Roc曲线分析比较PSAM和PSAMR在PSA灰区前列腺癌的诊断价值

Diagnostic value comparison of PSAM and PSAMR on PSA grey zone in prostate cancer by ROC curve analysis

目的探讨前列腺特异性抗原质量（PSAM）和前列腺特异性抗原质量比（PSAMR）在前列腺特异性抗原（PSA）灰区前列腺癌诊断中的应用价值。方法回顾性分析总前列腺特异抗原（t PSA）在4~10 ng/ml之间的良性前列腺增生患者120例、前列腺癌患者56例。比较前列腺癌组和良性前列腺增生组间PSAM、PSAMR和游离前列腺特异性抗原（f PSA）/t PSA各指标的差异,分析前列腺癌组各指标在ROC曲线下的面积、各指标的诊断特异性及敏感性。结果前列腺癌组患者中的f PSA/t PSA较良性前列腺增生组降低,PSAM和PSAMR均较良性前列腺增生组升高,差异均有统计学意义（t分别=2.45、8.93、7.87,P均〈0.05）。PSAM、PSAMR和f PSA/t PSA在ROC曲线下的面积依次为PSAMR〉PSAM〉f PSA/t PSA。结论 t PSA在4~10 ng/ml时,PSAM和PSAMR可以有效提高灰区前列腺癌诊断的敏感性和特异性,其中PSAMR的诊断价值高于f PSA/t PSA。

Objective To explore the clinical diagnostic value of PSAM and PSAMR on PSA grey zone in prostate cancer. Methods One hundred and twenty patients with benign prostate hyperplasia that t PSA was from 4 to 10 ng/ml and56 cases with prostate cancer were retrospectively analyzed. The f PSA/t PSA ratio, PSAM and PSAMR were compared between prostate cancer group and benign prostate hyperplasia group. The area under ROC curve of PSAM, PSAMR and f PSA/t PSA, the sensitivity and the specificity of these indexes were analyzed. Results The f PSA/t PSA ratio in prostate cancer group was lower than that of benign prostate hyperplasia group while the PSAM and PSAMR in prostate cancer group were significantly higher（t=2.45,8.93,7.87,P〈0.05）. The area under ROC curve showed that PSAMRPSAMf PSA/t PSA. Conclusion PSAM and PSAMR can improve sensitivity and specificity of PSA grey zone in prostate cancer effectively when t PSA was from 4 to 10 ng/ml, and PSAMR has better performance than f PSA/t PSA in diagnosing prostate cancer.