PROSTATE-SPECIFIC ANTIGEN IN MASS SCREENING FOR CARCINOMA OF THE PROSTATE

Background:
Prostate-specific antigen (PSA) has various advantages over prostatic acid phosphatase (PAP) as a marker for prostate cancer, but its role in prostate cancer mass screening remains controversial. We measured serum PSA in addition to serum PAP determination and digital rectal examination (DRE) in our mass screening program to assess the usefulness of PSA for prostate cancer mass screening.
Methods:
Serum PSA and PAP measurements and DRE were performed in 1249 patients in mass screening for carcinoma of the prostate in 1989 and 1990. Thirteen cancers were diagnosed. We calculated the mean plus standard deviations (2SD) of the PSA and PAP values of men without cancer, and assessed the usefulness of PSA for prostate cancer screening by using these figures as the upper limit of normal.
Results:
The number positive for PSA, PAP and DRE were 39, 36 and 48, respectively. If our screening had been performed without DRE, three cancers would have remained undetected, and the number would have been the same if performed without PSA. If the screening had been performed without PAP, on the other hand, no cancers would have remained undetected. The sensitivities of PSA and PAP were 54% and 23%, respectively. The screening detection rate with DRE and PSA was 0.88%, and with DRE and PAP was 0.64%.
Conclusions:
Measurement of serum PSA values with adjustment of the cut-off value was considered more useful than PAP in mass screening for prostate cancer.     

Prostatic specific antigen (PA) in mass screening for prostate cancer]

The usefulness of prostatic specific antigen (PA) was compared with that of prostatic acid phosphatase (PAP). PA was determined in the serum of 2,183 patient examined by the mass screening for prostate cancer from 1987 to 1990. The serum samples of these patients were obtained from our serum bank. PA was measured by the E test "TOSOH" II (PA). The relationship of PA and PAP to prostate size estimated by digital rectal examination (DRE) and ultrasound tomography (US), and age was investigated. PA and PAP correlated with aging and prostate size estimated by DRE. However PA was more apparently related with these things. The correlation between PA and prostatic size estimated by US was relatively high (r = 0.53), but the correlation between PAP and prostate size estimated by US was low (r = 0.20). When the upper limit of normal range was set at 6.0 ng/ml, the sensitivity, specificity and efficiency was 64%, 97% and 62%, respectively. PA was more sensitive than PAP and could be more useful since none of the patients with prostate cancer was PAP positive and PA negative. We conclude that PA should be a reliable tumor marker in our mass screening system.     

血清前列腺特异抗原测定的临床意义

以12例前列腺癌、102例前列腺良性增生(BPH)、16例直肠指检(DRE)异常、5例前列腺炎及30例正常男性为对象,用酶免法测定血清前列腺特异抗原(Prostate specific antigen,PSA)浓度,用放免法测定其中37例。前列腺癌的PSA浓度明显高于BPH(P<0.01),PSA对前列腺癌诊断的敏感性为91.7％。DRE异常者大于BPH(P<0.05),低于前列腺癌(P<0.01)。BPH高于正常对照(P<0.01)。前列腺切除术后一日的PSA高于术前(P<0.01),术后6～8日同术前无显著性差异(P>0.05)。70岁以上高于70岁以下(P<0.05)。PSA>10ng/ml时酶免检测值低于放免法(0.010.05)。单纯PSA升高并不能说明任何特异性病理过程,前列腺癌的诊断,应结合PSA系列测定值及DRE和经直肠B超(TRUS)来综合分析。     

