前列腺癌患者血清T-PSA、F-PSA水平和F/T比值变化及临床意义

目的:观察前列腺癌患者(PCa)血清总前列腺特异抗原(T-PSA)、游离前列腺特异抗原(F-PSA)和F-PSA/T-PSA比值(F/T值)变化,探讨其临床意义。方法: 用MEIA法检测121例PCa患者和554例良性前列腺增生(BPH)患者术前及其中82例PCa患者和396例BPH患者术后血清T-PSA、F-PSA水平,并计算F/T值。结果: 术前PCa患者T-PSA与F-PSA明显高于BPH患者,F/T比值明显低于BPH患者,两组间差异均显著(P＜0.01)。术后两组患者T-PSA、F-PSA水平较术前明显降低,F/T值则明显升高,与术前结果比较,差异均显著(P＜0.01)。在T-PSA＜10.0 μg/L范围,PCa患者占33.9%,BPH患者占85.5%,两组患者结果存在交叉。F/T值＜0.16时,PCa患者占83.5%,BPH患者占6.5%,两组差异显著(P＜0.01),F/T值＜0.16时诊断的灵敏度、特异性、阳性预示值、阴性预示值分别为83.5%、86.7%、81.1%、88.2%。结论: PCa和BPH患者手术前后血清T-PSA、F-PSA水平及F/T值均有明显变化。以F/T比值＜0.16作为PCa诊断临界值,可有效提高早期PCa诊断的特异性和敏感性,减少不必要的活检。

Changes of serum T - PSA, F - PSA and F/T ratio in patients with prostate cancer and its clinical significance

AIM: To evaluate the changes of serum total prostate specific antigen (T-PSA), free prostate specific antigen (F-PSA) and the ratio of F-PSA to T-PSA (F/T) in patients with prostate cancer (PCa) and its clinical significance. METHODS: The concentrations of T-PSA and F-PSA in serum were measured by micropartical enzyme immunoassay (MEIA) using AxSYM System, and the F/T ratio was calculated. RESULTS: Before operation, the concentrations of T-PSA and F-PSA in patients with PCa were much higher and F/T ratio was significantly lower than that in patients with benign prostate hyperplasia (BPH). T-PSA and F-PSA levels decreased, but F/T ratio increased after operation in PCa and BPH. F/T ratio in 83.5% PCa and 6.5% BPH was less than 0.16. To diagnosis PCa, the sensitivity of F/T ratio was 83.5%, and the specificity was 86.7%. CONCLUSION: Serum T-PSA, F-PSA and F/T ratio are important parameters for the early diagnosis of prostate cancer. [