前列腺癌及前列腺增生症中前列腺特异抗原密度（DPSA）的变化

目的研究前列腺癌及前列腺增生症中前列腺特异抗原密度(DPSA)的变化。方法回顾1997-10-01～1998-03-31间，在北大一院就诊的前列腺癌患者，及同期就诊的相同例数的前列腺增生症患者的前列腺特异抗原密度(DPSA)。所有患者均经组织学证实，并对前列腺癌患者予以分期分级，最后分别对各期前列腺癌及其与前列腺增生症者相比较，数据经统计学处理。结果发现DPSA是前列腺癌诊断的一项有意义的参考指标。当采用一定的界值，其效果明显优于PSA和游离与总PSA的比值(F/T)。无论是总PSA(T-PSA)或游离PSA(F-PSA)值的DPSA与前列腺增生症比较都有显著性差异(分别是P＜0.001，0.001＜P＜0.05)；同时，T-PSA和F-PSA的DPSA在PC早期(A-B期)与中期(C期)之间无明显差异，但中期(C期)与晚期(D期)的DtPSA(T-PSA计算的DPSA结果)差异显著。值得注意的是DtPSA在早期(A-B)PC与前列腺增生症比较时，发现其DPSA的差异性是显著的P＜0.001，提示DPSA在PC早期就有诊断意义的可能性。结论DPSA对区分前列腺增生症与PC有较高的临床价值；在PC早期(未发生局限性侵润及转移之前)就有提示PC的可能，对早期诊断PC及彻底根治性切除肿瘤提供更多的机会。但因病例数量较少，其结论有待于更大宗的病例进行证实；因DtPSA在PC的C期与D期呈现显著性的差异，在采用适当的界值时或许能大大减少对晚期PD的手术介入，使激素治疗更有针对性。

Changes of the Density of Prostate Specific Antigen in Benign of Prostate Hyperplasia and Prostatic Cancer

Objective　To study the changes of the density of prostate specific agent(DPSA) in prostatic cancer (PC) and in benign of prostate hyperplasia (BPH).Methods　To review the material of 105 patients who had treated for PC and 130 patients with BPH,during October 1st 1997 to March 31th 1998,in the Institute of Urology of Beijing Medical University.In these cases,there are 87 cases(age from 58-88,average 71)with PC and 75cases (age from 50～85,average 67.8) with BPH whose material had been described in detail.And compare DPSA in all of these cases in statistical way.Results　We find DPSA is very useful in PC diagnostic.Either total PSA or free PSA in PC,the difference of their DPSA is more obvious than that in BPH(P＜0.01,0.001＜P＜0.05 in each).Compare the early stage of PC(stage A to B) to C stage the difference is not appeared.When we compare C stage to D stage DPSA(under total PSA)is more obvious too.Surprisingly DPSA is far more different at early PC stage (stage A to stage B) than that of BPH(P＜0.001).Conclusions　DPSA is useful to screen PC,especially to early stage PC.To distinguish C stage and D stage when we use certain demarcation line.And much more amount of cases to study to prove this opinion is expected.