移行区前列腺特异性抗原密度诊断前列腺癌的应用研究

目的探讨移行区前列腺特异性抗原密度（PSATZ）诊断前列腺癌（PCa）的价值。方法选取血清前列腺特异性抗原（PSA≥4ng/ml）和（或）指检阳性（digital rectal exami-nation,DRE）患者行经直肠超声（transrec-tal ultrasonography,TRUS）检查,并经手术病理或自动活检枪行系统穿刺活检证实的79例患者进行分析。通过与血清PSA和前列腺特异性抗原密度（PSAD）对比,分析PSATZ诊断前列腺癌的敏感性和特异性。结果PSA、PS-AD、PSATZ三者相比,PSATZ优于血清PSA、PSAD,故PSATZ是较佳的PCa检测指标,具有最大的ROC曲线下面积和较高的特异性。结论PSATZ法优于血清PSA及PSAD法,用移行区体积对PSA进行校正具有一定价值。故在进行PCa筛选时,应在经直肠超声检查的基础上,有必要对于PSATZ大于0.35ng/（ml·cm^3）的患者进行超声引导下穿刺活检（Ultrasound-guided prostatic biopsies）。

Application of prostate specific antigen density of transition zone in prostate cancer

Objective To study the value of the prostate specific antigen density of the transition zone （PSATZ） in the detection of prostate cancer （PCa）. Methods A total of 29 PCa patients, 50 benign prostate hypertrophy （BPH） in patients with intermediate serum PSA ≥4.0 ng/ml and/or digital rectal examination （ DRE, ＋ ） level underwent cancer was found on biopsy or transrectal ultrasound （TRUS） guided biopsy. Compared with PSA and PSAD, the sensitivity and specificity of diagnosis in PSATZ was evaluated. Results Comparing with PSA, PSAD, PSATZ was superior to PSA, PSAD as a predictor of PCa, PSATZ had the highest the area of the receiver operating characteristic curve （AUG） and higher specificity. Conclusion As a predictor of PCa, PSATZ is superior to PSA and PSAD. It has great value that prostate specific antigen adjusted for transition zone volume （PSATZ） in discriminating prostate cancer with benign prostatic hyperplasia. Base on TRUS during screening, biopsies should be done for patients with PSATZ value higher than the cut off 0.35ng/ （ ml. cm^3 ）.