复合型PSA与总PSA比值在前列腺癌诊断中的应用

The role of the ratio of complexed PSA and total PSA in diagnosis of prostate cancer

目的 探讨复合型PSA(CPSA)与总PSA(TPSA)比值在前列腺癌(PCa)诊断的应用价值。方法 采用化学发光免疫分析法(CLIA)测定2 78例患者(其中PCa 6 3例,BPH2 15例)与112例正常健康体检男性的血清TPSA、CPSA水平,并计算TPSA/CPSA(C/T)比值。结果 BPH组、PCa组TPSA、CPSA水平均显著高于正常对照组(P <0 .0 1) ,PCa组的血清TPSA、CPSA、C/T水平显著高于BPH组(P <0 . 0 1)。TPSA <4 μg/L时各组间TPSA、CPSA、C/T均无显著差异(P>0 .0 5 ) ;4 μg/L≤TPSA≤10 μg/L时各组间TPSA、CPSA均无显著差异(P >0 .0 5 ) ,PCa组C/T显著高于BPH组(P <0 . 0 1) ;TPSA >10 μg/L时PCa组TPSA、CPSA、C/T均显著高于BPH组(P <0 . 0 1)。C/T以0 . 80为标准对PCa诊断具有较好的敏感性、特异性及实验有效率。结论 C/T在PCa诊断上具有重要临床价值,有很大可能成为新的较有意义的指标为PCa诊断提供更好的依据。

Objective To investigate the diagnostic value of the ratio of complexed PSA(CPSA) and total PSA(TPSA) in prostate cancer(PCa). Methods The serum TPSA and CPSA levels of 278 patients(63 patients with PCa, 215 patients with BPH) and 112 healthy men as normal control were determined by chemiluminescent immunoassay(CLIA). Results TPSA, CPSA of BPH and PCa were all significantly higher than in normal control( P <0.01), and TPSA, CPSA and C/T of PCa were significantly higher than of BPH( P <0.01). When TPSA<4 μg/L, the differences of TPSA, CPSA and C/T in three groups were not significant( P >0.05); When 4 μg/L≤TPSA≤10 μg/L, the differences of TPSA, CPSA in three groups were not significant( P >0.05), but C/T of PCa was significantly higher than of BPH( P <0.01); When TPSA>10 ug/L, TPSA, CPSA and C/T of PCa were significantly higher than of BPH( P <0.01). As the C/T cut off value was 0.80, sensitivity, specificity and experimental validity for the diagnosis of PCa were satisfactory. Conclusion C/T is of important clinical value in the diagnosis of PCa, and may be a new and significant indicator to provide a better basis for the diagnosis of PCa.