前列腺癌与前列腺增生患者血清游离PSA和总PSA的改变

背景与目的:血清总前列腺特异性抗原(totalprostate-specificantigen,TPSA)被认为是目前诊断前列腺癌(carcinomaofprostate,PCa)的最佳肿瘤标记物,游离前列腺特异性抗原(freeprostatespecificantigen,FPSA)与TPSA的比值(FPSA/TPSA)可以提高其诊断PCa的特异性。本研究比较PCa与前列腺增生(benignprostatehyperplasia,BPH)患者血清TPSA及FPSA/TPSA比值水平,为临床诊断PCa提供参考。方法:用酶联免疫法检测66例BPH患者、29例BPH合并急性尿潴留(acuteurinaryretention,AUR)患者及22例PCa患者的血清TPSA、FPSA值,并对三组患者的血清TPSA及FPSA/TPSA的差异进行比较分析。结果:BPH患者血清TPSA(4.10±1.39)μg/L、BPH合并AUR患者血清TPSA(15.50±3.34)μg/L与PCa患者血清TPSA(55.00±13.50)μg/L之间均有显著性差异(P<0.05)。但三组患者血清TPSA在<4.0μg/L、4.0～10.0μg/L、>10.0μg/L区间存在重叠,BPH合并AUR患者与PCa患者重叠更为明显;BPH患者和BPH合并AUR者的FPSA/TPSA值无显著性差别(P>0.05),但与PCa患者比较均有显著性差异(P<0.05);三组患者FPSA/TPSA水平在<0.15、0.15～0.25、>0.25区间均存在重叠。结论:TPSA、FPSA/TPSA在BPH患者、BPH合并AUR患者和PCa患者中均存在重叠。血清TPSA、FPSA/TPSA水平临床上

Changes of serum total PSA and free PSA in patients with prostate carcinoma and benign prostate hyperplasia

BACKGROUND & OBJECTIVE: Total prostate-specific antigen (TPSA) is considered the best marker in diagnosis of carcinoma of prostate (Pca), and FPSA (free prostate specific antigen)/TPSA can improve its specificity in diagnosis of PCa. This study was designed to compare the level of serum TPSA and FPSA/TPSA between PCa and benign prostate hyperplasia (BPH) patients, providing reference for diagnosis of PCa. METHODS: Values of serum TPSA and FPSA of 66 BPH cases, 29 BPH with acute urinary retention (AUR) cases, 22 PCa cases were determined by enzyme linked immunosorbent assay (ELISA). The differences of serum TPSA and FPSA/TPSA of the three groups were compared and analyzed. RESULTS: There were significant differences of serum TPSA concentration among the three groups (P< 0.05), when the serum TPSA in the patients with BPH, BPH and AUR, PCa were 4.1+/-1.39 microg/L, 15.5+/-3.34 microg/L, 55+/-13.5 microg/L, respectively. Serum TPSA concentration overlapped in the three groups especially in AUR group when the TPSA level in the three groups were less than 4.0 microg/L, 4.0-10.0 microg/L, and more than 10.0 microg/L. There was no significant difference between BPH group and AUR group when the FPSA/ TPSA of BPH group was 0.32+/-0.13, AUR group was 0.30+/-0.09 (P >0.05). However, there were significant differences between BPH and Pca group, between AUR and PCa group when the FPSA/TPSA of Pca group was 0.11+/-0.05 (P< 0.05). FPSA/TPSA level also overlapped in these three groups when FPSA/TPSA level was less than 0.15, 0.15-0.25, and more than 0.25. CONCLUSIONS: The serum TPSA and the level of FPSA/TPSA overlapped in these three groups. They can only be regarded clinically as reference index.