无前列腺疾病男性fPSA百分比正常参考值范围分析

目的 研究年龄对男性游离前列腺特异性抗原(free prostate specific antigen, fPSA)百分比的影响及fPSA百分比与前列腺癌病理分级及临床分期的关系,并探讨适合于中国人的fPSA百分比参考值范围.方法 选择无前列腺疾病男性679例,按年龄不同分为5组,测定血清PSA、fPSA并计算fPSA百分比,研究年龄与PSA、fPSA、fPSA百分比相关性.另选34例经病理证实的前列腺癌(PCa)患者,研究fPSA百分比与前列腺癌病理分级及临床分期的关系.结合无前列腺疾病男性的fPSA百分比,确定适合于中国人的fPSA百分比参考值范围. 结果 PSA、fPSA与年龄呈正相关(r值分别为0.608和0.534,P＜0.001),fPSA百分比与年龄无关.fPSA百分比与前列腺癌病理分级及临床分期相关(r值分别为0.427和-0.332,P＜0.05).以无前列腺疾病男性第5百分位上的fPSA百分比值(13.6%)及试剂盒上与多数文献报告fPSA百分比值为参考,选取10%、15%及20% 3个值作为鉴别值.当参考值范围为≥15%时,诊断前列腺癌的敏感性为94.1%,特异性高达89.7%.如参考值范围为≥10%时,特异性虽为 97.4%,但敏感性仅为70.6%.如参考值范围为≥20%时,敏感性亦为94.1%,但有253例无前列腺疾病男性为假阳性,特异性仅为62.8%.适合于中国人的fPSA百分比正常参考值范围为≥15%. 结论 fPSA百分比不受年龄因素影响,临床价值优于PSA.随着前列腺癌患者fPSA百分比降低,其病理分化程度降低,临床分期增加,恶性程度增高.适合于中国人的fPSA百分比正常参考值范围为≥15%.     

血清tPSA、fPSA/tPSA诊断前列腺癌可行性研究

目的:评价血清中tPSA及fPSA/tPSA在诊断前列腺癌中的临床价值.方法:采用电化学发光免疫法(ECLIA)检测前列腺癌组、前列腺增生组和对照组血清中tPSA、fPSA及fPSA/tPSA比值.结果:当tPSA在4～15 μg/L范围时,前列腺癌组与前列腺增生组之间tPSA差别无统计学意义(P＞0.05),而前列腺癌组fPSA/tPSA显著低于前列腺增生组(P＜0.01).结论:检测fPSA和fPSA/tPSA有助于前列腺癌的鉴别诊断,而且该法简单、客观,可用于前列腺癌的普查.     

前列腺特异性抗原及其相关因子在前列腺癌诊断中的应用

目的　探讨前列腺特异性抗原 (PSA)、前列腺特异性抗原密度 (PSAD)、游离前列腺特异性抗原比率 (f P-SA/ PSA)在前列腺癌 (Pca)诊断中的价值。方法　采用放射免疫分析方法测定 35例 Pca和 56例前列腺增生 (BPH)患者血清的 PSA、f PSA值 ,并计算 PSAD值。结果　Pca患者的 PSA、PSAD值高于 BPH,f PSA/ PSA比值低于 BPH患者 ,存在统计学上的显著性差异 (P<0 .0 1 ) ;以 PSA>4ng/ ml,PSAD>0 .2。 f PSA/ PSA<0 .1 5为临界值 ,PSA诊断准确性低于 PSAD、f PSA/ PSA;在 4ng/ ml相似文献   

