前立腺腫瘍マーカーとしての前立腺特異抗原(PA)の意義 : 前立腺集団検診受診者における検討

Abstract

前立腺特異抗原(PA)を前立腺酸性フォスファターゼ(PAP)と比較し'87年より'90年まで前立腺癌のマススクリーニングで2, 183例の血清で試したPAはEテスト"TOSOH"2で測定した。直腸診(DRE)と超音波断層(US)での前立腺の大きさとの関係では, DREではPAPとPAが相関しPAはより大きさと年齢とも相関する。またPAはUSにおいて大きさと相関(r=0.53)する。正常上限を6.0ng/mlとすると感受性, 特異性, 効率はそれぞれ64%, 97%, 62%であった。PAより感受性が高く, 有用であり, 前立腺腫瘍マーカーとして, マススクリーニング系で信頼するに至る結論をした

The usefulness of prostatic specific antigen (PA) was compared with that of prostatic acid phosphatase (PAP). PA was determined in the serum of 2, 183 patient examined by the mass screening for prostate cancer from 1987 to 1990. The serum samples of these patients were obtained from our serum bank. PA was measured by the E test "TOSOH" II (PA). The relationship of PA and PAP to prostate size estimated by digital rectal examination (DRE) and ultrasound tomography (US), and age was investigated. PA and PAP correlated with aging and prostate size estimated by DRE. However PA was more apparently related with these things. The correlation between PA and prostatic size estimated by US was relatively high (r = 0.53), but the correlation between PAP and prostate size estimated by US was low (r = 0.20). When the upper limit of normal range was set at 6.0 ng/ml, the sensitivity, specificity and efficiency was 64%, 97% and 62%, respectively. PA was more sensitive than PAP and could be more useful since none of the patients with prostate cancer was PAP positive and PA negative. We conclude that PA should be a reliable tumor marker in our mass screening system.