Monda J M, Myers R P, Bostwick D G, Oesterling J E
Department of Urology and Biostatistics, Mayo Clinic, Rochester, Minnesota 55905, USA.
Urology. 1995 Jul;46(1):62-4. doi: 10.1016/S0090-4295(99)80160-5.
To determine if the serum testosterone (T) concentration influences the ability of prostate-specific antigen (PSA) to predict prostate cancer volume and stage.
One hundred consecutive patients with clinically localized prostate cancer who underwent radical prostatectomy were examined prospectively. Each patient was evaluated preoperatively with a serum PSA, total T, free T, and percent free T. All surgical specimens were evaluated using the whole mount, step section technique for Gleason score, tumor volume, and extraprostatic disease.
Serum total T, free T, and percent free T did not correlate with the serum PSA level (r = .03, .08, and .07, respectively), tumor volume (r = .11, .08, and .11, respectively), prostate weight (r = .00, -.08, and .11, respectively), or Gleason score (r = .11, .08, and .11, respectively). Serum PSA correlated with tumor volume (r = .51, P < 0.0001). Extraprostatic disease was significantly associated with a higher percent free T value (r = .26, P = 0.02) but not with either the total or the free T level. Linear regression analysis showed that neither the total nor the free T concentration was a significant predictor of extraprostatic disease in the presence of PSA (P = 0.30 and 0.24, respectively); percent free T contributed only slightly to PSA in the prediction of extraprostatic disease (P = 0.05). However, neither total T, free T, nor percent free T was a significant predictor of tumor volume; in essence, the association between PSA and tumor volume was independent of the serum T concentration (P = 0.30, 0.24, and 0.60, respectively).
Serum total T, free T, and percent free T values do not enhance the ability of PSA to predict the tumor volume or pathologic stage in patients with clinically localized prostate cancer.
确定血清睾酮（T）浓度是否会影响前列腺特异性抗原（PSA）预测前列腺癌体积和分期的能力。
对100例接受根治性前列腺切除术的临床局限性前列腺癌患者进行前瞻性检查。术前对每位患者进行血清PSA、总T、游离T和游离T百分比评估。所有手术标本均采用全层、阶梯切片技术评估Gleason评分、肿瘤体积和前列腺外疾病。
血清总T、游离T和游离T百分比与血清PSA水平（分别为r = 0.03、0.08和0.07）、肿瘤体积（分别为r = 0.11、0.08和0.11）、前列腺重量（分别为r = 0.00、-0.08和0.11）或Gleason评分（分别为r = 0.11、0.08和0.11）均无相关性。血清PSA与肿瘤体积相关（r = 0.51，P < 0.0001）。前列腺外疾病与较高的游离T百分比值显著相关（r = 0.26，P = 0.02），但与总T或游离T水平均无关。线性回归分析表明，在存在PSA的情况下，总T浓度和游离T浓度均不是前列腺外疾病的显著预测指标（分别为P = 0.30和0.24）；游离T百分比在预测前列腺外疾病时对PSA的贡献仅轻微（P = 0.05）。然而，总T、游离T和游离T百分比均不是肿瘤体积的显著预测指标；本质上，PSA与肿瘤体积之间的关联独立于血清T浓度（分别为P = 0.30、0.24和0.60）。
血清总T、游离T和游离T百分比值并不能增强PSA预测临床局限性前列腺癌患者肿瘤体积或病理分期的能力。