前列腺癌患者血清PSA及相关参数检测结果分析

目的：寻找前列腺癌适宜的血清学诊断标志物。方法：测定良性前列腺增生和前列腺癌患者血清游离PSA、总PSA，并计算PSAD、FPSA／TPSA、PSA／TPSA／PSAD等。结果：将PSA值分为0～、4μg／L～、10μg／L～和20μg／L～四个范围，BPH组构成比为39．06％、28．13％、25％和7．81％，而PCA组构成比为10．71％、17．86％、28．57％和42．86％，差异具有显著性（P〈0．01）；与BPH组患者相比较，PCA组患者PSA和PSAD检测值升高，FPSA／TPSA和PSA／TPSA／PSAD降低，差异均具显著性（P〈0．01）；当4ug／L≤PSA≤10ug／L时，PCA和BPH患者的PSA检测值差异无统计学意义（P〉0．05），但PCA组FPSA／TPSA和PSA／TPSA／PSAD低于BPH组，差异均具有显著性（P〈0．01）；当PSA〉20μg／L时，两组患者PSA、PSAD、FPSA／TPSA的差异均无统计学意义（P〉0．05），PCA患者仅PSA／TPSA／PsAD低于BPH患者，且差异具有显著性（P〈0．01）。结论：用PSA、PSAD、FPSA／TPSA诊断前列腺癌均具有一定局限性，PSA／TPSA／PSAD可能是诊断前列腺癌最适宜的血清学标志物。     

北京地区646名健康成年男性前列腺特异性抗原水平的调查

目的 探讨北京地区部分健康成年男性中总前列腺特异性抗原（ＰＳＡ），游离前列腺特异性抗原（ｆＰＳＡ）和游离前列腺特异抗原与总前列腺特异性抗原（ｔＰＳＡ）比值的水平，并评价年龄与上述指标水平的相关性。方法 应用电化学发光免疫分析方法测定６４６名２０～９０岁健康男性血清ｔＰＳＡ、ｆＰＳＡ水平及ｆＰＳＡ／ｔＰＳＡ比值。同时应用两个变量间的直线相关方法统计年龄与各ＰＳＡ水平的相关性。结果 ２０～３０岁组血清     

血清PSA、F/TPSA检测诊断前列腺疾病

我们对106例前列腺疾病患者和76例正常体检对照的血清前列腺特异性抗原(TPSA)、游离前列腺特异性抗原(FPSA)水平进行检测,探讨PSA、F/T PSA在前列腺疾病诊断中的应用价值.     

前列腺癌患者血清PSA及相关参数检测结果分析

目的寻找前列腺癌适宜的血清学诊断标志物.方法测定良性前列腺增生和前列腺癌患者血清游离PSA、总PSA,并计算PSAD、FPSA/TPSA、PSA/TPSA/PSAD等.结果将PSA值分为0～、4 μgL～、10μg/L～和20μg/L～四个范围,BPH组构成比为39.06%、28.13%、25%和7.81%,而PCA组构成比为10.71%、17.86%、28.57%和42.86%,差异具有显著性(P＜0.01);与BPH组患者相比较,PCA组患者PSA和PSAD检测值升高,FPSA/TPSA和PSA/TPSA/PSAD降低,差异均具显著性(P＜0.01);当4 ug/L≤PSA≤10 ug/L时,PCA和BPH患者的PSA检测值差异无统计学意义(P＞0.05),但PCA组FPSA/TPSA和PSA/TPSA/PSAD低于BPH组,差异均具有显著性(P＜0.01);当PSA＞20μg/L时,两组患者PSA、PSAD、FPSA/TPSA的差异均无统计学意义(P＞0.05),PCA患者仅PSA/TPSA/PSAD低于BPH患者,且差异具有显著性(P＜0.01).结论用PSA、PSAD、FPSA/TPSA诊断前列腺癌均具有一定局限性,PSA/TPSA/PSAD可能是诊断前列腺癌最适宜的血清学标志物.     

检测游离PSA和总PSA鉴别前列腺癌和前列腺增生的临床应用

[目的 ]探讨游离前列腺特异性抗原 (F -PSA)、总前列腺特异性抗原 (T -PSA)及F -PSA和T -PSA比值 (F/T) ,对良性前列腺增生 (BPH)和前列腺癌 (PCa)患者的鉴别价值。 [方法 ]采用微粒子酶免疫化学发光技术 ,测定 32例健康体检者、12 0例BPH患者和 32例PCa患者的血清F-PSA、T -PSA ,并计算其比值F/T。 [结果 ]正常对照组、BPH组与PCa组F -PSA依次为 (0 .4± 0 .3)、(2 .3± 2 .4 )和 (5 .9± 5 .7) μg/L ,T -PSA依次为 (1.5± 1.5 )、(11.7± 8.8)和 (33.9± 2 9.5 ) μg/L ,各组间差异显著 (P <0 .0 1)、F/T值BPH组高于PCa组 ,但标准差过大未有显著性差异(P >0 .0 5 )。在T -PSA诊断灰区 (4.0～ 2 5 .0 μg/L)中BPH组F/T值高于PCa组 (P <0 .0 5 ) ,并且以T -PSA >4 .0 μg/L、F/T比值 <15 .0 %为界值时效果较好。 [结论 ]联合应用T -PSA、F -PSA及F/T诊断PCa明显优于单用T -PSA。     

