Regueiro López J C, Ruiz Alvarez Cienfuegos F, Leva Vallejo M, Requena Tapia M J, Merchan García J A, Prieto Castro R, Alvarez Kindelan J
Servicio de Urología, Hospital Regional Universitario Reina Sofía de Córdoba.
Actas Urol Esp. 1995 May;19(5):357-62.
Evaluation of the prognostic value of prostatic markers with regard to disease progression after endocrine therapy in patients with prostate carcinoma. A total of 51 patients (21 stage C, 5 stage D1 and 25 stage D2). Endocrine therapy consisted in complete hormonal blockade with flutamide and an LH-RH analog depot (leuprolide). PSA-PAP levels were determined both pre-treatment and during follow-up of patients using radioimmunometric techniques. Follow-up extended for 13 to 62 months (mean 30 months). Death due to progression happened in 24 of 51 patients. Previous PSA levels did not correlate to progression. Changes in PSA levels during treatment and time scope when they occurred were associated to subsequent evolution. Patients with PAP higher than 10 ng/ml at the beginning of therapy experienced higher progression rates (p < 0.05). Decrease of PSA levels by a percentage greater than 80% during the first quarter of treatment relative to initial figures was related to lower progression rates (p < 0.01). Maintenance of high levels in the first six months of treatment predicted a higher progression rate (p < 0.001). The study suggests a better prognosis for patients wit decreased serum PSA rates by a percentage of around 80% after one to three months treatment.
评估前列腺癌患者内分泌治疗后前列腺标志物对疾病进展的预后价值。共有51例患者（21例C期、5例D1期和25例D2期）。内分泌治疗包括使用氟他胺和促性腺激素释放激素类似物长效注射剂（亮丙瑞林）进行完全激素阻断。采用放射免疫测定技术在患者治疗前和随访期间测定PSA - PAP水平。随访时间为13至62个月（平均30个月）。51例患者中有24例因疾病进展死亡。既往PSA水平与疾病进展无关。治疗期间PSA水平的变化及其发生的时间范围与后续病情发展相关。治疗开始时PAP高于10 ng/ml的患者疾病进展率更高（p < 0.05）。治疗第一季度期间PSA水平相对于初始值下降超过80%与较低的疾病进展率相关（p < 0.01）。治疗前六个月维持高水平预示着更高的疾病进展率（p < 0.001）。该研究表明，治疗1至3个月后血清PSA水平下降约80%的患者预后较好。
