前列腺特异性抗原在前列腺增生和前列腺肿瘤中的鉴别诊断价值

TheEvaluationofPSAandPSADDeterminations forDifferentialDiagnosisbetweenProstate CancersandBenignProstaticHyperplasia

为评价前列腺特异性抗原（ＰＳＡ）及其密度（ＰＳＡＤ）对前列腺增生（ＢＰＨ）和肿瘤的鉴别诊断价值，采用放射免疫法对３０例前列腺癌（Ｐｃａ）和８０例ＰＢＨ患者进行了检测。结果发现：Ｐｃａ患者的平均血清ＰＳＡ含量显著高于ＢＰＨ患者，且界线以１０μｇ／Ｌ时的敏感性、特异性、准确性及诊断效率为高，分别为５０％、９１３％、８０％和４５７％；Ｐｃａ患者的ＰＳＡＤ值也明显高于ＢＰＨ者，当界线值≥０２时，其诊断的敏感性为９６７％，特异性为８５％，准确性为８８２％，诊断效率为８８２％，阴、阳性预测值也较理想。ＰＳＡ随病情进展升高，而ＰＳＡＤ则随病情进展下降，表明ＰＳＡ与临床分期成正相关而ＰＳＡＤ则成负相关，ＰＳＡＤ较ＰＳＡ对Ｐｃａ及ＰＢＨ更具有鉴别诊断意义。

SerumlevelsofPSAandPSAdensity(PASD)wereassayedbyradioimmunoassayin30patientswithprostatecancers(Pca)and80caseswithbenignprostatehyperplasia(BPH)toevaluatethevaluesofthesedeterminationsforthedifferentialdiagnosisamongthesecases.TheresultsshowedthatserumlevelsofPSAinpatientswithPcaweresignificantlyhigherthanthoseofBPH,andtheirsensitivity,specificity,accuracyanddiagnosticefficiencywere50%,91.3%,80%and45.7%respectively,whenthenormallimitofPSAwassetat10g/L.Meanwhile,thePSADinpatientswithPcawasalso significantlyhigherthoseinpatientswithBPHwithuppernormallimitsettingat0.2.Thesensitivity,specificity,accuracyandthediagnosticefficiencyofthelatterdeterminationwere96.7%,85%,88.2%and88.2%respectively.ThefindingsthatPASwaspositivelyandPASDnegativelycorrelatedwiththeclinicalstagesofdiseasemightsuggestthemoreusefulnessofPSADtodistinguishPcafromBPH.