PSA密度对PSA浓度轻度升高且肛指检查正常的前列腺癌诊断的意义

目的：探讨血中前列腺特异性抗原（PSA）浓度与前列腺体积的比值（PSA密度，PSAD）对PSA浓度在41～10μg／L之间、肛指检查（DRE）正常的良性前列腺增生（BPH）和前列腺癌（PC）鉴别诊断的意义、方法：对PSA浓度在4～10μg／L、DRE正常的12例PC和14例BPH病人的PSAD进行回顾性分析。PSAD为PSA浓度与前列腺体积的比值。结果：PC组和BPH组的PSA分别是6．20μg／L和6．16μg／L．两组相比差异不显著（P＞0．05）．而PSAD分别是0．29和0．16．两组相比差异显著（P＜0．01）、当取PSAD阈值为M＞0．20时．鉴别诊断的准确性最高．为76．92％．敏感性和特异性分别为75．00％和78．57％。结论：PSAD有助于鉴别PSA在4～10μg／L之间、DRE正常的BPH和PC．具有较高的敏感性和特异性，可减少不必要的活检，推荐使用的PSAD闭值为＞0．20。

Clinical significance of PSAD in differential diagnosis of prostate cancer and benign prostate hyperplasia with PSA levels between 4～10.0 μg/L and with normal DRE

Objectives: To evaluate the clinical significance of the PSA density (PSAD) in differential diagnosis of prostate cancer (PC) from benign prostate hyperplasia (BPH) with TPSA levels between 4.0-10.0μg/L, and with normal digital rectal examination(DER). Methods:We used a retrospective analysis. Patients were consisted of 12 PC patients and 14 BPH patients. PSA levels were determined using immunoassay. The PSAD was calculated by dividing the PSA by prostate volume. Results:The PSA levels in PC group and BPH group were 6.20μg/L and 6.16μg/L, respectively, the difference was not significant (P＞0.05).While the PSAD were 0.29 and 0.16,the difference was significant (P＜0.01). When PSAD were＞0.20,the sensitivity and specificity were 75. 00% and 78. 57%,respectively,the accu racy was 76. 92%. Conclusions:PSAD was a useful method and with higher sensitivity and specificity in differential diagnosis PC from BPH,and it may reduce the number of unneces sary biopsies in patients with PSA between 4.0-10.0μg/L, and normal DRE. The suggest ing threshold of PSAD was＞0.20.