F/T PSA在TPSA4～10μg/L之间的前列腺增生和前列腺癌鉴别诊断中的意义

目的：探讨总前列腺特异性抗原（TPSA）与游离前列腺特异性抗原（FPSA）的比值（F／TPSA）在TPSA4～10μg／L之间的良性前列腺增生（BPH）和前列腺癌（PC）中鉴别诊断的意义。方法：采用放免法对281例病人的TPSA和FPSA进行测定，并计算F／TPSA，其中TPSA在4～10μg／L的PC和BPH病人分别是10例和51例。结果：PC组和BPH组的TPSA分别是6．22μg／L和6．04μg／L，两组相比差异不显著（P＞0．05）；而F／TPSA比值分别是0．11和0．21，两组相比差异显著（P〈0．01）。当F／TPSA为0．15～0．20时，诊断的敏感性和特异性分别是70％～90％和88％～67％。结论：F／TPSA有助于鉴别TPSA在4～10μg／L之间的BPH和PC，具有较高的敏感性和特异性，可以减少不必要的活检，是一种较好的鉴别BPH和PC的方法。

Clinical significance of F/T PSA in differential diagnosis of benign prostate hyperplasia and prostate cancer with TPSA values between 4. 0 and 10. 0 μg/L

Objectives: To evaluate the clinical significance of the proportion of free prostate specific antigen(PSA,FPSA) to total prostate specific antigen(TPSA,F/T PSA) in differential diagnosis of benign prostate hyperplasia (BPH) and prostate cancer (PC) with TPSA values between 4. 0 and 10. 0 μg/L. Methods:Patients consisted of 51 BPH and 10 PC. TPSA and FPSA were determined using radioimmunoassay. The F/T PSA was calculated by dividing the FPSA to TPSA values. Results:The TPSA values in PC group and BPH group were 6. 22 μg/L and 6. 04 μg/L, respectively, the difference was not significant (P>0. 05 );the F/T PSA were 0. 11 and 0. 21,the difference was significant (P<0. 01). When F/T PSA values were 0. 15-0. 20, the sensitivity and specificity were 70%-90% and 88% -67%, respectively, the accuracy was 84%-85%. Conclusions: F/T PSA was a bettermethod in differential diagnosis between BPH and PC, its sensitivity and specificity were high,which may reduce the number of unnecessary biopsies in patients with TPSA between 4. 0 and 10. 0 μg/L.