游离前列腺特异性抗原百分比和前列腺特异性抗原密度对前列腺癌的诊断价值

The diagnosis value of f/tPSA and PSAD in detecting of prostate cancer in men with 'gray zone' PSA

目的探讨游离前列腺特异性抗原(PSA)百分比(f/tPSA)和PSA密度(PSAD)在PSA灰区(PSA介于4～10 ng/ml)患者中前列腺癌诊断的价值。方法回顾性分析258例于PSA灰区行前列腺穿刺活检患者的临床资料,按病理结果分为前列腺癌组(PCa组)和前列腺增生组(PBH组),比较两组f/tPSA和PSAD的差异;通过受试者工作特征(ROC)曲线分析法,评价f/tPSA和PSAD在预测前列腺癌中的价值。结果 258例中,病理确诊为前列腺癌70例,占27.13%。两组的f/tPSA和PSAD差异有统计学意义[PCa组vsBPH组:0.11±0.06 vs 0.16±0.07,(0.27±0.11)ng.ml-1.cm-3vs(0.20±0.09)ng.ml-1.cm-3,P<0.01]。ROC分析提示f/tPSA和PSAD的曲线下面积(AUC)分别为0.684和0.708,优于tPSA的AUC 0.566。结论 f/tPSA和PSAD是PSA灰区前列腺癌诊断理想的辅助参数。

Objective To evaluate the value of free serum prostate-specific antigen（f/tPSA） percent and prostate-specific antigen density（PSAD） in detecting prostate cancer in men with ＇gray zone＇ PSA.Methods We retrospectively assessed the clinical data of 258 patients with total PSA levels of 4-10ng / ml who underwent prostate biopsy.f / tPSA and PSAD was compared within two separate groups（PCa group and BPH group） according to biopsy re-sults.The diagnostic value of f / tPSA and PSAD for prostate cancer was investigated with receiver operator characteristic（ROC） curve analysis.Results Prostate biopsy specimens were positive for prostate cancer in the case of 70（27.13%） patients.The f/tPSA and PSAD were significantly different in the two groups（0.11 ± 0.06 vs 0.16 ± 0.07,0.27 ± 0.11 ng.ml-1.cm-3 vs 0.20 ± 0.09 ng.ml-1.cm-3,P 0.01）.Area under the receiver operating characteristic（ROC） curves（AUC） for f / tPSA,PSAD were 0.684 and 0.708 respectively,which were significantly better than tPSA.Conclusion In patients with ＇gray zone＇ PSA,f / tPSA and PSAD are ideal predictors,which should be utilized as further evaluation.