Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press39610.17650/1726-9776-2014-10-4-47-51PROSTATE CANCERРАК ПРЕДСТАТЕЛЬНОЙ ЖЕЛЕЗЫThe preoperative kinetics of prostate-specific antigen as a predict of relapse-free survival after radical prostatectomyПредоперационная кинетика простатспецифического антигена как ф актор прогноза безрецидивной выживаемости после радикальной прост атэктомииBogomolovO. A.БогомоловО. А.
Russian Federation
urologbogomolov@gmail.comShkolnikM. I.ШкольникМ. И.
Russian Federation
ZharinovG. M.ЖариновГ. М.
Russian Federation
FSBI «Russian Research Center for Radiology and Surgical Technologies», Ministry of Health of Russia, 68, Leningradskaya St., Pesochnyi Settlement, Saint Petersburg 197758ФГБУ «Российский научный центр радиологии и хирургических технологий» Минздрава России197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, 70FSBI «Russian Research Center for Radiology and Surgical Technologies», Ministry of Health of Russia, 68, Leningradskaya St., Pesochnyi Settlement, Saint Petersburg 197758197758 Санкт-Петербург, пос. Песочный, ул. Ленинградская, 70ФГБУ «Российский научный центр радиологии и хирургических технологий» Минздрава России3012201410447510112201401122014https://oncourology.abvpress.ru/oncur/article/view/396

Objectivе. The purpose of the study – to estimate the prognostic value of preoperative prostate-specific antigen (PSA) doubling time (PSADT) in patients with prostate cancer (PCa) after radical prostatectomy (RP).

Materials and Methods. The preoperative PSADT was determined in 92 patients with PCa who underwent RP in FSBI RRCRST. Incidence of biochemical recurrence and adverse pathologic features after surgery (positive lymph nodes and surgical margins, locally advanced and poorly differentiated tumors) were estimate according to the level of preoperative PSADT.

Results. The correlation between the preoperative PSA kinetics and postoperative pathological findings after radical prostatectomy was shown. Positive lymph nodes (p = 0.04), locally advanced (p = 0.03) and poorly differentiated tumors (p = 0.046) were significantly more frequent in patients with a PSADT ≤ 20,0 months. The role of preoperative PSADT as a predict of relapse-free survival after radical prostatectomy was confirmed. By multivariate analysis preoperative PSADT ≤ 20 months showed a statistically significant increase in the relative risk of biochemical recurrence.

Цель исследования – оценка прогностического значения предоперационного времени удвоения простатспецифического антигена (ВУПСА) у больных раком предстательной железы (РПЖ), перенесших радикальную простатэктомию (РПЭ).

Материалы и методы. Предоперационное ВУПСА определено у 92 больных РПЖ, перенесших РПЭ в ФГБУ РНЦРХТ. Оценивалась частота выявления биохимического рецидива (БХР) и неблагоприятных гистологических находок после оперативного лечения (поражение лимфатических узлов, положительный хирургический край, местно-распространенные и низкодифференцированные опухоли) в зависимости от предоперационного ВУПСА.

Результаты. Выявлена корреляция между исходной кинетикой ПСА и послеоперационными патологическими находками после РПЭ. У больных с ВУПСА ≤ 20,0 мес достоверно чаще выявлялись опухолевое поражение удаленных регионарных лимфатических узлов (р = 0,04), местное распространение (р = 0,03) и низкодифференцированные опухоли (р = 0,046). Подтверждена роль предоперационного ВУПСА в качестве фактора прогноза безрецидивной выживаемости после РПЭ. По результатам многофакторного анализа предоперационное ВУПСА ≤ 20 мес показало статистически значимое повышение относительных рисков развития БХР.

