血清前列腺特异抗原检测在前列腺癌诊断中的意义探析

目的探讨血清总前列腺特异抗原(t-PSA)、游离PSA(f-PSA)/t-PSA在前列腺癌(PCa)诊断中的意义。方法回顾性分析109例PCa与前列腺良性增生(BPH)患者血清t-PSA、f-PSA/t-PSA值在前列腺癌鉴别诊断中的意义。结果 PCa与BPH 2组患者间t-PSA、f-PSA/t-PSA值差异有统计学意义(P<0.01),当t-PSA含量在4.0~10.0μg/L时,2组患者间t-PSA水平差异无统计学意义(P>0.05),而f-PSA/t-PSA差异有统计学意义(P<0.01)。当t-PSA含量在4.0~10.0μg/L时,f-PSA/t-PSA值分别为0.125,0.15,0.175时,对PCa的诊断敏感度为:56.0%,76.0%,88.0%;特异性为:93.8%,86.5%,78.2%。结论PCa患者t-PSA显著升高,f-PSA/t-PSA明显降低。当t-PSA含量在4.0~10.0μg/L时,t-PSA的诊断意义很小,选取f-PSA/t-PSA值为0.16作为临界值,既可保证较高的特异性,又不降低其敏感性。

Diagnostic value of prostatic neoplasms for prostatic cancer

Objective To evaluate the diagnostic value of serum total prostatic specific antigen(t-PSA) and the ratio of free to t-PSA PSA for prostatic cancer(PCa).Methods It was studied retrospectively 109 cases of PCa and 317 cases of benign prostatic hyperplasia(BPH) and compared the differences of t-PSA level and f/t ratio between two groups.Results The differences of serum t-PSA and F/T ratio between two groups were significant(P<0.01),When t-PSA level was 4.0-10.0 g/L,the difference of t-PSA between two groups was not significant(P>0.05),but in f/t ratio,the difference was significant(P<0.01).And when t-PSA level was 4.0-10.0 g/L,f/t ratio was 0.125,0.15,0.175 respectively,the sensitivity for diagnosing PCa were 56%,76%,88% respectively,the specificity of them were 93.8%,86.5%,78.2%,respectively.Conclusion The level of serum T-PSA in PCa significantly increased,the f/t ratio signi-ficantly decreased.If serum t-PSA level was 4.0-10.0 g/L,it was not valuable for diagnosing PCa.It has high sensitivity and specificity for diagnosing cancer(PCa) to select 0.16 as critical value of the f/t ratio.