fPSA/tPSA比值优化前列腺癌早期诊断作用的研究  

Early Diagnosis of Prostate Cancer Using Free/Total Prostate-Specific Antigen Ratio with Population-Based Screening Data

作　　者：张灵[1] 计国义[1] 李晓萌[1] 王伟华[1] 高洪文[1] 潘玉琢[1] 王洪军[2] 桑原正明 赵雪俭[1] 

机构地区：[1]吉林大学前列腺疾病防治研究中心,吉林长春130021 [2]沈阳军区联勤部军事医学研究所,辽宁沈阳110000 [3]日本宫城县立癌中心泌尿外科

出　　处：《中华男科学杂志》2004年第8期582-585,共4页National Journal of Andrology

基　　金：中日政府间专项技术合作项目 (第 5 9项 )

摘　　要：目的 :探讨游离前列腺特异性抗原 /总前列腺特异性抗原 (fPSA/tPSA)比值在优化tPSA早期诊断前列腺癌(PCa)中的作用。　方法 :以长春市 5 0岁以上PCa集团普查中tPSA在 4 .0～ 2 0 .0 μg/L范围、并接受前列腺活检的1 87例受检者为研究对象 ,测定tPSA、fPSA含量 ,应用SPSS 1 0 .0软件对不同区间fPSA/tPSA比值进行统计学分析。结果 :①tPSA在 4 .0～ 1 0 .0 μg/L、1 0 .0～ 2 0 .0 μg/L区间时 ,PCa检出率分别为1 8.1 %、2 2 .5 %。②ROC曲线分析显示不同区间时fPSA/tPSA比值的曲线下面积 (AUC)均大于tPSA (P <0 .0 5 )。③fPSA/tPSA比值取 0 .2 5为界值时 ,tPSA在 4 .0～ 1 0 .0 μg/L、1 0 .0～ 2 0 .0 μg/L两区间诊断PCa的敏感度分别为90 .5 %和 87.5 % ,可以分别避免 2 6 .7%和 1 1 .3%的人群进行活检。　结论 :在集团普查中 ,fPSA/tPSA比值在tPSA为 4 .0～ 2 0 .0 μg/L时可以提高检测PCa的特异性 ,减少不必要的活检。Objective: To evaluate the use of free/total prostate specific antigen ratio (fPSA/tPSA ratio) in improving the early diagnosis of prostate cancer. Methods: fPSA/tPSA ratio in the serum was analyzed prospectively in 187 men with tPSA ranging between 4.0 and 20.0 μg/L. All of them underwent ultrasound guided sextant prostatic biopsies. Sensitivity, specificity, positive and negative predictive values were calculated by SPSS 10.0 soft ware. Results: Prostate cancer detection rates were 18.1 % and 22.5 % when tPSA was within the ranges of 4.0 ～ 10.0 g/L and 10.0 ～ 20.0 g/L respectively. fPSA/tPSA ratio was more significant than tPSA in all the men. When the cut off value of fPSA/tPSA ratio was set at 0.25 , 90.5 % and 87.5 % of cancers could be detected; and 26.7 % and 11.3 % of biopsies could be avoided within the tPSA ranges of 4.0 ～ 10.0 g/L and 10.0 ～ 20.0 g/L, respectively. Conclusion: The use of fPSA/tPSA ratio can improve prostate cancer detection and reduce unnecessary biopsies when tPSA is within the range of 4.0 ～ 10.0 μg/L and 10.0 ～ 20.0 μg/L.

关 键 词：前列腺癌 前列腺特异性抗原 游离前列腺特异性抗原/总前列腺特异性抗原比值 

分 类 号：R737.25[医药卫生—肿瘤] R446.62[医药卫生—临床医学]