日本人症例におけるTANDEM PSAの臨床的評価と他法の比較

Abstract

前立腺癌の診断とフォローアップにおける血清PSA値の意義について, 世界的に最も汎用されているTANDEM PSA(R)を用いて検討した。1)本法のquality control dataは良好であり, 0.50～100ng/mlの血清PSA値を測定できた。2)本邦症例の正常値は, age-match健常男性(n=217)の血清PSA値の平均+3S.D.値から1.9ng/mlと決定した。3)前立腺癌各病期とBPH症例間で, 血清PSA値の分布が有意に異なるのは, stage C以降であった。4)前立腺癌とBPHを効率よく鑑別するためには, BPH症例の平均+S.D.値である13ng/mlをcut-off値とする必要があることが判明した。5)他のPSA測定系とも良好な相関性を示した。6)前立腺癌患者のフォローアップについては, 43反応中40反応について臨床効果と一致した変動を示した

Clinical evaluation of TANDEM PSA which is the most frequently used prostate specific antigen (PSA) assay method in the world and a comparison with other methods were performed in Japanese cases in a cooperative research fashion. The minimum detectable level of the method was found to be 0.50 ng of PSA in one ml of serum and 1.9 ng/ml was regarded as the upper normal value in Japanese males. The distribution of serum PSA showed a significant difference between the benign prostate hypertrophy (BPH) cases and patients with stage C or D prostate cancer. The sero-diagnosis prostate cancer at an early stage with the TANDEM PSA was difficult. The correlation to other methods of PSA detection was very high. Furthermore, the clinical use of the method in following-up the clinical course of prostate cancer patients was very useful. These findings suggested that the PSA detection using TANDEM PSA is applicable even in Japanese cases although the upper cut-off level is decreased.