Currently,there is growing interest regarding prostatespecific antigen(PSA) and the cardiovascular system.Increased PSA serum levels have been reported after prolonged cardiopulmonary resuscitation,cardiac surgery,ext...Currently,there is growing interest regarding prostatespecific antigen(PSA) and the cardiovascular system.Increased PSA serum levels have been reported after prolonged cardiopulmonary resuscitation,cardiac surgery,extracorporeal cardiopulmonary bypass,acute myocardial infarction(AMI) and coronary artery stenting.The possible role of PSA in cardiac events has been questioned due to the finding of PSA decrease during AMI and by the correlation of variation in PSA levels with coronary lesions and occurrence of major adverse cardiac events.Complexed PSA forms and uncomplexed PSA forms are observed in the bloodstream but the increasing formation of irreversible bound PSA seems to be a crucial finding during AMI.Large studies need to be carried out to confirm these preliminary results and to elucidate unclear aspects.These findings present many potential directions for future research including the role of uncomplexed forms of PSA,the possible distribution of PSA in the heart,the relative expression levels in heart disease states,the mode of expression regulation and other potential specific substrates.The journey of PSA investigation could be longer than initially expected.展开更多
Objective:To investigate the association of persistently elevated prostate-specific antigen(PSA)after radical prostatectomy(RP)with clinicopathological features and long-term oncological prognosis for the development ...Objective:To investigate the association of persistently elevated prostate-specific antigen(PSA)after radical prostatectomy(RP)with clinicopathological features and long-term oncological prognosis for the development of a potential management strategy.Methods:A systematic literature search was performed using PubMed and Web of Science up to June 2021 to identify the eligible studies focusing on understanding the impact of persistent PSA in patients who underwent RP for localized prostate cancer.Meta-analyses were performed on parameters with available information.Results:A total of 32 RP studies were identified,of which 11 included 26719 patients with consecutive cohorts and the remaining 21 comprised 24177 patients with cohorts carrying specific restrictions.Of the 11 studies with consecutive cohorts,the incidence of persistent PSA varied between 3.1%and 34.6%with a median of 11.0%.Meta-analyses revealed patients with persistent PSA consistently showed unfavorable clinicopathological features and a more than 3.5-fold risk of poorer biochemical recurrence,metastasis,and prostate cancer-specific mortality prognosis independently,when compared to patients with undetectable PSA.Similarly,cases with persistent PSA in different specific patient cohorts with a higher risk of prostate cancer also showed a trend of worse outcomes.Conclusion:We found that the frequency of persistent PSA was about 11.0%in consecutive RP cohorts.Persistent PSA was significantly associated with unfavorable clinicopathological characteristics and worse oncological outcomes.Patients with persistent PSA after RP may benefit from early salvage treatment to delay or prevent biochemical recurrence,improving oncological outcomes for these patients.Further prospective randomized controlled trials are warranted to understand optimal systemic therapy in these patients.展开更多
目的 评价外周血前列腺癌抗原3基因（prostate cancer antigen3，PCA3mRNA）和前列腺特异性抗原基因（prostate specific antigen，PSAmRNA）联合检测对前列腺癌（PCa）及对其微转移诊断的价值。方法用双重荧光实时定量逆转录（dFQ—RT...目的 评价外周血前列腺癌抗原3基因（prostate cancer antigen3，PCA3mRNA）和前列腺特异性抗原基因（prostate specific antigen，PSAmRNA）联合检测对前列腺癌（PCa）及对其微转移诊断的价值。方法用双重荧光实时定量逆转录（dFQ—RT）-PCR对49例PCa和71例前列腺增生（BPH）患者外周血PCA3mRNA和PSAmRNA进行定量检测，通过受试者工作特征（ROC）曲线评价其在PCa诊断和微转移监测中的价值。结果PCa组外周血PCA3mRNA含量明显高于BPH组[2362（〈30—7421）拷贝／ml比〈30拷贝／ml，Z=-6．66，P〈0．01]，而PSAmRNA含量也明显高于BPH组[3425（908—36639）拷贝／ml比〈200拷贝／ml，Z=-6．40，P〈0．01]；PCa组外周血PCA3mRNA和PSAmRNA的阳性率随临床分期增高而增加[B期：均为30．0％（3／10），C期：60．0％（9／15）和86．7％（13／15），D期：91．7％（22／24）和91．7％（22／24）；X^2分别为13．534和16．451，P均〈0．01]，同时也随Gleason评分增高而增加[2—4分：20．0％（1／5）和40．0％（2／5）；5～7分：66．7％（12／18）和72．2％（13／18）；8～10分：84．6％（22／26）和92．3％（24／26）x^2分别为8．895和8．015，P均〈0．05]；ROC曲线显示，当PCA3mRNA和PSAmRNA临界值分别为846拷贝／ml和280拷贝／ml时，诊断PCa敏感度分别为69．4％（34／49）和81．7％（40／49），特异度分别为90．1％（64／71）和77．5％（55／71）；而联合检测时其敏感度可增至85．7％（42／49），但特异度下降为76．1％（54／71）。PCA3mRNA诊断PCa微转移的敏感度和特异度分别为90．9％（20／22）和84．7％（11／13）。结论外周血PCA3mRNA和PSAmRNA检测是PCa诊断的良好指标，而联合检测可弥补PCA3mRNA敏感度低和PSAmRNA特异度低的不足，而更有利于PCa诊断；PCA3mRNA可能为PCa微转移诊断的良好指标。展开更多
文摘Currently,there is growing interest regarding prostatespecific antigen(PSA) and the cardiovascular system.Increased PSA serum levels have been reported after prolonged cardiopulmonary resuscitation,cardiac surgery,extracorporeal cardiopulmonary bypass,acute myocardial infarction(AMI) and coronary artery stenting.The possible role of PSA in cardiac events has been questioned due to the finding of PSA decrease during AMI and by the correlation of variation in PSA levels with coronary lesions and occurrence of major adverse cardiac events.Complexed PSA forms and uncomplexed PSA forms are observed in the bloodstream but the increasing formation of irreversible bound PSA seems to be a crucial finding during AMI.Large studies need to be carried out to confirm these preliminary results and to elucidate unclear aspects.These findings present many potential directions for future research including the role of uncomplexed forms of PSA,the possible distribution of PSA in the heart,the relative expression levels in heart disease states,the mode of expression regulation and other potential specific substrates.The journey of PSA investigation could be longer than initially expected.