Detection of prostate cancer in males with prostatism

The present study was designed to compare the prostate cancer detection rate, sensitivity, specificity, and positive predictive value of digital rectal examination (DRE) and serum prostatic specific antigen (PSA) in a consecutive cohort of males presenting to a single institution with clinically significant prostatism. The study population was comprised of 224 consecutive males with clinically significant prostatism referred to the Prostate Center at the Medical College of Wisconsin between June 1990 and December 1991. Subjects were considered to have clinically significant prostatism if they elected to pursue medical or surgical therapy following exclusion of carcinoma of the prostate. The initial examination consisted of a Boyarsky symptom score assessment, DRE, uroflowmetry, postvoid residual determination, serum PSA level, and transrectal prostatic ultrasonography. Subjects with an abnormality on DRE or serum PSA > 4 ng/dl were advised to undergo transrectal prostatic biopsy. Of the 224 subjects, 40 (17.9%) had an abnormal DRE and 57 (25.4%) had an elevated serum PSA > 4 ng/dl. The overall detection rate of prostate cancer in the study population was 6.7%. The prostate cancer detection rates for PSA alone and DRE alone were 5.8% and 5.3%, respectively. The sensitivity, specificity, and positive predictive values of PSA alone were 86.7%, 80.9%, and 25.0% and of DRE alone 80.0%, 86.3%, and 30.0%, respectively. Receiver operator characteristic (ROC) curves were constructed for the entire study population in order to compare the screening measures serum PSA and PSA density. The area under the curves was 0.88 for both tests, indicating that these screening tests for prostate cancer were not significantly different. The present study demonstrated that males with clinically significant prostatism represent a high risk cohort for detecting prostate cancer. DRE and PSA are equally effective measures for detecting prostate cancer. PSA density does not offer any advantage over serum PSA in screening for prostate cancer, except in the subset of patients with a normal DRE and serum PSA levels between 4.0 and 9.9 ng/dl. © 1994 Wiley-Liss, Inc.     

HGPIN患者血清PSA特征及首次穿刺活检HGPIN阳性针数对再次活检PCa检出率的影响

目的 探讨高级别前列腺上皮内瘤(high grade prostatic intraepithelial neoplasia,HGPIN)患者血清前列腺特异性抗原(prostate specific antigen,PSA)特征及首次穿刺活检HGPIN阳性针数对再次活检前列腺癌(PCa)检测率的影响.方法 选取2013年2月至2015年12月在本院行前列腺穿刺的患者共320例,均行直肠超声引导下前列腺穿刺活检,分析各类患者血清PSA差异,对结果为非PCa患者于6个月后再次穿刺活检.结果 320例患者首次穿刺活检病理结果显示:其中HGPIN患者80例(孤立型51例,多灶型29例),低级别前列腺上皮内瘤(LGPIN)患者45例,前列腺增生(BPH)患者128例,PCa患者67例;其中PCa患者血清PSA为35.20(13.01,60.55) ng/mL,明显高于BPH、LGPIN、孤立型和多灶型HGPIN患者(P＜0.05);多灶型HGPIN血清PSA为12.15(6.82,16.43) ng/mL,明显高于BPH、LGPIN、孤立型HGPIN患者(P＜0.05);BPH、LGPIN、孤立型HGPIN患者血清PSA比较差异无统计学意义(P＞0.05);多灶性HGPIN患者再次穿刺为PCa的比例为38.46％ (10/26),明显高于BPH、LGPIN和孤立型HG-PIN患者(P＜0.05);BPH、LGPIN和孤立型HGPIN再次穿刺为PCa的比例比较差异无统计学意义(P＞0.05).结论 多灶型HGPIN血清PSA水平高于孤立型HGPIN、BPH以及LGPIN,但低于PCa;多灶型HGPIN患者再次活检PCa的检出率显著高于其他患者.     

Is the determination of prostatic acid phosphatase still worthwhile in prostate cancer patients?

