血清TPSA、PSAD对前列腺癌的诊断价值

Significance of serum TPSA,PSAD in diagnosis in patients with prostate cancer

目的探讨血清总前列腺特异抗原(TPSA)、前列腺特异抗原密度(PSAD)对前列腺癌的诊断价值。方法检测经病理诊断的39例前列腺癌、68例前列腺增生患者的血清TPSA,通过经直肠超声测定其前列腺的体积(PV)并计算PSAD。结果(1)前列腺癌组患者的TPSA、PSAD明显高于前列腺增生组;(2)TPSA、PSAD在工作特征曲线(ROC曲线)下的面积大小分别为0.652、0.852;由ROC曲线确定的诊断前列腺癌的最佳临床判断值为TPSA>8.35ng/ml、PSAD>0.1885ng/(ml·cm3);据此临界值诊断前列腺癌的敏感度、特异度分别为:TPSA为61.5%、69.1%,PSAD为82.1%、83.8%。结论PSAD是TPSA对前列腺癌诊断的有益补充。

Objective To compare the performance of prostate-specific antigen （PSA）,the PSA density （P SAD）in prostate cancer detection. Methods 107 patients （39 prostate cancer, 68 benign prostatic byperplasia）evaluated total PSA, and prostate volume（PV）. A direct comparison was performed between the different PSA ,PSAD to evaluate their ability to detect prostate cancer. Results （1）PSA and PSAD in patients with prostate cancer were significantly higher than those in patients with benign prostatic hyperplasia; （2）The area under receptive operator character curve （ROC）of TPSA,PSAD were 0.652,0.852 respectively;The ROC curve was used to take TPSA〉8.35 ng/ml,PSAD〉0.1885 ng/（ml·cm^3）as the best cutoff values,their sensitivity,specificity were 61.5%,69.1%（TPSA） ,82.1%,83.8%（PSAD） respectively. Conclusions The use of the PSAD offers improved prostate cancer detection compared with total PSA.