前列腺癌患者血清T-PSA、F-PSA水平和F/T比值变化及临床意义

Changes of serum T-PSA, F-PSA and F/T ratio in patients with prostate cancer and its clinical significance

目的 :观察前列腺癌患者 (PCa)血清总前列腺特异抗原 (T -PSA)、游离前列腺特异抗原 (F -PSA)和F -PSA/T -PSA比值 (F/T值 )变化 ,探讨其临床意义。方法 :用MEIA法检测 12 1例PCa患者和 5 5 4例良性前列腺增生 (BPH)患者术前及其中 82例PCa患者和 396例BPH患者术后血清T -PSA、F -PSA水平 ,并计算F/T值。结果 :术前PCa患者T -PSA与F -PSA明显高于BPH患者 ,F/T比值明显低于BPH患者 ,两组间差异均显著 (P <0 0 1)。术后两组患者T -PSA、F -PSA水平较术前明显降低 ,F/T值则明显升高 ,与术前结果比较 ,差异均显著 (P <0 0 1)。在T -PSA <10 0 μg/L范围 ,PCa患者占 33 9% ,BPH患者占 85 5 % ,两组患者结果存在交叉。F/T值 <0 16时 ,PCa患者占 83 5 % ,BPH患者占 6 5 % ,两组差异显著 (P <0 0 1) ,F/T值 <0 16时诊断的灵敏度、特异性、阳性预示值、阴性预示值分别为 83 5 %、86 7%、81 1%、88 2 %。结论 :PCa和BPH患者手术前后血清T -PSA、F -PSA水平及F/T比值均有明显变化。以F/T比值 <0 16作为PCa诊断临界值 ,可有效提高早期PCa诊断的特异性和敏感性 。

AIM: To evaluate the changes of serum total prostate specific antigen (T-PSA), free prostate specific antigen (F-PSA) and the ratio of F-PSA to T-PSA (F/T) in patients with prostate cancer (PCa) and its clinical significance. METHODS: The concentrations of T-PSA and F-PSA in serum were measured by micropartical enzyme immunoassay (MEIA) using AxSYM System, and the F/T ratio was calculated. RESULTS: Before operation, the concentrations of T-PSA and F-PSA in patients with PCa were much higher and F/T ratio was significantly lower than that in patients with benign prostate hyperplasia (BPH). T-PSA and F-PSA levels decreased, but F/T ratio increased after operation in PCa and BPH. F/T ratio in 83.5% PCa and 6.5% BPH was less than 0.16. To diagnosis PCa, the sensitivity of F/T ratio was 83.5%, and the specificity was 86.7%. CONCLUSION: Serum T-PSA, F-PSA and F/T ratio are important parameters for the early diagnosis of prostate cancer. [