t—PSA与c—PSA对前列腺癌和良性前列腺增生的鉴别诊断意义

The using Value of t-PSA and c-PSA to differential diagnosis the prostate neoplasms and BPH

目的研究复合前列腺特异性抗原（c—PSA）、总前列腺特异性抗原（t—PSA）在鉴别诊断前列腺癌和良性前列腺增生时的应用价值。方法选择两组实验对象，PCa组89例经B超、病理确诊的前列腺癌（PCa）者。BPH组为111例良性前列腺增生患者。采用化学发光法检测其c—PSA、t-PSA，记录结果并进干亍统计分析。结果PCa和BPH组的c—PSA、t—PSA和年龄值，BPH和PCa组t-PSA含量（3．6±2．4）ng／ml、（15．2±16．2）ng／ml，差异有极显著性（P〈0．01），年龄值两组间，差异兀显著性（P〉0．05）。t-PSA的cutoff为10ng／ml时，Pca89例中45例为假阴性（50．6％），t—PSA的cutoff为2．5ng／ml时，Pca89例中24例为假阴性（27．0％），但假阳性率相应升高。BPH和Pca的c—PSA含量（0．08±0．06）ng／ml、（28．9±37．6）ng／ml（P〈0．01），c—PSA的cutoff为2．5ng／ml时，Pca89例中18例为假阴性（20.2％1。t—PSA的cutoff为10ng／ml时，与c—PSA同时阳性占46．1％，而将t—PSA的cutoff定为2．5ng／ml时，与c—PSA同时阳性占69．7％。结论c—PSA在t-PSA〈10ng／mL的特异性优于t—PSA，t-PSA的cutoff为10ng／ml的设置过高，建议将其调整为2．5ng/ml，结合c—PSA（cutoff：2．5ng／ml）将有效提高PCa诊断的特异性和灵敏度。

Objective To research the using value of t-PSA and e-PSA to differential diagnosis the prostate neoplasms and BPH. Methods The level of t-PSA and e-PSA were measured in the 89 eases of PCa,111 cases of BPH by Chemiluminescence analysis. Results The level of t-PSA was （3.6 ± 2.4） ng/ml（BPH） and （15.2 ±16.2） ng/ml（PCa） （P〈0.01）. The false negative was 50.6% （cutoff= 10ng/ml） and 27.0% （cutoff =2.5ng/ml）. The level of c-PSA was （0.08 ± 0.06） ng/ml（BPH） and （28.9 ±37.6） ng/ml（PCa） （P〈0.01）, The false negative was 20.2% （cutoff =2.5ng/ml）. When the cutoff of t-PSA was 2.5 ng/ml, to combine the c-PSA would raise the positive up to 69.7 %. Conclusion When the cutoff of t-PSA was 10. 0 ng/ml, the c-PSA was significantly higher than t-PSA .We suggest adjust the cutoff of t-PSA to 2.5 ng/ml, and to combine the c-PSA would significant raise the Sensitivity and Specificity by diagnosis the prostate neoplasms.