前列腺癌患者前列腺特异性抗原水平和FPSA/TPSA临床诊断价值的探讨

目的探讨维吾尔族(简称维族)与汉族前列腺癌患者前列腺特异性抗原(PSA)水平和总PSA(FP-SA)/游离PSA(TPSA)(F/T)临床诊断价值。方法采用微粒子免疫荧光捕获法检测维族与汉族前列腺癌患者血清TPSA和FPSA水平及其比值。结果结果显示,维族与汉族前列腺癌患者分布构成差异均存在统计学意义(维族χ2=51.66,汉族χ2=28.71,P<0.01)。就单检测血清PSA而言,分别有24%(18/75)和23%(22/96)维族和汉族患者PSA<4 ng/mL(χ2=0.02,P>0.05),分别有24%(18/75)和15%(14/96)维族和汉族患者PSA为4~10ng/mL(χ2=2.45,P>0.05)。在血清PSA为4~10 ng/mL和F/T≤0.15条件下,维族患者检出率(24%,18/75)明显高于汉族(6.25%,6/96)(χ2=10.99,P<0.01);在血清PSA>10 ng/mL和F/T≤0.15条件下,维族患者检出率(44%,33/75)与汉族患者检出率(58%,56/96)差异无统计学意义(χ2=3.46,P>0.05)。结论血清PSA和F/T联合检测在前列腺癌临床诊断和鉴别诊断中存在一定程度的漏诊和误诊。

Study on the diagnostic value of PSA level and FPSA/TPSA ratio in patients with prostate cancer

Objective To discuss the clinical diagnostic value of PSA level and FPSA/TPSA（F/T） ratio in Uygur and Han patients with prostate cancer in Xinjiang.Methods Microparticle enzyme immunoassay（MEIA） was used to detect serum TPSA and FPSA levels and its F/T ratio in Uygur and Han patients with prostatic disease.Results Statistical significance were found in the difference of the distribution of Uygur and Han patients（χ2Uygur=51.66,χ2Han =28.71,P〈0.01）.As for the single test of PSA,the level of PSA4 ng/mL accounted for 24% in Uygur and 23% in Han patients（χ2=0.02,P〉0.05）,while the level of 4-10 ng/mL accounted for 24% in Uygur or 15% in Han,respectively（χ2=2.45,P〉0.05）.When PSA was 4-10 ng/mL and F/T ratio was ≤0.15,positive rate of Uygur patients（24%） was significantly higher than that of Han patients（6.25%）（χ2=10.99,P〈0.01）.When PSA was ≥10 ng/mL and F/T ratio was ≤0.15,there was no difference between Uygur（44%） and Han（58%） patients（χ2=3.46,P〉0.05）.Conclusion The co-detection of PSA and F/T ratio has certain degree of misdiagnosis and missed diagnosis in clinical and differential diagnosis on prostate cancer.