BPH病人血清FPSA/TPSA比值的临床应用

Clinical Application of Serum FPSA/TPSA Ratio in BPH Patients

目的 :探讨血清前列腺特异性抗原 (PSA)在 2 0 μg/L下的BPH有一个合适的游离PSA(FPSA)与总PSA(T PSA)比值 ,以提高PSA诊断的敏感性和特异性。 方法 :随机选择男性病人 332例 ,年龄 45～ 92岁。经肛指前列腺检查、经直肠超声检查和血清PSA检测排除前列腺癌 (PCa)。TPSA和FPSA检测采用单克隆抗体包被管放射免疫法。 结果 :TPSA与FPSA/TPSA比值呈负相关 ;TPSA在 5 μg/L以下的BPH病人 ,TPSA和FPSA与年龄的增长均呈正相关 (P <0 .0 1) ;而FPSA/TPSA比值与年龄增长无相关性变化。 结论 :FPSA/TPSA比值可用于BPH病人中早期发现PCa。

Objectives: To define a rational ratio of FPSA over TPSA in BPH patients with PSA value less than 20.0μg/L in an effort to enhance the diagnostic sensitivity and specificity. Methods: A total of 332 men with BPH, 45 to 92 years old, was randomly chosen from male inpatients and outpatients, and underwent a detailed clinical examination including digital rectal examination, serum PSA determination and transrectal ultrasound to exclude the presence of prostate cancer. Total PSA and free PSA levels were determined using monoclonal antibody sandwich radioimmunoassay. Results: TPSA and the ratio of free to total PSA appeared to have negative interrelationship. TPSA and FPSA molecular forms correlated directly with patient′s age whose TPSA level was below 5μg/L (respectively P <0.01), wheras free to total PSA ratio did not correlate with patient′s age. Conclusions: The proportion of free to total PSA is useful in detecting early curable prostate cancer in BHP patients.