Safa A A, Reese D M, Carter D M, Phillipson J, Smith R, Dougherty S
Department of Radiation Oncology, UCLA Medical Center, Los Angeles, California 90024, USA.
Am J Clin Oncol. 1998 Aug;21(4):323-6. doi: 10.1097/00000421-199808000-00001.
A 63-year-old man, who had undergone prostatectomy for prostate cancer that was positive for prostate-specific antigen (PSA) was examined and found to have metastatic disease, proven radiologically and pathologically, but with an undetectable PSA and highly elevated prostatic acid phosphatase (PAP). Prostatic acid phosphatase levels fell in response to chemotherapy but his clinical status continued to deteriorate. A review of the literature is presented and several possible explanations for PSA remaining undetectable in these situations are discussed. The authors conclude that although PSA can be used to monitor the majority of patients postprostatectomy, physicians may still need to rely on clinical suspicion, serum PAP, and bone scan for the detection of recurrent disease.
一名63岁男性，因前列腺特异性抗原（PSA）阳性的前列腺癌接受了前列腺切除术，检查发现有转移性疾病，经放射学和病理学证实，但PSA检测不到，而前列腺酸性磷酸酶（PAP）高度升高。前列腺酸性磷酸酶水平在化疗后下降，但他的临床状况持续恶化。本文对文献进行了综述，并讨论了在这些情况下PSA仍检测不到的几种可能解释。作者得出结论，虽然PSA可用于监测大多数前列腺切除术后的患者，但医生仍可能需要依靠临床怀疑、血清PAP和骨扫描来检测复发性疾病。
