Study On The Application Value Of PSA As A Tumor Marker In The Diagnosis Of Prostate Cancer

Objective:Since1991PSA as marker of prostate cancer was used to screen for prostate cancer, PSA has been demonstrated has a very important meaning in the application, and it has been widely used in prostate screening. However, with the further study of prostate cancer, we found that single application of PSA has difficulties to distinguish between prostate cancer and benign prostatic hyperplasia, especially in the4.0～10ng/ml area. And PSA screening for prostate cancer is more harm than good.We analyzed the current situation and existing problems of PSA application and its related parameters for prostate cancer screening and diagnosis, to explore the value of PSA in prostate cancer applications.Methods:Through China journal full-text database, Wanfang database,China’s doctoral dissertation full text database, China’s outstanding master’s dissertation full text database, China biomedical literature database, The Chinese medical association journal of digital library, Chinese important conference database,Pubmed database, Medline database, SpringerLink database, as well as the journal retrievaled a variety of keywords,such as PSA, PSA related parameters and prostate cancer related information.We Collected detailed data about PSA and PSA related parameter, Prostate cancer screening, then Meta-analysis and summary of all kinds of information.Result:1. The prostate cancer detection rate increased after the application of PSA for prostate cancer screening. But a growing number of studies suggest that screening can not increase the total survival rate,but it brings disadvantages of overdiagnosis and overtreatment,brings physical and mental effects to the patients with prostate cancer, increases economic burden to individuals and society.2. There are different oppions about the cutoff of PSA and its related parameters.PSA in the gray zone4.0～10.0ng/ml, F/TPSA, PSAD, PSAV significantly increased the positive rate of prostate cancer screening, reducing the unnecessary prostate biopsy.3. The higher the PSA, the Gleason score is also higher, but the relationship between PSA and pathological staging is inconclusive. 4. The risk of bone metastasis increased with the elevation of serum PSA,. It is suggested that bone scan is needed when PSA>20ng/ml. It is significant in diagnosis of bone metastasis, when PSA≥40ng/ml. when more than60ng/ml, even100ng/ml when almost all the bone metastasis.5. Prostate cancer tumor markers has made great progress, but no one is ideal marker, large-scale clinical trials research is still needed.Conclusion:1. It Is not recommended using PSA for mass screening of prostate cancer in the whole society, only screening for population have a family history of prostate cancer and in the area of high incidence of prostate cancer.2. PSA in a level of4.0～10.0ng/ml, F/TPSA, PSAD, PSAV can help improve the positive rate PSA screening for prostate cancer, avoiding unnecessary prostate biopsy.3. There are different views on the threshold PSA, F/TPSA, PSAD, PSAVD at home and abroad. Accordance with the best principles of sensitivity and specificity,to select the best cutoff. We choose4.0,0.16,0.15as cutoff of PSA. F/TPSA and PSAD at home, guiding the prostate biopsy when patients with serum PSA in the level of4.0～10.0ng/ml.4. PSA is positively correlated with Gleason score. The relationship with pathological stage is uncertain.5. Prostate cancer tumor markers have made great progress, but no one is ideal marker, large-scale clinical trials and research are still needed.6. Although serum PSA for prostate cancer screening is controversial, but before a better biomarker appears, it is still the best index for early diagnosis of prostate cancer.