前列腺癌患者血清tPSA、f/tPSA与Gleason评分的关系及其诊断价值

Relationship between serum tPSA,f/tPSA and Gleason score in patients with prostate cancer and its diagnostic value

目的探讨前列腺癌患者血清人总前列腺特异性抗原(tPSA)、游离前列腺特异性抗原/总前列腺特异性抗原(f/tPSA)的变化与Gleason评分的关系及其诊断学价值。方法选取2018年2月至2020年4月浙江省台州市立医院确诊的前列腺癌(PCa)患者90例(PCa组)、前列腺良性疾病患者90例(对照组),检测两组对象的血清tPSA、f/tPSA水平;分析不同Gleason评分的PCa患者血清tPSA、f/tPSA水平差异,并采用受试者工作曲线(ROC)分析上述两项指标诊断PCa的临床价值。结果PCa组患者血清tPSA高于对照组,差异有统计学意义(P<0.05),f/tPSA低于对照组,差异有统计学意义(P<0.05);Gleason评分>7分PCa组患者血清tSPA水平显著高于Gleason评分≤7分者,差异有统计学意义(P<0.05);tPSA诊断PCa敏感度为79.29%,特异度为71.61%,AUC值为0.848;f/tPSA诊断PCa敏感度为70.30%,特异度为74.53%,AUC值为0.774。结论血清tPSA、f/tPSA水平检测对于诊断PCa有一定的临床价值,血清tPSA水平变化与Gleason评分有一定的关系。

Objective To investigate the relationship between the changes of serum human total prostate-specific antigen(tPSA),free prostate-specific antigen/total prostate-specific antigen(f/tPSA)and Gleason score and their diagnostic value in prostate cancer patients.Methods The retrospective research method was adopted in this study,90 patients with prostate cancer(PCa)diagnosed in our hospital from February 2018 to April 2020(PCa group)and 90 patients with benign prostate diseases were selected as the control group,and the two groups were tested.The serum tPSA and f/tPSA levels of the subjects were analyzed;the differences in serum tPSA and f/tPSA levels of PCa patients with different Gleason scores were analyzed,and the receiver operating curve(ROC)was used to analyze the clinical value of the above two indicators in the diagnosis of PCa.Results The serum tPSA in the PCa group was higher than that in the control group,and the difference was statistically significant(P<0.05),and the f/tPSA was lower than that in the control group,and the difference was statistically significant(P<0.05).Gleason score>7 points in the PCa group The serum tSPA level of the patients was significantly higher than that of the patients with Gleason score≤7 points,and the difference was statistically significant(P<0.05).The sensitivity of PCa was 70.30%,the specificity was 74.53%,and the AUC value was 0.774.Conclusion The detection of serum tPSA and f/tPSA levels has certain clinical value in the diagnosis of PCa.The changes of serum tPSA level have a certain relationship with Gleason score.