前列腺疾病诊断中血清游离态PSA指标的应用价值

A preliminary study of free PSA in the differentiation of PC from BPH

目的探讨血清游离态ＰＳＡ（ＦＰＳＡ）和总ＰＳＡ（ＴＰＳＡ）及游离态／总（Ｆ／Ｔ）ＰＳＡ比值作为前列腺疾病诊断指标的价值。方法测定５６例未经治疗的ＢＰＨ病人和３９例前列腺癌病人血清ＦＰＳＡ和ＴＰＳＡ，并计算Ｆ／Ｔ比值。结果ＴＰＳＡ及Ｆ／Ｔ可有效区分ＢＰＨ和前列腺癌（Ｐ＜０．００５），尤其在诊断灰区（ＴＰＳＡ为４．０～１０．０μｇ／Ｌ）中效果更明显。以ＴＰＳＡ≤１０．０μｇ／Ｌ，Ｆ／Ｔ≥０．１６为界值时，前列腺癌筛选的临床概率敏感度为９４．７％。结论ＦＰＳＡ和Ｆ／Ｔ比值的引入，使血清ＰＳＡ测定更为精细，保持了实验的高敏感度。

Objective To evaluate serum free PSA(F PSA), total PSA(T PSA)and free/total (F/T)ratio as an indicator for the differential diagnosis between BPH and PC. Methods Serum samples were obtained from 56 men with untreated BPH and 39 men with untreated prostate cancer. Free PSA and F/T PSA levels of all samples were determined using free PSA and Equi Molar PSA diagnostic kits. Results When all subjects were detected both total PSA and the free to total PSA ratio were significantly different between patients with prostate cancer and patients with BPH ( P <0.005 ),in especialy,in men with total PSA values between 4. 0～10.0 μg/L (the diagnostic gray zone),when F/T≥0.16 was taken as the cutoff value, the sensitivity was as high as 94.7%. Conclusions With the introduction of free PSA and F/T ratio,the early detection of PC by the assessment of PSA has been made more sensitive and reliable especially when the PSA is within the diagnostic gray zone.