With the introduction of prostatic specific antigen (PSA), the role of prostatic acid phosphatase (PAP) has been questioned. Some authors still advocate its determination, because PAP may be helpful for identifying patients with organ confined cancer. Tumor progression may be detected earlier in some patients by PAP. With respect to cost, we analyzed whether PAP still has a place as a tumor marker for prostate cancer (PC). In 6,151 men seen for screening or treatment of PC or therapy of benign prostatic hyperplasia (BPH), parallel determinations of PAP and PSA were done. PC was diagnosed in 862 patients, BPH in 5,503 patients, and prostatitis in 86 patients. There were only 16 patients with PSA < 4 ng/ml and PAP > 5 ng/ml. Five of 16 patients had histologically proven BPH; 11 of 16 patients suffered from metastatic PC. Five of 11 patients were in remission on hormonal therapy; PSA had already normalized and PAP was still elevated. Three of I I patients had hormone resistant PC; PAP detected the progression earlier than PSA. In the absence of an effective treatment, this is not of clinical relevance. In 1 of 11 patients, a falsely low value was assumed. In all, 935 of 6,151 patients showed normal PAP and elevated PSA; 805 of 935 patients suffered from BPH or prostatitis; 130 of the 935 patients had PC. Stage D was found in 56 of 130 patients, stage C in 31 patients, and stage A B in 43 patients, which did not allow the identification of organ confined cancer. Therefore, there is no benefit from the determination of PAP in PC. It is both safe and cost-effective to abandon PAP as a tumor marker for PC.     

Study of free to total prostate specific antigen ratio in the detection of patients with prostate cancer

BACKGROUND: We investigated the clinical usefulness of free to total serum prostate specific antigen (PSA) ratio (F/T ratio) in order to improve the specificity of total PSA measurement for detecting prostate cancer. METHOD: In this study 129 patients with total PSA level 4-20 ng/ml underwent transrectal ultrasound guided sextant biopsy. Serum samples were assessed for total PSA, free PSA and the F/T ratio calculated. All patients were pathologically diagnosed as benign prostatic hyperplasia or prostate cancer. RESULTS: Of 129 patients 21 had prostate carcinoma (PCa) and 108 had benign prostatic hyperplasia (BPH) from the results of prostate biopsies. The mean of total PSA were not significantly different between men with PCa and with BPH. The mean of free PSA for PCa was significantly lower than that for BPH (p = 0.043). Furthermore, the mean of F/T ratio was significantly different between PCa and BPH group (p = 0.0014). The F/T ratio had a higher specificity than total PSA at all levels of sensitivity in detecting prostate cancers. Sensitivity, specificity and accuracy for cancer detection at a cut off 0.12 was 90.4%, 51.8% and 58.1%, respectively. Also, free PSA was as useful as F/T ratio for cancer detection when analyzed in receiver operating characteristic curves analysis. When determined the cut off number of free PSA at 0.78 ng/ml, the sensitivity, specificity and accuracy for cancer detection were 61.9%, 66.7% and 65.9%, respectively. CONCLUSION: This study indicated that the F/T ratio and free PSA could improve the specificity without impairing the sensitivity for detecting PCa in patients with 4-20 ng/ml of total PSA.     

Comparison of prostate secretory protein with prostate specific antigen and prostatic acid phosphatase as a serum biomarker for diagnosis and monitoring patients with prostate carcinoma

Serum prostate secretory protein (PSP) levels were measured in 49 patients with benign prostatic hyperplasia (BPH), 144 patients with various stages of prostatic carcinoma (CaP), and 82 CaP patients who were followed serially. PSP values were compared with serum levels of prostate specific antigen (PSA) and prostatic acid phosphatase (PAP). In the BPH group, PSP was elevated (> 10 ng/ml) in 41% of patients, whereas PSA (> 4 ng/ml) and PAP (> 3.3 ng/ml) were elevated in 39% and 23% of the cases, respectively. PSP levels were elevated in 48% of the CaP pretreatment specimens, compared to 79% for PSA and 40% for PAP. PSP levels in cancer patients who had intracapsular disease were about two to three times higher than those observed for PAP. PSP was found to be the only marker elevated in eight (6%) pretreatment CaP patient serum specimens, while PAP was never found to be elevated when PSA was normal. PSP serum concentrations correlated with the clinical course of the disease in 79% of patients, compared with 90% for PSA and 66% for PAP. In certain patients, monitored over time, disease correlation was reflected in serum values with only a single biomarker, i.e., 1% with PAP, 8% with PSP, and 10% with PSA. This study has shown that PSP is a less sensitive serum biomarker than PSA, but more sensitive than PAP for detection and monitoring the early stages of prostate cancer. This suggests that PSP as a biomarker may be a useful adjunct for the management of a subpopulation of low-stage and -grade CaP. © 1993 Wilcy-Liss, Inc.     

