攝護腺特異性抗原在攝護腺腺癌分期之臨床運用

The Use of Serum Prostatic Specific Antigen in the Staging of Adenocarcinoma of Prostate

王百孚(Bai-Fu Wang) ； 陳光國(kuang-Kuo Chen) ； 陳明村(Ming-Tsun Chen) ； 黃榮慶(Jong-Khing Huang) ； 林登龍(Alex T. L. Lin) ； 李瀛輝(Ying-Huei Lee) ； 張心湜(Luke S. Chang)

《中華民國泌尿科醫學會雜誌》 3卷1期 (1992/03) Pp. 688-693

https://doi.org/10.7024/JUAROC.199203.0688

摘要

從民國76年9月至78年7月間，回顧了本院102位攝護腺癌病患的資料，嘗試著尋求血清攝護腺特異性抗原(prostatic specific antigen,簡稱 PSA)與攝護腺碰擴散或轉移程度之相關性。其敏感度結果為82.9%(91/102)。A、B、C、D各期病人血清PSA值之中位數隨期別的增加有逐漸升高之趨勢，而且PSA值愈高時，就可能愈末期(當血清PSA值大於40.0 ng/ml時，第D期的機會高達82.1%)。對於血清PSA值較高的患者，若以電腦斷層掃描檢查骨盆腔淋巴腺，或以核子醫學骨骼掃描，發現有轉移病灶的機率亦較大，(當血清PSA值大於40.0ng/ml時，骨骼轉移的機率高達73.8%)。病患的組織病理分級以Gleason’s score 計算時，發現血清PSA直無相關性。雖然血清PSA值無法將攝護腺癌分期精確地表現出來，但由於它偵測攝護腺癌復發、擴散和轉移的高靈敏性，在臨床應用上做為預後和追蹤治病的指標是非常有價值的。

關鍵字

攝護腺特異性抗原。攝護腺癌

並列摘要

One hundred and two patients with adenocarcinoma of prostate encountered between September 1987 and July 1989 were retrospectively analyzed to evaluate the correlation of serum prostiatic specific antigen (PSA) level with the degree of extraprostatic tumor extension or metastasis. The sensitivity was 89.2% (91/102). The median value of serum PSA levels in each stage patients increased as staging marched. The incidence of stage D was 82.1% in patients with serum PSA level greater than 40.0ng/ml. Our study showed that the higher the serum PSA level, the higher the incidence of pelvic lymph node metastasis detected by CT scan, and bony metastasis detected by whole body bony scintigraphy. The incidence of bony metastasis was 73.8% when serum PSA level was greater than 40ng/ml. The Gleason’s scrore was found to have no correlation with the serum PAS level. Serum PSA level can not reflect the staging of prostatic cancer precisely. However, its hight sensitivity in detection of recurrence, spreading and metastasis still make it a valuable marker as a prognostic and following indicator for adenocarcinoma of prostate.