f/tPSA和PSAD在良性前列腺增生和前列腺癌中的诊断价值

Diagnositic value of f/t ratio and PSAD of benign prostatic hyperplasia and prostatic cancer

目的探讨前列腺特异性抗原(PSA)、游离前列腺特异性抗原/总前列腺特异性抗原(f/tPSA)和前列腺特异性抗原密度(PSAD)在不同PSA水平的诊断意义,及f/tPSA和PSAD诊断前列腺癌(PCa)的灵敏度和特异度。方法回顾性分析229例良性前列腺增生患者(BPH组)和138例前列腺癌患者(PCa组)血清PSA检测结果,经直肠超声测量前列腺体积,计算f/tPSA、PSAD。结果PSA﹤4ng/ml时,tPSA、f/tPSA、PSAD在BPH组和PCa组无显著性差异(P﹥0.05);PSA为4～10ng/ml时,tPSA无显著性差异(P﹥0.05),而f/tPSA、PSAD具有显著性差异(P﹤0.05,P﹤0.01);PSA﹥10ng/ml时,tPSA、f/tPSA、PSAD在两组间均具有显著性差异(P﹤0.01)。当f/t比值和PSAD分别取值0.12和0.22时,其诊断PCa的灵敏度和特异度分别为68.3%和75.6%、83.3%和63.8%。结论f/t比值和PSAD在辅助诊断前列腺疾病中具有重要意义。

Objective To evaluate diagnositic value of prostate specific antigen （PSA）, free/total PSA （f/t PSA）, and PSA density （PSAD） in differentiating benign prostatic hyperplasia （BPH） and prostatic cancer （PCa） and compare sensitivity and specificity of f/t PSA and PSAD in different setting cutoff. Methods Retrospecetive analyzing of serum tPSA, f/tPSA and PSAD were perforated in BPH group （229 patients） and PCa group （138 patients）, prostate volume was obtained by transrectal ultrasound （TRUS）. Results In group 1 （PSA 〈 4ng/ml）, tPSA, f/t PSA, PSAD had no significant difference （P〉 0.05）; in group 2 （PSA 4-10ng/ml）, f/tPSA, PSAD had statistical difference （P〈 0.05, P〈 0.01）;while in group 3 （PSA 〉 10ng/ml）, tPSA, f/t PSA and PSAD had signigicant difference （P 〈 0.01）. When the cutoff of f/t ratio and PSAD were set as 0.12 and 0.22 respectively, the sensitivity of diagnosing PCa were 68.3% and 83.3%, and speicificity were 75.6% and 63. 8%. Conclusions f/t PSA and PSAD have important clinical value in diagnosing PCa.