Kramer G, Steiner G E, Madersbacher S, Stulnig T, Lang T, Marberger M
Department of Urology, Institute for Medical Statistics, University of Vienna, Austria.
J Urol. 1997 Oct;158(4):1446-51.
We determined the impact of serum cytokeratin-18-related tissue polypeptide specific antigen (TPS) in monitoring hormone treated carcinoma of the prostate.
From 1991 to 1996, serial TPS and prostate specific antigen (PSA) determinations (3,882) in 443 hormone treated prostate carcinoma patients were correlated with the clinical course for a mean of 22 months.
Elevated TPS levels were significantly associated with disease progression in hormone treated stage M1 carcinoma of the prostate (p = 0.001), even in high grade, PSA negative tumors. Post-therapy TPS declines following second line therapy in hormone refractory prostate cancer patients (92) correlated significantly with subjective response (p = 0.001, PSA p = 0.02) and progression-free survival time (r(s) = -0.76, PSA r(s) = -0.32). A TPS decrease of more than 50% coincided with palliation in 90% of patients (PSA 64%) and predicted the best chance of a longer progression of free survival (p < 0.00005, PSA p = 0.036). Vice versa, rising TPS levels (more than 20%) coincided with subjective response in only 1 of 37 patients (PSA 9 of 33).
TPS may be a useful adjunct to PSA in monitoring hormone refractory, metastasized prostate cancer.
我们确定了血清细胞角蛋白-18相关组织多肽特异性抗原（TPS）在监测激素治疗前列腺癌中的作用。
1991年至1996年，对443例接受激素治疗的前列腺癌患者进行了连续TPS和前列腺特异性抗原（PSA）测定（共3882次），并将其与平均22个月的临床病程相关联。
TPS水平升高与激素治疗的M1期前列腺癌疾病进展显著相关（p = 0.001），即使在高级别、PSA阴性肿瘤中也是如此。激素难治性前列腺癌患者（92例）二线治疗后TPS下降与主观反应显著相关（p = 0.001，PSA p = 0.02）以及无进展生存时间相关（r(s)= -0.76，PSA r(s)= -0.32）。TPS下降超过50%与90%的患者病情缓解相符（PSA为64%），并预示着更长无进展生存期的最佳机会（p < 0.00005，PSA p = 0.036）。反之，TPS水平升高（超过20%）仅与37例患者中的1例主观反应相符（PSA为33例中的9例）。
在监测激素难治性转移性前列腺癌方面，TPS可能是PSA的有用辅助指标。
