Wirth M P, Pilarsky C
Klinik und Poliklinik für Urologie des Universitätsklinikums Carl Gustav Carus, Technischen Universität, Dresden.
Urologe A. 1995 Jul;34(4):297-302.
The prostate specific antigen (PSA) has gained great importance for the diagnosis and the treatment of prostate carcinoma since its isolation from prostate tissue in 1979. PSA is produced and secreted almost only by the prostatic tissue. After radical prostatectomy PSA changes from a tissue specific marker to a tumor specific parameter. At least 30 days after radical prostatectomy the PSA serum level should decline nondetectable values. A high incidence for a local recurrence, distant metastases, or a incomplete resection of the prostate is a still present PSA serum value. After a radiation or androgen deprivation therapy the PSA value is a prognostic marker. A good prognosis can be expected if the PSA level decreases after androgen deprivation therapy to values below 4 ng/ml. In contrast to that increasing PSA levels indicate a local or distant recurrence. Progression of the tumor without an increase of PSA values is possible but rare. It could be shown in several studies, that the determination of PSA values is sufficient for routine treatment control and that other methods could therefore be omitted.
自1979年从前列腺组织中分离出前列腺特异性抗原（PSA）以来，它在前列腺癌的诊断和治疗中变得极为重要。PSA几乎仅由前列腺组织产生和分泌。根治性前列腺切除术后，PSA从组织特异性标志物转变为肿瘤特异性参数。根治性前列腺切除术后至少30天，PSA血清水平应降至无法检测到的值。PSA血清值仍存在则提示局部复发、远处转移或前列腺切除不完全的发生率较高。放疗或雄激素剥夺治疗后，PSA值是一个预后标志物。如果雄激素剥夺治疗后PSA水平降至4 ng/ml以下，则预后良好。与此相反，PSA水平升高表明局部或远处复发。肿瘤进展但PSA值不升高是可能的，但很罕见。多项研究表明，测定PSA值足以进行常规治疗监测，因此可以省略其他方法。
