安徽马鞍山地区健康男性p2PSA及%p2PSA各年龄段分布特征

Study on different features of male age-related distribution curves of prostatic p2PSA and %p2PSA in a Maanshan health survey report

目的：探讨前列腺特异性抗原前体（p2PSA）相关指标价值及其与年龄相关性。方法对238名10～90岁年龄段马鞍山地区健康男性统一检测PSA和p2PSA等指标，按每10岁一组分8组，分别统计分析各组p2PSA和%p2PSA均值及其95%可信区间，与tPSA、fPSA及%fPSA等指标综合对比，绘制年龄相关曲线并分析曲线特征。结果 p2PSA 与 tPSA 曲线均随年龄增加而总体呈上升趋势。tPSA曲线以40岁为标志性临界点（1.0 ng/ml），p2PSA曲线按年龄段可划分为3个阶段：即p2PSA上升低区（0～29岁，95%CI 2.22～5.91 pg/ml）、波动上升期（30～59岁，95%CI 4.66～11.74 pg/ml）和老年上升期（60～89岁，95% CI 7.44～18.63 pg/ml）。其中40～49岁区间， p2PSA由5.24 pg/ml快速升至9.93 pg/ml，年增速度0.47 pg/ml，显著大于tPSA增速（P＜0.001）。70岁后，与tPSA转为下降趋势完全不同，p2PSA依然继续上升。40岁之前，%p2PSA曲线与%fPSA相似，呈总体下降趋势。但40～49岁期间走势与%fPSA下降趋势完全相反，由17.01再次快速上升，在45岁左右与%fPSA曲线交叉，至50～59岁期间达到26.65，为终生最高峰。p2PSA/tPSA曲线与年龄相关性较小，10岁后曲线终生都相对平稳，波动于5～10之间。结论 p2PSA及%p2PSA指标与PSA一样，也呈现年龄相关性特点。同时结合多指标和患者年龄因素综合分析判断在临床各方面潜在价值可能优于以往单一PSA指标。

Objective To study the relationships among p2PSA, %p2PSA and male ages, and to contrast some potential values of p2PSA and%p2PSA with conventional PSA tumor markers. Methods 238 healthy men, aged from 10-90, were simultaneously detected tPSA, fPSA and p2PSA levels in their sera. The mean levels and 95%confidence intervals were classified with every 10 years old into 8 groups, and these data were analyzed by SPSS 19.0 statistics software. The features among tPSA, fPSA, %fPSA, p2PSA and %p2PSA were mainly studied on their age-related distribution curves. Results With age increasing, the levels of tPSA and p2PSA were both overall climbed. As the critical point of age 40 when tPSA was just exactly climbing at 1.0 ng/ml, p2PSA curve could be segmentalized into 3 stages： initial climbout （aged 0-29, 95%CI 2.22-5.91）, fluctuating upgrade （aged 30-59, 95%CI 4.66-11.74） and senile increasing （aged 60-89, 95%CI 7.44-18.63）. Moreover, between aged 40-49, p2PSA zoomly rise from 5.24 to 9.93 with a rapid speed of 0.47pg/ml per year, which was even fast than tPSA （P〈0.001）. What＇s more, p2PSA level yet showed continually climbing after 70 years old, whereas tPSA had already stepped downhill. With regard to%p2PSA, before aged 40,%p2PSA curve was somewhat similar to%fPSA which were both in gradually decreasing trends. However, in the range of aged 40-49, by contrast to%fPSA curve still declining, %p2PSA curve showed second rapid climbing from 17.01. After up-crossed with %fPSA curve at about 45 years old,%p2PSA curve attained to 26.65 as a lifetime peak in aged 50-59. Nevertheless, the p2PSA/tPSA curve had less influence by age which had a lifetime fluctuations in the range of 5-10. Conclusions p2PSA and %p2PSA also have intimate relationships with age other than some different characteristic compared with tPSA, fPSA and %fPSA. Moreover, simultaneously pondering p2PSA and %p2PSA levels and age for comprehensive analyses and judgements might probably harvest more values in clinical diagnoses and treatments than conventional tumor marker of single PSA.