γ-sm/Act-PSA与PSA联合判定法在前列腺疾病中的临床应用意义

The Clinical Significance of Differential Diagnosis Method: γ sm/Act PSA Combined with PSA

目的 :探讨鉴别前列腺癌 (PCA)和前列腺特异抗原 (PSA)值增高的良性前列腺增生症 (BPH )判定方法 ,提高 PCA的诊断率及前列腺活检的阳性率。方法 :hybritech法测定 19例 PCA和 19例 BPH血清中结合 PSA(Act- PSA)、γ- sm(γ- sem inoprotein)水平 ,初步探讨 γ- sm/ Act- PSA界值。结果 :γ- sm/ Act- PSA平均值 :PCA组0 .70 5 ,BPH组 1.40 5 ,差异显著 (P <0 .0 0 1)。以 PSA>10 ng/ ml为诊断 PCA标准 ,敏感度为 78.9% ,特异度为73.7%。引入γ- sm/ Act- PSA界值 (1.0 )后 ,以 PSA>10 ng/ m l且γ- sm / Act- PSA<1.0为 PCA诊断标准 ,敏感度为 6 8.5 % ,特异度上升为 89.5 %。假阳性率 (误诊率 )下降为 10 .5 %。结论 :γ- sm/ Act- PSA与 PSA联合判定法对PCA和 PSA高值的

Objective:Our aim was to present a new method to distinguish prostate cancer(PCA) and benign prostatic hyperplasia(BPH) with prostate specific antigen (PSA) value, and to improve the diagnosis accuracy of PCA and the prostate biopsy. Methods: The PSA and γ sm were assayed in serum of 19 patients with PCA and 19 patients with BPH by hybritech tandem assay.Results: The average γ sm/Act PSA rate of PCA group was 0.705 and that of BPH group was 1.405 (P<0.001). If the dignosis standard of PCA were PSA >10 ng/ml,the sensitivity would be 78.9% and the speciality would be 73.7%. When the cutoff of γ sm/Act PSA was 1.0, combinated with total PSA value, the speciality would rise up to 89.5% and the fault positive rate would drop down to 10.5%.Conclusion: The results suggest that the differential diagnosis method, γ sm/Act PSA combined with PSA may be significant for the differential diagnosis between PCA and BPH.