联合检测F-PSA、T-PSA及F-PSA/T-PSA比值在前列腺疾病诊断中的意义

目的 探讨血清游离前列腺特异性抗原(F-PSA)、总前列腺特异性抗原(T-PSA)和F-PSA/T-PSA比值在前列腺疾病诊断中的意义.方法 选取2012年10月至2014年10月我院泌尿外科的前列腺疾病患者190例.通过化学发光法测定其血清中F-PSA、T-PSA的含量,计算F-PSA/T-PSA比值,并与100例健康体检者进行比较.结果 前列腺增生(BPH)组和前列腺癌(PCa)组F-PSA、T-PSA均显著高于正常对照组(P＜0.01); PCa患者组与BPH患者组差异亦存在统计学意义(P＜0.01).当T-PSA在4～ 10 ng/mL之间时,BPH患者组和PCa患者组T-PSA水平差异无统计学意义(P＞0.05);但PCa患者组F-PSA/T-PSA明显低于BPH患者组,差异具有统计学意义(P＜0.01).结论 同时检测F-PSA、T-PSA并计算F-PSA/T-PSA比值明显优于单纯检测T-PSA,在前列腺疾病的鉴别诊断中具有重要的意义.     

电化学发光免疫分析F/T PSA比值对前列腺癌早期诊断的观察

目的:观察前列腺特异性抗原游离与总量比值(F/T PSA比值)对前列腺癌(PCa)早期诊断的价值.方法:采用电化学发光免疫分析技术检测136例正常健康男性、98例前列腺增生(BPH)患者和99例前列腺癌(PCa)患者血清的T-PSA和F-PSA,并求出F/T PSA比值,然后进行统计学分析.结果:正常对照组、BPH组PCa组的T-PSA、F-PSA及F/TPSA比值分别为:1.43±1.13、0.44±0.34、0.36±0.15;7.84±6.08、1.88±1.37、0.26±0.08;23.95±21.12、3.52±3.41、0.16±0.08,上述各组三项指标两两之间比较均有显著性差异(P＜0.001).PCa组根据T-PSA检测值＜4.0μg/L、4.0～10.0μg/L、＞10μg/L分为三组,显示T-PSA、F-PSA组间两两比较均有显著性差异(P＜0.001),但F/TPSA比值相比较无显著性差异(P＞0.05).正常对照组与PCa组T-PSA＜4μg/L三项检测指标比较示T-PSA和F/TPSA比值均有显著性差异(P＜0.001),而F-PSA之间比较无显著性差异(P＞0.05).将F/T PSA比值分为＜0.10、0.11～0.15、0.16～0.2、0.21～0.25、0.26～0.30以及＞0.31以上六个截点,显示在0.20截点以内PCa患者占有率为74.51%.结论:F/T PSA比值的检测对血清T-PSA＜4μg/L、4～10μg/L以及＞10μg/L的患者在诊断PCa中均有良好的临床价值,特别当T-PSA处于较低水平状态下做到早期诊断PCa显得尤为重要.     

TRFIA法检测血清F-PSA在前列腺癌诊断中的应用

探讨血清游离PSA(F-PSA)、总PSA(T-PSA)和游离/总(F/T)PSA比值测定对良恶性前列腺疾病鉴别诊断的价值. 采用全自动时间分辨荧光免疫分析法(TRFIA)进行检测. T-PSA在2-20ng/mL范围内的患者共86例, 根据术后病检结果分为两组: 前列腺增生(BPH)症组68例, 前列腺癌组18例, 分析比较两组患者血清F-PSA、T-PSA和F/T PSA比值.结果是: ①前列腺癌组的F-PSA、T-PSA和前列腺增生组的F-PSA、T-PSA皆无显著性差异(P＞0.05), 但F/T PSA比值, 在前列腺癌组明显低于前列腺增生组(P＜0.01).②以F/T PSA=0.18作为诊断阈值, F/T PSA比值对前列腺癌诊断的灵敏度、特异性和阳性预测值分别为85%、72.5%、43.6%.结论是: F/T PSA比值测定有利于前列腺癌与前列腺增生症的鉴别诊断; 当T-PSA在2-20ng/mL范围时, 选用0.18作为诊断阈值有较大的临床应用价值.     

