前列腺特异性膜抗原和前列腺特异性抗原表达强度与前列腺癌Gleason评分之间的相关性研究

目的研究前列腺特异性膜抗原(PSMA)和前列腺特异性抗原(PSA)的表达强度与前列腺癌Gleason评分之间的相关性。方法制备抗PSMA膜外段表位的单克隆抗体,应用免疫组织化学方法检测前列腺癌中PSMA的表达,统计分析其与Gleason评分之间的相关性,并和PSA与Gleason评分之间的相关性进行对比。结果制备出8株分泌抗PSMA膜外段表位的单抗的杂交瘤细胞株。免疫组化结果表明,PSMA的表达强度与前列腺癌的Gleason评分之间存在相关性。在分化差的前列腺癌中,PSMA水平高于分化中等和分化良好的前列腺癌(P<0.01),而PSA在前列腺癌中的表达无明显差异(P>0.05)。结论PSMA表达水平在分化差的前列腺癌中明显升高,与Gleason评分存在相关性,可以作为前列腺癌的Gleason分级的标记物,提示PSMA可以作为对激素疗法效果不敏感的低分化前列腺癌抗体介导的免疫治疗靶点。     

前列腺特异性膜抗原在不同组织中的表达及其意义

目的：观察前列腺特异性膜抗原（PSMA）在前列腺不同病变组织及非前列腺肿瘤组织中的表达情况。从免疫化角度评价PSMA的前列腺组织器官特异性。方法：采用PSMA单克隆抗体，对111例前列腺不同病变组织和30例非前列腺肿瘤组织进行染色。结果：PSMA在绝大多数前列腺组织中存在不同程度的阳性表达，仅2例前列腺癌和4例前列腺良性增隆症呈阴性表达，而全部染色的非前列腺肿瘤组织中PSMA阴性表达。结论：PSMA仅在前列腺组织中表达，且在前列腺癌组织中呈明显高表达，是前列腺器官特异性的新型肿瘤标志物，在前列腺癌的诊断和免疫治疗方面具有良好的应用前景。     

前列腺特异性抗原在前列腺癌诊断中的意义

前列腺特异性抗原（PSA)在前列腺癌的诊断中被广泛应用，全文就PSA生物学特性、年龄标准化PSA、PSA速度、PSA密度和游离PSA与总PSA的比值几个指标进行了介绍，并分析了它们在前列腺癌诊断中的作用。     

前列腺特异性抗原人类激肽释放酶2和前列腺特异的膜抗原在前列腺癌患者外周血表达的临床意义

目的　探讨检测前列腺癌微转移的灵敏和特异性指标。方法　从 5 1例前列腺癌、33例前列腺增生 (BPH)患者及 32名正常人的外周血中分离单个核细胞 ,用巢式RT PCR方法检测其中前列腺上皮细胞前列腺特异性抗原 (PSA)、人类激肽释放酶 2 (hK2 )和前列腺特异的膜抗原 (PSMA)的表达。结果　PSA、hK2和PSMA在前列腺癌患者外周血中检出的阳性率分别为 5 2 .9%、4 3.1%和6 4 .7% ;正常人和BPH患者假阳性率分别为 6 .2 %、7.7%和 4 .6 % ,3项指标差异均有显著性 (P <0 .0 1)。各临床分期 (局限癌、侵袭性癌和转移癌 )间 ,PSA和hK2的阳性检出率差异无显著性 ;PSMA在各期前列腺癌中阳性检出率均较PSA和hK2高 ,且随临床分期进展 ,其阳性检出率亦增加 (P <0 .0 5 )。结论PSMA对前列腺癌诊断、治疗方案的选择及预后评估较PSA和hK2有更大的价值     

前列腺特异性抗原在前列腺癌中的诊断价值

[目的]探讨前列腺特异性抗原（PSA）在前列腺癌中的诊断作用。[方法]回顾性分析PSA水平正常患者3637例及PSA异常患者1259例,计算阳性、阴性率,结合文献进行分析。[结果]PSA〉4.0ng/ml中前列腺癌135例,阳性率10.86%。PSA诊断前列腺癌的敏感度为89.40%,特异性为76.57%。不同年龄、不同前列腺体积患者的前列腺癌检出率有统计学差异。[结论]PSA是诊断前列腺癌的肿瘤标志物,但特异性不高。     

