血清TPSA、FPSA和F/T比值在前列腺癌和良性前列腺增生的诊断价值

目的 探讨血清总前列腺特异抗原(TPSA)、游离前列腺特异抗原(FPSA)、FPSA/TPSA(F/T)值对前列腺癌(PC)和良性前列腺增生(BPH)的诊断价值。方法 采用微离子酶免疫标记法测定PC患者和BPH患者血清TPSA、FPSA浓度,并计算F/T值。结果PC组、BPH组TPSA浓度明显高于正常对照组(P<0.01),并与年龄呈正相关(P<0.05);在TPSA>10.0ug时,两组比较TPSA,F/T比值有显著差异(P<0.01):在TPSA<10.0ug时,两组比较TPSA无显著差异,而F/T值PC组明显低于BPH组(P<0.01)。TPSA浓度阈值为5.0ug/L时,PC的诊断效率最高(66.8％),F/T比值为0.20水平时,PC的诊断效率最高(69.6％),而联用TPSA 5.0ug/L、F/T值0.20双界值标准诊断PC的效率将提高到77.5％。结论PC和BPH患者TPSA均增高,当TPSA<10.0ug/L时,对PC的诊断缺乏特异性,而F/T值PC的诊断更具有临床价值;以TPSA5.0ug/L和F/T0.20双界值对PC的鉴别诊断效果最佳。

The diagnostic value of serum TPSA,FPSA and F/T ration in prostatic cancer and BPH

Objective To investigate the diagnostic value of total PSA(TPSA), free PSA(FPSA) and the ratio of free PSA to total PSA(F/T ratio) to discriminate prostate cancer (PC) and BPH patient. Methods Three groups: healthy males, males with BPH and PC patients were included in this study, FPSA and TPSA were measured with Microparticle Enzyme Immunosassay (MEIA) technology, the F/T ratio was calculated based on the results. Results The concentration of TPSA in PC and BPH gruop are both significantly higher than control(P<0. 01) ,and has positive correlation with ages (P<0.05). When TPSA>0. 0ug/1, there is statistical difference between PC group and BPH group, when TPSA< 10. 0ug/1, there is no difference. But the ration of F/T in the PC group are significantly lower than those in BPH group (P< 0. 01) , When the threshold of TPSA is 5. 0ug/1, the diagnostic efficency of PC is 66. 8% ; When the threshold of F/T is 0.20, the diagnostic efficency of PC is 69. 6% . The combining of the two threshold of TPSA(5. 0Ug/1) and F/T ration (0. 20) can improve the diagnostic efficiency of PC to 77. 5% . Conclusions The concentration of TPSA in PC and BPH patients are all increase, When TPSA< 10. 0ug/1, It has no specificity on the diagnosis of PC,but the ratio of F/T has clinical value, Combination of the two threshold of TPSA (5. 0ug/1) and F/T ratio (0. 20) can achieve the best diagnostic value.