监测前列腺特异抗原对前列腺癌的临床价值  

Clinical Value of Monitoring Prostate Specific Antigen for Prostatic Carcinoma

作　　者：史东民[1] 史沛清[1] 孙长华[1] 丁强[1] 刘国斌[1] 于雷[1] 黄永刚[1] 

机构地区：[1]哈尔滨市第一医院,黑龙江哈尔滨150010

出　　处：《黑龙江医学》2006年第3期184-186,共3页Heilongjiang Medical Journal

摘　　要：目的探讨PSA在前列腺癌（Pca）诊治中的临床价值。方法对30例Pca在诊断和治疗前后进行PSA纵向监测。诊断程序：对排尿困难老年患者→DRE（阳性或可疑者）→血清PSA检测升高者→前列腺穿刺活检，依据病理（＋）确诊。确诊后行去势以及抗雄性激素药物治疗或加放射治疗。然后定期复查PSA，进行监测。结果TPSA4-10ng／mL3例，11-30ng／mL10例，30-50ng／mL10例，〉50ng／mL7例。fPSA均值0．13ng/mL，fPSA／TPSA（f／T）比值〉0．2者4例（13％），〈0．2者26例（87％）。随访20例，未坚持用药者PSA再次升高3例，局部病变加重或有骨转移者PSA明显升高8例。对此11例PSA反弹升高病例，再次用药或给予放射治疗后PSA随之下降，1例放射治疗后3个月，TPSA由73．4ng／mL降至0．02ng,／mL。结论①本组病例PSA均显示升高；②f／T比值，有助于提高PSA在Pca诊断中的作用；③PSA的变化是观察病情最敏感的客观指标；④目前在我国，PSA仍不失为一项筛选Pca有价值的生物学指标。Objective To discuss the clinical value of monitoring prostate specific antigen （PSA） for prostatic carcinoma （Pca）. Methods The longitudinal monitor of PSA of 30 cases of Pca patient was performed before and after diagnosis and treatment. The diagnosis procedure was dysuresia elder patient DRE→PSA elevated biopsy of prostate pathology. The diagnosis was obtained and then treatment of castration and anti - androgen or radiotherapy. The PSA was monitored. Results The TPSA4 - 10 ng/mL in 13 cases , 11 - 30 ng/mL in 10 cases,and 〉 50 ng/mL in 7 cases. The FPSA average value was 0.13 ng/mL and fTSA/TPSA（f/T） 〉 0.2 in 4cases（ 13% ）, 〈 0.2 in 26 eases （87%）. 20 cases were followed up. There were 3 cases PSA increase due to without further therapy, 8 cases with severe local lesion and bone metastasis. 11 cases whose PSA increased were underwent treatment again and then PSA decreased from 73.4 ng/mL to 0.02 ng/mL TPSA in 1 ease radiotherapy after 3 months. Conclusion The PSA had increased in all eases and f/T ratio was helpful to improve the PSA action in diagnosis of Pca that PSA might be sensitive for PCa for screening in our country.

关 键 词：肿瘤学 前列腺癌 前列腺特异抗原 监测 

分 类 号：R737.25[医药卫生—肿瘤]