f/tPSA比值、PSA密度、PSA移行带密度在tPSA灰区前列腺偶发癌诊断中的意义

Value of F/t PSA ratio,PSA density and PSA density of transitional zone in the diagnosis of occasional prostate cancer located in tPSA grey area

目的探讨血清f/tPSA比值、PSA密度、PSA移行带密度在tPSA位于灰区时前列腺癌诊断中的意义。方法 tPSA位于4～10ng/ml的前列腺增生患者112例,术前经前列腺穿刺活检均证实为前列腺增生,行TURP术后病理证实21例为前列腺偶发癌患者。回顾性分析该21例前列腺偶发癌患者和其余前列腺增生患者间的血清f/tPSA比值、PSA密度、PSA移行带密度,并进行统计学分析,以了解其在tPSA灰区前列腺偶发癌诊断中的意义。结果前列腺偶发癌组和BPH组血清f/tPSA比值分别为0.13±0.03、0.21±0.04;PSAD分别为0.20±0.05ng/ml2、0.12±0.04ng/ml2;PSATZ分别为0.38±0.06ng/ml2、0.21±0.05ng/ml2;两组在以上三个检测指标上差异具有显著性(P<0.05)。以0.15ng/ml2为截断点则PSAD灵敏性为76.115%,特异性为69.146%;以0.35ng/ml2为截断点则PSATZ灵敏性为60.642%,特异性为93.943%。结论 f/tPSA比值、PSAD、PSATZ对前列腺偶发癌的诊断具有重要价值,其中尤以PSATZ更具预测价值。

Objective To study the importance of serum f/t prostate specific antigen ratio（f/t PSA）,prostate specific antigen density（PSAD）,prostate specific antigen density of transition zone（PSADTZ） when the tPSA located in grey area of prostate cancer.Methods One hundred and twelve cases with prostatic hyperplasia of tPSA located in 4～10 ng/ml were proved by prostatic needle biopsy preoperatively.After TURP,21 cases were diagnosed as occasional prostate cancer by pathology.21 cases with occasional prostate cancer and other cases with the prostatic hyperplasia patients were retrospectively analyzed by serum f/t PSA ratio,PSAD,PSA DTZ.And the statistical analysis was used to understand the importance in the tPSA grey area in the diagnosis of occasional prostate cancer.Results The prostate cancer group and the BPH group had the f/t serum PSA ratio 0.13±0.03 ng/ml and 0.21±0.04 ng/ml respectively.PSAD was 0.20±0.05 ng/ml2,0.12±0.04 ng/ml2 respectively.PSADTZ was 0.38 ＋ 0.06 ng/ml2,0.21 ＋ 0.05 ng/ml2 respectively.Two groups in the above three monitoring indexes had significant difference（P0.05）.With 0.15 ng/ml2 for truncated point of PSAD had sensitivity of 76.115%,specificity of 69.146%;With 0.35 ng/ml2 for truncated point of PSADTZ had sensitivity of 60.642%,specificity of 93.943%.Conclusion f/t PSA ratio,PSAD,PSADTZ possess important value for the diagnosis of prostate cancer,especially the PSADTZ has more predictive value.