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首页> 外文期刊>Seminars in Urologic Oncology >The significance of recurrent PSA after radical prostatectomy: benign versus malignant sources.
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The significance of recurrent PSA after radical prostatectomy: benign versus malignant sources.

机译：前列腺癌根治术后复发PSA的意义：良性与恶性来源。

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The purpose of this article is to review the available means to investigate whether an elevated serum prostate-specific antigen (PSA) after radical prostatectomy may be explained by the presence of residual benign tissue. To answer this question, one may consider the following features: the kinetics of recurrent/ persistent PSA, the incidence of rising PSA in the presence of capsular incisions exposing benign glands only, the level of urinary PSA and the ratio of free/total PSA in the urine, the results of anastomotic biopsy samples, and the detection of circulating prostate cells by PSA reverse transcriptase-polymerase chain reaction (RT-PCR) after surgery. Capsular incisions exposing benign tissue are not associated with a significant risk of biochemical failure. In case of an organ-confined cancer with negative surgical margins but a rising postoperative PSA, the systematic reevaluation of the initial pathological slides constantly shows capsular effraction or focal positive margins that have been overlooked at the first evaluation. Even when anastomotic biopsies document only benign tissue, the study of PSA doubling time is usually characteristic of the coexistence of residual tumoral cells. However, in a few cases, the persistent negative results of the detection of circulating prostate cells by PSA, RT-PCR in patients with organ-confined cancer and negative margins but elevated postoperative PSA might be explained by the presence of residual benign prostatic hyperplasia tissue. Most of the data in the literature are in favor of the responsibility of persistent/recurrent cancer in the recurring PSA rather than that of benign prostatic hyperplasiaormal residual tissue. Therefore, a persistent/recurrent detectable level of PSA is the serum after radical prostatectomy characterizes biochemical failure.
机译：本文的目的是综述可用于调查根治性前列腺切除术后血清前列腺特异性抗原（PSA）升高的原因可能是由于残留的良性组织所致。要回答这个问题，可以考虑以下特征：反复/持续性PSA的动力学，存在仅暴露良性腺的包膜切口的情况下PSA升高的发生率，尿中PSA的水平以及游离/总PSA的比例。尿液，吻合活检样本的结果，以及术后PSA逆转录聚合酶链反应（RT-PCR）对循环前列腺细胞的检测。暴露良性组织的囊状切口与生化失败的重大风险无关。如果器官限制癌的手术切缘阴性，但术后PSA升高，则对初始病理切片的系统性重新评估会不断显示出囊膜效果或局灶性阳性切缘，而在首次评估时被忽略。即使当吻合口活组织检查仅记录良性组织时，PSA倍增时间的研究通常仍是残留肿瘤细胞共存的特征。然而，在少数情况下，通过PSA，RT-PCR在器官受限癌和切缘阴性的患者中检测到循环前列腺细胞的持续阴性结果，但术后PSA升高可能是由于残留良性前列腺增生组织。文献中的大多数数据都支持复发性PSA中持续性/复发性癌症的责任，而不是良性前列腺增生/正常残留组织的责任。因此，根治性前列腺切除术表征生化衰竭后，血清中PSA的持续/可检测水平为血清。

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