Benson M C, Olsson C A
Department of Urology, Columbia University College of Physicians and Surgeons, New York, New York.
Cancer. 1994 Sep 15;74(6):1667-73. doi: 10.1002/1097-0142(19940915)74:6<1667::aid-cncr2820740605>3.0.co;2-2.
Prostate specific antigen (PSA) is the most accurate serum marker for prostate cancer. However, sensitivity and specificity are suboptimal, especially at the intermediate levels between 4.1 and 10.0 ng/ml (monoclonal). For intermediate PSA levels, PSA density (PSAD) provides unique information regarding the need for biopsy and the likelihood of prostate cancer. The authors prospectively used PSAD to determine the need for biopsy in 68 patients with PSAD values below 0.150 and normal results from a digital rectal examination. Ten patients have undergone biopsy secondary to a rising serum PSA. Three were found to harbor prostate cancer and have undergone therapy. The remaining 65 patients continue on surveillance. PSAD can predict treatment outcomes for patients with clinically localized prostate cancer treated with radical prostatectomy. PSADs at low values are 90% accurate in predicting operative success. PSADs at high values are 67% accurate in predicting failure. Cancer 1994; 74: 1667-73.
前列腺特异性抗原（PSA）是前列腺癌最准确的血清标志物。然而，其敏感性和特异性并不理想，尤其是在4.1至10.0 ng/ml（单克隆）的中间水平。对于中间PSA水平，PSA密度（PSAD）提供了有关活检必要性和前列腺癌可能性的独特信息。作者前瞻性地使用PSAD来确定68例PSAD值低于0.150且直肠指检结果正常的患者是否需要活检。10例患者因血清PSA升高而接受了活检。其中3例被发现患有前列腺癌并接受了治疗。其余65例患者继续接受监测。PSAD可以预测接受根治性前列腺切除术治疗的临床局限性前列腺癌患者的治疗结果。低值PSAD预测手术成功的准确率为90%。高值PSAD预测失败的准确率为67%。《癌症》1994年；74：1667 - 1673。