prostate cancerpreoperative prostate-specific antigen doubling timeрак предстательной железыпредоперационное время удвоения простатспецифического антигена1. Magklara A., Scorilas A., Stephan C. et al. Decreased concentrations of prostate-specific antigen and human glandular kallikrein 2 in malignant versus nonmalignant prostatic tissue. Urology 2000;56:527–32.Magklara A., Scorilas A., Stephan C. et al. Decreased concentrations of prostate-specific antigen and human glandular kallikrein 2 in malignant versus nonmalignant prostatic tissue. Urology 2000;56:527–32.2. Saleh A. Role of prostate specific antigen (PSA) in pathogenesis of prostate cancer. J of Cancer Therapy 2012;3:331–6.Saleh A. Role of prostate specific antigen (PSA) in pathogenesis of prostate cancer. J of Cancer Therapy 2012;3:331–6.3. Williams S.A., Singh P., Isaacs J.T., Denmeade S.R. Does PSA play a role as a promoting agent during the initiation and/or progression of prostate cancer. Prostate 2007;67(3):312–29.Williams S.A., Singh P., Isaacs J.T., Denmeade S.R. Does PSA play a role as a promoting agent during the initiation and/or progression of prostate cancer. Prostate 2007;67(3):312–29.4. Pandey R., Patil N., Rao M. Proteases and Protease Inhibitors: implications in antitumorogenesis and drug development. Int J Human Genetics 2007; 7(1): 67–82.Pandey R., Patil N., Rao M. Proteases and Protease Inhibitors: implications in antitumorogenesis and drug development. Int J Human Genetics 2007; 7(1): 67–82.5. Sutkowski D.M., Goode R.L., Banial J. et al. Growth regulation of prostatic stromal cells by prostate-specific antigen. J Natl Cancer Inst 1999; 91(19):1663–9.Sutkowski D.M., Goode R.L., Banial J. et al. Growth regulation of prostatic stromal cells by prostate-specific antigen. J Natl Cancer Inst 1999; 91(19):1663–9.6. Veveris-Lowe T.L., Lawrence M.G., Collard R.L. et al. Kallikrein 4 (hK4) and prostate-specific antigen (PSA) are associated with the loss of E-cadherin and an epithelial-mesenchymal transition (EMT)-like effect in prostate cancer cells. Endocrine-Related Cancer 2005;12:631–43.Veveris-Lowe T.L., Lawrence M.G., Collard R.L. et al. Kallikrein 4 (hK4) and prostate-specific antigen (PSA) are associated with the loss of E-cadherin and an epithelial-mesenchymal transition (EMT)-like effect in prostate cancer cells. Endocrine-Related Cancer 2005;12:631–43.7. Lin J.T., Wang J.S., Jiann B.P. et al. Correlation of p53 protein accumulation and Bcl-2 overexpression with histopathological features in prostatic cancer. J Formosan Med Association 2005;104(11): 864–7.Lin J.T., Wang J.S., Jiann B.P. et al. Correlation of p53 protein accumulation and Bcl-2 overexpression with histopathological features in prostatic cancer. J Formosan Med Association 2005;104(11): 864–7.8. Wang L.G., Liu X.M., Kreis W., Budman D.R. through inhibition of complex formation between androgen receptor and steroid receptor binding consensus in the promoter of the PSA gene in LNCaP cells. Cancer Res 1997; 57(4):714–9.Wang L.G., Liu X.M., Kreis W., Budman D.R. through inhibition of complex formation between androgen receptor and steroid receptor binding consensus in the promoter of the PSA gene in LNCaP cells. Cancer Res 1997; 57(4):714–9.9. Iwamura M., Hellman J., Cockett A.T. et al. Alteration of the hormonal bioactivity of parathyroid hormone-related protein (PTHrP) as a result of limited proteolysis by prostatespecific antigen. Urology 1996;48:317–25.Iwamura M., Hellman J., Cockett A.T. et al. Alteration of the hormonal bioactivity of parathyroid hormone-related protein (PTHrP) as a result of limited proteolysis by prostatespecific antigen. Urology 1996;48:317–25.10. Heidenreich A., Bolla M., Joniau S. et al. Members of the European Association of Urology (EAU) Guidelines Office. Guidelines on Prostate Cancer. In: EAU Guidelines, edition presented at the 25th EAU Annual Congress, Barcelona 2010.Heidenreich A., Bolla M., Joniau S. et al. Members of the European Association of Urology (EAU) Guidelines Office. Guidelines on Prostate Cancer. In: EAU Guidelines, edition presented at the 25th EAU Annual Congress, Barcelona 2010.11. Ramirez M.L., Nelson E.C., Devere R.W. et al. Current applications for prostate-specific antigen doubling time. Eur Urol 2008;54(2):291–300.Ramirez M.L., Nelson E.C., Devere R.W. et al. Current applications for prostate-specific antigen doubling time. Eur Urol 2008;54(2):291–300.12. Hanks G.E., Hanlon A.L., Lee W.R. et al. Pretreatment prostate-specific antigen doubling times: clinical utility of this predictor of prostate cancer behavior. Int J Radiat Oncol Biol Phys 1996;34:549–53.Hanks G.E., Hanlon A.L., Lee W.R. et al. Pretreatment prostate-specific antigen doubling times: clinical utility of this predictor of prostate cancer behavior. Int J Radiat Oncol Biol Phys 1996;34:549–53.13. Goluboff E.T., Heitjan D.F., DeVries G.M. et al. Pretreatment prostate specific antigen doubling times: use in patients before radical prostatectomy. J Urol 1997;158:1876–8.Goluboff E.T., Heitjan D.F., DeVries G.M. et al. Pretreatment prostate specific antigen doubling times: use in patients before radical prostatectomy. J Urol 1997;158:1876–8.14. Egawa S., Arai Y., Tobisu K. et al. Use of pretreatment prostate-specific antigen doubling time to predict outcome after radical prostatectomy. Prostate Cancer Prostatic Dis 2000;3:269–74.Egawa S., Arai Y., Tobisu K. et al. Use of pretreatment prostate-specific antigen doubling time to predict outcome after radical prostatectomy. Prostate Cancer Prostatic Dis 2000;3:269–74.15. Freedland S.J., Dorey F., Aronson W.J. Preoperative PSA velocity and doubling time do not predict adverse pathologic features or biochemical recurrence after radical prostatectomy. Urology 2001;57: 476–80.Freedland S.J., Dorey F., Aronson W.J. Preoperative PSA velocity and doubling time do not predict adverse pathologic features or biochemical recurrence after radical prostatectomy. Urology 2001;57: 476–80.16. Memorial Sloan-Kettering Cancer Center cancer information: prostate nomogram. http://www.mskcc.org/mskcc/html/10088.cfm.Memorial Sloan-Kettering Cancer Center cancer information: prostate nomogram. http://www.mskcc.org/mskcc/html/10088.cfm.