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直肠指检按摩对尿前列腺特异性抗原的影响:对前列腺癌根治术后局部复发检测的意义

Influence of digital rectal massage on urinary prostate-specific antigen: interest for the detection of local recurrence after radical prostatectomy.

作者信息

Malavaud B, Salama G, Miédougé M, Vincent C, Rischmann P, Sarramon J P, Serre G

机构信息

Department of Urology, Toulouse-Purpan University Hospital, France.

出版信息

Prostate. 1998 Jan 1;34(1):23-8. doi: 10.1002/(sici)1097-0045(19980101)34:1<23::aid-pros3>3.0.co;2-l.

Abstract

BACKGROUND

Following radical prostatectomy, urinary prostate-specific antigen (uPSA) may originate from periurethral glands or from recurrent carcinomatous prostatic cells. We evaluated massage of the urethro-vesical anastomosis as a uPSA-releasing method for the detection of local recurrence.

METHODS

PSA was assessed (PSA IMx, Abbott Diagnostic, Rungis, France) in serum and in the first voided urine before and after massage in 59 patients: 7 after cystoprostatectomy for bladder cancer, 22 with prostate in situ, and 30 after radical prostatectomy for prostate cancer.

RESULTS

No significant changes of uPSA were induced by the massage in cystoprostatectomy patients and in 4 radical prostatectomy patients with a negative biopsy of the anastomosis. In contrast, a significant increase of uPSA was observed after massage in the patients with prostate in situ and in 6 radical prostatectomy patients with biopsy-proven local relapse.

CONCLUSIONS

uPSA before and after massage of the prostatic fossa may constitute a new and efficient tool for the detection of local recurrence, if these preliminary results are confirmed on a larger scale.

摘要

背景

根治性前列腺切除术后,尿前列腺特异性抗原(uPSA)可能来源于尿道周围腺体或复发性前列腺癌细胞。我们评估了尿道膀胱吻合术按摩作为一种释放uPSA以检测局部复发的方法。

方法

对59例患者在按摩前后的血清和首次晨尿中进行PSA评估(使用法国鲁昂市雅培诊断公司的PSA IMx):7例因膀胱癌行膀胱前列腺切除术,22例前列腺原位患者,30例因前列腺癌行根治性前列腺切除术。

结果

膀胱前列腺切除术患者以及4例吻合口活检阴性的根治性前列腺切除术患者在按摩后uPSA无显著变化。相比之下,前列腺原位患者以及6例活检证实有局部复发的根治性前列腺切除术患者在按摩后uPSA显著升高。

结论

如果这些初步结果能在更大规模上得到证实,前列腺窝按摩前后的uPSA可能成为检测局部复发的一种新的有效工具。

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