前列腺增生症患者血清前列腺特异性抗原水平与前列腺炎关系的临床研究

目的探讨前列腺增生症患者血清中前列腺特异性抗原水平与前列腺炎的关系。方法120例门诊诊断为前列腺增生症的患者,其血清前列腺特异性抗原高于4.0ng/ml且合并前列腺炎;所有患者口服莫西沙星,治疗随访4周;根据治疗后血清前列腺特异性抗原水平及前列腺穿刺活检结果分为三组,观察比较各组治疗前后血清前列腺特异性抗原的水平及前列腺癌诊断阳性率。结果仅治疗后血清前列腺特异性抗原低于4.0ng/ml的一组在治疗前后的水平变化有统计学意义,其余两组均无统计学意义;治疗后前列腺癌诊断阳性率明显高于治疗前。结论对血清前列腺特异性抗原高于4.0ng/ml且合并前列腺炎的前列腺增生患者进行抗炎治疗,既可提高前列腺特异性抗原对前列癌早期诊断的特异性,又可使部分患者避免前列腺穿刺活检造成的痛苦和相关并发症。     

Importance of prostate-specific antigen (PSA) as a predictive factor for concordance between the Gleason scores of prostate biopsies and RADICAL prostatectomy specimens

OBJECTIVE:

To evaluate the concordance between the Gleason scores of prostate biopsies and radical prostatectomy specimens, thereby highlighting the importance of the prostate-specific antigen (PSA) level as a predictive factor of concordance.

METHODS:

We retrospectively analyzed 253 radical prostatectomy cases performed between 2006 and 2011. The patients were divided into 4 groups for the data analysis and dichotomized according to the preoperative PSA, <10 ng/mL and ≥10 ng/mL. A p-score <0.05 was considered significant.

RESULTS:

The average patient age was 63.3±7.8 years. The median PSA level was 9.3±4.9 ng/mL. The overall concordance between the Gleason scores was 52%. Patients presented preoperative PSA levels <10 ng/mL in 153 of 235 cases (65%) and ≥10 ng/mL in 82 of 235 cases (35%). The Gleason scores were identical in 86 of 153 cases (56%) in the <10 ng/mL group and 36 of 82 (44%) cases in the ≥10 ng/mL group (p = 0.017). The biopsy underestimated the Gleason score in 45 (30%) patients in the <10 ng/mL group and 38 (46%) patients in the ≥10 ng/mL (p = 0.243). Specifically, the patients with Gleason 3 + 3 scores according to the biopsies demonstrated global concordance in 56 of 110 cases (51%). In this group, the patients with preoperative PSA levels <10 ng/dL had higher concordance than those with preoperative PSA levels ≥10 ng/dL (61% x 23%, p = 0.023), which resulted in 77% upgrading after surgery in those patients with PSA levels ≥10 ng/dl.

CONCLUSION:

The Gleason scores of needle prostate biopsies and those of the surgical specimens were concordant in approximately half of the global sample. The preoperative PSA level was a strong predictor of discrepancy and might improve the identification of those patients who tended to be upgraded after surgery, particularly in patients with Gleason scores of 3 + 3 in the prostate biopsy and preoperative PSA levels ≥10 ng/mL.     

Prostate hyperplasia in St Mary's Hospital Lacor: utility of prostate specific antigen in screening for prostate malignancy

IntroductionProstate cancer is the second commonest cancer in men worldwide. At present, every patient with lower urinary tract symptoms (LUTS) in St. Mary''s Hospital Lacor is undergoing prostate biopsy regardless of the prostate specific antigen (PSA) level. We sought to determine the association between PSA and malignant prostate histology.MethodsThis was a retrospective study. Data on age, PSA, prostate volume and prostate histology reported between Jan 2012 and Dec 2019 were retrieved from St. Mary''s Hospital Lacor archive and analyzed using STATA SE/13.0.ResultsRecords of 97 patients with LUTS was analyzed. The median (range) age of the patients was 71 (43–100) years. Median (range) of prostate volume was 91.8 (8.0–360.0) cc. Overall, PSA ranged from 0.21 to 399.2 ng/ml. Prostate histology showed 3.1% acinar adenocarcinoma, 24.7% adenocarcinoma and 72.2% benign prostatic hyperplasia. The median PSA amongst patients with malignant and non-malignant prostates were 15.8 ng/ml and 6.07 ng/ml respectively. Serum PSA level was significantly higher in patients with malignant prostate histology (Difference of mean= 9.7; p=0.001).ConclusionPatients with LUTS and PSA levels of 15ng/ml or more were more likely to have malignant prostate histology.     

