血清游离与总前列腺特异抗原比值在前列腺疾病诊断中的应用

Diagnostic Value of Serum Free/Total Prostate Specific Antigen in the Prostate Disease

目的探讨游离前列腺特异抗原(F-PSA)与总PSA(T-PSA)的比值(F/T)对鉴别诊断前列腺疾病的临床价值.方法采用化学发光免疫法同时检测123例前列腺癌(Pca)和155例前列腺增生(BPH)患者的血清T-PSA、F-PSA,计算其F/T比值,并比较各F/T比值的总有效率.结果Pca组和BPH组血清T-PSA和F/T比值均有显著差异(P＜0.01),当T-PSA在4.0～10.0ng/ml区间时,两组患者血清T-PSA无显著差异(P＞0.05),但Pca患者组的F/T比值却明显低于BPH组(P＜0.01).通过总有效率的分析,F/T比值取20%作为临界值较为合适.结论F/T比值作为T-PSA的辅助指标在诊断灰区能显著提高前列腺癌的鉴别诊断能力.

Objective To research the clinical value of serum free prostate specific antigen (PSA) to total one ratio in the differential diagnosis prostate disease. Methods The levels of serum total and free PSA was determined in 123 patients with prostate cancer and 155 patients with benign prostatic hyperplasia(BPH),using chemiluminescence immunoassay. The ratio of free/total PSA was calculated and the total effective ratio of these ratio was statistically compared. Results Both total PSA and the ratio of free PSA to total PSA significantly differentiated between patients with prostate cancer and patients with BPH(P<0. 01). But,in men with total PSA values between 4. 0 and 10. 0 ng/ml,the ratio of free PSA to total PSA significantly differentiated between patients with prostate cancer and patients with BPH (P<0. 01) where the total PSA did not(P>0. 05) . Through the analysis of total effective ratio,it was fairly appropritated that the cut-off value of ratio of free PSA to total PSA was twenty percent. Conclusion The ratio of free PSA to total PSA being an adjuvant marker of total PSA can significantly enhance the ability to distinguish BPH from prostate cancer in patients within the 'gray zone'.