血清总前列腺特异抗原、f/t值及PSAD在鉴别前列腺良恶性疾病中的价值

Total PSA, f/t ratio and PSAD in the differential diagnosis of benign and malignant prostatic diseases

目的 比较血清总前列腺特异抗原 (tPSA)、游离PSA(fPSA)与tPSA的比值 (f t)、前列腺特异抗原密度 (PSAD)鉴别前列腺增生 (BPH)和前列腺癌 (Pca)的价值。方法 回顾性总结 2 0 0 0 - 0 1— 2 0 0 2 - 12在山西医科大学第二医院泌尿外科住院的 176例BPH患者及 5 6例Pca患者的血清tPSA、fPSA、经腹部B超前列腺的前后径、左右径、上下径、年龄 ,计算出f t比值、前列腺体积 (PV)及PSAD值。分别比较tPSA、f t及PSAD在诊断灰区、灰区外低值区、灰区外高值区中鉴别 2种疾病的能力。结果 在诊断灰区外高值区tPSA、f t及PSAD在 2组间的差别均有显著意义 (P <0 .0 0 1,P <0 .0 5和P <0 .0 1) ;在诊断灰区 ,2组患者间tPSA差别无显著意义 (P >0 .5 ) ,而f t、PSAD的差别则有显著意义 (P <0 .0 5 ) ;在灰区外低值区tPSA、f t及PSAD在2组间的差别均无显著意义 (P >0 .0 5 )。结论 血清tPSA为前列腺癌的标志物。f t及PSAD作为tPSA的辅助指标 。

Objective To evaluate serum tPSA,f/t ratio and PSAD in the differential diagnosis of BPH and Pca. Methods Serum tPSA,fPSA and PV by B ultrasound scanning in 176 cases of BPH and 56 cases of Pca were assessed, f/t ratio and PSAD were obtained.Total SPA(tPSA),f/t and PSAD in patients both within and outside the gray zone were analyzed. Results Total PSA,f/t and PSAD were significantly discriminated between benign and malignant diseases (P<0.001,P<0.01) when the assessed value were much higher beyond gray zone. When the assessed value were within the gray zone, tPSA could not serve as a differential marker for the two conditions(P>0.05) whereas f/t and PSAD could(P<0.05 both). However, tPSA, f/t,and PSAD could not specifically differentiae between the two conditions (both were P>0.05)in the lower value range beyond the gray zone. Conclusions Serum tPSA is a marker for diagnosis of prostatic carcinoma, f/t and PSAD, being an adjuvant marker to tPSA, are of importance in the differential diagnosis in patients whose B ultrasound findings are within the gray zone.