前列腺健康指数在前列腺癌早期诊断中的价值

PSA是目前PCa诊断应用最广泛的指标,但由于其敏感性和特异性欠佳,还是造成较多患者接受不必要的前列腺穿刺活检。PHI与传统PSA相比,具有更高的AUC;2012年美国食品和药物管理局批准了PHI用于PSA处于4~10 ng/ml,首次前列腺穿刺活检前的评估,明显提高了前列腺癌检出率。本文就PHI在前列腺穿刺患者的选择和其在高危前列腺癌判断中的价值做一综述。     

Distribution and secretory pathways of prostate specific antigen,alpha1-antichymotrypsin and prostate secretory granules in prostate cancers

Using 19 radical prostatectomy specimens, we studied the histological distribution of free prostate specific antigen (PSA), total PSA, alpha1-antichymotrypsin (ACT) and prostate secretory granules (PSG) in both normal and cancerous cells of the prostate. After glutaraldehyde fixation, numerous fine eosinophilic droplets of PSG could be found mainly in the apical portions of normal acinous epithelial cells, but was markedly decreased in cancer cells. With antibodies against free PSA, normal acinous cells were granularly positive in the apical portion of the epithelium, which corresponded to the PSG, whereas cancer cells were diffusely positive. With antibodies against ACT, normal duct cells and cancer cells were often positive, but few normal acinous cells were positive. Presumably, these findings indicate that free PSA is secreted into the lumen as PSG in normal glands, but not by the same pathway in cancers where free PSA appears to accumulate due to a decrease of PSG, then leak into the blood producing complexed PSA to some extent in the cytoplasm. One factor analysis of variance (ANOVA) on the correlation of tumor differentiation or Gleason score with serum values of total PSA, free PSA and a free/total PSA ratio demonstrated no significant links. Elucidation of secretory mechanisms should provide better comprehension of various PSA indices for prostate cancer screening.     

Cyclin D1 expression in prostate carcinoma

The purpose of this study was to investigate the relationship between cyclin D1 expression and clinicopathological parameters in patients with prostate carcinoma. We assessed cyclin D1 expression by conventional immunohistochemistry in 85 patients who underwent radical prostatectomy for prostate carcinoma and 10 normal prostate tissue samples retrieved from autopsies. We measured nuclear immunostaining in the entire tumor area and based the results on the percentage of positive tumor cells. The preoperative prostate-specific antigen (PSA) level was 8.68±5.16 ng/mL (mean±SD). Cyclin D1 staining was positive (cyclin D1 expression in >5% of tumor cells) in 64 cases (75.4%) and negative (cyclin D1 expression in ≤5% of tumor cells) in 21 cases (including 15 cases with no immunostaining). Normal prostate tissues were negative for cyclin D1. Among patients with a high-grade Gleason score (≥7), 86% of patients demonstrated cyclin D1 immunostaining of >5% (P<0.05). In the crude analysis of cyclin D1 expression, the high-grade Gleason score group showed a mean expression of 39.6%, compared to 26.9% in the low-grade Gleason score group (P<0.05). Perineural invasion tended to be associated with cyclin D1 expression (P=0.07), whereas cyclin D1 expression was not associated with PSA levels or other parameters. Our results suggest that high cyclin D1 expression could be a potential marker for tumor aggressiveness.     

