前列腺癌患者血清PSA及相关参数检测结果分析

Detection of prostate specific antigen and its relevant parameters in sera from patients with prostate cancer

目的:寻找前列腺癌适宜的血清学诊断标志物。方法:测定良性前列腺增生和前列腺癌患者血清游离PSA、总PSA,并计算PSAD、FPSA/TPSA、PSA/TPSA/PSAD等。结果:将PSA值分为0-、4μg/L-、10μg/L-和20μg/L-四个范围,BPH组构成比为39.06%、28.13%、25%和7.81%,而PCA组构成比为10.71%、17.86%、28.57%和42.86%,差异具有显著性(P<0.01);与BPH组患者相比较,PCA组患者PSA和PSAD检测值升高,FPSA/TPSA和PSA/TPSA/PSAD降低,差异均具显著性(P<0.01);当4 ug/L≤PSA≤10 ug/L时,PCA和BPH患者的PSA检测值差异无统计学意义(P>0.05),但PCA组FPSA/TPSA和PSA/TPSA/PSAD低于BPH组,差异均具有显著性(P<0.01);当PSA>20μg/L时,两组患者PSA、PSAD、FPSA/TPSA的差异均无统计学意义(P>0.05),PCA患者仅PSA/TPSA/PSAD低于BPH患者,且差异具有显著性(P<0.01)。结论:用PSA、PSAD、FPSA/TPSA诊断前列腺癌均具有一定局限性,PSA/TPSA/PSAD可能是诊断前列腺癌最适宜的血清学标志物。

Objective ： To explore appropriate serological marker for diagnosis of prostate cancer. Methods ： The levels of free prostate specific antigen （PSA）, total PSA were detected ＂in patients with benign prostatic hyperplasia （BPH） or prostate cancer （PCA） , and prostate specific antigen density （P SAD） , FPSA/TPSA and PSA/TPSA/PSAD were calculated. Results： The detected PSA values were divided into 0 - , 4ug/L - , 10ug/L - and 20ug/L - four areas, the constitute ratios were 39.06%, 28.13% , 25% and 7.81% in patients with BPH, and they were 10.71% , 17.86%, 28.57% , 42.86% in PCA, which were significant difference （P 〈0.01 ） ; Compared with the patients with BPH, the levels of PSA and PSAD increased, but the ratio of FPSA/TPSA and PSA/TPSA/PSAD decreased significantly （P 〈 0.01 ） ; when the levels PSA between 4ug/L and 101 -tg/L, no significant difference was observed in PSA values between PCA and BPH patients （ P 〉 0.05 ） , but the ratio of FPSA/TPSA and PSA/TPSA/PSAD were both lower than those in BPH （ P 〈 0.01 ） ; when PSA values were 20 g/L or more, there was no difference in the levels of PSA and PSAD and the ratio FPSA to TPSA between the two groups, only the ratio of PSA/TPSA/PSAD was lower in PCA group than that in BPH （ P 〈 0. 01 ）. Conclusions： There are some limitations and shortcoming using PSA, PSAD and FPSA/TPSA in diagnosis of PCA, and PSA/TPSA/PSAD maybe the most appropriate serological marker for diagnosis of PCA.