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.

The application of complex PSA and its relative indexes in the detection of prostate cancer

Objective To study the diagnostic value of complex PSA (cPSA), the calculated free/total PSA (f/t PSA) ratio 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 0.2–20.0 ng/ml were accessed from July 2001 to May 2002 consecutively. The correlation between tPSA and cPSA was analyzed. The receiver 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 three indices as independent variables 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 cutoff yielding 95% sensitivity. Serum cPSA concentration was determined to be the best index among the three through logistic regression analysis. 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.