PSA相关标志物在前列腺癌诊断中的价值

The diagnosis value of PSA related markers in prostate cancer

目的 探讨在前列腺特异抗原（prostate specific antigen,PSA）灰区（PSA 4～10ng/mL）患者中,血清总PSA及游离PSA比值（f/tPSA）、前列腺特异性抗原密度（PSAD）和（f/t） PSA/PSAD值对穿刺病理结果的诊断价值.方法 回顾2008年1月至2016年3月本院接受经直肠超声（transrectal ultrasound,TRUS）引导下前列腺穿刺的患者929例,对其中249例PSA 4～ 10 ng/mL患者的临床资料进行了整理分析.根据病理结果,分为前列腺癌组（PCa组）38例（15.26％）,前列腺增生组（BPH组）211例（84.74％）.对患者年龄、tPSA、f/tPSA、体积、PSAD、（f/t） PSA/PSAD值进行统计学分析.结果 两组患者的年龄水平比较差异无统计学意义（P＞0.05）;在f/tPSA、体积、（f/t） PSA/PSAD水平,BPH组大于PCa组;在tPSA、PSAD水平,PCa组大于BPH组,差异均有统计学意义（P＜0.05）.PCa组患者中f/tPSA或PSAD异常者32例,占84.21％：BPH组中f/tPSA或PSAD异常者110例,占52.13％,差异有统计学意义（X2=13.52,P ＜0.005）.结论 f/tPSA和PSAD异常对PSA灰区的患者是否行前列腺穿刺具有指导意义.如果f/tPSA和PSAD结果相矛盾,f/tPSA联合PSAD、PSAD联合（f/t） PSA/PSAD的诊断价值相对较高.

Objectives To investigate the diagnostic value of f/tPSA,PSAD and（f/t）PSA/PS-AD for the result of the biopsy in the patients （PSA 4 10 ng/mL）.Methods Clinical data of 929 patients who underwent TURS-guided prostate biopsy in our hospital from January 2008 to March 2016 were reviewed,of which the clinical data of 249 cases with PSA 4 ～ 10 ng/mL were analyzed.According to the pathology results,the patients were divided into prostate cancer group（PCa group） （38 cases）,benign prostatic hyperplasia group （BPH group）（211 cases）.Age,tPSA,f/tPSA,prostate volume,PSAD and （f/t） PSA/PSAD of patients were statistically analyzed.Results There was no statistically difference between the two groups on the mean value of age level （P 〉 0.05）.The mean value of f/tPSA,prostate volume,（f/t） PSA/PSAD level in the BPH group were significant higher than the PCa group.The mean value of tPSA,PSAD level in the PCa group were significant higher than the BPH group （P 〈 0.05）.Thirty-two cases with F/tPSA or PSAD abnormal were detected in the PCa group （84.21%）,and 110 cases with f/tPSA or PSAD abnormal were detected in BPH group （52.13%）.There was a statistically significant difference （x2 =13.52,P 〈0.005）.Conclusions f/t PSA and PSAD for patients with PSA（PSA 4 ～ 10 ng/mL） have guiding significance.If result of f/ t PSA and PSAD is contradict,the diagnostic value of f/tPSA joint PSAD,PSAD joint （f/t） PSA/PS-AD are relatively high.