文摘Objective:To investigate the association of persistently elevated prostate-specific antigen(PSA)after radical prostatectomy(RP)with clinicopathological features and long-term oncological prognosis for the development of a potential management strategy.Methods:A systematic literature search was performed using PubMed and Web of Science up to June 2021 to identify the eligible studies focusing on understanding the impact of persistent PSA in patients who underwent RP for localized prostate cancer.Meta-analyses were performed on parameters with available information.Results:A total of 32 RP studies were identified,of which 11 included 26719 patients with consecutive cohorts and the remaining 21 comprised 24177 patients with cohorts carrying specific restrictions.Of the 11 studies with consecutive cohorts,the incidence of persistent PSA varied between 3.1%and 34.6%with a median of 11.0%.Meta-analyses revealed patients with persistent PSA consistently showed unfavorable clinicopathological features and a more than 3.5-fold risk of poorer biochemical recurrence,metastasis,and prostate cancer-specific mortality prognosis independently,when compared to patients with undetectable PSA.Similarly,cases with persistent PSA in different specific patient cohorts with a higher risk of prostate cancer also showed a trend of worse outcomes.Conclusion:We found that the frequency of persistent PSA was about 11.0%in consecutive RP cohorts.Persistent PSA was significantly associated with unfavorable clinicopathological characteristics and worse oncological outcomes.Patients with persistent PSA after RP may benefit from early salvage treatment to delay or prevent biochemical recurrence,improving oncological outcomes for these patients.Further prospective randomized controlled trials are warranted to understand optimal systemic therapy in these patients.
文摘目的 评价外周血前列腺癌抗原3基因（prostate cancer antigen3，PCA3mRNA）和前列腺特异性抗原基因（prostate specific antigen，PSAmRNA）联合检测对前列腺癌（PCa）及对其微转移诊断的价值。方法用双重荧光实时定量逆转录（dFQ—RT）-PCR对49例PCa和71例前列腺增生（BPH）患者外周血PCA3mRNA和PSAmRNA进行定量检测，通过受试者工作特征（ROC）曲线评价其在PCa诊断和微转移监测中的价值。结果PCa组外周血PCA3mRNA含量明显高于BPH组[2362（〈30—7421）拷贝／ml比〈30拷贝／ml，Z=-6．66，P〈0．01]，而PSAmRNA含量也明显高于BPH组[3425（908—36639）拷贝／ml比〈200拷贝／ml，Z=-6．40，P〈0．01]；PCa组外周血PCA3mRNA和PSAmRNA的阳性率随临床分期增高而增加[B期：均为30．0％（3／10），C期：60．0％（9／15）和86．7％（13／15），D期：91．7％（22／24）和91．7％（22／24）；X^2分别为13．534和16．451，P均〈0．01]，同时也随Gleason评分增高而增加[2—4分：20．0％（1／5）和40．0％（2／5）；5～7分：66．7％（12／18）和72．2％（13／18）；8～10分：84．6％（22／26）和92．3％（24／26）x^2分别为8．895和8．015，P均〈0．05]；ROC曲线显示，当PCA3mRNA和PSAmRNA临界值分别为846拷贝／ml和280拷贝／ml时，诊断PCa敏感度分别为69．4％（34／49）和81．7％（40／49），特异度分别为90．1％（64／71）和77．5％（55／71）；而联合检测时其敏感度可增至85．7％（42／49），但特异度下降为76．1％（54／71）。PCA3mRNA诊断PCa微转移的敏感度和特异度分别为90．9％（20／22）和84．7％（11／13）。结论外周血PCA3mRNA和PSAmRNA检测是PCa诊断的良好指标，而联合检测可弥补PCA3mRNA敏感度低和PSAmRNA特异度低的不足，而更有利于PCa诊断；PCA3mRNA可能为PCa微转移诊断的良好指标。
