血清总前列腺特异抗原及其F/T比值对前列腺癌诊断价值的研究

目的探讨血清总前列腺特异抗原（T-PSA）、游离PSA与T-PSA比值（F-PSA/T-PSA）对前列腺癌的诊断价值。方法检测经病理诊断的29例前列腺癌、54例前列腺增生患者的血清T-PSA及F-PSA,并计算F-PSA/T-PSA比值。结果（1）前列腺癌组患者的T-PSA明显高于前列腺增生组（P〈0.05）,F-PSA/T-PSA明显低于前列腺增生组（P〈0.05）;（2）T-PSA、F-PSA/T-PSA在工作特征曲线（ROC曲线）下的面积大小分别为0.680、0.850;由ROC曲线确定的诊断前列腺癌的最佳临床判断值为T-PSA〉6ng/ml、F-PSA/T-PSA〈0.18;据此临界值诊断前列腺癌的敏感度、特异度分别为：T-PSA69.0%、51.8%,F-PSA/T-PSA79.3%、72.2%。结论F-PSA/T-PSA是PSA对前列腺癌诊断的有益补充。

Significance of serum PSA,F-PSA/T-PSA ratio in diagnosis of prostate cancer

Objective To compare the significance of prostate-specific antigen （PSA）,F-PSA/T-PSA ratio in prostate cancer diagnosis. Methods 83 patients （29 prostate cancer,54 benign prostatic hyperplasia）evaluated total PSA,free PSA,calculate F/T-PSA ratio. A direct comparison was performed between the different TPSA ,F/T-PSA ratio to evaluate their ability to detect prostate cancer. Results Of the 83 patients evaluated, 29 had prostate cancer detected. The mean and median values of PSA was significantly higher and the F/T PSA ratio was lower in patients with prostate cancer. The F/T PSA ratio performed better than total PSA. A higher specificity was observed with the F/T PSA ratio than with PSA. Conclusions The use of F/T-PSA ratio offers improved prostate cancer detection compared with total PSA.