示担忧。目前，缺乏较大规模的研究来调查 PSA 值与焦虑之间的关系。本研究旨在调查前列腺癌男性患者 PSA 值与焦虑之间的关系，同时调整了社会人口统计学因素、激素治疗和生活质量（QoL）的影响。
在这项针对 3165 名前列腺癌患者的横断面调查中，瑞典前列腺癌联合会的成员回答了有关社会人口统计学因素、PSA 值、焦虑、QoL 和治疗的问题。进行了描述性统计、双变量和多变量分析。结果基于四个 PSA 值组呈现：0-19ng/ml、20-99ng/ml、100-999ng/ml 和≥1000ng/ml。
53%的男性患者感到焦虑。焦虑与 PSA 值之间存在关联，较高的 PSA 值与不同 PSA 值组中焦虑的更高比值比（OR）相关：0-19ng/ml（参考 1）、20-99ng/ml（OR 1.25，95%CI 1.01-1.55）、100-999ng/ml（OR 1.47，95%CI 1.12-1.94）、≥1000ng/ml（OR 1.77，95%CI 1.11-2.85）。这些关联在调整了社会人口统计学因素和激素治疗后仍然存在。在多变量分析中，除了 PSA 值外，较高的焦虑水平与没有伴侣或激素治疗相关。当在多变量分析中加入 QoL 时，PSA 与焦虑之间的关联不再显著。
这些结果表明，PSA 值与焦虑相关，尤其是对于那些值较高的患者。然而，为了能够支持这些男性患者，需要进一步研究以获得更多关于情绪焦虑与 PSA 值之间关联机制的知识。
