PSA密度对TPSA灰区前列腺癌的诊断意义

目的：探讨总前列腺特异性抗原（TPSA）位于灰区（4．0～10．0μg／L）时前列腺特异性抗原密度（PS—AD）在前列腺癌（PCa）诊断中的意义并确定合适的PSAD值界点。方法：对T-PSA在灰区的128例BPH及54例PCa的血清PSA相关检测结果进行回顾性分析，将所有病例以F／T-PSA=0．16为界点分为两组并分别对其PSAD值进行对比分析。结果：通过分析在不同F／T-PSA下不同PSAD对前列腺癌阳性率的影响表明，当F／T-PSA％0．16时，PSAD以0．15为界值，PSAD〉0．15患者的前列腺癌阳性率显著高于PSAD〈O．15患者的前列腺癌阳性率；F／T-PSA〉0．16时，PSAD以0．20为界值，PSAD〉0．20患者前列腺癌阳性率显著高于PSAD〈0．20患者的前列腺癌阳性率。结论：PSA、F／T-PSA、PSAD是诊断前列腺癌的敏感指标，而联合测定PSA、F／T-PSA及PSAD能显著提高T-PSA位于灰区时前列腺癌的诊断。当F／T-PSA〈0．16时，PSAD以0．15为界值，PSAD在前列腺癌的诊断中有显著意义（P〈0．05）；当F／T-PSA〉0．16时，PSAD无论以0．15或0．20为界值，PSAD在前列腺癌的诊断中均有显著意义（P〈O．05），尤其当PSAD以0．20为界值时，PSAD在前列腺癌的诊断中意义更显著（P〈0．01）。故推荐在F／T-PSA〈O．16时PSAD以0．15为界值；在F／T-PSA〉0．16时PSAD以0．20为界值。

Diagnosis Significance of Relative Value of PSAD for TPSA Gray Zone Prostate Cancer

Objective：To explore the clinical significance of detecting prostate-specific antigen density （PSAD） for diagnosis of prostate cancer with TPSA in diagnostic gray zone（4.0-10.0 μg/L） and to determine the appropri ate PSAD cutoff value. Methods.. Retrospectively analyzed the detection of PSA in 128 benign prostatic hyperplasia （BPH）patients and 54 prostate cancer （PCa） patients which the range of TPSA were between 4 and 10 μg/L,Div- id all cases into two groups as F/T=0.16 the cutoff value then compared and analyzed their PSAD separately. Resuits：By analying different PSAD impact on the positive rate of prostate cancer under different F/T-PSA, It was suggested that the PSAD will take 0.15 as cutoff value when F/T-PSA〈0. 16 and the positive rate of prostate cancer of patients whose PSAD〉0. 15 is significantly higher than the positive rate of prostate cancer of patients whose PSAD〈0.15, the PSAD will take 0.20 as cutoff value when F/T-PSA〉0.16 and the positive rate of prostate cancer of patients whose PSAD〉0.20 is significantly higher than the positive rate of prostate cancer of patients whose PSAD〈0.20. Conclusion PSA, F/T-PSA and PSAD are pretty sensitive reference of diagnosis for prostate cancer, while joint ascertains levels of PSA, F/T and PSAD together can help improve the quality of diagnosis for prostate cancer with TPSA between 4 and 10 μg/L. The PSAD will take 0.15 as cutoff value when F/ T-PSA〈0.16 and PSAD are of significant in diagnosis of prostate cancer with TPSA between 4 and 10 μg/L（P〈 0.05）. Whatever the PSAD take 0.15 or 0.20 as cutoff value when F/T-PSA〉0.16 that PSAD is of significant in diagnosis of prostate cancer with TPSA between 4 and 10 μg/L（P〈0.05）, especially if the PSAD take 0. 20 as cutoff value PSAD is much more significant in diagnosis of prostate cancer with TPSA between 4 and 10 μg/L（P〈 0.01）. So it is recommended that we can take 0.15 as cutoff value when F/T-PSA〈0.16 and take 0.20 as cutoff value when F/T-PSA〉0.16.