TPSA、FPSA/TPSA及PSAD在前列腺癌诊断中作用的比较研究

目的比较TPSA、FPSA／TPSA及PSAD在前列腺癌诊断中的作用价值。方法回顾性研究经病理确诊的前列腺癌患者61例和前列腺增生患者74例的临床资料，计算肌值和PSAD值。统计分析两组间各指标的差异性。计算曼项指标不同取值时诊断前列腺癌的敏感度和特异度，比较其在前列腺癌诊断中的价值。结果前列腺癌（PCA）组与前列腺增生（BPH）组之间TPSA、FPSA／TPSA及PSAD的差异均有统计学意义。TPSA截点为4ng／ml和10ng／ml时的敏感度分别为98．36％和86．88％，特异度为55．05％和69．74％。F/T截点为0．1、0.15和0.20时的敏感度分别为38．64％、70．45％和81．82％，特异度为60．71％、58．49％、49．31％。PSAD截点为0．1、0．15和0．20时的敏感度为98．36％、93．44％、85．25％，特异度为67．41％、69．51％、81．25％。结论TPSA和PSAD在诊断前列腺癌时的敏感度相近，但PSAD的特异度优于TPSA。F/T作为单独指标诊断前列腺癌的价值不大，但作为TPSA的辅助指标能提高诊断的特异度。

Significance of TPSA, FPSA/TPSA and PSAD in diagnosis of prostatic cancer: a comparative study

Objective To compare the value of TPSA, FPSA/TPSA and PSAD for the diagnosis of prostatic cancer (PCa). Methods Data of 61 patients with PCa and 74 patients with BPH were reviewed retrospectively. The differences of TPSA, FPSA/TPSA and PSAD between the two groups were analyzed, and the sensitivity and specificity of them in diagnosing PCa were compared. Results TPSA, FPSA/TPSA and PSAD were significantly different between PCa and BPH groups. At the shear point of 4 ng/ml and 10 ng/ml, the sensitivity of TPSA was 98.36% and 86.88%, and the specificity was 55.05% and 69.74%, respectively. At the shear point of 0.1, 0.15 and 0.20, the sensitivity of F/T was 38.64%, 70.45% and 81.82%, and the specificity was 60.71%, 58.49% and 49.31%, respectively. At the shear point of 0.1, 0.15 and 0.20, the sensitivity of PSAD was 98.36%, 93.44% and 85.25%, and the specificity was 67.41%, 69.51% and 81.25%, respectively. Conclusions PSAD is more reliable than TPSA and F/T for diagnosing PCa.