血清铁蛋白联合前列腺特异性抗原检测对前列腺癌的诊断价值

目的探讨血清铁蛋白(Ferr)、总前列腺特异性抗原(tPSA)、游离前列腺特异性抗原(f PSA)、fPSA/tPSA联合检测对前列腺癌(PCa)的诊断价值。方法选择90例PCa患者、84例前列腺良性病变患者和50例健康男性体检者分别作为PCa组、良性组和对照组,检测3组研究对象的血清Ferr、tPSA、fPSA水平并计算fPSA/tPSA,分析Ferr、tPSA、fPSA、fPSA/tPSA联合检测对PCa的诊断价值。结果PCa组患者的血清Ferr、tPSA、fPSA水平均高于良性组和对照组,fPSA/tPSA低于良性组和对照组,差异均有统计学意义(P﹤0.05)。良性组患者的血清Ferr、tPSA、fPSA水平均高于对照组,fPSA/tPSA低于对照组,差异均有统计学意义(P﹤0.05)。PCa患者的血清Ferr与tPSA、fPSA均呈正相关,tPSA与f PSA呈正相关,tPSA与fPSA/tPSA呈负相关(P﹤0.05)。血清Ferr、tPSA、fPSA、fPSA/tPSA联合检测诊断PCa的灵敏度、特异度、曲线下面积均高于四个指标的三联、两联、单独检测。结论PCa患者的血清Ferr、t PSA、fPSA水平均高于前列腺良性病变患者,fPSA/tPSA低于前列腺良性病变患者。血清Ferr、tPSA、f PSA、f PSA/tPSA联合检测对PCa具有较高的诊断价值,值得在临床中推广应用。     

游离前列腺特异性抗原与总前列腺特异性抗原比值在前列腺癌鉴别诊断中的应用

 目的 探讨游离前列腺特异性抗原（fPSA）与总前列腺特异性抗原（tPSA）比值在前列腺癌（PCa）鉴别诊断中的意义。方法 采用电化学免疫发光技术对86例前列腺良性增生（BPH）45例PCa患者和60例健康男性体检者（正常对照组）血清fPSA和tPSA同时进行测定，并计算出fPSA／tPSA，进行统计分析。结果 BPH、PCa组tPSA水平明显高于正常对照组（P＜0.05）。PCa组和BPH组的血清tPSA差异亦有统计学意义，但当tPSA在4.0 ~ 10.0 μg／L范围时，PCa组血清fPSA／tPSA比值却明显低于BPH组（P＜0.01）。把fPSA／tPSA比值划分成8个区间，当fPSA／tPSA比值15 ％作为诊断灰区PCa诊断的临界值时，诊断的敏感性、特异性、阳性预测值、阴性预测值及正确诊断指数分别为72.8 %、67.5 %、62.5 %、82.2 %、50.2 %。结论 当血清tPSA处于诊断灰区时，联合检测fPSA／tPSA比值可明显提高tPSA对PCa早期诊断的特异性。     

游离和总前列腺特异性抗原比值、外周血中性粒细胞和淋巴细胞比值、白细胞介素6、前列腺健康指数密度检测在前列腺癌早期诊断中的应用

目的探讨游离和总前列腺特异性抗原比值(f/tPSA)、外周血中性粒细胞和淋巴细胞比值(NLR)、白细胞介素6(IL-6)、前列腺健康指数密度(PHID)检测在前列腺癌早期诊断中的临床应用。方法回顾性分析2020年1月至2022年1月徐州医科大学第二附属医院收治住院的160例前列腺特异性抗原(PSA)异常患者临床资料, 根据前列腺穿刺活组织检查或电切手术病理结果分为前列腺癌组68例、良性前列腺增生组92例;选取同期徐州医科大学第二附属医院男性健康体检者50名为健康对照组。3组均检测总前列腺特异性抗原(tPSA)、游离前列腺特异性抗原(fPSA)、前列腺特异性抗原同源异构体2(p2PSA)、IL-6等指标, 计算f/tPSA、前列腺健康指数(PHI)、PHID和NLR等。绘制受试者工作特征曲线(ROC), 比较各指标诊断和鉴别诊断前列腺癌、良性前列腺增生的效能。结果前列腺癌组患者血清tPSA、fPSA、p2PSA、PHI、PHID水平均高于良性前列腺增生组和健康对照组(均P<0.05);血清f/tPSA水平均低于良性前列腺增生组和健康对照组(均P<0.05)。PHID诊断早期前...     

