Yu H, Levesque M A, Clark G M, Diamandis E P
Diagnostic Systems Laboratories Inc., Webster, Texas 77598-4217, USA.
Clin Cancer Res. 1998 Jun;4(6):1489-97.
Prostate-specific antigen (PSA) is a valuable tumor marker used for diagnosis and management of prostate cancer. Recently, PSA has been found in various female tissues and body fluids. Female breasts, both normal and abnormal, including cancerous tissues, can produce PSA, and this production is regulated by androgens and progestins. Preliminary data suggested that patients with breast tumors positive for PSA may have better prognosis compared to those with PSA-negative breast tumors. This study examines the prognostic value of PSA in a large cohort study of United States patients. Using a PSA assay that has a lower detection limit of 0.001 ng/ml, we measured PSA in tumor cytosolic extracts of 953 women with primary breast cancer. Other information available for this study included age, follow-up time, survival outcome, tumor size, nodal status, steroid hormone receptor levels, DNA analysis by flow cytometry, and postoperative treatment. The median follow-up time was 73 months. During the follow-up, 200 patients relapsed and 188 died. PSA presence was found to be significantly associated with smaller tumors, tumors with low S-phase fraction, diploid tumors, younger patient age, and tumors with lower cellularity. Survival analysis indicated that the relative risks (RRs) for relapse and death were both significantly lower [RR = 0.67 (P = 0.01) for relapse; RR = 0.72 (P = 0.05) for death] in PSA-positive patients (levels higher than the 30th percentile of PSA values) than in PSA-negative patients. The reduced risks for relapse and death remained statistically significant after other clinical and pathological variables were adjusted in the multivariate analysis [RR = 0.68 (P = 0.02) for relapse; RR = 0.65 (P = 0.02) for death]. Our results suggest that the measurement of PSA in breast tumor extracts provides additional information on the prognosis of patients with primary breast cancer.
前列腺特异性抗原（PSA）是一种用于前列腺癌诊断和管理的重要肿瘤标志物。最近，在各种女性组织和体液中发现了PSA。正常和异常的女性乳房，包括癌组织，都能产生PSA，且这种产生受雄激素和孕激素调节。初步数据表明，PSA阳性的乳腺肿瘤患者与PSA阴性的乳腺肿瘤患者相比，预后可能更好。本研究在美国患者的大型队列研究中检验了PSA的预后价值。使用检测下限为0.001 ng/ml的PSA检测方法，我们测量了953例原发性乳腺癌女性患者肿瘤胞质提取物中的PSA。本研究可获得的其他信息包括年龄、随访时间、生存结果、肿瘤大小、淋巴结状态、类固醇激素受体水平、流式细胞术DNA分析以及术后治疗情况。中位随访时间为73个月。随访期间，200例患者复发，188例死亡。发现PSA的存在与较小的肿瘤、S期分数低的肿瘤、二倍体肿瘤、患者年龄较轻以及细胞密度较低的肿瘤显著相关。生存分析表明，PSA阳性患者（PSA水平高于PSA值第30百分位数）复发和死亡的相对风险（RRs）均显著低于PSA阴性患者[复发RR = 0.67（P = 0.01）；死亡RR = 0.72（P = 0.05）]。在多变量分析中对其他临床和病理变量进行调整后，复发和死亡风险降低仍具有统计学意义[复发RR = 0.68（P = 0.02）；死亡RR = 0.65（P = 0.02）]。我们的结果表明，测量乳腺肿瘤提取物中的PSA可为原发性乳腺癌患者的预后提供额外信息。
