22055名中老年男性前列腺特异性抗原及相关参数的年龄特异性分析

Analysis of age-specific prostate specific antigen and related parameters in 22 055 elderly men

目的明确我国中老年男性前列腺特异性抗原（PSA）及相关参数的年龄特异性正常参考值。方法对2007年4月至2011年11月我院体检中心22055名≥40岁男性血清PSA结果进行统计分析，以10岁为组距分成5组，记录总PSA（tPSA）、游离PSA（fPSA）、前列腺B超等结果，计算游离-总PSA比值（f／t）、PSA密度（PSAD）、PSA速率（PSAV）。百分位数P95视为某参数的正常值上限，百分位数P5视为正常值下限。结果tPSA与年龄呈正相关（r=O．349，P〈0．001）。f／t与年龄呈负相关（r=-0．154，P〈0．001），尽管各年龄组间f／t不尽相同（P〈0．001），然而各组P5均为0．18。〈70岁和≥70岁者PSAD差异有统计学意义（P〈0．001），P95分别为0．09和0．15，与年龄呈正相关（r=0．263，P〈0．01）。〈60岁与≥60岁PSAV差异有统计学意义（P〈0．001），P95分别为0．21和0．58，与年龄呈正相关（r=0．130，P〈0．01）。结论PSA、PSAD、PSAV与年龄呈正相关，而f／t与年龄呈负相关。我国男性f／t的正常范围是0．18～1．00，对40岁以上者适用。〈70岁和≥70岁男性PSAD正常值分别为〈0．09和〈0．15。〈60岁和≥60岁男性PSAV正常值分别为〈0．21和〈0．58。

Objective To define the age-specific normal reference, yalues of prostate specific antigen （PSA） and related parameters in Chinese middle-aged and elderly men. Methods From April 2007 to November 2011, serum PSAs of over 22 055 men aged more than 40 years old in our medical examination center were statistically analyzed. The men was divided into five groups by a 10-year-old interval. Total PSA （tPSA） , free PSA （fPSA） and prostate ultrasound results were recorded. The free-total PSA ratio （f/t） , PSA density （PSAD） and PSA velocity （PSAV） were calculated. By convention, the 95th percentile （P95） was used as the upper limit value, and the 5th percentile （PS） as the lower limit value. Results The tPSAs were positively correlated with age （r= 0.349, P〈0.001）. f/t was negatively correlated with age （r= -0.154, P〈0.01）. Although f/t was significantly different （P〈0.001） among each age group, P5 of all groups were 0.18. PSAD was significantly different （P〈0.001） between men over and under 70 years, with P95 as 0.09 and 0.15, respectively. PSAD had a positive correlation with age （r = 0.263, P〈0.01）. The significant difference of PSAV raised between men over and under 60 years, with P95 as 0.21 and 0.58, respectively. PSAV was positively correlated with age （r= 0.130, P〈0.01）. Conclusions PSA, PSAD and PSAV are positively correlated with age, while f/t is negatively correlated with age. The normal range of flit is 0.18-1.00 for Chinese men over 40 years old. PSAD＇s normal ranges are 〈0.09 and 〈0.15 in Chinese men over and under 70 years, respectively. The normal range of PSAV are 〈0.21 and 〈0.58 for Chinese men over and under 60 years, respectively.