前列腺特异性抗原及其衍生指标在前列腺良恶性疾病诊断中的应用价值

Significance of PSA and its derivative index in the diagnosis of benign and malignant prostatic diseases

目的通过对总前列腺抗原(tPSA)及其衍生指标(游离型前列腺抗原占总前列腺抗原比例,fPSA/tPSA;前列腺抗原密度,PSAD)的综合分析,探究其在诊断前列腺良恶性疾病的应用价值。方法收集2013年10月至2015年3月潍坊医学院附属医院泌尿外科门诊、病房就诊的前列腺炎患者145例、良性前列腺增生患者261例、经病理明确诊断的前列腺恶性肿瘤患者105例的tPSA、fPSA/tPSA、PSAD,分析PSA及其衍生指标诊断前列腺恶性肿瘤的能力。结果当tPSA<4μg/L时,fPSA/tPSA、PSAD在前列腺恶性肿瘤组与非肿瘤组差异不明显;当tPSA>4μg/L时,fPSA/tPSA在前列腺恶性肿瘤组明显低于非肿瘤组,PSAD在前列腺恶性肿瘤组明显高于非肿瘤组;当tPSA>20μg/L时,tPSA在前列腺恶性肿瘤组高于非肿瘤组。结论 tPSA及fPSA/tPSA、PSAD的综合分析可提高前列腺恶性肿瘤诊断的准确率。

Objective To explore the application value in the diagnosis of benign and malignant prostate disease by tPSA and its derivative index（fPSA/tPSA,PSAD）joint analysis.MethodsThe prostate tPSA,fPSA/tPSA and PSAD of 145 patients with prostatitis,261 patients with benign prostatic hyperplasia,105 patients with pathological diagnosed malignant tumor were collected in the Affiliated Hospital of Weifang Medical College from October 2013 to March 2015.The ability of diagnosis of prostate malignant tumor by PSA and its derivative index was analyzed.Results When tPSA〈 4μg/L,the difference of fPSA/tPSA,PSAD between prostate malignant tumor group and non-tumor group was not obvious.When tPSA〉4μg/L,fPSA/tPSA in malignant tumor of the prostate group was lower than that in non-tumor group and PSAD in prostate malignant tumor group was significantly higher than the non-tumor group.When tPSA〉20μg/L,tPSA in malignant tumor of the prostate group was higher than the non-tumor group.Conclusion tPSA,fPSA/tPSA and PSAD of conjoint analysis can improve the correct rate of diagnosing malignant tumor of the prostate.