The Use of Serum Free-To-Total Prostate Specific Antigen Ratio to Predict Pathological Stage and Gleason Grade of Prostate Cancer with PSA of 4-20 ng/ml

以自由型攝護腺特殊抗原的百分比預測攝護腺特殊抗原4-20ng/ml的攝護線癌患者的病理期別及葛里森分數

吳其翔(Jungle C. H. Wu) ； 張樹人(Daniel S. Chang) ； 林茂盛(Mao-Sheng Lin)

《秀傳醫學雜誌》 6卷1&2期 (2006/06) Pp. 1-8

摘要

The value of the free/total prostate-specific antigen (f/tPSA) ratio in predicting the pathological stage and Gleason grade has remained controversial. In this study, we analyzed the relationship of the f/tPSA, prostate cancer pathological stage and Gleason grade in PSA level of 4.0-20.0 ng/ml.
Total 66 patients were enrolled into this study. We divided the patients in 2 groups according to tPSA level. Group 1 was tPSA of 4.0-10.0 ng/ml, and Group 2 was tPSA of 10.0-20.0 ng/ml. The surgical specimens were examined with whole mount step section. We used the cutoff point of f/tPSA is 20%. Total and free PSA were determined using the immunoassays (Hybritech). Statistical analysis was used with Fisher exact test.
As for pathological stage, in Group 1, when f/tPSA ratio ＞ 0.2, there were 12 patients (44.45’r) with organ confined disease (pTlc+pT2) and 15 patients (55.6%) with pT3 or pT4. However, when f/tPSA ratio＞0.2, whereas 8 patients (88.9%) with organ confined disease and only one patient (11.1%) with pT3. So, f/tPSA ratio as potential predictive of pathological stage when tPSA of 4.0-10.0 ng./ml (P=0.026). In Group 2, when f/IPSA ratio＞0.2, there were 13 patients (50V) with organ confined disease and 13 patients (50%) with pT3 or pT4. likewise, when f/tPSA ratio ＞ 0.2, whereas 3 patients (75%) with organ confined disease and one patient (25%) with pTS (P=0.602). As for Gleason grade, in Group 1, when f tPSA ratio ＞ 0.2, there were 8 patients (28%) with favorable pathology, and 19 patients (72%) with unfavorable pathology. However, when f/tPSA ratio ＞ 0.2, whereas 5 patients (56%) with favorable pathology, and 4 patients (44%) with unfavorable pathology, the differences were not statistically significant (P=0.235). In Group 2, there were also clearly no significant differences (P=1.0).
Percent free PSA significantly predicted pathological stage of prostate cancer when serum PSA levels are 4.0-10.0 ng/ml (P 0.026). However, there was no significant relationship between f EPSA acid pathological features in serum PSA of 10.0-20.0 ng ml and Gleason grade in this study.

關鍵字

攝護線癌 ； 自由型攝護腺特殊抗原 ； 病理期別

並列摘要

The value of the free/total prostate-specific antigen (f/tPSA) ratio in predicting the pathological stage and Gleason grade has remained controversial. In this study, we analyzed the relationship of the f/tPSA, prostate cancer pathological stage and Gleason grade in PSA level of 4.0-20.0 ng/ml.
Total 66 patients were enrolled into this study. We divided the patients in 2 groups according to tPSA level. Group 1 was tPSA of 4.0-10.0 ng/ml, and Group 2 was tPSA of 10.0-20.0 ng/ml. The surgical specimens were examined with whole mount step section. We used the cutoff point of f/tPSA is 20%. Total and free PSA were determined using the immunoassays (Hybritech). Statistical analysis was used with Fisher exact test.
As for pathological stage, in Group 1, when f/tPSA ratio ＞ 0.2, there were 12 patients (44.45’r) with organ confined disease (pTlc+pT2) and 15 patients (55.6%) with pT3 or pT4. However, when f/tPSA ratio＞0.2, whereas 8 patients (88.9%) with organ confined disease and only one patient (11.1%) with pT3. So, f/tPSA ratio as potential predictive of pathological stage when tPSA of 4.0-10.0 ng./ml (P=0.026). In Group 2, when f/IPSA ratio＞0.2, there were 13 patients (50V) with organ confined disease and 13 patients (50%) with pT3 or pT4. likewise, when f/tPSA ratio ＞ 0.2, whereas 3 patients (75%) with organ confined disease and one patient (25%) with pTS (P=0.602). As for Gleason grade, in Group 1, when f tPSA ratio ＞ 0.2, there were 8 patients (28%) with favorable pathology, and 19 patients (72%) with unfavorable pathology. However, when f/tPSA ratio ＞ 0.2, whereas 5 patients (56%) with favorable pathology, and 4 patients (44%) with unfavorable pathology, the differences were not statistically significant (P=0.235). In Group 2, there were also clearly no significant differences (P=1.0).
Percent free PSA significantly predicted pathological stage of prostate cancer when serum PSA levels are 4.0-10.0 ng/ml (P 0.026). However, there was no significant relationship between f EPSA acid pathological features in serum PSA of 10.0-20.0 ng ml and Gleason grade in this study.

並列關鍵字

f/tPSA ratio ； prostate cancer ； pathological features