Significance of individual markers in different variants of prostate cancer
Summary. Prostate cancer (PC) is ranked first in the structure of oncological pathology in men, while it is the second most frequent cause of death from malignant neoplasms, and the five-year survival rate is 30%. Prostate specific antigen is one of the main tumor-associated markers, and in certain variants of the course of prostate cancer, the diagnostic and prognostic significance of other markers remains poorly understood, although there are highly significant correlations between individual parameters in the blood. Objective of the study. To assess the clinical and prognostic significance of certain tumor markers in the blood of patients with prostate cancer. Study object and methods. The study included 195 men with prostate cancer aged 52 to 82 years. The duration from the moment of diagnosis of the disease was 3 years on average. The ratio pT2a, pT3a, pT3c, pT4, pT2b, pT3, pT2c, pT3b, pT2 of the prostate cancer stages was 1: 1: 1: 2: 3: 5: 7: 7: 9. The indices pN1, pN2 and pN3 were found, respectively, in 22%, 9% and 8% of the examined individuals, pM1 and pM2 — in 26% and 17% of them. The parameters of cancer expansion were 3 points on average, tumor size — 2 points, Gleason score — 6 points, the ratio of peripheral to central tumor form was 3: 1; adenocarcinoma was diagnosed in 94% of the cases, and giant cell carcinoma — in 6%. The average tumor stage parameter was 3 relative units, maturity was 3 points. Blood levels of testosterone, luteinizing hormone, insulin-like growth factor 1, alkaline phosphatase, acid prostatic phosphatase and glycosyl hydrolase activities were evaluated. Results. An increase in the levels of prostate specific antigen, testosterone, insulin-like growth factor 1, alkaline phosphatase, acid prostatic phosphatase and glycosyl hydrolase is observed in 46% — 100% of the patients, which depends on the expansion, size, localization, stage and degree of differentiation of the tumor process, the nature of its metastasis to lymph nodes, distant organs and skeleton, and alkaline phosphatase and acid prostatic phosphatase activity parameters have prognostic value. Taking into account the performed statistical processing of the examination data, the following conclusion was made, which has a practical orientation: acid prostatic phosphatase activity parameter >7.5 ng/ml is predictive negative for liver metastases. According to the data of tumor markers, it is necessary to develop new algorithms to improve the preoperative assessment of the staging of prostate cancer. Conclusion. An increase in the level of the studied prostate cancer markers depends on the nature of the course of the tumor process, and some parameters have prognostic significance.
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