游离PSA与总PSA比值在前列腺癌鉴别诊断中的应用

目的:进一步了解前列腺特异性抗原(PSA)、游离前列腺特异性抗原(FPSA)与总前列腺特异性抗原(TPSA)比值(FPSA/TPSA)的测定在诊断前列腺癌的临床价值。方法:采用化学发光免疫分析法(CLIA)对前列腺癌患者57例,前列腺增生患者147例血清PSA、FPSA和FPSA/TPSA在各组中的改变情况及取不同界值时对前列腺癌的诊断意义。结果:在诊断灰区外高值区,TPSA、F/T在两组间的差别均有显著性意义(P<0.05,P<0.05);在诊断灰区患者间TPSA差别无显著性意义(P>0.05),而F/T值的差别有显著性意义(P<0.05);在灰区外低值区TPSA、F/T值在两组间差别无显著性意义(P>0.05)。如果以血清PSA值4 ng/ml为阈值,诊断前列腺癌的灵敏度为100%,特异性为52.6%,如果以血清PSA 4 ng/ml为阈值,同时结合FPSA/TPSA并以16为阈值,诊断前列腺癌的灵敏度为100%,而特异性为87.5%。结论:PSA与FPSA联合检测可以提高对前列腺癌诊断的特异性。

The usefulness of TPSA and F/T ratio in the diagnosis of prostate cancer

Objective:To evaluate serum TPSA and F/T ratio in the differential diagnosis of BPH and PCa.Methods:Serum TPSA,FPSA and F/T ratio in 147cases of BPH and 57 cases of PCa were assessed and evaluated both in patients within and outside the"gray zone".Results:TPSA and F/T ratio were both significantly discriminating between benign and malignant diseases(P<0.05,P<0.05),when the assessed values were much higher beyond the "gray zone";When the assessed values were within the"gray zone",TPSA couldn't be a differential marker for the 2 conditions(P>0.05),whereas F/T ratio could(P<0.05);however,in lower value range beyond the "gray zone",neither TPSA nor F/Tratio could specificly diffentiate the two(P>0.05).In case of PSA 4.0 ng/ml,the sensitivity of PCa was 100%,the specificity 52.6%.In case of PSA 4.0 ng/ml and FPSA/TPSA16,the sensitivity of PCa was 100%,the specificity 87.6%.Conclusion:Using of PSA and FPSA can improve the diagnostic specificity of prostatic cancer.