FPSA/TPSA比值在前列腺癌诊断中的应用

The Role of The Ratio of Free PSA and Total PSA in Diagnosis of Prostate Cancer

目的 :探讨 FPSA / TPSA(F/ T)比值在前列腺癌 (PCa)诊断的应用价值。方法 :采用电化学发光免疫分析法测定 136例患者 (其中 PCa4 2例 ,BPH94例 )与 6 5例正常健康体检男性的血清 TPSA、FPSA水平 ,并计算 F/ T比值。结果 :BPH组、PCa组 TPSA、FPSA水平均显著高于正常对照组 (P<0 .0 1) ,PCa组的血清 TPSA、FPSA水平显著高于BPH组 (P<0 .0 1) ,而 PCa组 F/ T显著低于 BPH组 (P<0 .0 1)。TPSA处于 4 μg/ L～ 10 μg/ L 时 BPH、PCa组间 TPSA、差异无显著性 (P>0 .0 5 ) ,PCa组 FPSA、F/ T均显著低于 BPH组 (P<0 .0 1)。以 F/ T≤ 0 .15为标准对 PCa诊断敏感性、特异性及实验有效率均达 70 %以上 ;而以 TPSA≥ 4μg/ L且 F/ T≤ 0 .15为 PCa诊断标准 ,敏感性、特异性、阳性预测值、阴性预测值及实验有效率分别为 71.4 %、87.4 %、6 0 .0 %、92 .1%与 84 .1%。结论 :F/ T可用作 PCa诊断指标为临床提供更好的依据 ,有利于 PCa的早期诊断 ,以 TPSA≥ 4μg/ L且 F/ T≤ 0 .15为标准 ,可在不升高漏检率的基础上提高PCa诊断准确性。

Objective To investigate the diagnostic value of the ratio of FPSA and TPSA in prostate cancer(PCa). Methods The serum TPSA and FPSA levels of 136 patients(42 patients with PCa, 94 patients with BPH) and 65 healthy men as normal control were determined by ECLIA, and the ratio of F/T was calculated. Results TPSA and FPSA of BPHand PCa were significantly higher than of normal control(P<0.01), TPSA and FPSA of PCa were significantly higher than of BPH(P<0.01), but F/T of PCa was significantly lower than of BPH(P<0.01). When TPSA in 4 μg/L～10 μg/L, the difference of TPSA between PCa and BPH was not significant(P>0.05);but FPSA and F/T of PCa were significantly lower than of BPH(P<0.01).When F/T≤0.15 used an the standard to diagnose PCa. sensitivity, specificity and experimental validity were and over 70 %;when TPSA≥4 μg/L and F/T≤0.15 used as the standard for the diagnosis of PCa, sensitivity, specificity, positive predictive value, negative predictive value, and experimental validity were 71.4 %,87.4 %,60.0 %,92.1 % and 84.1 %,respectively. Conclusion F/T can be used as a indicator to provide a better basis for the diagnosis of PCa,and be helpful for the PCa early diagnosis. when TPSA≥4 μg/L and F/T≤0.15 used as the standard, can improve the accuracy of the diagnosis of PCa basing on not increasing the missed-detectionrate.