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中華民國泌尿科醫學會雜誌

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篇名 Changes of Serum Prostate-Specific Antigen before and After Transurethral Vaporization of Prostate for Benign Prostatic Hyperplasia
卷期 10:3
並列篇名 良性攝護腺肥大病人經尿道攝護腺氣化手術前後血清PSA的變化
作者 陳修聖邱文祥陳光國張心湜
頁次 114-117
關鍵字 PSA良性攝護腺肥大經尿道攝護腺氣化手術BPHvaporizationTSCI
出刊日期 199909

中文摘要

為評估經尿道攝護腺氣化手術對良性攝護腺肥大病人血清PSA的影響,我們做了此一研究。共三十位有良性攝護腺肥大症狀病人,年齡62到80歲,平均70 .5 歲,而且肛門指診正常,進入此一研究。每一病人在術前都做血清PSA及經直腸攝護腺超音波的檢查以排除攝護腺癌的可能。血清PSA的檢查是用ELISA PSA II的方法,並在術前、術後20小時、2週、4週測定血清PSA。結果分別是5.3±4.2,20.5±9.1,5.1±3.1,3.6±2.3ng / ml。經直腸攝護腺超音波預估攝護腺重量為33.8±14.0公克。血清PSA在術後20小時平均上升3.85倍,然後逐漸下降。三十位病人中有十位血清PSA在術後2週降到術前濃度,26位在術後4週降到術前濃度。血清PSA在術後20小時上升的程度與術前PSA及經直腸攝護腺超音波預估攝護腺重量呈正相關。血清PSA在術後20小時明顯上升,然後逐漸下降。我們建議血清PSA最好在經尿道攝護腺氣化手術後4週測定以避免其影響。

英文摘要

We conducted this prospective study in order to assess the effect of transurethral vaporization of the prostate(TUVP) on the serum level of prostate-specific antigen(PSA). Thirty patients (average age: 70.5 yr, range: 62-80) with symptomatic benign prostatic hyperplasia(BPH) and negative rectal examination for hard nodule were included for evaluation. Transrectal ultra-sonography(TRUS) and serum PSA were checked in every patient before surgery. Biopsy was done if PSA was greater than 10 ng/ml or f suspicious lesion was detected by TRUS. Serum PSA in the morning(ELISA PSA II method-monoclonal antibody) was checked before TUVP, and at 20 h, 2, and 4 weeks after TUVP. Serum PSA values(mean±SD) were 5.3±4.2, 20.5±9.1, 5.1±3.1, and 3.6±2. 3 ng/ml, respect-tively. Estimated prostate weights were 33.8±14.0g. PSA was elevated 3.85 times at 20 h after TUVP and then decreased gradually after that. Of the 30 patients, the PSA level returned to less than pre-operative level 2 wk after surgery in 10 cases (33.3%), and 4 weeks after surgery in the other 26 cases (86.7%). PSA level at 20 h after TUVP correlated well with the estimated weight of the prostate(by TRUS) and preoperative PSA status (r=0.83 and 0.82, respectively, p<0.05). Serum PSA increased significantly at 20 h after TUVP then decreased gradually. The degree of postoperative PSA increase was higher for larger prostates and for patients with higher preoperative PSA levels. We recommend that checking serum PSA is preferably done at least 4 wk after TUVP to avoid influence from the surgical procedure.