前列腺特异抗原倍增时间对前列腺癌的预测作用

目的 用前列腺特异抗原倍增时间(PSADT)值来预测低危前列腺癌中需要进一步治疗的高危前列腺癌.方法 选择79 例前列腺癌确诊病例,之前没有接受任何治疗,至少连续2 次PSA 的检测值有上升的趋势.PSADT 的计算需2个PSA 值,且间隔时间3 个月以上.结果 79 例前列腺癌中有47 例(59.3%)低危前列腺癌,32 例(40.7%)高危前列腺癌.两组间年龄的比较无统计学差异.在高危和低危前列腺癌患者中PSADT 均值分别为12.70 个月和25.00 个月,差异有统计学意义(P ＝0.001).在高危前列腺癌中28 例(87.5%)患者PSADT 少于12 个月,低危前列腺癌中只有12 例(25.6%)PSADT少于12 个月.PSADT 为12 个月预测高危和低危前列腺癌有高敏感性(74%)和特异性(88%).结论 PSADT 可以预测高危前列腺癌,PSADT 少于12 个月的患者前列腺组织Gleason 评分高,为高危前列腺癌,需要进一步治疗.

Prostate-specific antigen doubling time as a predictor of prostate cancer

Objective To evaluate the value of serum prostate-specific antigen（PSA）doubling time（PSADT）to differentiate patients with high-grade prostate cancer who require more aggressive therapy from those with low-grade cancer.Methods Of 79 patients with confirmed prostate cancer were selected.They had not received any previous treatment for prostate cancer and had at least 2 consecutive serum PSA tests with a rising trend.The PSADT was calculated in patients with 2 serum PSA levels measured with an interval more than 3 months.Results Of 79 patients with prostate cancer,47（59.3%）had low-grade and 32（40.7%）had high-grade tumors.There was no difference in age between the two groups.The median PSADT in patients with high-grade and low-grade tumors were 12.50 months and 25.00 months,P=0.001.A total of 28 patients with high-grade tumors（87.5%）had a PSADT less than 12 months,while only 12 of those with low-grade tumors（25.6%）had a PSADT less than 12 months.A PSADT cut off of 12 months provided a sensitivity of 74% and a specificity of 88% for differentiation of high-grade from low-grade cancers.Conclusions PSADT can identify patients with high-grade tumors.Men with a short PSADT（12 months）were at a higher risk of harboring a high-grade prostate cancer who require more aggressive therapy.