THE USE OF PROSTATE-SPECIFIC ANTIGEN AND FREE/TOTAL PROSTATE-SPECIFIC ANTIGEN IN THE DIAGNOSIS OF LOCALIZED PROSTATE CANCER

作者：Alan Wayne Partin, H. Ballentine Carter · 发表于：Urologic Clinics of North America · 年份：1996 · DOI：10.1016/s0094-0143(05)70333-5 · 被引用次数：32 · 研究领域：Prostate Cancer Diagnosis and Treatment、Prostate Cancer Treatment and Research、Urinary Bladder and Prostate Research

In the United States in 1995, a new case of prostate cancer was diagnosed on average every 3 minutes. The majority of these newly diagnosed cases were detected through transrectal ultrasound (TRUS)–guided biopsy of the prostate, prompted only by an elevated serum prostatic-specific antigen (PSA) level. Although there is controversy regarding the benefit of early detection of prostate cancer, 36 it has been demonstrated that early detection can best be achieved through the use of a combination of digital rectal examination (DRE) and PSA. 12 , 35 , 58 The substantial overlap in serum PSA between men with prostate cancer and men with benign prostatic hyperplasia (BPH) 46 has prompted a great deal of enthusiasm for the development of better methods of using PSA in the diagnosis and management of men with prostate cancer. 48 Four methods have been proposed for improving the clinical usefulness of serum PSA: (1) PSA density, 3 , 4 (2) PSA velocity, 10 , 52 (3) use of age-specific PSA reference ranges, 43 and (4) most recently the molecular forms of PSA. 32 , 39 , 45 , 51 The point and counter-point arguments for early detection programs for prostate cancer and the use of PSA as an adjunct for early detection of prostate cancer have been presented elsewhere in this issue. This article outlines the clinical use of PSA for early detection of prostate cancer and focuses primarily on the value of molecular forms of PSA (free PSA, complexed PSA, and total PSA) in the diagnosis of localiz...