血液参数校正的前列腺特异性抗原在前列腺癌早期诊断中的价值

The value of prostate-specific antigen corrected by blood parameters in the early diagnosis of prostate cancer

目的旨在寻找廉价且较血清前列腺特异性抗原(PSA)检测具有更高效能的早期前列腺癌(PC)检测指标。方法回顾性分析61例PC患者(PC组)、15例偶发前列腺癌(iPC)患者(iPC组)和60例良性前列腺增生(BPH)患者(BPH组)初诊时的年龄、前列腺肿瘤标志物、前列腺体积、血红蛋白(Hb)、血清白蛋白(Alb)检测结果。对比分析3组样本年龄、前列腺体积、血清总PSA(tPSA)、游离PSA与总PSA比值(f/tPSA)、PSA密度(PSAD)、tPSA(ng/mL)与Hb(g/L)比值(tPSA/Hb)、tPSA(ng/mL)与Alb(g/L)比值(tPSA/Alb)差异。结果各组患者年龄、前列腺体积、Hb、Alb基线值均无显著性差异(P>0.05);BPH组与iPC组之间tPSA、PSAD、tPSA/Hb、tPSA/Alb均无显著性差异(P>0.05),而与PC组之间均有显著性差异(P<0.01);f/tPSA仅在BPH组和PC组之间有显著性差异(P<0.01);iPC组与PC组之间tPSA/Alb(P<0.001)的差异较PSAD、tPSA、tPSA/Hb(P<0.01)更为显著。结论常规检测方法不易鉴别BPH和iPC,但结合Alb校正的tPSA可能提升PC早期诊断效能。

Objective Prostate cancer(PC)is a common malignancy in adult males.At present,early screening of the disease mainly relies on serum prostate-specific antigen(PSA),but the detection efficiency remains to be improved.The aim of this study is to find out cheap and more effective indexes for the early screening of PC.Methods Data of 61 PC patients,60 benign prostatic hyperplasia(BPH)patients and 15 identical PC(iPC)patients were retrospectively collected.The differences in age,total PSA(tPSA),free/total PSA(f/tPSA),prostate volume,PSA density(PSAD),hemoglobin(Hb),seralbumin(Alb),tPSA/Hb,and tPSA/Alb were compared and analyzed.Results There were no significant differences in patients' baseline age,prostate volume,Hb and Alb among all the groups.There were no significant differences in tPSA,PSAD,tPSA/Hb and tPSA/Alb between BPH group and iPC group,while there were significant differences between BPH group and PC group.Remarkable significance was observed in f/tPSA between BPH group and PC group.Between iPC group and PC group,difference in tPSA/Alb was more prominent than that in PSAD,tPSA and tPSA/Hb.Conclusion It is not easy to distinguish BPH and iPC with conventional detection methods,but combination of tPSA/Alb may improve the early detection efficiency of prostate cancer.