Diagnostic Role of Prostate Resection in the Elderly Patients Who Experience Significant Co-Morbidity with a High Clinical Suspicion of Prostate Cancer

The necessity of routine prostate biopsy prior to transurethral resection of the prostate (TURP) in elderly comorbid patients with a high prostate specific antigen (PSA) level remains controversial. We assessed the role of TURP in prostate cancer diagnosis in these individuals. A total of 197 patients underwent TURP in conjunction with prostatic needle biopsy. Pathologic reviews of specimens of TUR chips and biopsy cores were analyzed. Overall, prostate cancer (CaP) was detected in 114 patients (57.6%). Ninety-eight cancers (86%) were detected with TURP and biopsy, and seven cancers (6.1%) with only TURP. The Gleason score of a TUR-specimen was identical to that of the biopsy-core in 43.9% of cases. Variables associated with diagnostic accuracy in the TUR-specimens included the prebiopsy PSA level, prostate specific antigen density (PSAD), and the Gleason score in biopsy cores. In patients with a PSA level and a PSAD that was greater than 15.4 ng/mL and 0.69 ng/mL/g, respectively, 100% of the cancers were detected in the TUR-specimens. Our results suggest that a prostatic biopsy might be omitted prior to TURP in elderly patients with significant co-morbidity and levels for PSA of >15.4 ng/mL.     

Practice Patterns of Korean Urologists for Screening and Managing Prostate Cancer according to PSA Level

Purpose

There are still debates on the benefit of mass screening for prostate cancer (PCA) by prostate specific antigen (PSA) testing, and on systemized surveillance protocols according to PSA level. Furthermore, there is a paucity of literature on current practice patterns according to PSA level in the Korean urologic field. Here, we report the results of a nationwide, multicenter, retrospective chart-review study.

Materials and Methods

Overall 2122 Korean men (>40 years old, PSA >2.5 ng/mL) were included in our study (from 122 centers, in 2008). The primary endpoint was to analyze the rate of prostate biopsy according to PSA level. Secondary aims were to analyze the detection rate of PCA, the clinical features of patients, and the status of surveillance for PCA according to PSA level.

Results

The rate of prostate biopsy was 7.1%, 26.3%, 54.2%, and 64.3% according to PSA levels of 2.5-3.0, 3.0-4.0, 4.0-10.0, and >10.0 ng/mL, respectively, and the PCA detection rate was 16.0%, 22.2%, 20.2%, and 59.6%, respectively. At a PSA level >4.0 ng/mL, we found a lower incidence of prostate biopsy in local clinics than in general hospitals (21.6% vs. 66.2%, respectively). A significant proportion (16.6%) of patients exhibited high Gleason scores (≥8) even in the group with low PSA values (2.5-4.0 ng/mL).

Conclusion

We believe that the results from this nationwide study might provide an important database for the establishment of practical guidelines for the screening and management of PCA in Korean populations.     

A new 5-grading score in the diagnosis of prostate cancer with real-time elastography

Objective: To evaluate the clinical significance of transrectal real-time elastography (TRTE) in diagnosis of prostate cancer (PCA). Methods: 195 patients with an elevated PSA level were enrolled in the study. A novel 5-grading score of prostate outer gland was applied by TRTE imaging. Receiver-operating characteristic curve (ROC) analyses were performed to assess the diagnostic performance of TRTE score. Results: TRTE scores in patients with PCA and benign condition were 3.20 ± 1.11 (range: 1-5) and 2.24 ± 1.01 (range: 1-4), respectively (P < 0.001). The best cutoff value of TRTE score was 3, and the sensitivity, specificity, accuracy in the diagnosis were 68.6% (35/51), 69.4% (100/144) and 69.2% (135/195), respectively. The accuracy of TRTE in volume ≤ 30 ml group was significantly higher than that in the volume ≥ 50 ml group and the 30-50 ml group (76.9% vs. 65.0% and 76.9% vs. 71.4%, both P < 0.001). Accuracy of TRTE score was higher for those with PSA ranged 4-10 ng/ml than those with PSA > 10 ng/ml (85.3% vs. 66.7%, P = 0.002). Conclusion: TRTE score, a novel semi-quantitative assessment of patients’ prostate stiffness, can be served as a useful screening method for patients suspicious of PCA, especially those only having an elevated PSA level.     

