复合PSA测定对前列腺癌诊断的临床应用价值

The Clinical Value of Complexed Prostate-Specific Antigen(cPSA) in Diagnosing Cancer of the Prostate

目的 化学发光法对复合 PSA( c PSA)测定方法的建立与应用。方法 采用化学发光技术对 1 5 8例经病理组织活检报告验证的前列腺增生 ( 5 8例 )及前列腺癌患者 ( 1 0 0例 )进行了总 PSA( t PSA)、游离PSA( f PSA)及 c PSA检测。同时选取健康成年男性 ( 90例 )作为正常对照组 ,确定了该地区健康男性 c PSA参考范围。结果 试验组 1 0 0例前列腺癌患者 c PSA和 t PSA两种指标经配对资料 χ2检验具有显著性差异 (χ2 =8.1 ,P<0 .0 1 ) ;c PSA与 f PSA/t PSA比率相比具有显著性差异 (χ2 =9.39,P<0 .0 1 )。t PSA在 4.0～ 1 0 .0 ng/ml灰区内的前列腺增生组与前列腺癌组相比 ,两组 t PSA之间无差异 ( t=1 .1 37,P>0 .0 5 ) ;两组 f PSA/t PSA百分比率相比具有一定的差异 ( t=2 .86,0 .0 1 <P<0 .0 5 ) ;两组 c PSA相比具有非常显著性差异 ( t=9.31 ,P<0 .0 1 )。正常组与前列腺增生组 t PSA相比 ,具有显著性差异 ( t=1 3.92 ,P<0 .0 1 ) ;正常组与前列腺癌组 t PSA相比 ,具有显著性差异 ( t=1 7.0 ,P<0 .0 1 )。研究结果表明 c PSA较 t PSA及 f P-SA/t PSA比率可大大提高前列腺癌诊断特异性。结论 c PSA优于传统的 t PSA及 f PSA/t PSA比率 ,可以替代后者成为诊断前列腺癌更好的实验室指标。同时 ,c

Objective To study the clinical value of complexed prostate-specific antigen(cPSA) in diagnosing cancer of the prostate.Methods Total PSA(tPSA),free PSA(fPSA) and complexed PSA(cPSA) were detected with chemiluminescence method in 158 patients with radical prostatectomy (58 men) and cancer of the prostate (100 men) receiving pathologic identify.90 healthy males were detected as controls and determine its own reference rang.Results In 100 prostate cancer of test group,both of cPSA and tPSA test with χ 2 (χ 2=8.1,P<0 01);both of cPSA and fPSA/tPSA test with χ 2(χ 2=9.39,P<0 01).tPSA in the 4～10 ng/ml,tPSA in both of radical prostatectomy and prostate cancer with t(t=1.137,P>0.05);fPSA/tPSA with t(t=2.86,0.01<P<0.05);cPSA with t(t=9.31,P<0.01).tPSA in both of healthy group and radical prostatectomy with t(t=13.92,P<0.01);tPSA in both of healthy group and prostate cancer with t(t=17.0,P<0.01).Study indicates cPSA greatly improves specificity in diagnosing prostate cancer.Conclusion cPSA is better than traditional tPSA and fPSA/tPSA.It is more better laboratory index in diagnosing prostate cancer instead of later.And contents of cPSA have certain clinical value in cancer's size,stage,grade,treatment,curative effects and prospective evaluation.