按年龄分层设定PSA在前列腺癌诊断中的诊断界值的意义探讨  

Significance of Setting the Cutoff Line of Serum PSA for Identification Patients withProstate Cancer

作　　者：毕红琳[1] 

机构地区：[1]黄石市中心医院检验科,湖北黄石435000

出　　处：《现代检验医学杂志》2011年第1期90-91,共2页Journal of Modern Laboratory Medicine

摘　　要：目的探讨男性血清前列腺特异性抗原（PSA）水平与年龄的相关性；应用ROC曲线确定各年龄组中PSA在诊断前列腺癌时的最佳临界值，计算各年龄组曲线下面积、比较不分组和按年龄分组后应用PSA诊断前列腺癌时的准确性。方法选择93例经病理证实的前列腺癌患者和88例年龄和性别相匹配的体检健康人员（正常对照组）。按年龄分为三组：45～60岁为Ⅰ组；61～70岁为Ⅱ组；〉71岁为Ⅲ组。所有对象均测定血清PSA。采用Pearson线性相关分析法分析PSA与年龄的相关性；采用MedCalc软件分别绘制三个年龄组的ROC曲线，比较不分组和按年龄分组后应用PSA诊断前列腺癌时的准确性。结果Pearson相关系数为0．329，P值为0．021，ROC曲线分析表明：I组最佳临界值为4．8ng／ml，AUC面积为0．898；Ⅱ组最佳临界值为6．2ng／ml，AUC面积为0．902；Ⅰ组最佳临界值为7．5ng／ml，AUC面积为0．913。与不分组时的ROC曲线比较（AUC面积为0．848），分组后各组AUC面积均明显增大（P〈0．05）。结论男性血清PSA水平与年龄密切相关；按年龄分层界定PSA在前列腺癌诊断中的临界值，可提高其诊断准确性。Objective To investigate the relationship between serum prostate-specific antigen （PSA） level and age in Chinese men over the age of 45 and evaluate clinical value of establishment of the age-specific reference ranges in prostate cancer （PC） diagnosis. Methods The total of 93 PC patients and 88 healthy individuals were enrolled in this study,and serum PSA concentrations in all subjects were measured. All subjects were divided into three groups （Group I ：45~60 years old; Group ~ ：61 ~ 70 years old ;Group E ：~〉 71 years old）. The diagnostic efficiency of PSA in three groups was assessed using ROC curve analysis and compared with that of non-age-specific group. Results The Pearson coefficient was 0. 329 and P value was 0. 021;The optimal cutoff value of PSA was 4. 8 ng/ml（AUC was 0. 898）,6. 2 ng/ml（AUC was 0. 902） and 7.5 ng/ml（AUC was 0. 913） in group Ⅰ ,Ⅱand Ⅲ respectively. Conclusion There were significant relationship between age and serum PSA level in Chinese men over age of 45. The diagnostic efficiency of prostate cancer by screening for PSA in serum is improved significantly when age-specific reference ranges are used.

关 键 词：前列腺特异性抗原 年龄 临界值 

分 类 号：R737.25[医药卫生—肿瘤] R730.45[医药卫生—临床医学]