Accuracy of a high prostate-specific antigen level for prostate cancer diagnosis upon initial biopsy in Korean men

PURPOSE: This study aimed to evaluate the cancer detection rate in a Korean population with prostate-specific antigen (PSA) levels greater than or equal to 20.0 ng/mL. MATERIALS AND METHODS: A total of 174 men 50 to 79 years old (median 69) included in the study. The median prostate volume of the patients was 44.8 mL (range 14.1 to 210.0) and their serum PSA ranged from 20.0 to 9725.0 ng/mL (median 44.8). RESULTS: Of 174 men 141 (81.0%) were diagnosed with prostate cancer on initial biopsy. In the total number of patients, the positive predictive value (PPV) was 62.9% for PSA 20 to 29.9, 72.7% for PSA 30 to 39.9 and 100% for PSA 40 to 49.9 ng/mL. In patients with an abnormal digital rectal examination (DRE), the values for these PSA ranges increased to 89.5%, 91.7% and 100%, respectively. The PPV was 81.0% for PSA cutoff of 20, 89.2% for a cutoff of 30, 95.4% for a cutoff of 40, and 94.7% for a cutoff of 50 ng/mL. In conjunction with an abnormal DRE, the values for these PSA cutoffs increased to 95.9%, 98.1%, 100%, and 100%, respectively. CONCLUSION: Our data suggest the ability to predict the presence of prostate cancer reliably on initial biopsy when PSA threshold is greater than or equal to 50 ng/mL. This PSA threshold may be lowered to 40 ng/mL in the presence of an abnormal DRE. In Korean men with high PSA, the detection rate of prostate cancer on biopsy appears to be comparable to that for American men.     

miRNA-15a 在前列腺癌中的表达及诊断意义

目的:检测前列腺癌患者miRNA-15a 的表达情况,探讨其在前列腺癌诊断的意义。方法:选择2014 年1 月至2015 年1 月本院泌尿外科收治的前列腺癌患者血清及肿瘤组织36 例,良性前列腺增生患者(Prostatic hyperplasia,BPH)血清40 例,健康对照血清40 例。miRNA鄄15a 表达采用实时定量聚合酶链反应(Real鄄time PCR)技术检测。结果:miRNA-15a 在前列腺癌患者、良性前列腺增生患者和健康对照血清的表达量分别为(0.193±0.081)、(0.359±0.04)和(0.376±0.037),miRNA-15a 在前列腺癌患者血清中的表达量显著低于良性前列腺增生患者和健康对照(P<0.05),在BPH 组和对照组中的表达差异无统计学意义(P>0.05),前列腺癌患者血清miRNA-15a 表达在不同PSA 表达水平、Gleason 评分、临床分期、有无远处转移之间差异有统计学意义(P<0.05),与其他病理因素无关(P>0.05);前列腺癌患者肿瘤组织中的miRNA-15a 的表达与PSA 表达水平、Gleason 评分、临床分期、有无远处转移之间差异有统计学意义(P <0.05),与其他病理因素无关(P >0.05)。结论:miRNA-15a 低表达参与了前列腺癌的发生、发展过程,是前列腺癌辅助诊断及治疗的潜在的指标。     

Clinicopathological Features of Prostate Ductal Carcinoma: Matching Analysis and Comparison with Prostate Acinar Carcinoma

We evaluated the clinicopathological features and prognosis of 29 cases of prostate ductal carcinoma was considered to be an aggressive subtype of prostate acinar carcinoma. We selected 29 cases who were diagnosed prostate ductal carcinoma and had a radical prostatectomy (RP). The acinar group (n = 116) was selected among 3,980 patients who underwent a prostatectomy. The acinar group was matched to the ductal group for prostate specific antigen (PSA), clinical stage, Gleason score, and age. The mean (range) of the follow-up periods for the ductal and acinar group was 23.8 ± 20.6 and 58 ± 10.5 months, respectively. The mean age of the prostate ductal and acinar carcinoma patients was 67.3 and 67.0 yr and the mean PSA level was 14.7 and 16.2 ng/mL, respectively. No statistical differences were evident between groups in terms of the final pathologic stage or positive resection margin rate other than the postoperative Gleason score. A greater proportion of the ductal group demonstrated a postoperative Gleason score ≥ 8 in comparison with the acinar group (P = 0.024). Additionally, we observed significant prognostic difference in our patient series in biochemical recurrence. The ductal group showed a poorer prognosis than the acinar group (P = 0.016). There were no differences significantly in terms of final pathology and rate of positive resection margin, but a greater proportion of the ductal group demonstrated a Gleason score ≥ 8 than the acinar group after matching for PSA, Gleason score in biopsy and clinical stage. The ductal group also showed a poorer prognosis.