外周血中前列腺特异性抗原mRNA表达的临床意义

多年临床实践表明 ,前列腺特异性抗原 (prostaticspecificantigen ,PSA)在前列腺癌的诊断和治疗中有重要作用。但是PSA并不能协助前列腺癌的早期诊断 ,很多患者在确诊时已属晚期 ,这也是前列腺癌治疗效果不尽人意的重要原因之一。为寻找更为准确可靠的前列腺癌诊断指标 ,我们采用RT PCR技术对前列腺癌患者进行研究 ,为前列腺癌转移的分子生物学行为提供理论依据 ,并希望在前列腺癌的诊断方面有所突破。一、资料与方法1.临床资料 :病例组 :选取天津医科大学第二医院和天津市肿瘤医院 2 0 0 1年 2月～ 2 0 0 2年 5月住院前列腺癌患者3 3…     

前列腺特异性膜抗原与前列腺癌的关系及其临床应用

前列腺特异性膜抗原(PSMA)是位于前列腺细胞膜上的Ⅱ型跨膜糖蛋白,特异地表达于上皮细胞,在前列腺癌及其转移灶中表达增高,特别是在晚期患者及对激素治疗不敏感的患者中其表达升高尤为明显.因此可作为靶蛋白,在前列腺癌的早期诊断、判断病情进展及预后,以及在前列腺癌的靶向治疗中具有重大意义.     

前列腺特异性膜抗原与前列腺癌的关系及其临床应用

前列腺特异性膜抗原（PSMA）是位于前列膛细胞膜上的II型跨膜糖蛋白，特异地表达于上皮细胞，在前列腺癌及其转移灶中表达增高，特别是在晚期患者及对激治疗不敏感的患者中其表达升高尤为明显，因此可作靶蛋白，在前列腺癌的早期诊断，判断病情进展及预后，以及在前列腺癌的靶向治疗中具有有重大意义。     

以前列腺器官特异性抗原指标测定前列腺癌微转移

我们应用ＲＴ 巢式ＰＣＲ方法 ,以前列腺特异性抗原(ｐｒｏｓｔａｔｅｓｐｅｃｉｆｉｃａｎｔｉｇｅｎ ,ＰＳＡ)及前列腺特异性膜抗原 (ｐｒｏｓｔａｔｅｓｐｅｃｉｆｉｃｍｅｍｂｒａｎｅａｎｔｉｇｅｎ ,ＰＳＭ)为标志 ,对不同临床分期的前列腺癌患者外周血进行检测 ,并结合临床资料进行分析 ,以期对前列腺癌的分期诊断及治疗方案选择提供准确的指标。一、材料和方法1 标本 :自 1996年 8月至 1999年 1月 ,收集天津各大医院前列腺癌患者外周血 37份 ,其临床分期为 :Ａ期 3例 ,Ｂ期14例 ,Ｃ期 11例 ,Ｄ期 9例。同期收集前列腺增生患者外周血…     

前列腺特异性抗原各分子形式在前列腺癌诊断中的意义

前列腺特异性抗原（PSA）是前列腺癌重要的肿瘤标记物。PSA各种分子形式及相关指标可提高PSA诊断前列腺癌的敏感性和特异性。     

前列腺特异膜抗原基因的克隆和真核表达

目的克隆前列腺特异膜抗原(PSMA)基因的编码区序列,并进行真核表达.方法用RT-PCR方法扩增前列腺癌组织标本中的PSMA cDNA序列,并将其克隆至真核表达载体pcDNA3.0.用脂质体转染法,把pcDNA3.0-PSMA转染哺乳动物细胞,鉴定PSMA蛋白的表达.结果序列测定结果表明,两条引物之间的片断长度为2279 bp,与预期长度一致.将克隆的编码区序列与Genebank的PSMA序列进行Blast对比分析,同源性为99.7%;间接免疫荧光法显示表达的蛋白质为膜蛋白,免疫印迹表明表达蛋白质的分子量为100 000.结论利用RT-PCR技术成功扩增了PSMA编码区序列,经序列分析显示扩增片断的序列正确.构建了PSMA真核表达载体,建立了PSMA稳定表达的细胞株.经免疫分析,证实了真核细胞内表达的PSMA为分子量正确的膜蛋白,且具有良好的抗原性.所获得的PSMA真核表达系统为进一步研究PSMA基因修饰的DCs疫苗对前列腺癌的治疗提供了物质基础.     

