PSAD和游离/总PSA比值在前列腺癌诊断中的意义

 目的　比较研究前列腺特异抗原(PSA)、PSA密度(PSAD)和游离/总PSA比值(F/TPSA)在前列腺癌诊断中的价值。方法　41例前列腺增生和22例前列腺癌患者，术前用放免法测定血清PSA和游离PSA。所有患者经直肠腔内B超测出前列腺体积，求得PSAD，用t检验比较分析。结果　前列腺癌组的PSA、PSAD均显著高于前列腺增生组(PSA：46.3±33.8μg/Lvs7.04±6.91μg/L，P=0.000021；PSAD：1.43±1.21μg。L-1。ml-1vs0.14±0.15ng。ml-1。ml-1，P=0.000055)。两组的F/TPSA比值无显著差异(0.18±0.11vs0.22±0.18，P=0.34)。结果　PSA和PSAD是鉴别前列腺癌的良好指标，对于PSA可疑者，PSAD有助于区分前列腺癌和前列腺增生，本组游离/总PSA比值不能帮助鉴别诊断。

PSAD and Free-to-Total PSA Ratio in Patients with Prostate Cancer or Benign Prostatic Hyperplasia

Objective To evaluate PSAD and free-to-total PSA ratio in the differential diagnosis of prostate cancer.Methods 41 BPH and 22 prostate cancer (PCa) patients had their serum prostate specific antigen (PSA) and free PSA levels measured by radioimmunoassay.Prostate glands volumes of all patients were detected using transrectal ultrasound to calculate PSA density (PSAD).Results PSA,PSAD of PCa were significantly higher than that of BPH (PSA：46.3±33.8μg/Lvs7.04±6.91　μg/L，P=0.000021；PSAD：1.43±1.21μg.L-1.ml-1vs0.14±0.15ng.ml-1.ml-1，P=0.000055).Theres no difference of F/TPSA ratio between BPH and PCa cases (0.22±0.18vs 0.18±0.11，P=0.34).Comparing with PSA,PSAD provides better sensitivity and specificity (90.9% and 92.7%)。Conclusion:PSAD can provide useful information in differentiating PCa and BPH.But no diagnostic value of F/TPSA ratio is shown in our study.