前列腺疾病患者血清中tPSA、fPSA、f/tPSA变化研究

目的探索前列腺癌（Pca）与前列腺增生（BPH）患者血清tPSA、fPSA、f/tPSA在前列腺疾病辅助诊断中的应用价值。方法观察98例经病理确诊的前列腺癌患者、42例前列腺增生患者和87例健康体检男性血清tPSA和fPSA水平,采用ABBOOT i2000型自动免疫分析仪进行检测,并计算fPSA与tPSA比值。结果前列腺增生组tPSA、fPSA、f/tPSA分别为（8.13±7.24）ng/ml,（1.77±1.74）ng/ml,（0.23±0.1）ng/ml,前两项高于健康对照组,后者低于健康对照组;前列腺癌患者tPSA、fPSA、f/tPSA分别为（94.23±161.4）ng/ml,（11.97±40.92）ng/ml,（0.12±0.07）ng/ml,前两项高于健康对照组和前列腺增生组,后者低于健康对照组和前列腺增生组（P〈0.05）。ROC曲线下面积以f/tPSA最大,A=0.826。结论血清tPSA与fPSA在前列腺增生与前列腺癌中呈升高趋势,计算f/tPSA有助于鉴别良恶性病变,但与病理分期无关。

Change of serum tPSA, fPSA and f/tPSA levels in patients with prostate disease

Objective To study the value of serum tPSA,fPSA and f/tPSA levels in accessory diagnosis of prostate disease in patients with prostate cancer and hyperplasia of prostate.Methods Serum fPSA and tPSA levels were observed in 98 patients with pathology-established prostate cancer,42 patients with hyperplasia of prostate,and 87 healthy males with the ABBOOT i2000 automatic immune analyzer to calculate the ratio of fPSA and tPSA.Results The serum level of TPSA,fPSA and f/tPSA in patients with hyperplasia of prostate was（8.13±7.24）ng/ml,（1.77±1.74）ng/ml and（0.23±0.1）ng/ml,respectively.The serum level of tPSA and fPSA was higher in patients with hyperplasia of prostate than in healthy controls,but the serum level of f/tPSA was lower in patients with hyperplasia of prostate than in healthy controls.The serum level of tPSA,fPSA,and f/t PSA in patients with prostate cancer was（94.23±161.4）ng/ml,（11.97±40.92）ng/ml,and（0.12±0.07）ng/ml,respectively.The serum level of tPSA and fPSA was higher in patients with prostate cancer than in healthy controls and in patients with hyperplasia of prostate,but the serum level of f/t PSA was lower in patients with prostate cancer than in healthy controls and in patients with hyperplasia of prostate（P0.05）.The area under ROC curve for f/tPSA in patients with prostate cancer（A=0.826） was much higher than that for tPSA and fPSA.Conclusion Serum tPSA and fPSA levels tend to increase in patients with hyperplasia of prostate and prostate cancer.f/t PSA contributes to differential diagnosis of benign from malignant diseases,but is not related with pathological grading.