RESUMEN
More and more studies have revealed that the level of serum prostate specific antigen(PSA) has little value for early diagnosis of prostate cancer (PCa). For example, negative prostate biopsies are as high as 70%-80% for patients with serum PSA ranging between 4 ng/mL and 10 ng/mL. However, the negative results cannot exclude the existence of cancer. In the studies of the early diagnosis of PCa, investigators focused on seeking biomarkers that have higher sensitivity and specificity. Recently, PSA derivatives, HPC1, PCA3, TMPRSS2: ETS, GSTP1, AMACR, GOLPH2, EPCA, sarcosine, and the combination of multiple biomarkers are widely discussed. In this article, we have reviewed their recent development and the prospective value of the combination of multiple biomarkers, which may be helpful for the early diagnosis and the prognostic monitoring of patients with PCa.
Asunto(s)
Humanos , Masculino , Antígenos de Neoplasias , Metabolismo , Biomarcadores de Tumor , Metabolismo , Diagnóstico Precoz , Endorribonucleasas , Metabolismo , Gutatión-S-Transferasa pi , Metabolismo , Proteínas de la Membrana , Metabolismo , Proteínas de Fusión Oncogénica , Metabolismo , Antígeno Prostático Específico , Metabolismo , Neoplasias de la Próstata , Diagnóstico , Metabolismo , Racemasas y Epimerasas , Metabolismo , Sarcosina , MetabolismoRESUMEN
<p><b>OBJECTIVES</b>To analyze the clinical and pathological informations of metastatic prostate cancer patients to find the predictive factors of the survival.</p><p><b>METHODS</b>To filter 364 cases of metastatic prostate cancer in the 940 cases of prostate cancer that were treated in Cancer Hospital Fudan University in Shanghai from March 1998 to June 2009, the cases had hormonal therapy and full clinical and pathological records. All the 364 cases were followed up and the clinical and pathological informations were analyzed, to find the predictive factors that related to the prognosis. Statistic software SPSS 15.0 was used for analysis. Cumulative survival was analyzed by the method of Kaplan-Meier. Cox regression was used for univariate and multivariate analysis. Log-rank method was used for the significance test.</p><p><b>RESULTS</b>The last follow-up date was 30th June 2009 and the median follow-up time was 24 months. At the final follow-up, 240 cases were alive, 109 cases were dead and 15 cases were lost to follow up. The median survival time of metastatic prostate cancer was 64 months, and the one-year, two-year, three-year, four-year, five-year survival rate was 92%, 78%, 66%, 60%, 54%. The univariate analysis indicated that Gleason score (P = 0.033), clinical stage (P < 0.001), the effectiveness of hormonal therapy (P < 0.001), the prostate specific antigen (PSA) nadir during hormonal therapy (P < 0.001) and the time from the start of hormonal therapy to the PSA nadir (P = 0.002) were predictive factors for the survival time of metastatic prostate cancer. The multivariate analysis indicated that the PSA nadir during hormonal therapy (P < 0.001) and the time from the start of hormonal therapy to the PSA nadir (P < 0.001) were independent factors that predict the survival time of metastatic prostate cancer.</p><p><b>CONCLUSION</b>The PSA nadir during hormonal therapy and the time from the start of hormonal therapy to the PSA nadir are independent factors that predict the survival time of metastatic prostate cancer.</p>