nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.24884/1561-6274-2011-15-4-55-61nefr-661Research ArticleЖУРНАЛ В ЖУРНАЛЕ (АКТУАЛЬНЫЕ ПРОБЛЕМЫ УРОЛОГИИ, ВОПРОСЫ ПЕДИАТРИЧЕСКОЙ НЕФРОЛОГИИ, ГЕРИАТРИЧЕСКОЙ НЕФРОЛОГИИ)РОЛЬ ПРОСТАТОСПЕЦИФИЧЕСКОГО АНТИГЕНА И ЕГО КИНЕТИЧЕСКИХ ХАРАКТЕРИСТИК ПРИ ОТБОРЕ БОЛЬНЫХ ДЛЯ КОНТРОЛЬНОЙ 11C-ХОЛИН ПОЗИТРОННО-ЭМИССИОННОЙ/ КОМПЬЮТЕРНОЙ ТОМОГРАФИИ ПОСЛЕ РАДИОТЕРАПИИ ИЛИ РАДИКАЛЬНОЙ ПРОСТАТЭКТОМИИROLE OF PROSTATE SPECIFIC ANTIGEN AND ITS KINETIC CHARACTERISTICS AT PАTIENT SELECTION FOR CONTROL 11C-CHOLIN POSITRON-EMISSION/COMPUTERIZED TOMOGRAPHY AFTER RADIOTHERAPY AND RADICAL PROSTATECTOMYРЫБАЛОВМ. А.RYBALOVM. A.

Кафедра урологии

ДЕ ЙОНГИ. Я.De YONGI. Ya

Кафедра урологии

БРЕУСМАА. Й.BREUSMAA. J.

Кафедра урологии

АЛЬ-ШУКРИС. Х.AL-SHUKRIS. H.

кафедра урологии

БОРОВЕЦС. Ю.BOROVETSS. Yu.

кафедра урологии

Медицинский центр Университета г. Гронинген, Санкт-Петербургский государственный медицинский университет им. акад. И.П. ПавловаNetherlandsМедицинский центр Университета г. ГронингенNetherlandsСанкт-Петербургский государственный медицинский университет им. акад. И.П. ПавловаRussian Federation2011100420111545561Copyright © РЫБАЛОВ М.А., ДЕ ЙОНГ И.Я., БРЕУСМА А.Й., АЛЬ-ШУКРИ С.Х., БОРОВЕЦ С.Ю., 20112011РЫБАЛОВ М.А., ДЕ ЙОНГ И.Я., БРЕУСМА А.Й., АЛЬ-ШУКРИ С.Х., БОРОВЕЦ С.Ю.RYBALOV M.A., De YONG I.Y., BREUSMA A.J., AL-SHUKRI S.H., BOROVETS S.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/661

ЦЕЛЬ ИССЛЕДОВАНИЯ. Изучить диагностическую значимость определения уровня простатоспецифического антигена (ПСА) в плазме крови и его кинетических характеристик (скорость нарастания и время удвоения ПСА) при отборе больных для контрольной "C-холин позитронно-эмиссионной/компьютерной томографии (ПЭТ/КТ) с целью выявления местных рецидивов у больных раком предстательной железы (РПЖ), а также определить зависимость этих показателей от первичного метода лечения - радиотерапии (РТ) или радикальной простатэктомии (РП). ПАЦИЕНТЫ И МЕТОДЫ. В основу исследования положены результаты обследования и лечения 125 больных после проведенной им РТ (64 пациента) или РП (61 пациент) по поводу гистологически подтвержденного РПЖ. Всем больным, перенесшим один из вариантов лечения, проводилось обследование с помощью 11C-холин ПЭТ/КТ с целью выявления местных рецидивов. Сравнивали клинико- морфологические параметры у больных после РП и РТ. Производили расчет скорости нарастания ПСА и времени удвоения ПСА. ROC-αнализ полученных данных был произведен с помощью статистической программы SPSS-16. РЕЗУЛЬТАТЫ. Средние значения ПСА значительно различались у больных после РП и РТ (4,8 и 12,9 нг/мл соответственно). Была выявлена взаимосвязь между показателями скорости нарастания ПСА, времени удвоения ПСА и наличием или отсутствием рецидива по результатам ПЭТ/КТ. Время удвоения ПСА оказалось наиболее значимым показателем, указывающим на вероятность обнаружения местного рецидива, диагностируемого по результатам ПЭТ/КТ. ROC-αнализ не выявил значимых различий у больных после РП и РТ по уровню ПСА (AUC=0,646 и 0,606 соответственно), времени удвоения ПСА (AUC=0,718 и 0,721 соответственно) и скорости нарастания ПСА (AUC=0,691 и 0,663 соответственно), что подтверждает предположение о независимости данных показателей от первичного метода лечения. ЗАКЛЮЧЕНИЕ. Значения ПСА и его кинетических характеристик не зависят от первичного метода лечения. Время удвоения ПСА является наиболее значимым показателем при отборе пациентов для контрольной 11C-холин ПЭТ/КТ, производимой с целью выявления местного рецидива РПЖ после РТ или РП

THE AIM. Investigate diagnostic significance of prostate specific antigen (PSA) level detection in blood plasma and its kinetic characteristics (PSA development speed and doubling time) at patients selection for control "C-cholin positron-emission/ computerized tomography (PET/CT) to show local recurrences at patients with prostate cancer (PC) and to ascertain factors dependence on primary treatment methof - radiotherapy (RT) or radical prostate ectomy (RP). PATIENTS AND METHODS. Investigation is based on 125 patients examination and treatment after RT (64 patients) or RP (61 patients) in regard to histologically approved PC. Investigation was carried on for every patient after any variant of treatment with 11C-cholin PET/CT to show local recurrences. Clinicopathologic characteristics at patients after RP and RT were compared. PSA development speed and PSA doubling time were calculated. ROC-analysis of data was done with SPSS-16 statistic program. RESULTS. Average PSA value much differ after RP and RT (4,8 ng/ml and 12,9 ng/ml). There is relation between values of rate of PSA development, doubling time and recurrence presence or absence diagnosed by results of PET/CT. ROC analysis didn't show important differs between patients after RP and RT by PSA level (AUC=0,646 and 0,721) and rate of PSA development (AUC=0,691 and 0,663) that confirms proposition about independence of these data from primary treatment method. CONCLUSION. PSA values and its kinetic characteristics don't depend on primary treatment mode. PSA doubling time is most important value at patients selection for control C-choline PET/CT for PC local recurrence detection after RT and RP

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The authors declare that there are no conflicts of interest present.