Schmid H P, McNeal J E, Stamey T A
Department of Urology, Stanford University School of Medicine, Calif.
Eur Urol. 1993;23 Suppl 2:60-3. doi: 10.1159/000474708.
The serum marker prostate-specific antigen (PSA) has been shown to be proportional to the volume of prostate cancer (Yang polyclonal assay). Therefore, changes in PSA with time in untreated patients should reflect tumor growth rate and the shape of the growth curve. Forty-three patients with untreated prostate cancer had serial PSA measurements over an average time span of 30 months. The increase of PSA was exponential (log-linear) throughout the measured interval. Doubling times were faster in patients with higher stages and grades. Twenty of 28 cancers thought to be clinically organ confined doubled at rates exceeding 4 years. Tumor doubling times were overestimated in patients with large volume benign prostatic hyperplasia since hyperplasia increases serum PSA, albeit 12 times less than cancer. We conclude that prostate cancer has a constant (log-linear) growth rate which is very slow. This slow doubling time has substantial consequences for therapeutic decisions and for screening programs.
血清标志物前列腺特异性抗原（PSA）已被证明与前列腺癌体积成正比（杨多克隆检测法）。因此，未经治疗患者的PSA随时间变化应反映肿瘤生长速率和生长曲线形状。43例未经治疗的前列腺癌患者在平均30个月的时间跨度内进行了系列PSA测量。在整个测量间隔内，PSA的升高呈指数形式（对数线性）。分期和分级较高的患者倍增时间更快。28例被认为临床局限于器官的癌症中，有20例的倍增速率超过4年。对于前列腺体积较大的良性前列腺增生患者，肿瘤倍增时间被高估，因为增生会使血清PSA升高，尽管其升高幅度仅为癌症的1/12。我们得出结论，前列腺癌具有恒定的（对数线性）生长速率，且非常缓慢。这种缓慢的倍增时间对治疗决策和筛查计划具有重大影响。
