血清t-PSA、f-PSA/t-PSA、DRE及TRUS对前列腺癌的诊断价值分析

目的探讨前列腺特异抗原(t-PSA)、游离PSA与总PSA比值(f-PSA/t-PSA)、直肠指诊(DRE)和直肠超声(TRUS)诊断前列腺癌(PCa)的价值。方法回顾性分析经病理诊断的31例PCa患者和34例前列腺增生(BPH)患者的血清PSA水平、f-PSA/t-PSA比值、DRE和TRUS的检测结果。结果 ROC曲线分析结果显示t-PSA和f-PSA/t-PSA对PCa的诊断敏感性分别为67.7%和77.4%,特异性分别为58.8%和73.5%,曲线下面积(AUC)分别能达到0.659和0.808。而DRE和TRUS对PCa的诊断敏感性分别为58.1%和51.6%,特异性分别为82.3%和73.5%。联合f-PSA/t-PSA与DRE或TRUS检测,对PCa的诊断敏感性分别上升到87.1%和83.9%,3项指标联合可提高诊断敏感性至90.3%。结论 f-PSA/t-PSA比t-PSA更适合用于临床PCa的诊断,联合f-PSA/t-PSA,TRUS和DRE检查可明显提高临床PCa的检出率。

Study of the diagnostic value of serum t-PSA,f-PSA/t-PSA,DRE,TRUS in patients with prostate cancer

Objective To investigate the value of t-PSA,f-PSA/t-PSA,DRE and TRUS in prostate cancer diagnosis.Methods Based on retrospective investigation method,31 patients with PCa and 34 patients with BPH were collected.Serum t-PSA,f-PSA/t-PSA ratio,DRE and TRUS were compared to valuate their ability to detect prostate cancer.Results The ROC curve indicated the sensitivity of t-PSA and f-PSA/t-PSA reached 67.7% and 77.4%,the specificity reached 58.8% and 73.5%.and the AUC value reached 0.659 and 0.808.The data also showed that the diagnostic sensitivity of DRE and TRUS were 58.1% and 51.6%,and the diagnostic specificity of were 82.3% and 73.5%,respectively.The diagnostic sensitivity of f-PSA/t-PSA combined DRE or TRUS were 87.1% and 83.9%,and which of 3-marker combination reached 90.3%.Conclusion The use of f-PSA/t-PSA offers improved prostate cancer detection compared with t-PSA.It can enhance the diagnostic accurate rate of PCa by combining f-PSA/t-PSA,TRUS and DRE.