fPSA百分比在前列腺癌和前列腺增生症鉴别中的意义

前列腺特异性抗原(PSA)是目前诊断前列腺癌最有价值的肿瘤标记物之一，但用PSA诊断前列腺癌仍缺乏足够的敏感性和特异性。近年来有学者又提出了游离PSA(fPSA)百分比概念，已成为PSA研究的新趋势。我国前列腺癌的发病率与国外不太一样，应用fPSA百分比鉴别前列腺癌和前列腺增生意义如何，值得进一步探讨研究。     

PSA与fPSA联合诊断前列腺疾病的临床研究

前列腺特异抗原（Pn）在临床上已广泛地用于前列腺癌与良性前列腺疾病的鉴别诊断，同时也是前列腺癌患者术后随访的重要标志．但仅依据PSA来诊断前列腺癌有一定比例的假阳性率，前列腺增生、前列腺炎以及前列腺缺血梗死等均可引起血清PSA值的升高。我们对100例前列腺疾病患者的PSA与游离前列腺特异抗原（fPSA）的检测结果进行了分析，通过联合检测来提高前列腺癌诊断的特异性。     

Analysis of results related to the percent free prostate specific antigen among men without prostate diseases in Xi’an area

To measure the percent of free prostate specific antigen （fPSA） among men without prostate diseases in Xi＇an area, and to study the relationship of percent fPSA with age and pathological grade, clinical stage of prostate cancer （PCa） with percent fPSA, and to analyze the difference between the data in China and the.overseas data to determine appropriate reference range for Chinese male. Methods： A total of 713 participants were enrolled into the study, with PSA, fPSA in serum measured and the percent fPSA calculated. Out of 713 cases, 679 without prostate diseases were divided into 5 groups by age, and then the relationships of PSA, fPSA and percent fPSA with age were studied, respectively. The relationship of pathological grade and clinical stage with percent fPSA of the 34 participants with PCa was also studied. With the help of the related data of men without prostate disease, the appropriate reference range for Chinese male was established. Results： The increases in PSA or fPSA were correlated with age, while there was no significant correlation between age and percent fPSA. The percent fPSA was also correlated with pathological grade and clinical stage of PCa. The percent fPSA of men without prostate disease in Xi＇an area was significandy lower than that in the related overseas data. The reference range of percent fPSA for Chinese male was≥ 15%. Conclusion： Percent fPSA might be more useful than PSA in the detection of prostate cancer. As the percent fPSA is decreased, the pathological grade is decreased, and the clinical stage is increased, the malignant degree is increased. The reference range of ≥15% is more appropriate for Chinese male.     

Analysis of results related to the percent free prostate specific antigen among men without prostate diseases in Xi'an area

ObjectiveTo measure the percent of free prostate specific antigen (fPSA) among men without prostate diseases in Xi' an area, and to study the relationship of percent fPSA with age and pathological grade, clinical stage of prostate cancer (PCa) with percent fPSA, and to analyze the difference between the data in China and the overseas data to determine appropriate reference range for Chinese male.MethodsA total of 713 participants were enrolled into the study, with PSA, fPSA in serum measured and the percent fPSA calculated. Out of 713 cases, 679 without prostate diseases were divided into 5 groups by age, and then the relationships of PSA, fPSA and percent fPSA with age were studied, respectively. The relationship of pathological grade and clinical stage with percent fPSA of the 34 participants with PCa was also studied. With the help of the related data of men without prostate disease, the appropriate reference range for Chinese male was established.ResultsThe increases in PSA or fPSA were correlated with age, while there was no significant correlation between age and percent fPSA. The percent fPSA was also correlated with pathological grade and clinical stage of PCa. The percent fPSA of men without prostate disease in Xi'an area was significantly lower than that in the related overseas data. The reference range of percent fPSA for Chinese male was ≥ 15%.ConclusionPercent fPSA might be more useful than PSA in the detection of prostate cancer. As the percent fPSA is decreased, the pathological grade is decreased, and the clinical stage is increased, the malignant degree is increased. The reference range of ≥ 15% is more appropriate for Chinese male.     