血清PSA及fPSA/tPSA比值在前列腺癌骨转移诊断中的价值

目的:通过分析前列腺癌患者血清中前列腺癌特异性抗原（PSA）浓度和游离前列腺特异性抗原（fPSA）/总前列腺特异性抗原（tPSA）与骨转移的关系,探讨血清PSA和fPSA/tPSA在诊断前列腺癌骨转移中的价值。方法:采用电化学发光法检测74例前列腺癌患者血清中的fPSA、tPSA浓度并计算fPSA/tPSA,并对所有前列腺癌患者进行全身骨扫描显像。结果:74例前列腺癌患者当中无骨转移的29例,有骨转移的45例,分别占前列腺癌患者的39.2％和60.8％。在发生骨转移的前列腺癌患者当中单一病灶的有5例,占11.1%,其中3例转移灶在骨盆,2例在椎体;转移灶为两处的有3例,占6.7%;三处或三处以上转移的有37例,占82.2%。从骨转移发生的部位来看,椎体转移的最多,有35例;其次为骨盆转移,有31例;发生肋骨转移的有28例;四肢骨转移的有9例;其它部位转移的有2例。前列腺癌骨转移组和无骨转移组的PSA和fPSA/tPSA分别为（57.68±38.67） ng/ml、0.14±0.08和（21.61±17.87） ng/ml、0.25±0.09,差异均有统计学意义（P<0.05）。结论:前列腺癌骨转移以多发病灶为主,且病灶主要发生在脊柱和骨盆。前列腺癌患者随血清PSA浓度的升高,fPSA/tPSA比值降低,发生骨转移的比例增高,当PSA>20.00 ng/ml或fPSA/tPSA≤0.15时,诊断前列腺癌骨转移的灵敏度和特异度较高。     

分析血清PSA系列及Gleason评分在前列腺癌分期中的预测价值

目的：探讨血清前列腺特异性抗原（prostate specific antigen,PSA）系列及穿刺活检Gleason评分对前列腺癌病理分期的预测价值。方法：回顾性分析根治术后病理证实为前列腺腺癌的92例患者资料,具备术前总前列腺特异抗原（total pros-tate specific antigen,tPSA）、游离PSA（free prostate specific antigen,fPSA）、fPSA/tPSA、前列腺特异抗原密度（prostate specific antigen density,PSAD）及穿刺活检Gleason评分。比较器官局限组和包膜外侵犯组之间以上指标的差异,运用工作特征曲线（ROC曲线）比较各指标的预测价值,并通过多因素logistic回归分析筛选器官局限最主要的影响因素。结果：包膜外侵犯组PSAD、tPSA、fPSA/tPSA和穿刺活检Gleason评分值均高于器官局限组（P〈0.05）;ROC曲线对器官局限性前列腺癌的单因素预测比较,仅PSAD、tPSA预测价值较好[工作特征曲线下面积（areaunder ROC,AUC）〉0.7,P〈0.05];多因素分析中仅PSAD、穿刺活检Gleason评分为器官局限最主要的影响因素（P〈0.05）,AUC达0.8（P=0.000）。结论：PSAD比tPSA对病理分期显示了更好的预测价值,病理分期预测模型可考虑以PSAD替代tPSA,结合其他因素,有望提高预测准确度。     