Graphical Abstract

相似文献   

tPSA和cPSA对前列腺疾病诊断的临床价值

为了进一步探讨血清总前列腺特异性抗原(tPSA)和复合前列腺特异性抗原(cPSA)对前列腺疾病诊断的临床价值,用CLIA检测良性前列腺增生(BPH)组30例、前列腺癌(Pca)组30例患者和对照组45名血清tPSA和cPSA水平,比较各组间差异。结果表明:Pca组患者血清tPSA和cPSA水平较对照组及BPH组有显著性差异(P<0.01)。血清tPSA在低水平(4.0~10.0ng/mL),即“灰色区域”内,cPSA与tPSA对Pca组的阳性预测值比较有显著性差异(P<0.01)。Pca组联检tPSA cPSA的阳性率与单检tPSA或cPSA的阳性率比较有显著性差异(P<0.05)。本研究认为:tPSA、cPSA均是诊断与鉴别诊断Pca和BPH的重要指标。对Pca的诊断,血清tPSA在4.0~10.0ng/mL时,cPSA优于tPSA。联检tPSA cPSA可明显提高对早期Pca诊断的准确率。     

Association of serum EPCA-2 level with prostate cancer in Chinese Han population

Background: Early prostate cancer antigen 2 (EPCA-2), a kind of nuclear matrix protein, may relate to prostate cancer. However, the association of EPCA-2 level in serum with prostate diseases has not been clarified in Chinese Han population. Methods: EPCA-2 and prostate-specific antigen (PSA) levels in serum were detected by enzyme linked immunosorbent assay in 116 patients with prostate cancer (PCa), 342 patients with benign prostatic hyperplasia (BPH), and 174 healthy controls (Control) in Chinese population. Associations of serum EPCA-2 and PSA level with prostate diseases were analyzed by ANOVA. Comparison of diagnostic effect for prostate cancer between EPCA-2 and PSA was evaluated by Receiver Operator Curve, Chi-square test, and others. Results: Serum EPCA-2 and PSA levels in PCa group were significantly higher than BPH and Control group (EPCA-2: F=200.05, P<0.01; PSA: F=210.65, P<0.01). However, EPCA-2 levels in the prostate cancers with different pathological grade were no significant difference. Furthermore, for detection of prostate cancer, EPCA-2 had a sensitivity of 81.9% and a specificity of 87.6%. Conclusions: Serum EPCA-2 could be used as a potential serological marker to diagnose prostate cancer in Chinese Han population, which was more specific than PSA and did not associate with pathological grades of prostate cancer.     

磷酸甘油酸激酶1和前列腺癌临床特征的相关性及在预后预测中的作用

目的:探讨磷酸甘油酸激酶1在前列腺癌中的表达水平,并分析其与前列腺癌临床特征的相关性以及在预后预测中的作用。方法:收集2013年1月~2014年12月于南方医科大学中西医结合医院住院部行手术治疗的30例良性前列腺增生患者和132例前列腺癌患者标本,用Western blot和免疫组化法分析磷酸甘油酸激酶1在前列腺细胞以及标本中的蛋白表达,并分析磷酸甘油酸激酶1的表达水平与前列腺癌临床特征的相关性以及对前列腺癌预后预测的作用。结果:磷酸甘油酸激酶1在前列腺癌组织和细胞中的表达明显上升,且其表达水平与前列腺癌的Gleason评分、TNM分期、局部浸润、骨转移和血清前列腺特异性抗原(PSA)水平具有显著相关性;Cox分析表明骨转移、血清PSA和PGK1表达是影响前列腺癌患者生存的独立危险因素。生存曲线分析表明高表达的PGK1与前列腺癌的预后不良明显相关。结论:磷酸甘油酸激酶1是影响前列腺癌患者生存的独立危险因素,并能够作为前列腺癌的预后预测标志物。     

