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Korean J Urol Oncol > Volume 10(2); 2012 > Article
The Korean Journal of Urological Oncology 2012;10(2): 56-62.
5알파 환원효소억제제 복용 후 혈중 전립선특이항원의 변화
김현우, 하홍구
부산대학교 의학전문대학원 비뇨기과학교실
PSA Kinetics after Use of 5Ձ-reductase Inhibitors
Hyeon Woo Kim , Hong Koo Ha
Department of Urology, Pusan National University School of Medicine, Busan, Korea
Published online: August 30, 2012.
ABSTRACT
The aim of this review is to provide a discussion of serum prostate specific antigen (PSA) after use of 5Ձ- reductase inhibitors (5ՁRIs). The 5ՁRIs that are used to treat benign prostatic hyperplasia may reduce operation risks and acute urinary retention. However, it causes alteration of serum PSA level requiring clinician's attention. After two large studies, Prostate Cancer Prevention Trial (PCPT) and Reduction by Dutasteride of Prostate Cancer Events (REDUCE) study, many literatures has showed that 5ՁRI reduces the prevalence of prostate cancer, especially in low grade cancer. However, the incidence of high grade prostate cancer increased in 5ՁRI group than placebo group. Recently, some authors revealed that serum PSA sensitivity to prostate cancer increased in the 5ՁRIs arm than placebo using serum PSA doubling rule, serum PSA density and increasing serum PSA after nadir level. The serum PSA is usually doubled in patients with 5ՁRIs more than 12 months because these decrease serum PSA level down to approximately 50% at 1 year compared to baseline. It seems to be such a simple method but may yield serum PSA overestimation during first 6 months and underestimation after 4 years of the use of 5ՁRIs. Some authors have reported serum PSA density is useful in increasing sensitivity to prostate cancer after 1 year use of 5ՁRI that reduce serum PSA noising effect of benign prostatic hyperplasia. Recently, increasing serum PSA after nadir level has been seemed to be an attractive method to detect prostate cancer in patients with use of 5ՁRIs. (Korean J Urol Oncol 2012;10:56-62)
Key Words: Prostate-specific antigen; 5-alpha reductase inhibitors; Prostate neoplasms
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