The serum concentrations of prostatic secretory protein of 94 amino acid residues (PSP94) as well as those of prostate-specific antigen (PSA) were determined in 40 patients with established prostatic carcinoma, prior to transurethral resection of the prostate. In a comparison with a control group of healthy men (n = 40) and a group of patients with histologically established benign prostatic hyperplasia (n = 40) no significant differences in PSP94 serum concentrations between the groups were observed. Similarly, correlations of PSP94 serum concentrations with prostatic carcinoma stages or grades were not detected. In contrast, and as expected, PSA behaved as a prostate tumor marker of known sensitivity and specificity. A correlation of PSP94 and PSA concentrations in sera of patients with benign prostatic hyperplasia and/or prostatic carcinoma could not be verified. PSP94 apparently does not fulfill the criteria of a serum marker for monitoring adenomas and/or carcinomas of the prostate.
Die von Oberhausen entwickelte Ganzkörperclearance ist ein neueskatheterloses Verfahren zur Bestimmung der renalen Clearance. Im Gegensatz zu bisher bekannten Verfahren wird dabei nach intravenöser Injektion die zeitliche Abnahme der Clearancesubstanz nicht nur im vasalen Raum, sondern im gesamten Körper gemessen. Aus dem Differentialquotienten und der Plasmakonzentration 20 und 25 Minuten nach der Injektion läßt sich nach dem Fickschen Prinzip die Clearance berechnen. Wird die Ganzkörperclearance mit den relativ kleinen Sonden eines Funktionsmeßplatzes gemessen, muß die unterschiedliche Höheneinstellung der Sonden beachtet werden. Weiterhin muß das Zeitintervall zur Blutentnahme von 20 und 25 Minuten eingehalten werden, da die Clearanceformel nur in diesem Bereich Gültigkeit hat. In Kombination mit der Radionephrographie lassen sich neben den quantitativen Angaben über den effektiven Nierenpiasmastrom Aussagen über die Einzelnierenfunktion machen. Wegen ihrer einfachen und ungefährlichen Anwendung ist die Ganzkörperclearance sehr gut für die nephrologische Diagnostik geeignet.
To evaluate the clinical and prognostic value of prostate-specific antigen (PSA) for the detection of tumor and tumor growth after therapy, 520 sera from 246 patients with prostatic carcinoma, 990 sera from patients with BPH, and 1,488 sera from patients with other urological diseases were analyzed. The values ranged from 0.1 to 1,828.9 ng/ml. 51 % of all values were about 2.5 ng/ml, and 76.8% of all values about 10 ng/ml. The commercial recommendation for the cutoff values is 2.5 ng/ml (IBL, FRG). In patients with benign prostatic hypertrophy this cutoff means 61% false-positive results, which makes the test highly sensitive but unspecific. In prostatic carcinoma patients this borderline means a false-negative result in 9.75% (24 of 246). By determinating the cutoff at 10 ng/ml in our series, a false-negative result appeared in 14.6 %. Therefore a plea is made for the 10-ng/ml cutoff. In follow-up studies a marked decline in PSA values after transurethral resection or antiandrogen therapy (orchiectomy/Zoladex® /ICI/flutamide, Essex). Generally, the greater the PSA levels the more advanced the stage of disease. These data suggest that PSA may be a useful adjuvant marker for monitoring tumor growth in patients with regionally confined tumor.
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