联合检测IL-6、T-PSA、F-PSA及F-PSA/T-PSA在前列腺疾病鉴别诊断中的应用价值

目的 探讨血清中白细胞介素6(IL-6)、总前列腺特异性抗原(T-PSA)及游离前列腺特异性抗原(F-PSA)在前列腺癌(PCa)患者和前列腺增生(BPH)患者中的表达情况,用于鉴别诊断临床上的前列腺癌和前列腺增生患者.方法 经直肠行前列腺穿刺活检病理诊断确诊为PCa和BPH的患者,回顾性分析其治疗前血清中的IL-6、T-PSA及F-PSA的检测结果.结果 PCa患者血清中的IL-6、T-PSA及F-PSA明显高于BPH患者(P<0.05);按照年龄分层(45~,55~,65~,75~)分析的结果显示在各个年龄段PCa患者血清中的IL-6、T-PSA及F-PSA均明显高于BPH患者(P<0.05).在75~年龄段,PCa患者F-PSA/T-PSA明显低于BPH患者(P<0.05).结论 IL-6、T-PSA及F-PSA的联合检测对PCa和BPH患者具有鉴别意义.     

血清游离PSA和游离/总PSA在前列腺癌诊断中的价值

探讨游离前列腺特异性抗原(FPSA)和游离/总前列腺特异性抗原比值(F/T PSA)在前列腺癌(PC)和良性前列腺增生(BPH)鉴别诊断中的价值.采用美国DPC公司的酶放大化学发光仪测定89名正常志愿者、85例PC患者和97例BPH患者血清FPSA和TPSA水平,并计算F/T PSA的比值.结果表明正常男性(41～88岁)组血清FPSA和TPSA水平与青年组相比明显升高,老年组升高特别明显(P＜0.01),直线相关统计分析表明,年龄与血清FPSA和TPSA水平有显著正相关性(FPSA/年龄:r为0.49～0.51,P＜0.01;TPSA/年龄:r为0.44～0.45,P＜0.01);PC组和BPH组血清FPSA、TPSA水平明显高于对照组(P＜0.01),而PC组F/T PSA比值则明显低于BPH组和对照组(P＜0.01).血清TPSA＜4.0、4.0～10.0和＞10.0μg/L的BPH患者分别占65.0%、30.9%和4.1%,PC患者分别为5.9%、20.0%和74.1%,经卡方检验,两组间患者的分布差别有极显著性意义(P＜0.01);F/T PSA比值的分段研究显示,在TPSA灰色区,F/T PSA 0.1,提示PC可能性较大(88.9%),而F/T PSA＞0.25时,表明PC可能性很小(6.1%).提示40岁以上正常男性血清FPSA和TPSA水平随年龄升高而增加,并与年龄呈明显的正相关;约30.9%的BPH与20.0%的PC患者血清TPSA水平存在重叠,F/T PSA比值的应用可以明显提高TPSA在灰色区鉴别诊断PC的特异性.     

前列腺增生及前列腺癌患者f-PSA/T-PSA的变化

目的:探讨诊断灰区内血清游离态前列腺特异性抗原与总前列腺特异性抗原的比值,在前列腺增生与前列腺癌的鉴别诊断中的应用价值.方法:选择血清总前列腺特异性抗原(4.0～10.0)μg/L的39例前列腺癌患者和36例前列腺增生患者,检测血清中总前列腺特异性抗原(T-PSA)和游离态前列腺特异性抗原(f-PSA),计算f/T比值.结果:T-PSA在(4.0～10.0)μg/L,组间T-PSA浓度无显著性差异(P＞0.05),而(f/T)PSA比值有显著性差异(P＜0.05),前列腺癌患者f/T比值明显低于前列腺增生患者(P＜0.01).结论:应用f/T比值＜0.16为鉴别点,提高了对前列腺癌诊断灵敏性和特异性,尤其T-PSA在(4.0～10.0)μg/L更有意义.     