Anatomoclinical and biologic correlations in prostatic pathology. Apropos of 150 case reports

The authors analyzed 150 patient files (16 controls with no prostatic pathology, 96 patients with benign prostatic hypertrophy (BPH), 38 prostate cancer patients) in an attempt to answer three questions: how should borderline values of PSA be interpreted in patients with BPH; is there a correlation between the Gleason grade and PSA levels in prostate cancer? Should both PSA and PAP concentrations be assayed? All patients underwent digital rectal examination and transrectal ultrasonography (TU), and were assayed for PSA and PAP. All prostate cancer patients had a bone scintigraphy (Bs). In view of the correlation coefficient of 0.391 (p less than 0.001), it can be affirmed that PSA and weight are linearly correlated in BPH (5 g BPH = 1 ng/ml PSA). This lower value of PSA is due to the overevaluation of prostate weight by TU. In contrast, the authors did not find any correlation between the PSA level and the Gleason grade in prostate cancer patients with a negative bone scintiscan. Finally, the sensitivity of PSA was markedly better than that of PAP (75% vs 50%), and no PSA false negative error was corrected by the PAP value.     

PSA、PSAD和PSAT对前列腺癌诊断的比较

目的　比较前列腺移行带特异性抗原密度（PSAT）与前列腺特异性抗原（PSA）及前列腺特异性抗原密度（PSAD）在前列腺癌诊断中的意义。方法　对78例PSA4～20ng/ml的患者行前列腺穿刺活检后比较PSA、PSAD和PSAT指标。结果　78例中,病理诊断为前列腺癌(PCa)32例,良性前列腺增生(BPH)46例,二者PSA平均值分别为(14.32±1.46)ng/ml、(13.89±1.52)ng/ml,二者相比差别无显著性意义(P>0.05);PSAD平均值分别为0.43±0.14、0.36±0.17,二者相比差别有显著性意义(P<0.05);PSAT平均值分别为0.75±0.19、0.31±0.06,二者相比差别有非常显著性意义(P<0.01)。结论　PSAD和PSAT对预测PSA<20ng/ml的患者是否患前列腺癌有较大帮助,特别是PSAT更为准确。     

Comparative study of the clinical usefulness of prostate specific antigen and prostatic acid phosphatase in prostatic disease

The clinical usefulness of prostate specific antigen (PSA) and prostatic acid phosphatase (PAP) activity measurements has been compared in 45 patients with benign prostatic hyperplasia (BPH) and 132 patients with prostatic carcinoma (PC), 21 of whom had metastatic disease (MPC) and 111 of whom had intracapsular cancer. No BPH patient had increased PAP but 47% had increased PSA. Of the PC patients only 27% had increased PAP and 70% increased PSA. All of the MPC patients had increased PSA but only 62% had increased PAP. Increased PAP was found only in MPC but increased PSA was also found in BPH. In identifying PC, the predictive value of an increased PSA concentration is 83% and an increased PAP activity is 100%. On the other hand, the predictive value of a normal PSA concentration is 51% and of a normal PAP activity only 34%. As the PAP test is much less efficient than the PSA test, it should be discontinued.     

