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Significance of Serum Concentration of Free and Total Prostate Specific Antigen in Benign Prostatic Hyperplasia and Prostate Cancer
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¼ÇõÁØ/Hyeok Jun Seo
¹ÚÇü¹Î/±ÇűÕ/Á¤¼º±¤/±è¹ý¿Ï/ÀÌÀçÅÂ/Hyung Min Park/Tae Gyun Kwon/Sung Kwang Chung/Bup Wan Kim/Jae Tse Lee
KMID : 0358319990400091132
Abstract
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¾ç¿¡¼´Â ºóµµ°¡ ³ôÀº ÁúȯÀ̳ª µ¿¾ç¿¡¼´Â »ó´ëÀûÀ¸·Î ³·Àº ºóµµ¸¦ º¸ÀÌ°í ÀÖ´Ù. ÇÏÁö¸¸
ÃÖ±Ù ¿ì¸®³ª¶ó¿¡¼µµ Æò±Õ ¼ö¸íÀÇ Áõ°¡ ȤÀº °Ë»ç¹æ¹ýÀÇ ¹ß´Þ µî ¿©·¯ °¡Áö »çȸÀû ¿äÀεé
·Î ÀÎÇØ Àü¸³¼±¾Ï ȯÀÚÀÇ ¼ö°¡ Áõ°¡ Ãß¼¼¿¡ ÀÖ´Ù. ÇöÀç Àü¸³¼±¾ÏÀÇ Á¶±âÁø´Ü°ú Ä¡·á¸¦ À§ÇÑ
¼±º°°Ë»ç·Î Á÷Àå¼öÁö°Ë»ç, °æÁ÷ÀåÃÊÀ½ÆÄ°Ë»ç ±×¸®°í Á¾¾çÁöÇ¥·Î Àνĵǰí ÀÖ´Â Ç÷û Àü¸³¼±
ƯÀÌÇ׿ø(prostate specific antigen; PSA)°Ë»ç µîÀÌ ÀÌ¿ëµÇ°í ÀÖÀ¸³ª ¹Î°¨µµ¿Í ƯÀ̵µ°¡ ¸ð
µÎ ³ôÀº ¼±º°°Ë»ç´Â ¾ÆÁ÷±îÁö È®¸³µÇ¾î ÀÖÁö ¾ÊÀº ½ÇÁ¤ÀÌ´Ù. ÀÌ Áß PSA´Â Àü¸³¼±¾ÏÀÇ Á¶±â
Áø´Ü°ú Ä¡·á ÈÄ ÃßÀû°Ë»ç¿¡ À¯¿ëÇÑ Á¾¾çÁöÇ¥·Î ÀÌ¿ëµÇ°í ÀÖÀ¸³ª Àü¸³¼±¾Ï»Ó¸¸ ¾Æ´Ï¶ó Àü¸³
¼±ºñ´ëÁõ ȯÀÚÀÇ ¾à 25%¿¡¼µµ PSAÀÇ Áõ°¡¸¦ °üÂûÇÒ ¼ö ÀÖ´Ù. ¶ÇÇÑ Àå±â¿¡ ±¹ÇÑµÈ Àü¸³¼±
¾ÏÀÇ °æ¿ì ¾à 38-48%¿¡¼ PSA´Â Á¤»ó¹üÀ§¸¦ º¸ÀÏ ¼ö ÀÖÀ¸¸ç ´Ù¸¸ ±× Å©±â°¡ Å©°Å³ª ÀüÀÌ
µÈ °æ¿ì¿¡¸¸ Ç÷û PSA°¡ ÇöÀúÇÑ Áõ°¡¸¦ º¸À̱⠶§¹®¿¡ ƯÈ÷ Ç÷û PSA°¡ 4-10ng/§¢ Á¤µµ
·Î Áõ°¡µÈ °æ¿ì¿¡ ´Â Àü¸³¼±ºñ´ëÁõ°ú Àü¸³¼±¾ÏÀ» °¨º°Çϴµ¥ ÀÓ»óÀûÀ¸·Î ¾î·Á¿òÀÌ ÀÖ´Ù.
º» ¿¬±¸¿¡¼´Â Àü¸³¼±ºñ´ëÁõ ¹× Àü¸³¼±¾Ï ȯÀÚÀÇ Ç÷û ÃÑ PSA ¹× À¯¸®Çü PSA¸¦ ºÐ¸®
ÃøÁ¤ÇÏ°í ƯÈ÷ ÃÑ PSA¸¸À¸·Î ¾çÀÚÀÇ ±¸º°ÀÌ ¾î·Á¿î ȯÀÚ¿¡¼ ÃÑ PSA¿¡ ´ëÇÑ À¯¸®Çü
PSA(F/T PSA) ºñÀ²ÀÇ ÃøÁ¤ÀÌ Àü¸³¼±¾Ï Áø´Ü¿¡ ÀÖ¾î µµ¿òÀÌ µÇ´ÂÁö ¾Ë¾Æº¸°íÀÚ ÇÏ¿´´Ù.
Purpose : This study was performed to investigate whether the free to total PSA
ratio(F/T PSA ratio) offers a better discriminant for the detection of patient with
prostatic cancer(CaP) and those with benign prostatic hyperplasia(BPH) than serum total
PSA alone.
Materials and Methods : From September 1996 to February 1999, free and total PSA
levels were measured on frozen sera samples of 154 men with BPH and 46 with CaP
using immunoradiometric assay.
Results : In all subjects, the mean total PSA was significantly higher in CaP
group(72.59¡¾66.58ng/§¢) than BPH group(3.12¡¾4.10ng/§¢). The mean PSAD was
significantly higher in CaP group(l.64¡¾1.86) than BPH group(0.08¡¾0.01). The mean F/T
PSA ratio was significantly lower in CaP group(0.19¡¾0.07) than BPH group(0.30¡¾0.13).
Among 41 subjects whose total PSA were between 4-20ng/§¢, the mean PSAD was
significantly higher in CaP group(0.37¡¾0.16) than BPH group(0.17¡¾0.07), but the mean
F/T PSA ratio was not significantly different between CaP(0.19¡¾0.10) and BPH
group(0.25¡¾0.13). By comparing the sensitivity and specificity of total PSA alone, PSAD
and F/T PSA ratio on receiver operating characteristic (ROC) curve in all subjects and
subjects with total PSA between 4-20ng/§¢, F/T PSA ratio had no superiority than total
PSA alone and PSAD for discrimination between CaP and BPH.
Conclusions : We suggest that the F/T PSA ratio is not superior to total PSA alone
and PSAD in the detection of prostatic cancer, and further evaluation of the usefulness
of F/T PSA ratio should be required.
Å°¿öµå
Prostate cancer; PSA; PSAD; Free to total PSA ratio;
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