Detection of prostate cancer using prostate-specific antigen adjusted for the transition zone volume in patients with intermediate serum prostate-specific antigen levels

Background. The prostate-specific antigen (PSA) density of the transition zone (PSATZ) in patients with PSA values of 4.1–10 ng/ml was determined to find whether PSATZ is useful in the detection of prostate cancer. Methods. The PSA, PSA density (PSAD), and PSATZ were determined in 101 patients with intermediate levels of serum PSA. The relationship of these parameters to prostate cancer detection was examined. Results. Patients with prostate cancer had significantly higher PSAD and PSATZ values than those without prostate cancer. In patients with a PSA value of 4.1–10 ng/ml, especially in those without abnormal digital rectal examination findings, PSATZ was superior to PSA as an indicator for positive biopsy when analyzed by receiver operating characteristics curves. In those patients with a cutoff value of 0.3 ng/ml per ml of transition zone volume, PSATZ had a sensitivity of 79% and a specificity of 51%. A cutoff value of 0.3 for PSATZ provided a sensitivity of 88% and a specificity of 51% in patients without abnormal digital rectal examination findings. Conclusion. The present study demonstrated that PSATZ was superior to PSA as an indicator for positive biopsy, especially in patients with normal digital rectal examination findings. PSATZ was not superior to PSAD in the detection of prostate cancer. Received: November 17, 1999 / Accepted: April 11, 2000     

Value of free-to-total prostate-specific antigen ratio for detection and staging of prostate cancer

Background. We aimed to evaluate the clinical usefulness of measurement of the free-to-total (F/T) ratio of prostate-specific antigen (PSA) for the differentiation of prostate cancer from benign prostate hyperplasia (BPH) and for the staging of prostate cancer. Values for PSA density (PSAD) and PSAD adjusted to the transition zone volume (PSAD-T) were also evaluated in patients with mildly elevated PSA levels (4.1–10 ng/ml). Methods. Total and free PSA and the F/T ratio were determined in 80 men with prostate cancer and 48 men BPH before treatment. PSA levels were measured with a chemiluminescent enzyme immunoassay. Results. Patients with prostate cancer had a significantly lower F/T ratio than those with BPH. A cut-off value of 14% for the F/T ratio provided a positive predictive value of 81.6% and a negative predictive value of 65.4%. The F/T ratio did not differ between patients with clinically localized and metastatic prostate cancer. In patients with a PSA value of 4.1–10 ng/ml, a cut-off value of 14% for the F/T ratio provided a sensitivity of 66.7% and a specificity of 76.2%. Sixty percent of the missed cancer in patients with an F/T value of 14% or more could be rescued using the PSAD value. Conclusion. Measurement of the F/T PSA ratio has good sensitivity and specificity in distinguishing prostate cancer from BPH, especially in patients with a PSA level of 4.1–10 ng/ml. However, compared with serum PSA level, the F/T PSA ratio is not valuable for the clinical staging of prostate cancer. Received: June 23, 1999 / Accepted: September 22, 1999     

Predictors of mortality after prostate-specific antigen failure

PURPOSE: We identified factors associated with the length of survival after prostate-specific antigen (PSA) failure. METHODS AND MATERIALS: The study cohort comprised 81 of 206 men enrolled on a randomized trial evaluating external-beam radiation therapy (RT) with or without androgen suppression therapy (AST) and who experienced PSA failure. Salvage AST was administered at a PSA level of approximately 10 ng/mL as per protocol. Cox regression was used to determine factors associated with length of survival after PSA failure. RESULTS: A PSA DT (doubling time) <6 months (p = 0.04) and age at the time of PSA failure (p = 0.009) were significantly associated with length of survival. By 5 years, 35% and 65% of all-cause mortality was from prostate cancer in men whose age at PSA failure was 75 or higher vs. <75, respectively. Across all ages, 0%, 4%, as compared with 63% of men, were estimated to die of prostate cancer within 5 years after PSA failure if their PSA DT was >12, 6-12, or <6 months, respectively. CONCLUSIONS: Advanced age and a PSA DT <6 months at the time of PSA failure are associated with a significantly shorter survival.     