应用ROC曲线分析血清PSA系列在前列腺癌中的诊断价值

应用ROC曲线分析tPSA、PSA密度(PSAD)、fPSA/tPSA、前列腺酸性磷酸酶(PAP)等指标在前列腺癌(PCa)诊断中的价值。经活检或术后病理证实良性前列腺增生(BPH)组患者53例,PCa组患者49例。用化学发光法测定血清tPSA和fPSA,RIA法测定PAP,经直肠超声(TRUS)测定前列腺体积。结果表明PCa组血清tPSA、PSAD、PAP检测值均较BPH组升高(P<0.01),PCa组血清fPSA/tPSA较BPH组降低(P<0.01)。tP-SA、PSAD、fPSA/tPSA比值、PAP在ROC曲线下的面积从大到小为PSAD>tPSA>PAP>fPSA/tPSA。在保持91.9%的敏感性时,tPSA、PSAD、fPSA/tPSA、PAP截点值分别是7.6、0.27、0.03、0.70,特异性是47.4、78.6、0.0、46.4。PSAD较tPSA、PAP、fPSA/tPSA能更好地检出PCa。对于tPSA处于诊断灰色区间(4ng/mL~10ng/mL)的患者时,PSAD较tPSA有更高的诊断特异性。     

血清PSA、fPSA和fPSA/tPSA比值在前列腺疾病诊断中的价值

本文通过对60例前列腺癌(PCa)和60例前腺增生(BPH)的本院住院患者血清PSA和fPSA及fPSA/tPSA比值比较,旨在探讨这三项指标对前列腺疾病诊断的临床价值。1材料和方法1.1对象正常对照组60例,平均年龄59岁,来自健康体检者;PCa患者组60例,平均年龄68岁,BPH患者组60例,平均年龄65岁。PCa、BPH患者均经前列腺组织活检或手术     

f-PSA与t-PSA的比值对PCa和前列腺增生的鉴别诊断价值

为提高前列腺癌(PCa)诊断的准确性,国际上提出了游离PSA[f-PSA]和总PSA[t-PSA]比值的概念,现将我院经确诊的自2011年5月～2011年12月的PCa和前列腺良性增生(BPH)患者血清tPSA、fPSA、fPSA/tPSA比值结果报道如下。1资料和方法1.1临床资料将本院2011年5月～2011年12月住院的前列腺疾病患者进行筛选,选择tPSA>4.0ng/ml范围的BPH和PCa患者81例,其中BPH患者49例,PCa患者32     

前列腺癌患者的血清IL-6、性激素和PSA水平的临床评价

目的:探讨前列腺癌(prostate cancer,PCa)患者血清白介素-6(IL-6)、性激素和前列腺特异性抗原(prostate specific antigen,PSA)的水平及其临床评价.方法:采用化学发光免疫分析法测定了178例前列腺疾病[其中68例PCa,43例前列腺增生(BPH),31例BPH+急性尿潴留(AUR)和36例急性前列腺炎(AP)]患者和60例正常对照组血清IL-6、T、FSH和 LH以及PSA的水平,并同时进行比较性分析.结果:在178例前列腺疾病中,68例PCa患者血清IL-6水平较43例BPH、31例BPH+AUR、36例AP患者和60例正常对照组均明显增高(P<0.01、<0.05、<0.05和<0.01).在性激素分析中,68例PCa患者血清T水平较60例正常对照组明显降低(P<0.01),其他各组均正常(P均 >0.05);68例PCa患者血清FSH水平较60例正常对照组明显增高(P<0.01),43例BPH和36例AP患者均正常(P均>0.05),而31例BPH+AUR患者稍增高(P<0.05);68例PCa患者血清LH较60例正常对照组明显增高(P<0.05),而31例AP患者明显降低,有待进一步探讨.在PSA测定中,68例PCa患者血清PSA较其他前列腺疾病组和60例正常对照组非常明显增高(P均<0.01),在68例PCa患者中,37例骨转移患者的血清IL-6和PSA水平较31例未转移患者明显增高(P分别为<0.01和<0.05),性激素之间无明显差异(P均>0.05).结论:PCa患者血清IL-6、FSH、LH和PSA水平明显增高和血清T明显降低是诊断和鉴别前列腺良恶性疾病的有价值的临床指标,而PCa患者骨转移的典型特点是血清IL-6和PSA水平的增高,但与血清性激素水平无关.     