血清hK2、AMACR联合PSA检测对前列腺癌诊断及预后判断的临床价值

目的:探讨血清腺激肽释放酶2（hK2）、甲基酰基辅酶A消旋酶（AMACR）联合前列腺特异性抗原（PSA）检测对前列腺癌诊断及预后判断的临床价值。方法:前瞻性选取2016年01月至2018年01月收治的前列腺癌患者50例为前列腺癌组和良性前列腺增生患者50例为良性前列腺增生组。并以同期健康查体者50例为对照组。检测比较三组血清hK2、AMACR和PSA水平,Logistic分析血清hK2、AMACR和PSA水平对前列腺癌发生状况的影响,ROC曲线分析血清hK2、AMACR和PSA水平联合检测对前列腺癌的诊断效能。对前列腺癌组进行为期3年的随访,记录患者复发和生存情况。比较不同复发和生存预后情况患者的基线血清hK2、AMACR和PSA水平,Logistic分析基线血清hK2、AMACR和PSA水平对前列腺癌患者复发和生存预后的影响,ROC曲线分析血清hK2、AMACR和PSA水平联合检测对前列腺癌患者复发和死亡早期评估效能。结果:前列腺癌组血清hK2、AMACR水平高于良性前列腺增生组和对照组（P＜0.05）;而良性前列腺增生组和对照组血清hK2、AMACR水平比较差异无统计学意义（P＞0.05）。前列腺癌组、良性前列腺增生组和对照组的血清PSA水平依次降低（P＜0.05）。Logistic分析结果显示,血清hK2、AMACR和PSA水平对前列腺癌发生状况具有明显影响（P＜0.05）。ROC曲线分析结果显示血清hK2、AMACR和PSA水平联合检测对前列腺癌具有良好的诊断效能。前列腺癌组50例患者的3年复发率和生存率分别为56%（28/50）和52%（26/50）。前列腺癌组复发患者的血清hK2、AMACR和PSA水平均高于未复发患者（P＜0.05）;且前列腺癌组死亡患者的血清hK2、AMACR和PSA水平均高于存活患者（P＜0.05）。Logistic分析结果显示,血清hK2、AMACR和PSA水平均受到前列腺癌患者复发和生存预后的影响（P＜0.05）。ROC曲线分析结果显示血清hK2、AMACR和PSA水平联合检测对前列腺癌患者复发和死亡均具有良好的早期评估效能。结论:血清hK2、AMACR和PSA水平在前列腺癌患者中表达水平较高,具有一定的前列腺癌诊断价值,且可能作为预后早期预测的有效参考指标。     

血清BSP水平联合PSADT检测在前列腺癌骨转移早期诊断中的价值

目的探讨骨代谢生化指标骨唾液酸蛋白 ( bone sialoprotein,BSP ) 联合前列腺特异性抗原倍增时间(prostate-specific antigen doubling time,PSADT)检测在前列腺癌骨转移临床诊断中的意义。方法选择 2009年1月-2011年4月我院收治的前列腺癌患者58例,依据诊断分为转移组（28例）和无骨转移组（30例）,取前列腺良性增生患者60例以及60例健康体检人员分别作为增生组和健康对照组。采用视觉模拟疼痛评分( VAS)评价骨痛程度;采用ELISA法检测血清BSP水平;采用电化学免疫发光技术检测血清f-PSA、t-PSA水平,采用倍增公式PSADT=lg(2) [log(PSA2)-log(PSA1)]计算PSADT;采用ROC曲线评价BSP、PSADT及两者联合检测在前列腺癌骨转移诊断中的意义。结果两组患者BSP水平均高于健康对照组和增生组(P<0.05);骨转移组患者血清BSP水平均明显高于无转移组(P<0.05);Pearson’s分析结果显示：前列腺癌骨转移患者的BSP和VAS骨痛评分呈显著正相关（P<0.05）;ROC曲线显示, BSP 诊断骨转移的敏感度和特异性分别为71.12%和72.8%;PSADT诊断骨转移的敏感度和特异性分别为84.15%和82.96%;BSP联合PSADT在前列腺癌骨转移诊断中的敏感度、特异性、AUC面积分别为91.26%,89.54%,0.932。结论BSP可能是前列腺癌骨转移患者的有效诊断指标;BSP和PSADT联合检测能大大提高前列腺癌骨转移的敏感度和准确性,便于前列腺癌骨转移的早期诊断。     