前列腺癌患者癌组织前列腺干细胞抗原、血清前列腺特异抗原检测

目的:探讨前列腺癌(PCa)组织中前列腺干细胞抗原(PSCA)的表达及与血清前列腺特异抗原(PSA)的关系.方法:采用免疫组织化学方法检测36例PCa组织、20例前列腺高分级上皮样内瘤样病变(HG-PIN)及20例良性前列腺增生(BPH)组织中PSCA的表达,术前ELISA法检测血清PSA水平.结果:BPH组织中无PSCA表达,HG-PIN、PCa组织中PSCA阳性率分别为70.0%(14/20)、80.6%(29/36),高于BPH组织(P＜0.05).高分化、中分化、低分化PCa组织中PSCA的阳性率分别为6/11、14/16、9/9,依次增高(P＜0.05).PSCA阳性率与PCa患者血清PSA水平无相关性(r=0.215,P＞0.05).结论:PSCA有可能是一种新的PCa肿瘤标志物.     

前列腺特异抗原(PSA)在晚期前列腺癌诊治中的作用

目的：研究前列腺特异抗原在晚期前列腺癌诊治中的作用。方法：分析11例晚期前列腺癌,包括肿瘤分期,PSA水平,转移部位与诊断方法,抗雄激素治疗反应,缓退瘤撤除反应。结果：PSA随临床分期增高而升高,它可以反映肿瘤对治疗的反应,结论：PSA作为瘤标对晚期前列腺癌有意义,它可指导调整治疗方案,值得临床应用。     

前列腺特异抗原测定临床意义的初步评价

我们用北京医科大学泌尿外科研究所提供的药盒，并采用他们创立的生物素－亲和素酶联免疫法进行ＰＳＡ测定，总病例数１４８例，其中前列腺癌１３例，前列腺增生症５５例，前列腺炎２７例，其他无前列腺增生疾病的患者２９例，女性病人２４例。测定结果表明，前列腺癌患者ＰＳＡ含量明显升高，分期越晚ＰＳＡ越高，前列腺增生症患者有一部分ＰＳＡ在一定范围内有所增高，其他病人及女性病人ＰＳＡ均正常。我们认为ＰＳＡ是诊断较为早期前列腺癌的灵敏的标记物。     

前列腺增生患者前列腺特异性抗原测定

目的:测定前列腺增生(BPH)患者血清总前列腺特异性抗原(tPSA),为临床诊断前列腺癌提供参考。方法:用酶联免疫法检测280例非前列腺癌查体男性的血清tPSA,57例非急诊入院BPH患者以及23例BPH并发急性尿潴留(AUR)患者的血清tPSA值。结果:非急诊入院BPH患者血清tPSA(3.50±1.45)μg/L,BPH并发AUR患者血清tPSA(16.6±3.56)μg/L与非前列腺癌男性查体人群血清tPSA(1.15±0.95)μg/L之间差异均有统计学意义(P<0.05)。非急诊入院BPH患者与BPH并发AUR患者血清tPSA之间差异亦有统计学意义(P<0.05)。结论:BPH,尤其BPH并发AUR患者血清tPSA显著升高,故对血清tPSA大于4.0μg/L而准备行前列腺穿刺的患者应审慎。     

前列腺特异性抗原相关变数与前列腺癌Gleason评分及临床分期的关系

目的:探讨前列腺特异性抗原(PSA)相关变数与前列腺癌病理分级及临床分期的关系。方法:回顾性分析125例经穿刺活检病理证实为前列腺癌患者的临床资料,采用Spearman相关分析探讨游离PSA(FPSA)、FPSA比率(F/TPSA)、PSA密度(PSAD)与Gleason评分及临床分期的关系。结果:FPSA与前列腺癌Gleason评分呈正相关(rS=0.499,P<0.001),与临床分期呈负相关(rS=-0.300,P<0.001);PSAD与前列腺癌Gleason评分呈正相关(rS=0.616,P<0.001),与临床分期无相关性(rS=-0.128,P=0.155);F/TPSA与前列腺癌Gleason评分呈弱相关(rS=0.182,P=0.042),与临床分期呈负相关(rS=-0.417,P<0.001)。结论:FPSA可作为前列腺癌病理分级和临床分期的参考指标;而PSAD可作为前列腺癌病理分级的参考指标,F/TPSA可作为前列腺癌临床分期的参考指标。     

