Uvavanyo lwasimahla lweProstate-Specific Antigen (f-PSA) lilitye lembombo loxilongo lwale mihla lweurological, ludlala indima ebaluleke kakhulu kuvavanyo olululo lwengozi yomhlaza wedlala lesinyi. Ukubaluleka kwayo akukhona njengesixhobo sokuhlola esizimeleyo kodwa njengesincedisi esibalulekileyo kuvavanyo olupheleleyo lwe-PSA (t-PSA), ukuqinisa kakhulu ukuchaneka koxilongo kunye nokukhokela izigqibo ezibalulekileyo zeklinikhi, ngokukodwa ngokunceda ukuphepha iinkqubo ezingenasidingo ezingeyomfuneko.

Umceli mngeni osisiseko ekuhlolweni komhlaza wedlala lesinyi kukunqongophala kokucaciswa kwe-t-PSA. Izinga eliphakamileyo le-t-PSA (ngokwesiko> i-4 ng / mL) inokubangelwa ngumhlaza wesifo seprotate, kodwa kunye neemeko ezinobungozi ezifana ne-Benign Prostatic Hyperplasia (BPH) kunye ne-prostatitis. Oku kudala "indawo yokuxilonga engwevu," ngakumbi kumaxabiso e-t-PSA phakathi kwe-4 kunye ne-10 ng/mL. Kumadoda akulolu luhlu, isigqibo sokuba uqhubele phambili kwi-prostate biopsy-inkqubo ehlaselayo enobungozi obunjengokopha, ukusuleleka kunye nokungahambi kakuhle-kuba nzima. Kukule meko apho uvavanyo lwe-f-PSA lungqina ixabiso layo eliphambili.

Eyona nto ibalulekileyo ye-f-PSA isekukwazini kwayo ukucokisa uvavanyo lomngcipheko ngomlinganiselo we-f-PSA ukuya kwi-t-PSA (ipesenti yasimahla yePSA). Ngokwe-biochemically, i-PSA ikhona egazini ngeendlela ezimbini: ibotshelelwe kwiiprotheni kwaye ikhululekile. Uphando luye lwabonisa ukuba umlinganiselo we-f-PSA uphantsi kumadoda anomhlaza we-prostate xa kuthelekiswa nalawo ane-BPH. Iiseli ezinobungozi zivame ukuvelisa i-PSA engena egazini kwaye ibophe ngokukhawuleza, okukhokelela kwipesenti ephantsi yefomu yamahhala. Ngokuchaseneyo, umlinganiselo ophezulu we-f-PSA unxulunyaniswa rhoqo nokwandiswa okungalunganga.

Lo mahluko we-biochemical uxhatshazwa ngokonyango ukubala ipesenti yasimahla yePSA. Ipesenti esezantsi ye-PSA yasimahla (umz., ngaphantsi kwe-10-15%, kunye nokunqunyulwa okuchanekileyo okwahlukileyo) kubonisa amathuba aphezulu omhlaza wedlala lesinyi kwaye ithethelela ngamandla isindululo se-prostate biopsy. Ngokwahlukileyo, ipesenti ephezulu ye-PSA yamahhala (umzekelo, ngaphezulu kwe-20-25%) ibonisa amathuba aphantsi omhlaza, ebonisa ukuba ukuphakama kwe-t-PSA kunokwenzeka ngenxa ye-BPH. Kwiimeko ezinjalo, ugqirha unokucebisa ngokuzithemba isicwangciso sokucupha okusebenzayo-okubandakanya ukuphinda uvavanyo lwe-PSA kunye neemviwo ze-digital rectal ekuhambeni kwexesha-kunokuba i-biopsy yangoko.

Ngenxa yoko, eyona mpembelelo ibalulekileyo yovavanyo lwe-f-PSA kukuncitshiswa okukhulu kwe-prostate biopsies ngokungeyomfuneko. Ngokubonelela ngolu lwazi lubalulekileyo localucalulo, uvavanyo lunceda ukuthintela inani elikhulu lamadoda ekubeni lingene kwinkqubo ehlaselayo angayifuniyo, ngaloo ndlela kuncitshiswa ukugula kwesigulana, ukunciphisa iindleko zokhathalelo lwempilo, kunye nokunciphisa ixhala elibalulekileyo elinxulunyaniswa ne-biopsy kunye nokulinda iziphumo zayo.

Ngaphaya kweklasikhi ye-4-10 ng/mL grey zone, i-f-PSA ikwaxabisekile kwezinye iimeko: kumadoda ane-t-PSA eqhubekayo yokunyuka nangona i-biopsy yangaphambili embi, okanye nakwabo bane-t-PSA eqhelekileyo kodwa uviwo olungaqhelekanga lwe-digital rectal. Iya ifakwa ngakumbi kwi-multi-parametric risk calculators ukwenzela uvavanyo olubanzi.

Ukuqukumbela, ukubaluleka kovavanyo lwe-f-PSA akunakubaxwa. Iguqula isiphumo se-t-PSA esikrwada, esingangcacisi sibe sisixhobo esinamandla nesikrelekrele sokuxilonga. Ngokwenza ukuba i-stratification yomngcipheko ngaphakathi kwendawo yokuxilonga i-grey, ixhobisa oogqirha ukuba benze izigqibo ezinolwazi ngakumbi, ezisekelwe kubungqina, ekugqibeleni baphucule ukhathalelo lwesigulane ngokunciphisa ngokukhuselekileyo ukuxilongwa kunye nokunyangwa ngokugqithiseleyo ngelixa uqinisekisa ukuba amadoda asemngciphekweni omkhulu achongiwe kwaye ahlolwe ngokukhawuleza.