F/TPSA比值及PSAD对TPSA灰区前列腺癌的诊断意义

Diagnosis significance of relative value of F/TPSA and PSAD for TPSA gray zone prostate cancer

目的探讨血清前列腺特异抗原（TPSA）、血清游离PSA及总PSA比值（F／TPSA）及前列腺特异性抗原密度（PSAD）对TPSA灰区（4．0～10．0μg／L）前列腺癌的诊断价值。方法回顾性分析TPSA在灰区的82例前列腺癌患者及157例良性前列腺增生症（BPH）患者血清PSA相关检测结果。结果2组患者血清TPSA值无显著性差异；前列腺癌组F／T显著低于BPH组（P〈0．01），PSAD显著高于BPH组（P〈0．01）。以F／T≤0．16、PSAD≥O．15作为诊断前列腺癌阈值的敏感性为86．7％，78．9％，特异性为63．1％，53．8％。结论TPSA〉4．0μg／L作为筛选前列腺癌的临界值存在一定缺陷；当TPSA为4．0～10．0μg／L诊断灰区时，F／T比值与PSAD对诊断前列腺癌有重要的临床意义。

Objective It is to investigate the diagnosis significance of TPSA, F/TPSA and PSAD for prostate cancer （PCa） with TPSA in gray zone （4.0 - 10.0μg/L）. Methods The correlated determined results of serum PSA of 82 patients with PCa and 157 patients with benign prostatic hypertrophy （BPH） whose PTSA was in gray zone were retrospective analyzed. Results The difference in serum TPSA between the two groups was not significant（P〉 0.01 ）, but F/T of Pca group was significantly lower and PSAD of PCa was significantly higher than that of BPH group（P 〈 0.01 ）. When F/T≤0.16 or PSAD≥0.15 were used as the standard to diagnose PCa, sensitivity were 86.7%, 78.9% and specificity were 63.1%, 53.8 % respectively. Conclusion It is unreasonable that TPSA〉 4.0 μg/L is regarded as a critical value for the diagnosis of prostate carcinoma. When TPSA level is from 4.0 - 10.0μg/L in gray zone, F/T ratio and PSAD has a significant value for diagnosing PCa.