电化学发光免疫分析F/TPSA比值对前列腺癌早期诊断的观察  

Measurement of F/T PSA Ratio with ECLIA for Early Detction of Prostatic Cancer

作　　者：李雨升[1] 董胜国[1] 武风玉[1] 马超[1] 纪祥瑞[1] 余云云[1] 王麟[1] 

机构地区：[1]青岛大学医学院附属医院,266003

出　　处：《放射免疫学杂志》2007年第5期462-464,共3页Journal of Radioimmanology

摘　　要：目的:观察前列腺特异性抗原游离与总量比值(F/TPSA比值)对前列腺癌(PCa)早期诊断的价值。方法:采用电化学发光免疫分析技术检测136例正常健康男性、98例前列腺增生(BPH)患者和99例前列腺癌(PCa)患者血清的T-PSA和F-PSA,并求出F/TPSA比值,然后进行统计学分析。结果:正常对照组、BPH组PCa组的T-PSA、F-PSA及F/TPSA比值分别为:1.43±1.13、0.44±0.34、0.36±0.15;7.84±6.08、1.88±1.37、0.26±0.08;23.95±21.12、3.52±3.41、0.16±0.08,上述各组三项指标两两之间比较均有显著性差异(P<0.001)。PCa组根据T-PSA检测值<4.0μg/L、4.0～10.0μg/L、>10μg/L分为三组,显示T-PSA、F-PSA组间两两比较均有显著性差异(P<0.001),但F/TPSA比值相比较无显著性差异(P>0.05)。正常对照组与PCa组T-PSA<4μg/L三项检测指标比较示T-PSA和F/TPSA比值均有显著性差异(P<0.001),而F-PSA之间比较无显著性差异(P>0.05)。将F/TPSA比值分为<0.10、0.11～0.15、0.16～0.2、0.21～0.25、0.26～0.30以及>0.31以上六个截点,显示在0.20截点以内PCa患者占有率为74.51%。结论:F/TPSA比值的检测对血清T-PSA<4μg/L、4～10μg/L以及>10μg/L的患者在诊断PCa中均有良好的临床价值,特别当T-PSA处于较低水平状态下做到早期诊断PCa显得尤为重要。Objective To investigate the value of determination of serum levels of total and free PSA for early detection of prostatic cancer. Methods Serum total and free PSA levels were measured with ECLIA and F/T PSA ratios calculated in 99 patients with prostatic cancer, 98 patients with BPH and 136 controls. Results In patients with prostatic cancer, the serum total and free PSA levels were significantly higher but F/T ratio was significantly lower than those in patients with BPH, again the values in patients with BPH were significantly different from those in controls （ all P 〈 0. 001 ）. The levels of total PSA in majority of the patients with prostatic cancer were above 10μg/L （53/99）, however, in not a few patients （ 12/99）, the levels were below 4μg/L. Yet the F/T PSA ratios among all the cancer patients were about the same （ P 〉 0.05 ）. Taking 0.2 as the cut - off value of F/T PSA ratio, we found that 74. 5% of all the patients with prostatic cancer were included. Conclusion Low F/T PSA ratio, even in patients with ＂normal＂ total PSA level （ below 4μg/L） favored the diagnosis of malignancy. We set the arbitrary cut - off value at 0.2 and patients with ratio less than 0.2 deserved further intensive exploration for malignancy.

关 键 词：前列腺特异性抗原 前列腺癌 前列腺良性增生 游离PSA/总PSA比值 

分 类 号：R446.6[医药卫生—诊断学]