文章：

超高前列腺特异性抗原水平：局部高危前列腺癌的潜在极高风险因素

Ultra-High Prostate-Specific Antigen Level: A Potential Very-High-Risk Factor for Localized High-Risk Prostate Cancer

原文发布日期：29 November 2023

DOI: 10.3390/cancers15235644

类型: Article

开放获取: 是

英文摘要：

To examine the impact of ultra-high iPSA levels of >50 ng/mL (uhPSA) after modern radiotherapy, we compared outcomes of 214 patients with uhPSA levels to 1161 other high-risk patients. Radiotherapy included brachytherapy ± external beam radiotherapy (EBRT) and EBRT alone (intensity-modulated radiotherapy or stereotactic body radiotherapy). The biochemical disease-free survival rate (bDFS), the distant metastasis-free survival rate (DMFS), local control, and pelvic lymph node control were analyzed. Patients with uhPSA levels had an inferior bDFS (84.8% at 5 years) and DMFS (93.9% at 5 years) compared to other high-risk patients (92.7% and 97.2%, bothp< 0.001). The uhPSA group showed more distant metastases than the non-uhPSA group; however, the frequencies of local failure and pelvic lymph node recurrence were similar. The uhPSA group demonstrated hazard ratios (HRs) of 2.74 for bDFS and 2.71 for DMFS, similar to those of T3b–4 (HR 2.805 and 2.678 for bDFS and DMFS) and GS 9–10 (HR 2.280 and 2.743 for bDFS and DMFS). An uhPSA level could be a candidate for a single VHR factor to identify high-risk patients who require intensified treatment.

摘要翻译： 

为评估现代放疗后初始前列腺特异性抗原（iPSA）水平>50 ng/mL（超高iPSA，uhPSA）对预后的影响，本研究将214例uhPSA患者与1161例其他高危患者进行疗效对比。放疗方案包括近距离放疗±外照射放疗（EBRT）及单纯EBRT（调强放疗或立体定向体部放疗）。分析指标涵盖生化无病生存率（bDFS）、无远处转移生存率（DMFS）、局部控制率及盆腔淋巴结控制率。结果显示：uhPSA组患者5年bDFS（84.8%）和DMFS（93.9%）均显著低于其他高危患者组（分别为92.7%和97.2%，p值均<0.001）。uhPSA组远处转移发生率更高，但局部失败率与盆腔淋巴结复发率与非uhPSA组相近。uhPSA组的风险比（HR）显示：bDFS的HR为2.74，DMFS的HR为2.71，与T3b–4分期（bDFS与DMFS的HR分别为2.805和2.678）及GS 9–10分级（bDFS与DMFS的HR分别为2.280和2.743）的风险水平相当。超高iPSA水平可作为单一极高危因素，用于识别需要强化治疗的高危患者群体。

原文链接：

Ultra-High Prostate-Specific Antigen Level: A Potential Very-High-Risk Factor for Localized High-Risk Prostate Cancer