F/TPSA比值及PSAD对TPSA灰区前列腺癌的诊断意义

目的探讨血清前列腺特异抗原(TPSA)、血清游离PSA及总PSA比值(F/TPSA)及前列腺特异性抗原密度(PSAD)对TPSA灰区(4.0~10.0μg/L)前列腺癌的诊断价值。方法回顾性分析TPSA在灰区的82例前列腺癌患者及157例良性前列腺增生症(BPH)患者血清PSA相关检测结果。结果2组患者血清TPSA值无显著性差异;前列腺癌组F/T显著低于BPH组(P<0.01),PSAD显著高于BPH组(P<0.01)。以F/T≤0.16、PSAD≥0.15作为诊断前列腺癌阈值的敏感性为86.7%,78.9%,特异性为63.1%,53.8%。结论TPSA>4.0μg/L作为筛选前列腺癌的临界值存在一定缺陷;当TPSA为4.0~10.0μg/L诊断灰区时,F/T比值与PSAD对诊断前列腺癌有重要的临床意义。

Diagnosis significance of relative value of F/TPSA and PSAD for TPSA gray zone prostate cancer

Objective It is to investigate the diagnosis significance of TPSA, F/TPSA and PSAD for prostate cancer (PCa) with TPSA in gray zone (4.0 - 10.0 μg/L,). Methods The correlated determined results of serum PSA of 82 patients with PCa and 157 patients with benign prostatic hypertrophy (BPH) whose PTSA was in gray zone were retrospective ana-lyzed. Results The difference in serum TPSA between the two groups was not significant(P>0.01), but F/T of Pca group was significantly lower and PSAD of PCa was significantly higher than that of BPH group(P < 0.01 ). When F/≤0.16 orPSAD≥0.15 were used as the standard to diagnose PCa, sensitivity were 86.7%, 78.9% and specificity were 63.1%, 53.8% respectively. Conclusion It is unreasonable that TPSA>4.0 μg/L is regarded as a critical value for the diagnosis of prostate carcinoma. When TPSA level is from 4.0 - 10.0 μg/L in gray zone, F/T ratio and PSAD has a significant value for diagnosing PCa.