攝護腺特異抗原及其變化對攝護腺癌患者生活品質的影響
1*高耀臨、1*蔡育賢、1歐妃雅、2林宗瑩、1歐建慧、1楊文宏、1鄭鴻琳、1蔡宗欣、2王榮德
國立成功大學醫學院附設醫院 1泌尿部，2公共衛生研究所
Effect of prostate specific antigen and its variation in quality of life of among prostate cancer patients
Yao-Lin Kao1*, Yuh-Shyan Tsai1*, Fat-Ya Ou1, Lin Zong-Ying2, Chien-Hui Ou1, Wen-Horng Yang1, Hong-Lin Chen1, Tzong-Shin Tzai1*, Jung-Der Wang2
Department of 1Urology and 2Public Health, Medical College and Hospital, National Cheng Kung University, Tainan, Taiwan
*Drs. Kao YL, Tsai YS, and Tzai TS contributes equally to this article.
Abstract
Purpose :
Prostate cancer (PC) is one of leading male malignancies all over the world, including Taiwan. Several characteristics such as stage distribution, attitude to therapy modality, and response to androgen deprivation therapy may be different in Taiwan from western countries. Previous study has shown that treatment modality and sociodemographic factors are an independent determinant for quality of life (QoL). However, little is known about the impact of prostatic specific antigen (PSA) and its dynamic change in global quality of life in PC patients. Therefore, the aim of the study is to explore the effect of PSA on determinants of QoL in PC.
Patients and Methods:
From January 2013 to April 2015, self-reported questionnaires, World Health Organization Quality of Life-BREF (WHOQOL-BREF), were randomly obtained from PC patients cancer at urologic outpatient clinic. The WHOQOL-BREF served as a tool for global quality of life assessment. Repeated measurements in same individuals may be utilized and collected at different times.
The association between each WHOQOL-BREF item and patients' variables including age, education, economic income, marital status, risk classification of disease status a were analyzed using a mixed effect model. PSA value, log of PSA, trend of PSA variation of recent two times of lab data were also analyzed.
Results:
A total of 330 patients and 666 person-times completed with the WHOQOL-BREF questionnaire, including localized disease (n=156), locally advanced (n=43), metastatic disease (n=131). There was no significant association between disease risk status and other determinants, such as, education (p=0.59), personal income (p=0.88), marital status (p=0.27), and cardiovascular comorbidity (p=0.55) except patients' age (p=0.003). Overall, the continuing PSA values significantly influence the physical domain of global QoL (p<0.001). Increase in trend of PSA value demonstrate negative impact on psychological domain of global QoL (p<0.02) which was poor performance in facets of overall QoL(0.046), enjoying of life(p=0.001), meaning of life(p=0.01), time for leisure activity(p=0.002). However, log of PSA showed lack of impact in QoL.
Conclusion:
Our data demonstrated the PSA values and trend of PSA value play an important role in determining QoL in Taiwanese PC patients. Which could provide information for clinician in decision making. The underlying reason is worth to explore in future.