摘要
OBJECTIVE To investigate the diagnostic value of modified prostate specific antigen(PSA)parameters in the diagnosis of prostate cancer(PCA) when the serum PSAis in a grey zone of 4~10 ng/ml. METHODS The results of serum PSA determinations of the patients receiving a transrectal ultrasound-guided multiphase prostatic biopsy,were retrospectively analyzed.In the 88 patients with a serum PSA value of 4-10 ng/ml,the final diagnosis of PCA was made in 21,and that of benign prostate hyperplasia(BPH)in 67 patients.The percentage of the free-serum PSA([FPSA]/total-serum PSA[TPSA],F/T),PSA density(PSAD)and the sensitivity and specificity of the new PSA modified parameter(F/T)/PSAD in diagnosing PCA,within a set threshold value,was compared. RESULTS In the 88 patients with serum PSA in the grey zone of 4.0-10.0 ng/ml,there was no significant difference in comparing the TPSA between the 21 PCA patients and 67 BPH patients(P>0.05).However, there was a significant difference in the value of modified PSA parameters, such as F/T,PSAD and(F/T)/PSAD,between the PCA and the BPH groups (P<0.001).As the cut off point-value of the F/T,PSAD and(F/T)/PSAD was set at 0.16,0.15 and 0.8,the diagnostic sensitivity for PCA was 66.7%, 76.2%and 85.7%,and the specificity was 41.8%,43.3%and 68.7%,respectively.There was no significant difference in the sensitivity comparing the modified parameters for diagnosing PCA(P>0.05),whereas an overt predominance was present in the specificity of(F/T)/PSAD for PCAdiagnosis (P<0.05). CONCLUSION In the serum PSA grey zone of 4-10 ng/ml,a modified PSA parameter can improve the PCA diagnostic accuracy rate.With a considerably high sensitivity,application of the(F/T)/PSAD may effectively enhance the diagnostic specificity,which is superior to the F/T and PSAD, and can be expected to be one of the new indices derived from the PSA.
OBJECTIVE To investigate the diagnostic value of modified prostate specific antigen （PSA） parameters in the diagnosis of prostate cancer （PCA） when the serum PSA is in a grey zone of 4-10 ng/ml. METHODS The results of serum PSA determinations of the patients receiving a transrectal ultrasound- guided multiphase prostatic biopsy, were retrospectively analyzed. In the 88 patients with a serum PSA value of 4-10 ng/ml, the final diagnosis of PCA was made in 21, and that of benign prostate hyperplasia （BPH） in 67 patients. The percentage of the free-serum PSA （[FPSA]/total-serum PSA [TPSA], F/T）, PSA density （PSAD） and the sensitivity and specificity of the new PSA modified parameter （F/T）/PSAD in diagnosing PCA, within a set threshold value, was compared. RESULTS In the 88 patients with serum PSA in the grey zone of 4.0-10.0 ng/ml, there was no significant difference in comparing the TPSA between the 21 PCA patients and 67 BPH patients （P〉0.05）. However, there was a significant difference in the value of modified PSA parameters, such as F/T, PSAD and （F/T）/PSAD, between the PCA and the BPH groups （P〈0.001）. As the cut off point-value of the F/T, PSAD and （F/T）/PSAD was set at 0.16, 0.15 and 0.8, the diagnostic sensitivity for PCA was 66.7%, 76.2% and 85.7%, and the specificity was 41.8%, 43.3% and 68.7%, respectively. There was no significant difference in the sensitivity comparing the modified parameters for diagnosing PCA （P〉0.05）, whereas an overt predominance was present in the specificity of （F/T）/PSAD for PCA diagnosis （P〈0.05）. CONCLUSION In the serum PSA grey zone of 4-10 ng/ml, a modified PSA parameter can improve the PCA diagnostic accuracy rate. With a considerably high sensitivity, application of the （F/T）/PSAD may effectively enhance the diagnostic specificity, which is superior to the F/T and PSAD, and can be expected to be one of the new indices derived from the PSA.