超声与血清t-PSA和f-PSA／t—PSA比值对前列腺癌诊断的价值

目的探讨血清总前列腺特异性抗原（t-PSA）、游离前列腺抗原／总前列腺抗原（f-PSA／t-PSA）比值与超声联检对前列腺癌（PCa）的诊断价值。方法将38例经手术和病理证实的PCa患者与45例前列腺增生（BPH）患者和40名正常人的t-PSA、f-PSA／t-PSA比值检测结果进行对比。并和超声联检结果进行分析。结果PCa患者血清t-PSA含量显著高于其它两组,差异有统计学意义（P〈0．01）。t-PSA和f-PSA／t-PSA比值作为单一指标应用于诊断PCa时,灵敏度分别为47．37％、73．68％,准确性分别为51．8l％、71．08％,与超声影像学三者联检,诊断PCa的灵敏度为94．73％,特异性为95．56％,准确性为95．18％。三者联检均高于其单检的敏感性,差异有统计学意义（P〈0．01）。结论t-PSA、t-PSA／foPSA是诊断PCa的较好指标。血清t-PSA、t-PSA／f—PSA比值和影像学联检可大大提高对PCa的诊断率,对PCa患者早期诊断、早期治疗和监控有重要作用。     

循环miRNA-141对前列腺癌的诊断和预后价值研究

 目的:研究血清miR-141在前列腺癌中的表达及临床意义。方法:采用实时荧光定量PCR检测75例前列腺癌和52例良性前列腺增生（BPH）患者,以及40例健康对照血清miR-141的相对表达水平。结果:前列腺癌血清miR-141的表达量较BPH和健康对照增高,差异有统计学意义（P＜0.01）。但miR-141在BPH组和对照组中的表达差异无统计学意义（P>0.05）。ROC曲线显示miR-141能够较好地区分前列腺癌与BPH（或健康对照）,曲线下面积分别为0.785（95%CI∶0.689～0.823）和0.801（95%CI∶0.723～0.868）。血清miR-141表达与Gleason积分、临床分期和骨转移相关（均P<0.05）,随着临床分期的增加,miR-141的表达水平增加;但miR-141表达量与患者年龄、肿瘤复发和血清前列腺特异性抗原水平无关(均P>0.05)。结论: 循环miR-141可作为非侵入性诊断前列腺癌并且判断其预后的分子标志物。     

The significance of PSA/IGF-1 ratio in differentiating benign prostate hyperplasia from prostate cancer

The importance of insulin-like growth factor 1 (IGF-1) in human serum for the early diagnosis of prostate cancer is controversial. The IGF-1/PSA ratio may improve the performance of prostate specific antigen (PSA) as a prostate cancer marker. IGF-1, along with PSA and free PSA concentration, was measured in the serum of 34 patients with prostate cancer and in 131 patients with benign prostatic hyperplasia (BPH). Although IGF-1 concentration did not significantly differ between the groups, PSA/IGF-1 ratio could clearly distinguish the two groups. In patients with cancer but not in patients with BPH, IGF-1 concentration correlated with PSA and free PSA. The values of PSA and free PSA correlated with each other for both groups. Receivers Operating Curve (ROC) analysis indicated a better sensitivity to specificity ratio for PSA/IGF-1 than for PSA or Free/Total (F/T) PSA.     

