Prostate-specific antigen

被引:164
作者
Stenman, UH [1 ]
Leinonen, J [1 ]
Zhang, WM [1 ]
Finne, P [1 ]
机构
[1] Univ Helsinki, Cent Hosp, Dept Clin Chem, FIN-00290 Helsinki, Finland
关键词
D O I
10.1006/scbi.1998.0086
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Prostate specific antigen (PSA) is serine protease produced at high concentrations by normal and malignant prostatic epithelium. It is mainly secreted into seminal fluid, where it digests the gel forming after ejaculation. Only minor amounts of PSA leak out into circulation from the normal prostate, but the release of PSA is increased in prostatic disease. Thus PSA is a sensitize serum marker for prostate cancer but its specificity is limited by a high frequency of falsely elevated values in men with benign prostatic hyperplasia (BPH). Approximately two-thirds of all elevated values (>4 mu g/l) in mpn over 50 years of age are due to BPH. In serum, most of the PSA immunoreactivity consists of a complex between PSA and alpha(1)-antichymotrysin (PSA-ACT) whereas approximately 5-40% are free. The proportion of PSA-ACT is larger and the free fraction is smaller in prostate cancer than in Benign prostatic hyperplasia (BPH). Determination of the proportion of free PSA has become widely used to improve the cancer specificity of PSA especially in men with PSA values in the 'grey zone' (4-10 mu g/l). PSA also occurs in complexes with other protease inhibitors and determination of these and other markers may further improve the diagnostic tie accuracy for prostate cancer Interpretation of the results for many different markers is complicated, but this call be simplified by using statistical methods. The diagnostic accuracy can be further improved by using logistic regression ol neural networks to estimate the combined impact of marker results and other findings like digital rectal examination (DRE), transrectal ultrasound (TRUS) and heredity.
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页码:83 / 93
页数:11
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