血清IGF-1, IGFBP-3, PSA及fPSA在前列腺癌诊断中的意义

目的探讨胰岛素样生长因子-1（IGF-1）和胰岛素样生长因子结合蛋白-3（IGFBP-3）在前列腺癌（PCa）患者血清中的水平及其与前列腺特异抗原（PSA）、游离PSA（fPSA）联合检测的意义。方法采用化学发光法（CLIA）检测52例PCa患者、48例良性前列腺增生症（BPH）患者和48例健康对照者的血清IGF-1，IGFBP-3，PSA及fPSA水平。结果 PCa组IGF-1水平较BPH组、健康对照组明显升高（P＜0.01），BPH组与健康对照组比较，差异无统计学意义（P＞0.05）；PCa组IGFBP-3水平低于BPH组和健康对照组（P＜0.01），BPH组与健康对照组比较，差异有统计学意义（P＜0.01）。IGF-1及IGFBP-3诊断PCa的灵敏度分别为83.6%和76.4%，特异度分别为84.0%和74.0%，阳性预测值分别为85.2%和76.4%,阴性预测值分别为82.4%和74.0%。血清IGF-1与PSA或fPSA联合检测可明显提高诊断PCa的灵敏度。结论 PCa患者的IGF-1及IGFBP-3水平较健康对照者发生改变，IGF-1与PSA或fPSA联合检测更有助于PCa的诊断。

Clinical significance of serum levels of IGF-1, IGFBP-3, PSA and fPSA in diagnosis of prostate cancer

Objective To evaluate the clinical significance of serum levels of insulin-like growth factor-1 （IGF-1）, insulin-like growth factor binding protein-3 （IGFBP-3） in the diagnosis of prostate cancer （PCa）, as well as the significance of their combination with prostate-specific antigen （PSA） and free PSA （fPSA）. Methods The serum levels of IGF-1, IGFBP-3, PSA and fPSA were measured with chemoiluminescence immunoassay （CLIA） in 52 patients of pathologically identified prostate cancer, 48 cases of benign prostatic hyperplasia （BPH） and 48 healthy individuals. Results The serum levels of IGF-1 was significantly higher in the PCa group than in the BPH and healthy control groups （P〈0.01）. However, there was no statistically difference in the IGF-1 level between BPH and healthy control groups （P〉0.05）. The serum concentration of IGFBP-3 was significantly lower in the PCa group than in the BPH and healthy control groups （P〈0.01）, and there was also significant difference between BPH and healthy control group （P〈0.01）. IGF-1 and IGFBP-3 had the sensitivity of 83.6%and 76.4%in the diagnosis of PCa respectively, and specificity of 84.0%and 74.0%, positive prediction value of 85.2%and 76.4%, and negative prediction value of 82.4% and 74.0%, respectively. Combined detection of serum levels of IGF-1 and PSA/fPSA increased the sensitivity of diagnosis significantly. Conclusion Serum levels of IGF-1 and IGFBP-3 are quite different in PCa patients when compared with normal healthy control. Combined application of IGF-1 and PSA or fPSA enhances their clinical value in diagnosis of PCa.