血清锌在前列腺癌筛查中的意义  

Serum zinc improves the performance of prostate cancer

作　　者：李晓萌[1] 李江[2] 张灵[1] 李扬[1] 王洪亮[1] 计国义[1] 桑原正明 赵雪俭[1] 

机构地区：[1]吉林大学基础医学院病理生理教研室暨吉林大学前列腺疾病防治研究中心,吉林长春130021 [2]吉林大学口腔医院 [3]日本宫城县立癌中心

出　　处：《中国实验诊断学》2006年第2期132-135,共4页Chinese Journal of Laboratory Diagnosis

基　　金：中日政府间专项技术合作项目(第59项);吉林省科技发展计划项目(20030710)

摘　　要：目的探讨血清锌含量在前列腺癌筛查中的意义。方法应用血清前列腺特异性抗原（t-PSA）检测方法对3940名50岁以上男性进行前列腺癌的集团普查。通过ROC曲线对比分析血清锌和游离PSA／t—PSA比值（f-PSA／t-PS比值）在提高前列腺癌联查结果中的作用。结果在血清t-PSA〉4．0ng/ml且接受前列腺穿刺活检的116例受检者中，诊断前列腺癌者29例。血清锌含量80-100μg/ml的人群经年龄调整的OR值为5．54（95％可信区间为1．33—23．12），血清锌在40-60μg/ml的人群，经年龄调整的OR值为24．28（95％可信区问为2．78～212．32）。PSA〉4．0ng/ml人群中锌的ROC-AUC74．3％高于f-PSA／t-PSA比值的65．3％（P〈0．01）。而PSA在4—10ng/ml的灰色区域，锌的ROC-AUC是70．5％，高于f-PSA／t-PSA比值的62．4％（P〈0．01）。用100μg／ml作为血清锌的临界值，前列腺癌诊断的灵敏度和特异度分别为86％和53％，PSA在4—10ng／ml人群中分别为83％和53％。结论前列腺癌患者血清锌含量显著降低，血清锌测定可明显提高PSA增高人群前列腺癌诊断率，而且优于f-PSA／t-PSA比值。Objective We investigated in total PSA more than 4 ng/mL or with PSA of 4 to 10 ng/mL（dingnostic ＂gray zone＂） , whether zinc serum measurement may improve the detection of prostate cancer compared with the ratio of free PSA to total PSA. Methods In China we firstly. Carried out a mass screening project of prostate cancer using serum total PSA. A total of 3940 men over 50 years old were carried out a mass screening project of prostate cancer using serum toltal PSA. We compare the performance of cancer detection among serum zinc, and free PSA/total PSA ratio by ROC curves. Results （ 1 ） 190 men with elevated PSA and 116 underwent a TRUS-guided biopsy of the prostate, of whom 29 were found to have cancer. （2）The men with serum zinc 80 - 100 ng/ml had a age-adjusted OR of 5.54. The men with serum zinc 40 -60 ng/ml had a age-adjusted OR of 24.28. （3） In the elevated PSA range more than 4.0 ng/ml, the ROC-AUC for zinc was 74.3 % （ P 〈 0. 001 ）, higherthan 65.3 % （ P 〈 0.01 ） of f/t PSA ratio. Whereas in the gray zone ranges of 4 to 10ng/mL, the ROC-AUC for zinc was 70.5 % （P 〈 0.01 ） higher than 62.4% of f/t PSA ratio. Using the standard cutoff of 100 ng/ml, a sensitivity and specificity of 86% and 53% respectively in elevated PSA range, a sensitivity and specificity of 83% and 53% respectively in gray zone were observed. Cone.lesion Prostate cancer has a Lower serum zinc concentration. The use of the zinc offers improved prostate cancer detection in the elevated PSA range or in the gray zone, compared with f/t PSA ratio.

关 键 词：前列腺癌 前列腺特异性抗原 锌 灰色区间 

分 类 号：R737.25[医药卫生—肿瘤] R446.11[医药卫生—临床医学]