【摘要翻译】PSA（前列腺特异性抗原）筛选方法的一篇综述
这个帖子发布于 20 年零 250 天前，其中的信息可能已发生改变或有所发展。
前几天应助了一关于前列腺特异性抗原的帖子，这里介绍一篇关于PSA的综述。
【Title】 Prostate-specific antigen: a review of the validation of the most commonly used cancer biomarker.
【Journal】 Cancer. 2004 Sep 1;101(5):894-904.
【Author】 Hernandez J, Thompson IM.
Division of Urology, The University of Texas Health Science Center at San Antonio, 78229, USA.
【Abstract】
BACKGROUND: The widespread use of prostate-specific antigen (PSA) screening has had a tremendous impact on all aspects of the management of prostate carcinoma. Although PSA-based screening has resulted in a stage migration to more organ-confined tumors at the time of diagnosis, and has been temporally associated with a decrease in prostate carcinoma mortality, PSA screening is imperfect. A recent analysis of results from the Prostate Cancer Prevention Trial (PCPT) has provided insight into the positive predictive value of PSA in the so-called "normal" range. METHODS: The history of the discovery, initial studies, and subsequent widespread application of PSA screening is reviewed. RESULTS: The application of PSA for screening preceded the development of current prostate biopsy techniques and an upper limit of normal was established without complete disease ascertainment. More recent modifications of PSA-based screening have been adopted clinically without sufficient validation. With current methods, overdiagnosis of clinically unimportant disease almost certainly occurs and high-grade, aggressive disease may not be detected sufficiently early to allow successful treatment. CONCLUSIONS: To the authors' knowledge, the optimal upper limit of normal for PSA for prostate carcinoma screening is unknown. New biomarkers of disease are needed; these must be linked with disease prognosis and must be validated in rigorously designed clinical trials. Copyright 2004 American Cancer Society.
【摘要翻译】
PSA(前列腺特异性抗原)筛选方法在临床上的广泛运用给前列腺癌诊治的各个方面都带来巨大的影响。虽然以PSA为基础的筛选方法使我们在诊断时更为明确哪个器官发生肿瘤，并且目前还和前列腺癌的死亡率相关，但仍然不是一个完美的方法。最近对前列腺癌预防实验的结果进行分析在所谓的正常范围内的阳性预测值
方法：对PSA筛选方法发现的历史，最初的研究，随后临床广泛的应用进行综述
结果：在现在前列腺活检技术发展之前已经有PSA筛选方法的应用，故PSA正常值的上限是在没有疾病确诊的证据的情况下确立的。而且现在以PSA为基础的筛选方法的修正技术在临床的应用并没有足够的有效性。用现在的一些方法，肯定会漏诊一些临床上症状较轻的病例，及对一些高
分期，侵袭力强的疾病并不能在足够早期发现，导致治疗的不成功。
结论：根据作者的经验，前列腺癌筛选中的PSA的理想的正常值上限仍未知。应该发现一些新的疾病生物标志物，这些标志物必须和疾病的预后相联系并且是经过严格设计的临床实验证明是有效的。
【全文】
http://www.dxy.cn/bbs/user/download/2415323/12.pdf
【Title】 Prostate-specific antigen: a review of the validation of the most commonly used cancer biomarker.
【Journal】 Cancer. 2004 Sep 1;101(5):894-904.
【Author】 Hernandez J, Thompson IM.
Division of Urology, The University of Texas Health Science Center at San Antonio, 78229, USA.
【Abstract】
BACKGROUND: The widespread use of prostate-specific antigen (PSA) screening has had a tremendous impact on all aspects of the management of prostate carcinoma. Although PSA-based screening has resulted in a stage migration to more organ-confined tumors at the time of diagnosis, and has been temporally associated with a decrease in prostate carcinoma mortality, PSA screening is imperfect. A recent analysis of results from the Prostate Cancer Prevention Trial (PCPT) has provided insight into the positive predictive value of PSA in the so-called "normal" range. METHODS: The history of the discovery, initial studies, and subsequent widespread application of PSA screening is reviewed. RESULTS: The application of PSA for screening preceded the development of current prostate biopsy techniques and an upper limit of normal was established without complete disease ascertainment. More recent modifications of PSA-based screening have been adopted clinically without sufficient validation. With current methods, overdiagnosis of clinically unimportant disease almost certainly occurs and high-grade, aggressive disease may not be detected sufficiently early to allow successful treatment. CONCLUSIONS: To the authors' knowledge, the optimal upper limit of normal for PSA for prostate carcinoma screening is unknown. New biomarkers of disease are needed; these must be linked with disease prognosis and must be validated in rigorously designed clinical trials. Copyright 2004 American Cancer Society.
【摘要翻译】
PSA(前列腺特异性抗原)筛选方法在临床上的广泛运用给前列腺癌诊治的各个方面都带来巨大的影响。虽然以PSA为基础的筛选方法使我们在诊断时更为明确哪个器官发生肿瘤，并且目前还和前列腺癌的死亡率相关，但仍然不是一个完美的方法。最近对前列腺癌预防实验的结果进行分析在所谓的正常范围内的阳性预测值
方法：对PSA筛选方法发现的历史，最初的研究，随后临床广泛的应用进行综述
结果：在现在前列腺活检技术发展之前已经有PSA筛选方法的应用，故PSA正常值的上限是在没有疾病确诊的证据的情况下确立的。而且现在以PSA为基础的筛选方法的修正技术在临床的应用并没有足够的有效性。用现在的一些方法，肯定会漏诊一些临床上症状较轻的病例，及对一些高
分期，侵袭力强的疾病并不能在足够早期发现，导致治疗的不成功。
结论：根据作者的经验，前列腺癌筛选中的PSA的理想的正常值上限仍未知。应该发现一些新的疾病生物标志物，这些标志物必须和疾病的预后相联系并且是经过严格设计的临床实验证明是有效的。
【全文】
http://www.dxy.cn/bbs/user/download/2415323/12.pdf
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