前列腺上皮内瘤变似乎不会升高血清前列腺特异性抗原浓度。

Prostatic intraepithelial neoplasia does not appear to raise serum prostate-specific antigen concentration.

作者信息

Alexander E E, Qian J, Wollan P C, Myers R P, Bostwick D G

机构信息

Department of Urology, Mayo Clinic, Rochester, Minnesota 55905, USA.

出版信息

Urology. 1996 May;47(5):693-8. doi: 10.1016/s0090-4295(96)00004-0.

DOI:10.1016/s0090-4295(96)00004-0

PMID:8650867

Abstract

OBJECTIVES

Conflicting findings have been reported regarding the relationship between prostatic intraepithelial neoplasia (PIN) and serum prostate-specific antigen (PSA) concentration. This study evaluates whether high-grade PIN significantly raises serum PSA concentration.

METHODS

We evaluated 194 totally embedded whole-mounted radical prostatectomy specimens removed for clinically localized prostate cancer. No patient received preoperative therapy. In each specimen, the volume of high-grade PIN and carcinoma was calculated using the grid-counting method. Serum PSA concentration was determined prior to surgery. Cancer volume, gland weight, Gleason score, extraprostatic extension, and PIN volume were then compared according to serum PSA concentration and PSA density.

RESULTS

Of the 194 patients, 170 (88%) had high-grade PIN-associated cancer and 24 (12%) had PIN-free cancer within the specimen. PIN volume ranged from 0 to 8.1 cc (mean, 1.3) and cancer volume ranged from 0 to 56.9 cc (mean, 9.1). In a subset of 93 patients with small cancers (less than 6.0 cc), PIN volume ranged from 0 to 6.1 (mean, 0.83) and did not correlate with serum PSA concentration or PSA density (P = 0.80 and P = 0.69, respectively). In the entire study group, PIN volume did not correlate with PSA density (P = 0.17), but did correlate with serum PSA concentration (P = 0.005). Using multiple regression analysis, adjusting for cancer volume, gland weight, Gleason score, and extraprostatic extension, log PIN volume did not contribute to log serum PSA concentration (regression coefficient -0.108; P = 0.51) or log PSA density (regression coefficient -0.104; P = 0.56) in small cancers (less than 6.0 cc). In the entire study group, log PIN volume did not contribute to log serum PSA concentration (regression coefficient -0.182; P = 0.05) or log PSA density (regression coefficient -0.202; P = 0.56).

CONCLUSIONS

Our data indicate that high-grade PIN does not significantly contribute to serum PSA concentration. We suggest that patients with elevated serum PSA concentration found to have high-grade PIN on transrectal biopsy should not have their elevated serum PSA concentration attributed to high-grade PIN.

摘要

目的

关于前列腺上皮内瘤变（PIN）与血清前列腺特异性抗原（PSA）浓度之间的关系，已有相互矛盾的研究结果报道。本研究旨在评估高级别PIN是否会显著提高血清PSA浓度。

方法

我们评估了194例因临床局限性前列腺癌而切除的全组织包埋的根治性前列腺切除术标本。所有患者均未接受术前治疗。在每个标本中，采用网格计数法计算高级别PIN和癌的体积。术前测定血清PSA浓度。然后根据血清PSA浓度和PSA密度比较癌体积、腺体重量、Gleason评分、前列腺外侵犯情况和PIN体积。

结果

194例患者中，170例（88%）标本中有高级别PIN相关癌，24例（12%）标本中无PIN癌。PIN体积范围为0至8.1立方厘米（平均1.3立方厘米），癌体积范围为0至56.9立方厘米（平均9.1立方厘米）。在93例小癌（小于6.0立方厘米）患者的亚组中，PIN体积范围为0至6.1（平均0.83），与血清PSA浓度或PSA密度均无相关性（P值分别为0.80和0.69）。在整个研究组中，PIN体积与PSA密度无相关性（P = 0.17），但与血清PSA浓度相关（P = 0.005）。采用多元回归分析，校正癌体积、腺体重量、Gleason评分和前列腺外侵犯情况后，在小癌（小于6.0立方厘米）中，log PIN体积对log血清PSA浓度（回归系数 -0.108；P = 0.51）或log PSA密度（回归系数 -0.104；P = 0.56）无贡献。在整个研究组中，log PIN体积对log血清PSA浓度（回归系数 -0.182；P = 0.05）或log PSA密度（回归系数 -0.202；P = 0.56）无贡献。