前列腺特异性抗原在前列腺癌中的诊断价值

The value of prostate-specific antigen in the diagnosis of prostate cancer

目的：探讨前列腺特异性抗原（tPSA）及其相关指标在前列腺癌（PCa）诊断中的价值。方法：选择45例PCa患者作为观察组，50例前列腺良性增生（BPH）患者（BPH组）和45名健康志愿者（正常对照组）作为对照。血清总PSA（tPSA）和血清游离PSA（fPSA）采用酶放大化学发光仪进行测定，并计算fPSA／tPSA的比值。结果：观察组血清tPSA和fPSA水平均显著高于BPH组（P〈0．叭），BPH组又明显高于正常对照组（P〈0．01）。当tPSA的值〈4．0、4．0～10．0及〉10．0ug／L时，BPH患者分别占64．0％、30．0％和4．0％，PCa患者分别占8．9％、22．2％和68．9％，正常对照组分别占97．8％、2．2％和0．0％，3组差异有统计学意义（P〈0．01）。观察组fPSA／tPSA比值均明显低于正常对照组和BPH组（P〈0．01），而BPH组亦明显低于正常对照组（P〈0．01）。在4．0—10．0的灰色区域内，PCa和BPH患者在fPSA／tPSA临界值为0．16时，观察组中80．0％的患者fPSA／tPSA比值〈0．16，而BHP组中86．7％的患者fPSA／tPSA比值〉0．16，差异有统计学意义（P=0．002）。结论：tPSA结合fPSA／tPSA可以作为临床上诊断PCa的重要依据。

Objective ：To explore the value of the prostate-specific antigen （tPSA） and its related index in the diagnosis of prostate cancer（PCa）. Methods： Forty-five patients with PCa, 50 patients with benign prostatic hyperplasia and 45 healthy volunteers were served as observation group, benign prostate hyperplasia（BPH） group and control group, respectively. The levels of serum tPSA and free tPSA（fPSA） were measured by enzyme amplification chemiluminescence analyzer, and the ratio of fPSA and tPSA was calculated. Results ：The levels of tPSA and fPSA in observation group were significantly higher than those in BPH group（ P 〈 0.01 ） ,the levels of tPSA and fPSA in BPH group were significantly higher than those in control group（ P 〈 0.01 ）. When the value of tPSA were less than 4.0,4.0 to 10.0 and greater than 10.0 p,g/L, BPH patients accounted for 64.0%, 30.0% and 4.0%, respectively, PCa patients accounted for 8.9% ,22.2% and 68.9% , respectively, and the healthy people accounted for 97.8% , 2.2% and 0.0% , respectively, the differences of there groups have statistical significance（ P 〈 0.01 ）. The ratio of fPSA and tPSA in observation group was significantly lower than that in control group and BPH group（P 〈 0.01 ） ,the ratio of fPSA and tPSA in BPH group was significantly lower than that in control group（ P 〈 0.01 ）. Within the 4.0 to 10.0 of gray area, the critical value of fPSA and tPSA in observation group and BPH group was 0.16 ,the ratio of fPSA and tPSA in 80.0% of patients of observation group was less than 0.16, and the ratio of fPSA and tPSA in 86.7% of patients in BHP group was greater than 0.16, the difference of which was statistical significance （ P = 0. 002）. Conclusions ： The tPSA combined with the ratio of fPSA/tPSA can be used as an important basis in the diagnosis of prostate cancer.