Lin D W, Noteboom J L, Blumenstein B A, Ellis W J, Lange P H, Vessella R L
Department of Urology and Hutchison Cancer Research Center, University of Washington, Seattle 98195, USA.
Urology. 1998 Sep;52(3):366-71. doi: 10.1016/s0090-4295(98)00240-4.
To define the serum prostate-specific antigen (PSA) isoform profile in patients who have prostate cancer but do not have a prostate gland, that is, men who have had a previous radical prostatectomy (RP) and subsequently persistent disease as evidenced by elevated PSA. PSA can be reliably measured in the serum in two major isoforms: PSA complexed to alpha1-antichymotrypsin and uncomplexed free PSA (fPSA). Multiple investigations have illustrated the usefulness of the free/total PSA proportion (percent fPSA) in differentiating prostate cancer from benign prostate disease in patients who still have their prostate gland in situ.
Sera were evaluated from 52 men who underwent RP and postoperatively had increased PSA. fPSA and total PSA (tPSA) concentrations were determined using the Abbott AxSYM PSA assays. Percent fPSA was calculated for all patients.
Median tPSA was 5.45 ng/mL (range 0.93 to 214.99). Median fPSA was 0.69 ng/mL (range 0.11 to 54.93); the median percent fPSA was 13.3% (range 3.9% to 62.9%). There were 27 (52%) patients with percent fPSA less than 15%, 25 (48%) patients with greater than 15%, and 7 (13%) with greater than 30%. No significant relationship was found between percent fPSA and grade, stage, and severity of disease. Percent fPSA was significantly increased in patients who received hormonal, radiation, or combination treatment versus those who received no treatment (P = 0.02 to 0.0007).
Serum percent fPSA in men after RP with persistent prostate cancer encompasses a wide range of values with no clear stratifying factor or factors. These observations and further serial studies in patients with progressive metastatic disease may be important in determining the mechanism(s) for lower percent fPSA in men with newly diagnosed prostate cancer.
确定前列腺癌患者但无前列腺者（即既往接受过根治性前列腺切除术（RP）且随后出现PSA升高提示疾病持续存在的男性）的血清前列腺特异性抗原（PSA）异构体谱。PSA在血清中可可靠地以两种主要异构体形式进行测量：与α1 - 抗糜蛋白酶结合的PSA和未结合的游离PSA（fPSA）。多项研究表明，在前列腺仍原位存在的患者中，游离/总PSA比例（fPSA百分比）在区分前列腺癌与良性前列腺疾病方面具有实用性。
对52例接受RP且术后PSA升高的男性血清进行评估。使用雅培AxSYM PSA检测法测定fPSA和总PSA（tPSA）浓度。计算所有患者的fPSA百分比。
tPSA中位数为5.45 ng/mL（范围0.93至214.99）。fPSA中位数为0.69 ng/mL（范围为0.11至54.93）；fPSA百分比中位数为13.3%（范围为3.9%至62.9%）。fPSA百分比低于15%的患者有27例（52%），高于15%的患者有25例（48%），高于30%的患者有7例（13%）。未发现fPSA百分比与疾病分级、分期及严重程度之间存在显著关系。与未接受治疗的患者相比，接受激素、放疗或联合治疗的患者fPSA百分比显著升高（P = 0.02至0.0007）。
RP后患有持续性前列腺癌的男性血清fPSA百分比涵盖广泛的值，且无明确的分层因素。这些观察结果以及对进行性转移性疾病患者的进一步系列研究，对于确定新诊断前列腺癌男性中fPSA百分比降低的机制可能具有重要意义。
