BALP与f-PSA/t-PSA联合检测对前列腺癌骨转移诊断价值的研究

目的评价BALP与f-PSA/t-PSA单独及联合在诊断前列腺癌（Pca）发生骨转移时的意义及应用价值。方法56例前列腺癌患者中经骨扫描和3个月随访CT发现有35例存在多发生骨转移灶。ELISA方法检测患者血清中的BALP、PSA及f-PSA浓度。结果骨转移组外周血BALPt、-PSA水平均显著高于未发生骨转移前列腺癌对照组（P〈0.05）,相反f-PSA/t-PSA比值显著低于未发生骨转移对照组。在骨转移诊断的敏感性和特异性的比较中,f-PSA/t-PSA比值〈0.15诊断的敏感度最高,可以达到85.7%,但是其特异度只有47.6%;而f-PSA/t-PSA＋BALP敏感度最低为62.9%,但是可以提高特异度达到76.2%。结论联合检测BALP＋f-PSA/t-PSA可以提高单独应用BALP在诊断前列腺癌发生骨转移中诊断特异度。BALP＋f-PSA/t-PSA检测可尽早、全面地发现前列腺癌患者全身骨转移。

The diagnostic value on detecting the BALP and f-PSA/t-PSA in patients with bone metastasis of prostatic cancer

Objective To investigate the expression of BALP and free/total prostate-specific antigen（f/t-PSA） in patients of prostatic carcinoma（Pca）,and evaluate the importance on detecting the BALP and f-PSA/t-PSA in prostatic carcinoma complicating osseous metastasis patients.Methods Osseous metastasis was diagnosed by the bone imaging adding CT after 3 monthes as glod standard,35 patients having multiple osseous metastasiswere recruited into experiment group,other 21 prostatic carcinoma patients without osseous metastasis were control group,extecting the PSA,BALP by ELISA methods,calculate the ensitivity and specificity of different diagnosis methods.Results The level of t-PSA and BALP in peripherial blood in osseous group show significant higher than control group（P〈0.05）,while the f-PSA/t-PSA show significant lower than control group with none osseous metastasis.The sensitivity of f-PSA/t-PSA0.15 is highest（85.7%）,but specificity lower（47.6%）;The sensitivity combining f-PSA/t-PSA and BALP was lowest（62.9%）,but the specificity was highest（76.2%）.Conclusion Combining the BALP with f-PSA/t-PSA can increase specificity of BALP on diagnosising the osseous metastasis of prostatic carcinoma.Detection of BALP combined with f-PSA/t-PSA is a valuable scheme for early diagnosis of skeletal metastasis of prostate cancer.