PSA和PSAD在前列腺癌诊断中的作用

Diagnosis value of PSA and PSAD in prostate cancer

采用放射免疫双抗体法，对２１例前列腺癌（ＰＣ）和６８例前列腺增生（ＢＰＨ）患者的血清前列腺特异抗原（ＰＳＡ）、前列腺特异抗原密度（ＰＳＡＤ）进行了检测分析，比较了其在ＰＣ诊断中的作用。结果显示：①ＰＳＡ对ＰＣ诊断的敏感度高，特异性、阳性预测值低，而ＰＳＡＤ可显著提高诊断的特异性和阳性预测值；②ＰＳＡＤ界值由０．１５提高到０．４０时，其敏感度无明显降低，而特异性、阳性预测值明显升高；③ＰＳＡＤ＞０．１５，特别是＞０．４０者，应高度怀疑ＰＣ，需行穿刺活检以进一步确诊。认为筛选ＰＣ时，应在直肠指检和经直肠Ｂ超检查的基础上，将ＰＳＡ和ＰＳＡＤ结合使用，可提高特异性和敏感度。

Serum prostatic specific antigen (PSA) and prostatic specific antigen density (PSAD) were studied in 21 cases of prostate cancer (PC) and 68 cases of BPH. The results showed that, the diagnostic specificity and positive preditive value (PPV) of PSA in PC were signficantly preditive value (PPV) of PSA in PC were significantly lower though its sensitivity was little higher. PSAD can significantly enhance its specificity and PPV. The combined use of both can increased the early diagnostic rate of PC,and when the critical value of PSAD was elevated from 0.15 to 0.40, the specifity and PPV were significantly enhanced, and when patient's PSAD was more than 0.15,particularly more than 0. 40,the prostate biopsy should be indicated.