游离前列腺特异抗原比值结合前列腺特异抗原密度对PSA<4.0ng/ml前列腺癌的诊断价值

The diagnostic value of free prostate specific antigen ratio combined with prostate specific antigen densityin detecting prostate cancer that PSA<4.0ng/ml

目的探讨游离前列腺特异抗原(fPSA)比值(f/tPSA)结合PSA密度(PSAD)对PSA<4.0 ng/ml前列腺癌的诊断价值。方法回顾性分析2012年1月-2019年9月广州医科大学第六附属医院收治的284例PSA<4.0 ng/ml行前列腺穿刺活检或手术患者作为研究对象,按病理结果分为前列腺癌(PCa)组和前列腺增生(BPH)组,收集tPSA、fPSA、f/tPSA、PSAD、病理资料,按照f/tPSA分成0.01~0.08、0.09~0.16、0.17~0.24、0.25~0.32、0.33~0.40五区间,PSAD分成0.01~0.10、0.11~0.20、>0.21三区间,比较区间PCa检出率。结果两组tPSA和fPSA比较,差异不具有统计学意义(P>0.05),f/tPSA、PSAD,差异具有统计学意义(P<0.05);在f/tPSA 0.09~0.16、0.17~0.24,PSAD 0.11~0.20、>0.21检出率比较,差异具有统计学意义(P<0.05)。结论 f/tPSA及PSAD对PSA<4.0 ng/ml前列腺癌患者具有较高的诊断价值。

Objective To explore the value of free prostate specific antigen(fPSA) ratio(f/tPSA) combined withprostate specific antigen density( PSAD) in the diagnosis of prostate cancer that PSA<4.0 ng/ml.Methods A total of 284 cases of patients whose PSA<4.0 ng/ml and received prostate biopsy from January 2012 to September 2019 were retrospectively analyzed. According to the pathological results,they were divided into prostate cancer( PCa) group and benign prostatic hyperplasia( BPH) group. The total prostate specific antigen( t PSA),free prostate specific antigen( f PSA) and f/t PSA,PSAD,pathological data were collected.According to the f/t PSA ratio the patients were divided into 5 intervals of 0.01 ~ 0.08,0.09 ~ 0.16,0.17 ~ 0.24,0.25 ~ 0.32,0.33 ~ 0.40,and the patients were divided into 3 intervals according to PSAD: 0.01 ~ 0.10,0.11 ~ 0.20,and over0.21. The detection rates of prostate cancer of each interval were compared.Results The difference of t PSA and f PSA between the 2 groupswere not statistically significant( P>0.05),f/t PSA ratio and PSAD were significantly different between the two groups( P<0.05).But the difference of detection rates of prostate cancerbetween the two groups were statistically significant when f/t PSA ratios of 0.09 ~ 0.16 and 0.17 ~ 0.24 and PSAD of 0.11 ~ 0.20 and over 0.21( P<0.05).Conclusions f/t PSA and PSAD have good diagnostic value for the patients with prostate cancer that PSA<4.0 ng/ml.