前列腺特异抗原诊断前列腺癌的临床应用

目的　探讨前列腺特异抗原诊断前列腺癌的临床应用价值。方法　采用酶联免疫方法分别测定了 41例前列腺癌 ,3 6例前列腺增生血清前列腺特异性抗原 ,游离前列腺特异抗原含量 ,并计算出f -PSA/t -PSA的比率 ,同时测定了前列腺体积。结果　t -PSA在 4 0～ 10 0 μg/L范围时 ,t -PSA的平均值在前列腺癌组 ,前列腺增生组之间无显著性差异 ;f-PSA/t -PSA比率在前列腺癌组织中显著降低 ;同时f-PSA/t -PSA比率和前列腺体积在前列腺癌组中呈正相关 ,在前列腺增生组中无相关性。结论　f-PSA/t -PSA比率在前列腺体积小于 40cm× 40cm× 40cm可更好地诊断前列腺癌     

前列腺特异性抗原的检测对前列腺癌及前列腺增生的诊断意义

目的　探讨血清总前列腺特异性抗原 (t PSA)、游离PSA (f PSA)、PSA密度 (PSAD )及其f PSA/t PSA比值对前列腺癌 (PCa)及前列腺增生 (BPH )的诊断价值。方法　采用酶联免疫分析方法 (ELISA )检测未经治疗的 62例BPH患者和 2 4例PCa患者血清f PSA、t PSA水平 ,并计算f PSA/t PSA值和PSAD ,对检测结果进行统计学处理。结果　BPH组与PCa组的f PSA、t PSA水平均明显高于对照组 (P <0 .0 1) ;前列腺癌组的f PSA /t PSA值明显小于对照组及前列腺癌增生组 (P <0 .0 1) ;PCa组PSAD明显大于对照组和BPH组 (P <0 .0 1)。结论　检测f PSA/t PSA和PSAD比单一检测f PSA、t PSA可显著提高对PCa诊断的特异性及符合率 ,对前列腺体积较大的BPH和PCa患者 ,检测PSAD更有意义     

放射性核素骨显像联合血清PSA、fPSA、ALP及BAP在评价内分泌疗法治疗前列腺癌

目的 探讨放射性核素骨显像联合前列腺特异性抗原（PSA）、游离前列腺特异性抗原（fPSA）、碱性磷酸酶（ALP）及骨特异性碱性磷酸酶（BAP）在评价内分泌疗法治疗前列腺癌疗效中的应用价值。 方法 选取2016年1月至2017年12月于随州市中心医院接受内分泌疗法治疗的64例前列腺癌患者作为研究对象。接受内分泌治疗后1年，进行PSA、fPSA、ALP、BAP水平检测以及放射性核素骨显像检查，根据检查结果评估放射性核素骨显像在评价前列腺癌内分泌疗法治疗效果中的应用。 结果 内分泌治疗后的64例患者经放射性核素骨显像检查结果显示共发生51例骨转移；放射性核素骨显像转移灶数目＞2个骨转移灶的患者的血清PSA、fPSA水平高于骨转移灶≤2个患者的的血清PSA、fPSA水平（均P＜005）；随着骨显像分型的增高，前列腺癌骨转移患者血清PSA、ALP与BAP水平均增高，呈正相关（均P＜005）。 结论 放射性核素骨显像联合PSA、fPSA、ALP、BAP能够实现内分泌疗效的准确评价与骨转移瘤的早期诊断。     