前列腺特异性抗原对中国人群前列腺癌早期检测价值的Meta分析

背景与目的：前列腺特异性抗原（prostate-specific antigen,PSA）是一种前列腺癌标志物,但关于使用PSA作为筛查标准是否合适仍存在争论。评价PSA在中国人群前列腺癌早期检测中的价值,旨在为前列腺癌筛查策略的制定提供依据。方法：对万方数据库、中国医院知识仓库（China Hospital Knowledge Database,CHKD）和PubMed数据库进行文献检索,再根据已发表文献中的参考文献追溯进行手工检索。收集2000年1月—2020年3月有关PSA对中国人群前列腺癌早期检测的文献资料。按确定的纳入标准筛选文献,对纳入的文献进行质量评价。对以PSA>4 ng/mL作为临界点检测前列腺癌的灵敏度、特异度等进行Meta分析。结果：共检索到5 722篇文献,排除重复及不符合标准的5 713篇后,纳入9篇文献。累计研究对象共6 425人,其中前列腺癌患者596例;Meta分析结果显示,以PSA>4 ng/mL作为临界点检测前列腺癌的灵敏度、特异度和集成受试者工作特征（summary receiver operating characteristic,SROC）曲线的曲线下面积（area under curve,AUC）分别为91%（95% CI：89%~93%）、41%（95% CI：27%~56%）和0.91（95% CI：0.88~0.93）。结论：中国人群中以PSA>4 ng/mL作为检测前列腺癌的界值,具有较高的灵敏度,但特异度较低,前列腺癌筛查可在PSA>4 ng/mL的基础上进一步筛选。     

Comparison of various assay systems for prostate-specific antigen standardization.

To avoid confusion between serum prostate-specific antigen (PSA) values among various assay systems, clinical studies on the possibility of conversion among detection values were performed. The assay kits used for the PSA comparisons were MARKIT-F PA, MARKIT-M PA, EIKEN PA, PA test WAKO, Ball ELSA PSA, E-Test Tosoh II PA, PROS-CHECK PSA, DELFIA PSA and TANDEM-R PSA. Using each kit, the standards attached to each assay system were detected, and 142 sera samples from benign hypertrophies or prostate cancers were assayed for serum PSA values. By detecting the standards for each kit, slopes were obtained which were almost identical to those obtained from original assay system. The coefficients of correlation among the PSA detection systems, using patients' sera, were very high, and linear regression lines were also obtained. The results suggest that almost identical serum PSA values may be detected either by multiplying by a coefficient to bring it to the standard or using the conversion formula.     

Prostate cancer screening strategies with re-screening interval determined by individual baseline prostate-specific antigen values are cost-effective.

AIMS: To determine whether prostate cancer screening strategies with re-screening interval determined by individual baseline prostate-specific antigen values are cost-effective. METHODS: Based on the results of an actual contemporary screening program, we established Markov decision analytic models of prostate cancer screening with personalized re-screening interval strategies using cutoff baseline PSA levels for biennial screening as well as a model of uniformly annual or biennial screening. These strategies were compared in terms of cumulative incidence of early cancer and cost-effectiveness. RESULTS: Early cancer detection rates were similar among all strategies. Personalized strategies were more cost-effective compared to uniform screening strategies. If all participants with negative PSA results uniformly omit annual screening, it would be more costly but less effective (dominated). Contrary, annual screening for all participants would cost too much. These results were robust throughout sensitivity analysis incorporating every assumption in the models. CONCLUSIONS: This study adds important evidence that personalized rescreening strategies based on individual baseline PSA have advantages of cost-effectiveness against conventional uniform strategies.