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首页> 外文期刊>Urology >PSA response to finasteride challenge in men with a serum PSA greater than 4 ng/ml and previous negative prostate biopsy: preliminary study.
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PSA response to finasteride challenge in men with a serum PSA greater than 4 ng/ml and previous negative prostate biopsy: preliminary study.

机译：血清PSA大于4 ng / ml且先前前列腺活检阴性的男性对非那雄胺激发的PSA反应：初步研究。

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OBJECTIVES: To determine, in a prospective study, the prostate-specific antigen (PSA) response to finasteride challenge in men with a serum PSA greater than 4 ng/mL who had undergone previous biopsy. Patients with a serum PSA level greater than 4 ng/mL who have undergone repeated prostate biopsy with prostate cancer (CaP) that was not detected present a diagnostic dilemma. The magnitude of PSA reduction after administration of finasteride has been well documented. In addition, doubling of the PSA value after 1 year of finasteride has been touted to be a more useful paradigm for diagnosing CaP than PSA alone. METHODS: Thirty-eight men with a baseline serum PSA level greater than 4 ng/mL and a normal digital rectal examination who had been previously biopsied a minimum of two times, with CaP not detected, were given 5 mg finasteride daily. The PSA level was measured at 6 and 12 months with repeat transrectal ultrasonography and biopsy (12 cores) performed at 1 year. Changes in prostate volume, serum PSA, PSA density, and the incidence of CaP at 1 year were assessed. RESULTS: The mean age of the group was 60.5 years (+/-7.6). For the group, the average number of previous biopsies performed was 2.9 (range 2 to 6). The baseline PSA level for the entire group was 6.32 ng/mL (+/-3.2), and the baseline prostate volume was 37.3 cm3 (+/-12.4). At 1 year, the PSA level had decreased to 3.73 ng/mL (-41.0%), and the prostate volume had decreased to 30.4 cm3 (-18.5%). In the 11 men (29%) in whom CaP was detected, the serum PSA decreased from 7.3 to 5.2 ng/mL (-28.8%) and the prostate volume decreased from 37.3 to 32.3 cm3 (-13.4%). CaP was detected in 0 of 10 men with a serum PSA decrease of 50% or higher, in 6 (32%) of 19 men with a PSA decrease between 33% and 50%, and in 5 (56%) of 9 men who had a PSA decrease of less than 33%. CONCLUSIONS: The data in this preliminary study suggest that the magnitude of change in serum PSA after 1 year of finasteride challenge may be useful in diagnosing CaP in patients with elevated PSA levels and prior negative prostate biopsy.
机译：目的：在一项前瞻性研究中，确定接受过先前活检的血清PSA大于4 ng / mL的男性对非那雄胺激发的前列腺特异性抗原（PSA）反应。血清PSA大于4 ng / mL的患者经过反复的前列腺癌（CaP）活检而未发现，则存在诊断难题。非那雄胺给药后PSA降低的幅度已有充分文献记载。此外，与非单独使用PSA相比，将非那雄胺1年后的PSA值加倍被认为是诊断CaP的更有用的范例。方法：38名基线血清PSA水平大于4 ng / mL且经正常直肠指检的男性，其先前曾接受过至少两次活检，但未检测到CaP，每天给予5 mg非那雄胺。在第6和12个月测量PSA水平，并在第1年重复进行直肠超声检查和活检（12芯）。评估1年时前列腺体积，血清PSA，PSA密度和CaP发生率的变化。结果：该组的平均年龄为60.5岁（+/- 7.6）。对于该组，先前进行的活检的平均次数为2.9（范围2至6）。整个组的基线PSA水平为6.32 ng / mL（+/- 3.2），基线前列腺体积为37.3 cm3（+/- 12.4）。在1年时，PSA水平已降至3.73 ng / mL（-41.0％），前列腺体积已降至30.4 cm3（-18.5％）。在检测到CaP的11名男性中（29％），血清PSA从7.3降至5.2 ng / mL（-28.8％），前列腺体积从37.3 cm3降至32.3 cm3（-13.4％）。在血清PSA降低50％或更高的10位男性中，有0位检测到CaP;在PSA降低33％至50％之间的19位男性中，有6位（32％）检测到了9名男性中的5位（56％）， PSA下降幅度小于33％。结论：这项初步研究的数据表明，非那雄胺激发1年后血清PSA的变化幅度可能有助于诊断PSA水平升高和先前前列腺活检阴性的患者的CaP。

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