复合PSA及相关指标在前列腺癌诊断中的应用

Objective:To study the diagnostic value of complex PSA(cPSA),the calculated free/total PSA(f/t PSA) raio and total PSA(tPSA)in the differentiation of prostate cancer from benign prostate hyperplasia.Methods:The tPSA,cPSA and fPSA were measured using the Bayer ACS-180 chemiluminescence immuno-assay.152 patients(21 with prostate cancer and 131 with benign prostate hyperplasia proven by tissue pathology)whose serum total PSA ranged from 0.2-20.0ng/ml were accessed from July 2001 to May 2002 consecutively.The correlation between tPSA and cPSA was analyzed.The re-ceiver operator characteristic curves(ROC curve)were generated by plotting the sensitivity versus specificity.Areas under the curve were calculated for each assay.Logistic regression analysis was used to evaluate the ability of the indices as independent varia-bles to predict prostate cancer.Results:In the experimental group,the areas under the ROC curve of cPSA ,tPSA and fPSA/tPSA ratio were 0.811,0.799 and 0.376 respectively.The specificity for tPSA,fPSA/tPSA ratio and cPSA were 62%,57% and 4.7%,respectively,at cotoff yield-ing 95% sensitivity.Serum cPSA concentration was determined to be the best index among the three through logistic regression analy-sis.Conclusion:The serum levels of cPSA and tPSA are better indices than f/tPSA in the differentiation of prostate cancer from benign prostate hyperplasia.At the same level of sensitivity,cPSA has a higher specificity than tPSA.Serum cPSA may be a better indicator in the prediction of prostate cancer of early stage.     

Limited usefulness of the free-to-total prostate-specific antigen ratio for the diagnosis and staging of prostate cancer in Japanese men

Background The objective of this study was to evaluate the clinical significance of measuring the free-to-total (f/t) prostate-specific antigen (PSA) ratio for the differentiation of prostate cancer from benign prostatic hypertrophy (BPH) and for the staging of prostate cancer in Japanese men.Methods Before treatment, tPSA and fPSA were measured in 147 patients with prostate cancer and in 253 with BPH, using immunofluorometric techniques. Furthermore, the f/t PSA ratio and the tPSA density of the whole prostate (PSAD) were calculated.Results The tPSA and PSAD levels in patients with prostate cancer paralleled the clinical stage, and were significantly higher than the levels in patients with BPH, while the f/t PSA ratio was not associated with clinical stage, despite the significantly lower values in prostate cancer patients than in BPH patients. Furthermore, the tPSA and PSAD values, but not the f/t PSA ratio, were significantly different between patients with pathologically extraprostatic disease and those with organ-confined disease. Calculation of the specificity of each assay within the range of 80%–95% sensitivity showed that tPSA and PSAD provided better specificities than the f/t PSA ratio. However, there was no significant difference in specificities among these three assays. In prostate cancer and BPH patients with PSA values of 4.1–10ng/ml, the specificities of tPSA and PSAD were also superior to that of the f/t PSA ratio.Conclusion These findings suggest that measurement of the f/t PSA ratio does not provide any significant additional information for the diagnosis and staging of prostate cancer in Japanese men when tPSA and PSAD values are available.     

A new Model Consists of Intravesical Prostatic Protrusion,Prostate Volume and Serum Prostatic-Specific Antigen in the Evaluation of Prostate Cancer

