血清PSA、FPSA/TPSA、PSAD对前列腺癌诊断的临床意义

目的　进一步了解前列腺特异性抗原 (PSA)、游离PSA/总PSA(FPSA/TPSA)、PSA密度 (PSAD)对国人前列腺癌诊断的意义。方法　选择前列腺癌 40例 ,良性前列腺增生 46例 ,PSA <2 0ng/ml,比较两组间PSA、FPSA/TPSA、PSAD的差异及当取不同界值时对前列腺癌诊断的意义。结果　PSA、PSAD两组间均数差异有显著意义 (P <0 .0 1及P <0 .0 5 ) ;FPSA/TPSA两组均数差异无统计学意义 (P >0 .0 5 ) ;当PSA取 4ng/ml、6ng/ml及 10ng/ml为界值时 ,诊断前列腺癌的敏感性和特异性分别为 92 .5 %和 45 .7%、67.5 %和 78.3 %、3 0 .0 %和 91.3 % ;当PSAD分别以 0 .15和 0 .2为界值时 ,诊断前列腺癌的敏感性和特异性分别为 5 0 %和 67.4%、3 0 %和 84.8%。结论　当PSA≥ 10ng/ml时 ,提示高度怀疑前列腺癌 ,应进行前列腺穿刺活检确诊 ;PSAD诊断前列腺癌与PSA相比较无明显优越性。

Clinical Significance of Serum PSA, Free-to-Total PSA Ratio and PSAD in Diagnosis of Prostate Carcinoma

Objective To investigate the diagnostic sig ni ficance of prostate-specific antigen(PSA),free-to-total PSA ratio(F/T),and de nsity of PSA(PSAD) in Chinese men.Method 40 patients with prost ate carcinoma and 46 patients with benign prostate hyperplasia(BPH) whose PSA wa s less than 20ng/ml were chosen.PSA,F/T,PSAD were compared between the two group s.Diagnostic accuracy for various values of parameters were investigated. Results Although there was no significant difference in mean F/T betw een two groups( P >0.05),the mean PSA level and PSAD were significantly highe r in patients with prostate carcinoma than those in BPH patients( P<0.01,P< 0 .05).In discriminating prostate carcinoma,when the value of PSA was 4ng/ml,6ng/m l and 10ng/ml,the sensitivity was 92.5%, 67.5%and 30% respectively,and the speci ficity was 45.7%,78.3%and 91.3% respectively.While the value of PSAD was 0.1 5ng/ml/cc and 0.20ng/ml/cc,the sensitivity was 50% and 30%,and the specificity w as 67.4% and 84.8%.Conclusions In patients with PSA more than 1 0ng/ml,prostate biopsy should be undergone to detect cancer.PSAD is not superior to PSA in the diagnosis of prostate carcinoma.