血清tPSA和cPSA测定对前列腺疾病诊断的价值

Determination of Serum Complexed and Total Prostate Specific Antigen Levels in Patients with Prostate Cancer

目的探讨血清cPSA测定在前列腺癌诊断中的价值。方法用化学发光法测定良性前列腺增生和前列腺癌患者血清tPSA、cPSA和fPSA,并进行各种PSA的稳定性试验。结果新鲜血清于4℃放置1周后,tPSA和cPSA含量基本无变化,但fPSA下降了11%。在本组181例病例的前列腺癌筛选中,cPSA的敏感性为86.8%,特异性为63.3%,准确性为70.2%,其作用与tPSA相当。早期前列腺癌(A、B期)患者,cPSA优于tPSA(P<0.001),当tPSA浓度为2.5-10ng/ml时,cPSA的敏感性、特异性和准确性均高于tPSA,其差异有显著性(P<0.05)。结论在4℃放置条件下,cPSA的稳定性最好。cPSA在tPSA为2.5-10ng/ml时,对早期前列腺癌的诊断优于tPSA。

Objective To evaluate the value of the determination of serum complexed prostate specific antigen (cPSA) for the diagnosis of prostate cancer(CaP). Methods From October 2000 to May 2003, 181 patients (53 with prostate cancer and 128 with benign prostatic hyperplasia proved) were enrolled. Serum was collected and immediately tested with the auto-immuno-chemistryluminescence then retested the aliquots of these serum samples after storage at 4℃. Results No significant difference was found for change in tPSA and cPSA after stored for 7 days at 4℃. But a significant change was found in fPSA. The concentration of tPSA and cPSA in serum of CaP (275.48⒈1243.22) ng/ml and (198.37⒈971.94)ng/ml, respectively were higher(P<0.001) than that in BPH(6.58⒈8.44)ng/ml and (4.34⒈6.1)ng/ml,respectively. The specificity of the cPSA as diagnosis marker was 63.3% at cutoff yielding 86.8% sensitivity. The cPSA as diagnosis marker is more stable and sensitive than tPSA. Conclusions tPSA and cPSA are more stable than fPSA at 4℃. The use of cPSA as diagnosis marker is more specific than tPSA.