The Prostate-specific antigen (PSA) level is largely used to diagnose prostate cancer (PCa) in last decades. However, its specificity is low in patients with a PSA level ranging from 4.0 to 10.0 ng/ml. This study aims to define the correlation between intravesical prostatic protrusion (IPP) and PSA and to establish a new model to predict PCa. A total of 339 patients order than 45 years examined between October 2010 and June 2012 were enrolled. Eligible patients were recommended for transrectal ultrasonography (TRUS)-guided prostate biopsies after measuring total prostate volume (TPV), tranzisional zone volume (TZV) and IPP. The levels of total PSA (tPSA), free PSA (fPSA) were analyzed by using Hybritech calibrated Access tPSA and fPSA assays. A new mathematical model, named IPP removed PCa predicting score (IRPPS), consists of tPSA, TZV and IPP was established. The predictive accuracy of IRPPS, PSA density (PSAD), %PSA and tPSA were compared using receiver-operator characteristic (ROC) analysis. Eighty-six patients had PSA levels of 4.0–10.0 ng/ml. Twenty of them were diagnosed as PCa. Using ROC curves, the areas under the curve for IRPPS, PSAD and %PSA and tPSA were 0.786, 0.768 and 0.664 and 0.585, respectively. We suggested IPP grade had a significant relationship with serum tPSA levels. The predictive accuracy of IRPPS was higher than the other 3 indictors.     

Serum insulin-like growth factor I/free prostate specific antigen (IGF-I/fPSA) ratio enhances prostate cancer detection in men with total PSA 4.0-10.0 ng/ml

BACKGROUND: Recent studies have suggested that IGF-I and IGFBP-3, in combination with PSA, may enhance PCa detection. This study was to investigate the use of serum IGF-I and IGFBP-3, and their combinations with prostate volume and fPSA in enhancing the discriminatory diagnosis of PCa in men with tPSA of 4.0-10.0 ng/ml. METHODS: Serum IGF-I and IGFBP-3 were determined by ELISA from 586 men with tPSA between 4.0 and 10.0 ng/ml. Of them, 281 were diagnosed with PCa and 305 without. ROC, univariate and multivariate logistic regression analyses were performed to evaluate the predictive performance of those parameters. RESULTS: IGF-I, IGFD, IGF-I/fPSA, and IGFBP-3/fPSA were significantly higher in PCa cases than benign controls, whereas the differences of IGFBP-3 and IGFBPD were statistically insignificant between the two groups, respectively. The AUC values indicated enhanced performance of IGF-I/fPSA ratio (AUC = 0.753) in PCa detection compared with the currently used f/tPSA (AUC = 0.689). Multivariate logistic regression confirmed the observed relationships and identified IGF-I/fPSA as independent factor in PCa presence. CONCLUSION: Our data show that IGF-I/fPSA as a promising marker can enhance PCa detection in ambiguous cases often found in the tPSA between 4.0 and 10.0 ng/ml.     

Clinical usefulness of free PSA in early detection of prostate cancer.

OBJECTIVE: Measurement of serum prostate-specific antigen (PSA) is widely used as an aid in early detection of prostate cancer. Most patients with prostate cancer and a PSA level less than 10.0 ng/ml have early-stage disease. Thus, the detection of prostate cancer in its potentially curable stages requires the use of low PSA cutoffs, inevitably leading to many unnecessary biopsies. The combined use of free PSA and total PSA increases specificity of early detection. To develop risk assessment guidelines and a cutoff value of ratio of free (f) to total (t) PSA with a high predictive value for prostate cancer in men to whom the test would be applied in real life practice, a multicenter early detection trial was initiated. PATIENTS AND METHODS: In one week in November 1997, 963 urologists prospectively examined 11,644 men between 45 and 75 years by digital rectal examination (DRE) and prostate-specific antigen with 4.0 ng/ml as cutoff. Data of physical examination were collected by questionnaire. At this time participants were not aware of their PSA values. Suspicious findings were further investigated with sextant biopsy. Prostate volume was determined with transrectal ultrasound (TRUS). Different cutoff levels were correlated to age and detection rate. RESULTS: From1,115 biopsied men, the data of 633 men fulfilled the criteria DRE-negative, TRUS-estimated volume, and PSA 4.0-10.0 ng/ml. In that cohort 91 cancers were detected. Percentage of fPSA was significantly more predictive of cancer than tPSA (p < 0.001). The area under the ROC curve was 0.72 for percent fPSA (% fPSA) and 0.62 for total PSA. The cancer risk nearly doubled using a cutoff of 10% fPSA, the median %PSA level of the detected cancers. A better discrimination of cancer and noncancer especially in the age group above 70 years is possible. Using a cutoff of 16% fPSA increases positive predictive value (PPV) to 25% missing only 4% of cancers. Nearly 45% of the biopsies could be avoided. In the age group 45-69 years, a cutoff of 20% fPSA leads to PPV of 15%, missing 6% of cancers. Unnecessary biopsies could be avoided in 12%. CONCLUSIONS: Using % fPSA in early detection of prostate cancer reduces the number of unnecessary biopsies, especially in men with negative rectal examination in the PSA range of 4.0-10.0 ng/ml. In order to diminish biopsy rate in men 70 years or older a cutoff of 16% fPSA should be used. A cutoff of 20% fPSA in men younger than 70 years is recommended to increase sensitivity in that age group.     