The Profile of Prostate Epithelial Cytokines and its Impact on Sera Prostate Specific Antigen Levels

The aim of this study was determined the expression of pro inflammatory cytokines in prostate epithelial cells. Furthermore, we analysed the relation between these cytokines and sera PSA levels according the three groups: 0–4, 4–20 and >20 ng/mL. The study was carried out in five normal prostate (NP), 27 benign prostate hyperplastic (BPH) and 18 prostate cancer (PC). Immunohistochemical and Western blot analysis was performed. Serum levels of PSA were assayed by Immulite autoanalyser. The western Blotting analysis revealed an immunoexpression of IL-1α, IL-6 and TNFα in BPH and PC. IL-1α, was absent in NP. Immunohistochemical analysis showed significant high optical density to IL-1α and IL-6 in cancer epithelial cells (19.45 ± 3.25 and 26.2 ± 3.19) compared to normal cells (1.73 ± 1.51 and 4.83 ± 2.65). While, TNFα optical densities were not significant in NP (12.03 ± 2.9), BPH (9.87 ± 3.85) and PC (13.34 ± 2.34). The different profiles of cytokines according sera PSA levels showed a high immunoexpression of the profile (IL-6+, IL-1α+) in BPH patients with PSA between 0–4 and 4–20 ng/mL. However, PC patients with sera PSA between 4 and 20 ng/mL, showed a significant high immunoexpression of the profile (IL-6+, IL-1α−). This data demonstrate a locally production of pro-inflammatory cytokines by prostate epithelial cells and a cross talk between PSA and these cytokines in prostate pathologies.     

前列腺特异抗原及其密度测定在前列腺癌

为探讨前列腺特异抗原（PSA）及前列腺特异抗原密度（PSAD）的临床应用价值,用放射免疫分析法测定了28例前列腺癌（Pca)及80例良性前列腺增生（BPH）患者的治疗前,后PSA含量,其中18例Pca及50例BPH患者同时测定了PSAD,结果PSA诊断Pca的灵敏度,特异性和准确度分别为85．7％,80．0％和81．4％,在鉴别Pca和BPH上PSAD优于PSA,使假阳性率由PSA的20％降到6％,但在临床应用中要注意结合其它检查进行综合分析。治疗后定期检测血清PSA对早期发现局部复发或转移,判断疗效和估测预后均有重要价值。     

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。     

Prostate adenocarcinoma using Gleason scores correlates with prostate-specific antigen and prostate acid phosphatase measurements.

To evaluate a relationship between Gleason scores of histopathology of prostate carcinoma and concurrent serum prostate-specific antigen (PSA) and prostate acid phosphatase (PAP) values, 65 men with prostate carcinoma were studied. These patients' cumulative Gleason scores were obtained by totaling the primary and secondary patterns, resulting in two groups: 42 patients received high (6-10) and 23 received low (2-5) Gleason scores. Serum PSA and PAP values were measured by radioimmunometric assay 1 to 7 days before surgical procedures or biopsy for prostate carcinoma. Mean serum PSA for patients in the high Gleason score group was 134.39 ng/mL (normal range: 0 to 4), and the mean serum PSA for patients in the low Gleason score group was 23.62 ng/mL. Mean serum PAP for patients with high scores was 28.08 ng/mL (normal range: 0 to 5), and the mean serum PAP for patients with low scores was 18.19 ng/mL. Patients with high Gleason scores showed significantly greater elevation of serum PSA than those with low Gleason scores (P = .047), using two samples to test for groups having unequal variants. Prostate acid phosphatase levels of patients with high scores were not significantly higher than the levels in patients with low scores (P = .60). These results indicate that PSA levels but not PAP levels correlate with Gleason scores.     

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.