临床肿瘤标志物监测的精细化：为何不使用倍增时间的倒数？
A Refinement of Clinical Tumor Marker Monitoring: Why Not Use an Inverse Value of Doubling Time?
机构信息
National Cancer Institute Lithuania, NVI, Vilnius, Lithuania.
Vilnius University, Vilnius, Lithuania.
出版信息
Med Princ Pract. 2021;30(3):292-296. doi: 10.1159/000515977. Epub 2021 Mar 19.
OBJECTIVES
The aim of this study was to compare prostate-specific antigen (PSA) kinetics - half-life time (HT), doubling time (DT), and elimination rate PSA (ePSA) in prostate cancer (PCa) monitoring. Implementation of ePSA in clinical practice could help simplify patient monitoring in the remission phase.
MATERIALS AND METHODS
A total of 49 PCa patients were examined by their PSA tests before prostatectomy and after 30 days, 91 days, and 24 months. Conventional PSA rate of change parameters (HT and DT) were compared to a new clinically understandable ePSA parameter.
RESULTS
We observed that implementation of inverse value (ePSA) rather than HT or DT has distinct advantages: (1) values are valid when PSA is unchanged (ePSA equals zero), (2) the concept of ePSA can be easily understood, as it is a growth fraction, (3) ePSA fluctuates within a narrow range and is thus easy to interpret, and (4) there are no mathematical flaws (no positive skewing).
CONCLUSION
Exploring ePSA norm as ≤0% could help spot biochemical recurrence in a timely manner. Primary health care providers tend to use an irrelevant PSA threshold, that is, 4.0 ng/mL, in postoperative follow-up. The delayed referrals of patients in remission might be reduced if ePSA testing is adopted.
目的
本研究旨在比较前列腺癌（PCa）监测中前列腺特异性抗原（PSA）的动力学-半衰期（HT）、倍增时间（DT）和 PSA 消除率（ePSA）。在临床实践中实施 ePSA 有助于简化缓解期患者的监测。
材料和方法
共对 49 例前列腺切除术前后 30 天、91 天和 24 个月的 PSA 检测的 PCa 患者进行了检查。将常规 PSA 变化参数（HT 和 DT）与新的临床可理解的 ePSA 参数进行了比较。
结果
我们观察到，使用倒数值（ePSA）而不是 HT 或 DT 具有明显的优势：（1）当 PSA 不变时，值是有效的（ePSA 等于零）；（2）ePSA 的概念很容易理解，因为它是一个生长分数；（3）ePSA 波动范围窄，易于解释；（4）没有数学缺陷（没有正偏斜）。
结论
探索 ePSA 正常范围≤0%有助于及时发现生化复发。初级保健提供者在术后随访中倾向于使用不相关的 PSA 阈值，即 4.0ng/mL。如果采用 ePSA 检测，可能会减少缓解期患者的延迟转诊。
Zotero 插件