Does baseline total testosterone improve the yielding of prostate cancer screening?

Previous studies suggest an association between total testosterone (tT) and prostate cancer, but results are conflicting and it is not clear if accounting for the tT levels improves the yielding of patient selection for prostatic biopsy. We evaluated the potential for tT levels and the tT/total PSA (tPSA) ratio to be used as diagnostic tools for prostate cancer and its relation with cancer aggressiveness. We measured tT, tPSA and free PSA (fPSA) in fasting blood samples of 1570 subjects consecutively referred for prostate biopsy due to abnormal digital rectal examination and/or elevated tPSA levels. These values were compared between groups defined according to the pathological results of the biopsy. No significant difference was observed in tT levels when comparing cases with prostate cancer, high grade prostate intraepithelial neoplasia, pathological prostatitis, benign prostatic hyperplasia or no alteration (median: 4.26 versus 4.44 versus 4.31 versus 4.16 pg/mL, respectively; p=0.643). The tT/tPSA ratio had a better area under the curve than tT alone (0.62, 95% CI, 0.59-0.65 versus 0.50, 95% CI, 0.47-0.53), but worse than the f/tPSA ratio (0.70, 95% CI, 0.67-0.73). In multivariate analysis, using the median of distribution as cut-off no significant association was observed between tT or tT/tPSA and prostate cancer (OR=1.06, 95% CI, 0.84-1.33; OR=0.94, 95% CI, 0.70-1.27, respectively). The tT levels were not significantly different across Gleason score groups (p=0.553). In patients suspected of having prostate cancer the tT levels are not useful to improve the yielding of patient selection for prostatic biopsy or to predict cancer aggressiveness.     

甲胎蛋白异质体3、高尔基体蛋白73、磷脂酰肌醇蛋白聚糖3在原发性肝癌诊断中的价值

目的 探讨血清肿瘤标志物甲胎蛋白异质体3（AFP-L3）、高尔基体蛋白73（GP73）和磷脂酰肌醇蛋白聚糖3（GPC-3）联合检测在原发性肝癌诊断中的临床价值.方法 采用酶联免疫吸附法检测34例原发性肝癌患者血清AFP-L3、GP73、GPC-3的表达水平,同期选择20例门诊健康体检者作为对照组.采用软件绘制受试者工作特征（ROC）曲线,并计算曲线下面积（AUC）,并对各指标表达情况进行比较分析.结果 原发性肝癌组AFP-L3、GP73、GPC-3表达水平均高于健康对照组[（1890.13±506.47）ng/L比 （623.40 ±317.89）ng/L,（219.53±136.33）ng/ml比 （56.40±25.63） ng/ml,（14.28±7.15）μg/L比（7.33±3.71）μg/L]（均P＜ 0.01）.三项标志物单项检测原发性肝癌的AUC分别为0.909、0.832、0.817,AFP-L3＋GP73为0.935、AFP-L3＋GPC-3为0.945、GP73＋GPC-3为0.912,三项指标联合AUC可高达0.960.结论 AFP-L3、GP73和GPC-3联合检测可提高原发性肝癌的检出率,对原发性肝癌的早期诊断具有重要的临床意义.