血tPSA、cPSA、IGF-I联检对前列腺疾病诊断的临床价值

Clinical Diagnostic Value of Combined Determination of Serum tPSA,cPSA and IGF-I Levels in Patients with Prostatic Disorders

目的:探讨联检血清前列腺特异性抗原(tPSA)、复合前列腺特异性抗原(cPSA)、胰岛素样生长因子-I(IGF-I)含量及cPSA/tPSA比值对前列腺疾病诊断的临床价值。方法:分别采用磁微粒免疫化学发光法(ICLMA)和免疫放射分析(IRMA)对41例前列腺癌(PCa)、60例前列腺增生(BPH)患者和55例正常对照者进行tPSA、cPSA、IGF-I定量检测和计算cPSA/tPSA比值并比较分析。结果:PCa患者血清中tPSA、cPSA、IGF-I水平明显高于BPH组和正常对照组(P<0.01);BPH、PCa两组患者各项检测指标在"灰色区域"上分布差异有显著性(P<0.01);以tPSA>4ng/ml、cPSA>3.6ng/ml、IGF-I>150和cPSA/tPSA>0.74作为筛选PCa的临界值,其临床灵敏度、特异度、阳性预测值、阴性预测值分别为88.6%、84.9%、83.0%、90.0%。结论:联合使用tPSA、cPSA、cPSA/tPSA和IGF-I指标进行PCa的筛选,其临床诊断概率优于各单一指标,且对早期PCa的诊断和BPH的区别有重要的临床价值。

Objective To investigate the diagnostic value of combined determination of serum total prostatic specific antigen （ tPSA）, complex prostatic specific antigen （cPSA） and IGF - I levels in patients with prostatic disorders. Methods Serum tPSA, cPSA （with CL/A） and IGF -I （with IRMA） levels were determined in 41 patients with prostatic carcinoma, 60 patients with benign prostatic hypertrophy （BPH） and 55 controls. Results The serum tPSA, cPSA and IGF - I levels in patients with prostatic cancer were significantly higher than those in patients with BPH and controls （P 〈0.01）. Taking the cut - off values of 4ng/ml, 3.6ng/ml and 150 for tPSA, cPSA and IGF - I respectively, the combined determination of these three items would yield a sensitivity of 88.6%, specificity of 84.9%, positive predicative value of 83% and negative predicative value ofg0.0% for diagnosis of prostatic cancer. Conclusion Combined determination of tPSA, cPSA and IGF -I would yield better sensitive and accurate diagnostic rate in patients with prostatic cancer, especially in those with laboratory values within the ＂grey zone＂.