F-PSA和F/T比值在前列腺癌“诊断灰色带”中的临床应用

Clinical Application of F-PSA and F-PSA to T-PSA Ratio in Prostate Cancer Patients with T-PSA between 4.0 to 10.0 μg/L

目的 探讨血清总前列腺特异抗原 ( T- PSA)在前列腺癌“诊断灰色带”( 4 .0～ 1 0 .0μg/L范围内 ) ,游离前列腺特异抗原 ( F- PSA)和 F- PSA与 T- PSA比值 ( F/T值 )诊断前列腺癌 ( PCa)的临床应用价值。方法 选取血清 T- PSA在 4.0～ 1 0 .0 μg/L范围内的 46例前列腺癌 ( PCa)患者和 82例良性前列腺增生 ( BPH)患者 ,检测血清 F- PSA,计算 F/T比值 ,并与正常对照组比较。结果 T- PSA 4.0～ 1 0 .0μg/L范围内 ,各组间 T- PSA和 F- PSA浓度差异不显著 ( P>0 .0 5 ) ,F/T比值差异显著 ( P<0 .0 1 ) ,PCa患者F/T值明显低于 BPH患者和正常健康者 ,以 F/T值 <0 .1 6作为诊断前列腺癌的临界值 ,其灵敏度、特异性、阳性预示值、阴性预示值分别为 85 .6% ,89.1 % ,81 .2 % ,91 .0 %。结论 对 T- PSA处于诊断灰色带( 4 .0～ 1 0 .0μg/L范围 )的良性和恶性前列腺疾病患者 ,同时检测血清 F- PSA,并应用 F/T比值 ,可有效提高前列腺疾病诊断的特异性和敏感性 ,有利于对 T-

objective To study the clinical application of F-PSA and F-PSA to T-PSA ratio in prostate cancer(PCa) patients with T-PSA between 4 0 to 10 0 μg/L.Methods In this study,46 prostate cancer patients with T-PSA between 4 0 to 10 0 μg/L as well as 82 patients with benign prostate hyperplasia(BPH)were selected.Total,free PSA and the free-to-total PSA ratio were determined for each participant.Results Within the range of T-PSA between 4 0 to 10 0 μg/L,total and free PSA in individual group had no significant difference(P>0 05),while the free-to-total PSA ratio had significant difference (P<0 01),and the ratio in PCa patients was much lower than that of BPH and healthy groups.When the cutoff value of free-to-total PSA ratio was 0 16,the sensitivity was 85 6% and the specificity was 89 1%.Conclusion The application of total,free PSA and free-to-total PSA ratio can help diagnosing the prostate cancer patients with T-PSA between 4 0 to 10 0 μg/L.