前列腺癌综合指数及临床意义初探

目的 寻求一种诊断前列腺癌（ＰＣａ）的更有效方法．方法 ＰＣａ７８例和前列腺增生症７３例临床资料进行分析,并根据前列腺特异抗原（ＰＳＡ）、直肠指检及年龄与ＰＣａ的相关性设计出一公式,将直肠指检所得到的前列腺大小、结节、硬度进行量化,所得数值称为“前列腺癌综合指数一公式,将直甩指检所得的前列腺大小、结节、硬度进行量化,所得数值称为“前列腺癌综合指数（ＩｐＣａ）”。结果 当ＩｐＣａ以５．８０为阈值时,     

Diagnostic significance of digital rectal examination and transrectal ultrasonography in men with prostate-specific antigen levels of 4 ng/mL or less

Objectives. To investigate the usefulness of digital rectal examination (DRE) and transrectal ultrasonography (TRUS) for prostate cancer diagnosis and to propose a diagnostic algorithm for individual-based cancer screening in subjects with prostate-specific antigen (PSA) levels of 4.0 ng/mL or less.Methods. Between January 1992 and March 2000, 129 subjects with PSA levels of 4.0 or less and abnormal findings on DRE or TRUS underwent prostate biopsy. The subjects were divided into four groups according to the PSA range: 0 to 0.9 ng/mL, 1.0 to 1.9 ng/mL, 2.0 to 2.9 ng/mL, and 3.0 to 4.0 ng/mL. The reliability of the DRE and TRUS and the clinicopathologic features of prostate cancer were investigated among these four groups.Results. Of the 129 subjects, 17 (13.2%) patients with prostate cancer were diagnosed. The detection rate was 2.2% (1 of 45), 0% (0 of 27), 20.6% (7 of 34), and 39.1% (9 of 23) in subjects with PSA levels of less than 1.0 ng/mL, 1.0 to 1.9 ng/mL, 2.0 to 2.9 ng/mL, and 3.0 to 4.0 ng/mL, respectively. The proportion of patients with Stage II, III, and IV was 58.8%, 41.2%, and 0%, respectively. The percentage with Gleason scores of 8 to 10 was 17.6%. The detection rate of abnormal findings on DRE and TRUS was 14.4% (13 of 90) and 9.5% (7 of 74), respectively. Adding TRUS to DRE in the screening program of subjects with PSA levels of 2.0 to 4.0 ng/mL, increased the detection rate of prostate cancer to 30.8% (4 of 13).Conclusions. Routine prostate biopsy should not be undertaken except for highly suspicious DRE findings in subjects with PSA levels less than 2.0 ng/mL. The additional use of TRUS in subjects with PSA levels of 2.0 to 4.0 ng/mL would improve the sensitivity of prostate cancer detection. The diagnostic algorithm proposed in the present study is useful as a screening method for prostate cancer in subjects with PSA levels of 4.0 ng/mL or less.     

MRS对可疑前列腺癌鉴别诊断价值的研究

目的探讨3.0T三维磁共振波谱成像(MRS)影像学检查对可疑前列腺癌患者鉴别诊断的价值。方法收集2013年1月至2014年4月在本院就诊怀疑前列腺癌并行MRI及MRS检查患者的临床资料,根据病理结果分为前列腺癌(Pca)组、前列腺增生(BHP)组。观察两组患者MRS参数胆碱(Choline,Cho)+肌酸(Creatine,Cre)/枸橼酸盐(Citrate,Cit)值(CC/C),并与病理Gleason评分(G)对照;评估MRS对Pca诊断效能,分析CC/C值与病理分级的关系。结果 32例Pca的CC/C平均值为2.52±1.42,而52例BHP的为0.70±0.77(P0.01),MRS对前列腺癌诊断效率:灵敏度87.5%、特异度86.3%、阳性预测值80%、阴性预测值91.6%;G≤7患者CC/C平均值为1.81±1.09,G7患者为3.38±0.98(P0.01)。结论 MRS的应用有助于对可疑前列腺癌患者进行鉴别诊断,且其参数对前列腺癌病理分级有参考意义。     

Prostate specific antigen--a screening test for prostatic cancer?

