游离与总前列腺特异抗原检测在前列腺癌诊断中的应用

The Diagnostic Value of Free Prostate Specific Antigen (FPSA)/Total Prostate Specific Antigen (TPSA) in Prostate Cancer

目的研究血清游离前列腺特异抗原(FPSA)与总前列腺特异抗原(TPSA)比值对前列腺癌患者的诊断价值。方法用电化学发光免疫分析法检测54例前列腺增生(BPH),32例前列腺癌(Pca)和38例正常男性的血清FPSA、TPSA含量,并计算FPSA/TPSA比值,讨论它们对前列腺癌的诊断意义。结果单独以血清TPSA大于4.0μg/L作为前列腺癌的诊断标准,其敏感性和特异性分别为85.0%,76.2%。以FPSA/TPSA小于0.11作为前列腺癌的诊断限定值,当血清TPSA小于4.0μg/L时,FPSA/TPSA比值的敏感性和特异性分别为98.0%,68.1%;当血清TPSA大于10.0μg/L时,FPSA/TPSA比值的敏感性和特异性分别为68.5%,69.1%;而当血清TPSA在4.0￣10.0μg/L时,FPSA/TPSA比值的敏感性和特异性分别为95.3%,90.5%。结论当血清TPSA在4.0￣10.0μg/L时,FPSA/TPSA比值可大大提高前列腺癌诊断的准确率。

Objective To investigate the diagnostic value of free prostate specific antigen （FPSA）/total prostate specific antigen （TPSA） in prostate cancer.Methods Serum TPSA and FPSA level were measured by electrochemistry luminescent immunoassay （ECLIA） and FPSA/TPSA ratio was calculated.Samples were drawn from 54 patients with BPH,32 patients with Pea and 38 health men.Results Serum TPSA〉4.0 μg/L as only cut off for diagnosis Pea, sensitivity and specificity of FPSA/TPSA ratio were 85.0%,76.2% respectively.But FPSA/TPSA ratio 〈0.11 for diagnosis Pea;they were 98.0%,68.1% respectively when serum TPSA〈4.0 μg/L; they were 68.5%,69.1% when serum TPSA〉10.0μg/L;they were 95.3%,90.5% when serum TPSA was 4.0-10.0 μ g/L.Conclusion When TPSA level between 4.0-10.0 μ g/L,FPSA/TPSA ratio may greatly raise accurate rate for diagnosis prostate cancer.