游离前列腺特异性抗原联合癌胚抗原 对前列腺癌的早期诊断价值

目的 分析游离前列腺特异性抗原（fPSA）联合癌胚抗原（CEA）对前列腺癌的早期诊断价值。 方法 选取2017 年1 月—2019 年12 月在滁州市第一人民医院就诊的256 例疑似前列腺癌患者作为研究对象。 血清总前列腺特异抗原（tPSA）水平介于4.0 ～ 20.0μg/L,根据血清tPSA 水平分为tPSA 4.0 ～ 10.0μg/L 组180 例和tPSA 10.1 ～ 20.0μg/L 组76 例。比较两组前列腺癌与非前列腺癌患者血清fPSA、CEA、游离与 总前列腺特异性抗原比值（f/tPSA）、前列腺健康指数（PHI）。进行Pearson 相关性分析和线性回归性分析, 使用受试者工作特征曲线下面积（AUC）评价fPSA 联合CEA 对前列腺癌的诊断效能。结果 tPSA 4.0 ～ 10.0μg/L 组前列腺癌与非前列腺癌患者血清fPSA、CEA 水平比较,差异有统计学意义（P <0.05）;而年龄、 血清tPSA 水平、f/t PSA 及PHI 比较,差异无统计学意义（P >0.05）。tPSA 10.1 ～ 20.0μg/L 组前列腺癌与 非前列腺癌患者血清fPSA、CEA 及PHI 比较,差异有统计学意义（P <0.05）;而年龄、血清tPSA 水平及 f/t PSA 比较,差异无统计学意义（P >0.05）。Pearson 相关性分析显示,前列腺癌患者血清fPSA、CEA 水平与 PHI 呈正相关（r =0.348 和0.392,P <0.05）。线性回归分析显示,血清fPSA、CEA 水平是PHI 水平的影响因 素（b =0.046 和0.449,P <0.05）。ROC 曲线结果显示,FPSA 联合CEA 诊断前列腺癌的AUC 为0.921,大于 fPSA 的0.672 和CEA 的0.703（P <0.05）。结论 fPSA 和CEA 是早期诊断前列腺癌的重要线索,两者联合诊 断血清tPSA 低水平升高前列腺癌的效能较好,可能成为更好的前列腺癌早期诊断的新途径。     

Mass screening of 12027 elderly men for prostate carcinoma by measuring serum prostate specific antigen

Background The incidence of prostate carcinoma (Pca) has been increasing in China. We detected Pca in elderly men in Changchun, north China and the significance of prostate specific antigen (PSA) in mass screening and clinical staging of Pca.Methods Serum PSA from 12 027 men over 50 years old from Changchun was analyzed. In case of serum PSA greater than 4. 0 ng/ml, the patient was suspected of potentially suffering from Pca, and transrectal six-point puncture prostate biopsies were performed under ultrasound guidance.Pathological examinations were performed on the biopsy tissue, and ABCD and TNM clinical stagings were used in accordance with international standards. Correlations between serum PSA level andclinical stage were analyzed.Results PSA was greater than 4.0ng/ml in 813 patients (6.8% of the 12027 men). Transrectal six-point prostate puncture biopsies guided by ultrasound were performed in 273 patients (33. 6% of the 813 patients who were tested positive in the initial mass screening). Of these 273 patients,69 cases of Pca (25.3% of 273 ) were confirmed by biopsy in the second screening, with an overall detection rate for Pca of 0. 57% (69/12 027). The total number of patients in stages A, B, T1, or T2 was 57.9%, and over 20% of them suffered from late stage Pca with lymph node and bone metastasis. An obvious positive correlation was observed between ABCD staging, TNM staging, and serum PSA level.Conclusions Serum PSA level is not only the golden standard for mass screening of Pca, but also the predictor for clinical stage of Pca. PSA testing revealed asymptomatic Pca cases in early, middle,and later stages in the elderly, suggesting that mass screening is of paramount importance.