A series of 287 patients referred by their family doctors with symptoms of bladder outflow obstruction were asked to attend the hospital for "pre-clinic" screening for carcinoma of prostate (CaP). Blood samples were collected from 211 patients and analysed for serum prostate specific antigen (PSA) and prostatic acid phosphatase (PAP). Thirty-six patients had a serum PSA greater than 10 micrograms/l and 7 had PAP levels greater than 5 iu/l. In no instance was the PAP elevated without an associated increase in PSA concentration. Patients with raised markers underwent further investigations which included prostatic biopsy and/or resection; 17 patients were proved to have carcinoma of the prostate, 9 of whom had distant metastases. The specificity of PSA for detecting prostate cancer in this study was 90% with a sensitivity of 89.5%, in contrast to values for PAP of 100% and 36.8%. The routine use of PAP as a marker for prostatic cancer should be abandoned. The use of PSA as a screening test in a group of patients with prostatism appears justified, but with a positive predictive value of only 47%, its use in a mass unselected screening programme is not recommended.     

Evaluation of prostate-specific antigen and prosttic acid phosphatase as prostate cancer markers

Prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) have been evaluated in patients with prostate cancer, benign prostatic hypertrophy (BPH), and prostatitis. PSA has proved to be diagnostically more sensitive than PAP for the detection of prostate cancer: 95.0 per cent vs 60.0 per cent for 40 newly diagnosed cancer cases, and 97.1 per cent vs 65.7 per cent for 35 relapsed cases. This also holds true for those patients with early-stage disease: 71.4 per cent vs 0 per cent for 7 Stage A1 cases. The specificities of PSA and PAP are comparable, 96.8 per cent vs 98.9 per cent, respectively. PSA is also more sensitive for monitoring therapy, since it usually rises before PAP and always precedes clinical signs of relapse. Although PSA may be elevated more frequently than PAP in some patients with BPH and prostatitis, it is postulated that these patients with elevated serum PSA and normal serum PAP may fall into a high-risk sub-population which may have early prostate cancer or precancerous conditions not easily detectable by current clinical and diagnostic techniques. Our data suggest PSA is a sensitive useful tumor marker for the diagnosis and management of prostate cancer. In addition, PAP, in combination with PSA, may serve as a useful adjunct for differential diagnosis and confirmation of advanced stage prostate cancer.     

Evaluation of prostate-specific antigen and prostatic acid phosphatase as prostate cancer markers

Prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) have been evaluated in patients with prostate cancer, benign prostatic hypertrophy (BPH), and prostatitis. PSA has proved to be diagnostically more sensitive than PAP for the detection of prostate cancer: 95.0 per cent vs 60.0 per cent for 40 newly diagnosed cancer cases, and 97.1 per cent vs 65.7 per cent for 35 relapsed cases. This also holds true for those patients with early-stage disease: 71.4 per cent vs 0 per cent for 7 Stage A1 cases. The specificities of PSA and PAP are comparable, 96.8 per cent vs 98.9 per cent, respectively. PSA is also more sensitive for monitoring therapy, since it usually rises before PAP and always precedes clinical signs of relapse. Although PSA may be elevated more frequently than PAP in some patients with BPH and prostatitis, it is postulated that these patients with elevated serum PSA and normal serum PAP may fall into a high-risk sub-population which may have early prostate cancer or precancerous conditions not easily detectable by current clinical and diagnostic techniques. Our data suggest PSA is a sensitive useful tumor marker for the diagnosis and management of prostate cancer. In addition, PAP, in combination with PSA, may serve as a useful adjunct for differential diagnosis and confirmation of advanced stage prostate cancer.     

