t-PSA与c-PSA对前列腺癌和良性前列腺增生的鉴别诊断意义

目的研究复合前列腺特异性抗原（c—PSA）、总前列腺特异性抗原（t—PSA）在鉴别诊断前列腺癌和良性前列腺增生时的应用价值。方法选择两组实验对象,PCa组89例经B超、病理确诊的前列腺癌（PCa）者。BPH组为111例良性前列腺增生患者。采用化学发光法检测其c—PSA、t-PSA,记录结果并进干亍统计分析。结果PCa和BPH组的c—PSA、t—PSA和年龄值,BPH和PCa组t-PSA含量（3．6±2．4）ng／ml、（15．2±16．2）ng／ml,差异有极显著性（P〈0．01）,年龄值两组间,差异兀显著性（P〉0．05）。t-PSA的cutoff为10ng／ml时,Pca89例中45例为假阴性（50．6％）,t—PSA的cutoff为2．5ng／ml时,Pca89例中24例为假阴性（27．0％）,但假阳性率相应升高。BPH和Pca的c—PSA含量（0．08±0．06）ng／ml、（28．9±37．6）ng／ml（P〈0．01）,c—PSA的cutoff为2．5ng／ml时,Pca89例中18例为假阴性（20.2％1。t—PSA的cutoff为10ng／ml时,与c—PSA同时阳性占46．1％,而将t—PSA的cutoff定为2．5ng／ml时,与c—PSA同时阳性占69．7％。结论c—PSA在t-PSA〈10ng／mL的特异性优于t—PSA,t-PSA的cutoff为10ng／ml的设置过高,建议将其调整为2．5ng/ml,结合c—PSA（cutoff：2．5ng／ml）将有效提高PCa诊断的特异性和灵敏度。

The using Value of t-PSA and c-PSA to differential diagnosis the prostate neoplasms and BPH

Objective To research the using value of t-PSA and c-PSA to differential diagnosis the prostate neoplasms and BPH. Methods The level of t-PSA and c-PSA were measured in the 89 cases of PCa, 111 cases of BPH by Chemiluminescence analysis. Results The level of t-PSA was (3.6±2.4) ng/ml(BPH) and (15.2±16.2) ng/ml(PCa) (P<0.01). The false negative was 50.6% (cutoff= 10ng/ml) and 27.0% (cutoff =2.5ng/ml). The level of c-PSA was (0.08±0.06) ng/ml(BPH) and (28.9±37.6) ng/ml(PCa) (P<0.01), The false negative was 20.2% (cutoff =2.5ng/ml). When the cutoff of t-PSA was 2.5 ng/ml, to combine the c-PSA would raise the positive up to 69.7 %. Conclusion When the cutoff of t-PSA was 10.0 ng/ml, the c-PSA was significantly higher than t-PSA. We suggest adjust the cutoff of t-PSA to 2.5 ng/ml, and to combine the c-PSA would significant raise the Sensitivity and Specificity by diagnosis the prostate neoplasms.