复合PSA及相关指标在前列腺癌诊断中的应用

目的 :研究复合前列腺特异性抗原 (CPSA)在前列腺癌诊断中的应用价值。　方法 :总PSA(TPSA)值在0 .2～ 2 1.9μg/L的血清值共 15 2例 ,病理诊断证实 2 1例为前列腺癌 ,131例为前列腺增生。Bayer化学发光法测得TPSA、游离PSA(FPSA)和CPSA ,计算FPSA/TPSA比值。比较前列腺增生和前列腺癌CPSA、TPSA和FPSA/TPSA比值的ROC曲线下面积。通过Logistic回归分析判断 3者诊断前列腺癌准确性的差异。　结果 :CPSA、TPSA、FPSA/TPSA比值的曲线下面积分别为 0 811、0 799和 0 376。在保持 95 %敏感性时 ,CPSA、TPSA和FPSA/TPSA比值的特异性分别为 6 2 .0 %、5 7.0 %和 4 7%。Logistic回归分析确定CPSA是最好的前列腺癌诊断指标。　结论 :TPSA值在 0～ 2 0 μg/L时 ,CPSA和TPSA均较FPSA/TPSA比值更好地检出前列腺癌 ,且CPSA略优于TPSA。在保持同一敏感性时 ,CPSA较TPSA具有更高的特异性

The Aoolication of Comolexed PSA and Its Relative Indexes in the Diagnosis of Prostate Cancer

OBJECTIVES: To investigate the applicable value of complexed prostate-specific antigen (PSA) in the diagnosis of prostate cancer. METHODS: From July 2001 to May 2002, 152 consecutive patients (21 were prostate cancer and 131 were benign prostate hyperplasia proved by pathologic diagnosis) whose serum total PSA (TPSA) ranged from 0.2 microgram/L to 21.9 micrograms/L were accessed. The measurement of total PSA, free PSA (FPSA) and complexed PSA was performed by chemiluminescence immuno-assay method. The correlation of TPSA and CPSA was analysed by SPPS 10.0. The receiver operating characteristic curves were generated by plotting the sensitivity versus specificity. RESULTS: Area under the curve was calculated for each assay. Logistic regression analysis was used to evaluate the ability of CPSA, TPSA and FPSA/TPSA. Area under the ROC curve of CPSA, TPSA and FPSA/TPSA ratio were 0.811, 0.799 and 0.376, respectively. The specificity for the complexed PSA, TPSA and FPSA/FPSA ratio were 62%, 57% and 4.7%, respectively, at cutoffs yielding 95% sensitivity. CPSA was determined to be the best index among the three ones by logistic regression analysis. CONCLUSIONS: The CPSA and TPSA level in serum may provide good differentiation effect of prostate cancer and benign prostate hyperplasia than FPSA/TPSA ratio. The CPSA performs better than TPSA. At the same sensitivity, CPSA has higher specificity.