血清前列腺特异抗原测定的临床意义

以12例前列腺癌、102例前列腺良性增生(BPH)、16例直肠指检(DRE)异常、5例前列腺炎及30例正常男性为对象,用酶免法测定血清前列腺特异抗原(Prostate specific antigen,PSA)浓度,用放免法测定其中37例。前列腺癌的PSA浓度明显高于BPH(P<0.01),PSA对前列腺癌诊断的敏感性为91.7％。DRE异常者大于BPH(P<0.05),低于前列腺癌(P<0.01)。BPH高于正常对照(P<0.01)。前列腺切除术后一日的PSA高于术前(P<0.01),术后6～8日同术前无显著性差异(P>0.05)。70岁以上高于70岁以下(P<0.05)。PSA>10ng/ml时酶免检测值低于放免法(0.010.05)。单纯PSA升高并不能说明任何特异性病理过程,前列腺癌的诊断,应结合PSA系列测定值及DRE和经直肠B超(TRUS)来综合分析。

Clinical Usefulness of Serum Prostate Specific Antigen

In this expriment serum prostate specific antigen CPSA) were measured with immuno-enzy-matic technique in 12 prostate cancer. 102 BPH. 16 digital rectum examination (DRE) abnormality, 5 pro-statics, and 30 normal men. To comparison with immuno-enzymatic method. 37 serum sample were measured with radio-immunologic method. The levels of PSA in prostatic cancer were obviously higher than those in BPH (P< 0. 01) . The sensitivity of PSA in the detection of prostatic cancer was 93. 3%. on the other hand. 41. 2% of the patients with BPH have PSA levels high than 4. 0 ng/ml. Serum PSA levels in patients with DRE abnomality were higher than those in BPH (P < 0. 05) , but it were obviously lower than those in prostatic cancer. A significant difference in PSA was found between BPH and the normal men (P < 0. 01) . the change of PSA was obvious in patients after operation 1 day (P < 0. 01) . and it fell to the level as preoperative 7 days later (P > 0. 05) . PSA levels measured with immuno-enzymatic method was lower than radio-immunologic method (0. 01 < P < 0. 05) . but the difference was not obvious when the level was below 10 ng/ml. It was found that PSA is the most improtant. accurate, and clinically useful biochemical marker in the prostate, but its value is limited as a marker in screening prostatic cancer.