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首页> 外文期刊>BJU international >Validity of prostate-specific antigen as a tumour marker in men with prostate cancer managed by watchful-waiting: correlation with findings at serial endorectal magnetic resonance imaging and spectroscopic imaging.
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Validity of prostate-specific antigen as a tumour marker in men with prostate cancer managed by watchful-waiting: correlation with findings at serial endorectal magnetic resonance imaging and spectroscopic imaging.

机译：通过观察等待来管理前列腺特异性抗原作为男性前列腺癌肿瘤标记物的有效性：与直肠内磁共振成像和光谱成像结果的相关性。

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OBJECTIVE: To investigate the validity of prostate-specific antigen (PSA) as a tumour marker in men with clinically localized prostate cancer who have selected watchful waiting, by determining if serial PSA level measurements are correlated with findings of malignancy or benign prostatic hyperplasia (BPH) at serial endorectal magnetic resonance imaging (MRI) and magnetic resonance spectroscopic imaging (MRSI). PATIENTS AND METHODS: We retrospectively identified 69 men with biopsy-proven prostate cancer being managed by watchful waiting, who underwent serial endorectal MRI/MRSI and who had contemporaneous serial PSA measurements. The mean (range) follow-up was 392 (294-571) days. A panel of three experienced readers reviewed the initial and follow-up MRI/MRSI studies, and classified findings of prostate cancer as stable or progressive. Another reader assessed BPH by calculating total gland and central gland volumes on all studies. RESULTS: At the follow-up MRI/MRSI, 51, 17 and one patient had stable, progressive, or unevaluable prostate cancer, respectively. The mean PSA velocity was significantly greater in patients with radiologically progressive disease (1.42 vs 0.42 ng/mL/year, P = 0.04). A PSA velocity of >0.75 ng/mL/year identified those with radiologically progressive disease with a true-positive fraction of 0.71 and a false-positive fraction of 0.39. PSA levels were not correlated with changes in total or central gland volumes (P > 0.05). CONCLUSIONS: In men with clinically localized prostate cancer who select watchful waiting, serial PSA levels are correlated with findings of malignancy but not BPH at serial endorectal MRI/MRSI, suggesting that PSA is a useful longitudinal tumour marker in this population.
机译：目的：通过确定一系列PSA水平测量值是否与恶性或良性前列腺增生（BPH）结果相关联，以研究前列腺特异性抗原（PSA）作为临床标志性前列腺癌男性患者的肿瘤标志物的有效性）进行直肠内磁共振成像（MRI）和磁共振波谱成像（MRSI）。患者与方法：我们回顾性分析了69名经活检证实为前列腺癌的男性，这些患者正在等待观察，他们接受了直肠内MRI / MRSI串行检查并且同时进行了PSA连续测量。平均（范围）随访为392（294-571）天。由三名经验丰富的读者组成的小组对MRI / MRSI的初始和后续研究进行了回顾，并将前列腺癌的发现归为稳定或进行性。另一位读者通过计算所有研究的总腺体和中央腺体体积来评估BPH。结果：在后续的MRI / MRSI中，分别有51、17和1名患者患有稳定，进行性或无法评估的前列腺癌。放射进展性疾病患者的平均PSA速度明显更高（1.42 vs 0.42 ng / mL /年，P = 0.04）。 PSA速度> 0.75 ng / mL /年可确定患有放射学进展疾病的患者，其真阳性分数为0.71，假阳性分数为0.39。 PSA水平与总或中央腺体体积的变化无关（P> 0.05）。结论：在临床上选择局部等待的前列腺癌男性患者中，系列PSA水平与直肠内MRI / MRSI系列的恶性程度相关，而与BPH无关，提示PSA是该人群有用的纵向肿瘤标志物。

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