Free/total prostate specific antigen ratio (%PSA) to predict probability of prostate cancer

It has been reported recently that %PSA, the ratio of free-PSA(F-PSA) and total-PSA(T-PSA), remains significantly lower in sera of patients with prostatic cancer(PCA) than there in cases with benign prostate hypertrophy(BPH). We examined %PSA can be used for differential diagnosis of PCA from BPH. Forty-seven non-treated Japanese patients with prostate problem were examined for PSA assays and biopsy. On biopsy, 25 cases were diagnosed as PCA, and 22 cases as BPH. On T-PSA value, there were 18 cases of PCA and 8 cases of BPH whose T-PSA values were over 10 ng/ml. When %PSA was studied, cases with less than 15% of %PSA were found to be PCA exclusively(16/16), while cases with less than 20 of %PSA included 19 PCAs and 4 BPHs. In 17 PCA patients with stage B to stage D, the %PSA was less than 20 except one case. T-PSA was examined in 88 cases at the checkup in our old age home. Four samples of which T-PAS levels were in gray zone, were assayed for %PSA. Two of them, with %PSA values less than 20 ng/ml, were found to be PCA, while the remaining two, with %PSA over 20 ng/ml, were BPH.     

血清PSA和性激素六项联合检测与前列腺良恶性疾病的关系

为探讨血清前列腺特异性抗原(PSA)、游离前列腺特异性抗原(fPSA)、f/t PSA及性激素六项在前列腺疾病中的应用价值,用放射免疫法(RIA)测定72例前列腺增生(BPH)患者和40例前列腺癌(Pca)患者血清中的PSA、fPSA、f/t PSA及性激素六项[睾酮(T)、孕酮(P)、雌二醇(E2)、垂体泌乳素(PRL)、促黄体生成素(LH)、促卵泡成熟激素(FSH)]水平.结果表明,BPH组的性激素T、E2、PRL、LH、FSH水平均明显低于Pca组,Pca组中P水平明显低于BPH组;BPH组fPSA、f/t PSA比值均明显高于Pca组.提示前列腺良恶性疾病(BPH和Pca)与激素水平失调有关,血清tPSA、fPSA均是诊断Pca和BPH的重要指标,与血清f/t PSA联合测定,可提示哪些患者需要进行前列腺TRUS,并可提高Pca早期检出率.     

Proper cut-off value of free to total PSA ratio for detection of prostate cancer in Korean men

To assess whether the free-to-total prostate specific antigen (PSA) ratio (F/T PSA ratio) would enhance prostate cancer detection in Korean men with serum total PSA levels between 4 and 20 ng/ml. Methods: A total of 240 consecutive patients whose serum PSA levels were between 4 and 20 ng/ml were enrolled in this two-year study. All patients underwent ultrasound-guided transrectal biopsies of the prostate gland. The F/T PSA ratio was measured using the Roche immunoassay. Results: Of the 240 patients, 202 (84%) had benign histologies, while 38 (16%) had prostate cancer. The two patient groups were well matched for age. The mean F/T PSA ratio showed a statistically significant difference between the two groups: in the benign histology group it was 0.14 (0.04 - 0.37), and 0.10 (0.08 - 0.20) in the prostate cancer group (p < 0.05). Out of the 183 patients with a PSA level between 4-10 ng/ml, the mean F/T PSA ratios were 0.14 and 0.11 in the benign histology (n=158) and prostate cancer groups (n=25), respectively (p < 0.05). From the 57 patients with a PSA level between 10 - 20 ng/ml, the mean F/T PSA ratios were 0.14 and 0.10 in the benign histology (n=44) and prostate cancer groups (n=13), respectively (p < 0.05). Overall, when the cut-off value of the F/T PSA ratio was 0.10, the sensitivity and specificity were 75.0% and 76.5%, while for the cut-off value of 0.15 they were 83.3% and 39.7% respectively. Conclusion: Our data demonstrated the usefulness of the free to total PSA ratio in distinguishing benign prostate disease and cancer disease, hence eliminating unnecessary biopsies. It is recommended that a cut-off value for the F/T PSA ratio of 0.10 be applied to Korean men which this is lower than the value used in Western countries.     