Evaluation of prostate-specific antigen in untreated prostatic carcinoma

A study was performed on 290 men to compare the level of serum prostate-specific antigen (PSA) in controls, patients with benign prostatic hyperplasia (BPH) and patients with prostatic cancer. The upper limit of normal was 5.0 micrograms/l as determined in 110 elderly hospitalized males (mean age 62 years) without urological complaints. Of the 106 patients with BPH, 33% had raised values above 5.0 micrograms/l. Values above 10 micrograms/l were found in 18 BPH patients. A positive correlation was found between prostate volume (grams of tissue removed during transurethral resection) and preoperative PSA levels (r = 0.55, n = 106, p less than 0.001). PSA levels above 10 micrograms/l were found in 4% of BPH patients with a prostate volume of less than 20 g (n = 54), in contrast with 45% of patients with a prostate volume above 40 g (n = 20). The sensitivity of this PSA assay (cutoff level 10 micrograms/l) as established in 74 prostate carcinoma patients was 31% for category T0 (n = 13), 56% for category T1-2 (n = 16), 75% for category T3-4 (n = 20) and 100% for category M1 or N1-4 (n = 25). In an earlier study prostatic acid phosphatase (PAP) was measured in these same samples. PSA appeared to be much more sensitive than PAP. Seventeen of the 74 prostatic carcinoma patients (23%) had normal PAP levels but their PSA values were raised above 10 micrograms/l, while in only 2 patients an increased PAP level was combined with a normal PSA.(ABSTRACT TRUNCATED AT 250 WORDS)     

应用表面增强激光解析电离飞行时间质谱蛋白质芯片技术筛选前列腺癌血清标志物的研究

目的 应用表面增强激光解析电离飞行时间质谱(SELDI-TOF-MS)检测前列腺癌患者的血清蛋白质指纹图谱,筛选特异性诊断标志物.方法 以病理确诊的45例前列腺癌患者血清和45例BPH患者血清为研究对象.采用SELDI蛋白质芯片技术检测血清的蛋白表达图谱.用BiomarkerWizard软件分析差异蛋白,对所得蛋白进行初步诊断分析.结果 应用IMAC-CU固相金属亲和芯片在未经治疗的前列腺癌和BPH患者血清中检测到9个差异蛋白质峰,其蛋白质含量差异有统计学意义(P＜0.01),其中7个差异蛋白(3771.14,3968.26,4050.39,4279.20,4464.03,4481.59,8919.34)在前列腺癌患者血清中呈高表达,2个差异蛋白(5440.68,6102.82)呈低表达.联合相对分子质量为3771.14和4481.59的2个羞异蛋白诊断前列腺癌,其敏感性为86.7%(39/45),特异性为88.9%(40/45).经蛋白质数据库搜索,找到6种与差异蛋白相对分子质量最接近的蛋白质,分别为Pepeide YY、Apolipoprotin C-II、Glueagon like peptide(7-37)、uncharacterized protein C14orf128、Medin、Neuropeptide Y.结论 SELDI蛋白质芯片技术可筛选出前列腺癌中相对特异的潜在标志蛋白,具有较好的临床应用前景.     

Effect of digital rectal examination on plasma prostate-specific antigen (PSA)

Presented are results of determination of plasma PSA before, 1 and 24 hours and 3 weeks after digital rectal examination (DRE) in 130 patients with prostatic adenoma (BPH). Mean pre-examination PSA level was 8.5 ng/ml (max. 27.0 ng/ml, min 0.3 ng/ml, SD=6.2). PSA rose at 1 and 24 hr post-DRE: 9.4 ng/ml (max. 28.9 ng/ml, min 0.5 ng/ml, SD=6.7) and 10.7 ng/ml (max. 28.0 ng/ml, min 0.5 ng/ml, SD=7.9), respectively. Conclusion: in patients with prostatic adenoma DRE is followed by a rise in plasma PSA, which returns almost to baseline values by 3 weeks.