应用Logistic回归和ROC曲线综合分析PSA、fPSA、fPSA/PSA和EPCA对前列腺癌的诊断价值

目的 探讨Logistic回归和ROC曲线综合分析PSA、fPSA、fPSA/PSA和EPCA对前列腺癌的诊断价值.方法 检测107例前列腺癌(prostate cancer,PCa)患者、84例良性前列腺增生(benign prostatic hyperplasia,BPH)患者和50例健康对照者的血清PSA、fPSA和EPCA水平,计算fPSA/PSA,建立Logistic回归模型,绘制ROC曲线并计算曲线下面积来评价各肿瘤标志物对PCa的诊断价值.结果 PCa组血清PSA、fPSA和EPCA水平较BPH组和健康对照组明显升高(P<0.01),PCa组和BPH组fPSA/PSA水平低于健康对照组(P<0.01);单项指标中,EPCA的灵敏度和特异性最高(78.5%、96.0%),约登指数最大(0.777);建立回归模型Y=logit(P)=-6.906+0.843XPSA-1.402XfPSA+0.271XEPCA,新变量P的AUC为0.935,灵敏度和特异性分别为87.9%和96.0%.结论 PSA、EPCA检测在PCa诊断中具有一定的临床意义,与fPSA联合检测与单项检测相比可以显著提高诊断能力,综合应用Logistic回归和ROC曲线分析有助于提高PCa的诊断效能.     

前列腺癌与前列腺增生HER-2及C-myc基因mRNA表达的研究

目的 检测良性前列腺增生(BPH)与前列腺癌(PCa)组织标本HER-2及C-mvc mRNA相对值,探讨此值对PCa诊断的特异性意义.方法 通过实时荧光定量PCR检测63例PCa、37例BPH及3例正常前列腺组织HER-2及C-myc mRNA的表达,比较其在PCa与BPH中组织定量的差异.结果 相对于BPH,PCa HER-2及C-myc mRNA表达相对值分别为4.25±0.03,7.24±0.06,PCa HER-2及C-myc表达相对值较BPH高,差异有统计学意义(均为P<0.05).结论 实时荧光PCR定量检测HER-2及C-myc mRNA为PCa的诊断提供了重要的辅助指标.     

PSA density and PSA transition zone density in the diagnosis of prostate cancer in PSA gray zone cases

This study assessed the efficacy of prostate specific antigen density (PSAD) and PSA transition zone density (PSATZ) in predicting prostate cancer in men with PSA levels of 4.0-10.0 ng/ml. Between July 1996 and July 2000, PSAD and PSATZ were determined in 202 patients who underwent ultrasonography-guided systemic sextant biopsies plus 2 transitional zone biopsies. Of the 202 patients, 27 (13.4%) had prostate cancer and 175 (86.6%) had benign prostatic hyperplasia (BPH) on pathologic examination. Although there was no significant difference in mean PSA level between the prostate cancer and BPH patients (p = 0.28), the mean PSAD (p = 0.011) and PSATZ (p = 0.036) were significantly higher in prostate cancer than in BPH patients. In discriminating prostate cancer patients, the cut-off values of 0.35 ng/ml/cc for PSATZ, and 0.15 ng/ml/cc for PSAD yielded specificity levels of 69 and 56, and sensitivity levels of 63 and 81%, respectively. In conclusion, no substantial advantage of PSATZ over PSAD could be demonstrated.